New Communication Structure Essay Example for Free

New Communication Structure Essay Communication is important in every aspect of our lives. This is also true for the communication used in our professional lives. When at work we â€Å"depend on cooperation with others to accomplish our goals, and communication is the critical human process we use to promote such cooperation.† (Kreps, 2011; sec. 1.1) Understanding communication is the best way to make sure it is being used effectively correctly. When communication is effective then organizational components will run smoother and efficiently. Smoother and effective communication means that an organization has a greater chance of following its mission and achieving its goals. Successful communication can be as important to organizational productivity as any other component used. There are five concepts that are important for successful communication within an organizational setting and this proposal will discuss their necessity in an organization. Culture is something that needs to be recognized and aware of when we are communicating with everyone. It is also important in organizational communication. Organizational culture includes the norms and attitudes of the organization. To support clear and effective communication in an organization the employees must be pay close attention the organizational culture. The process of socialization will also help an employee to adapt to an organization’s culture. The process of socialization is where, â€Å"established members of cultural groups educate others and enforce adherence to established cultural rules or norms for appropriate behavior.† (Kreps, 2011; pg. 17) In understanding the norms in an organization communication will be smoother because there will be less chance for misunderstandings. An example of organizational culture would be the style of dress in the office. If an organization is one where the employees dress in suits and formal business wear then an employee who came to work in shorts and a t-shirt would affect  the culture in a negative way. Those communicating with those employees could become uncomforta ble, or distracted. This may result in avoiding communication with this employee and over all communication will breakdown. Avoidance of communication with only one employee is enough to cause a gap in efficiency. The book â€Å"Communications in Organizations† explains, â€Å"Strategic organizational communicators initiate and develop strong, effective, and satisfying relationships with others to promote cooperation and coordination in organizational life.† (Kreps, 2011; pg. 15) Understanding the organizational culture also builds trust and respect among employees which in turn brings higher production. Paying attention to organizational culture helps to build the relational communication to support effective communication. Part of an organization’s culture is the forms of communication used. Informal and formal communications are two types of communication that play an important role in an organization. The difference in both forms of communication can be explained as â€Å"Formal patterns of organizational communication follow the power hierarchy within organizations, whereas informal patterns of communication do not necessarily follow along power hierarchy lines† (Kreps, 2011; sec. 1.5) Formal communication is used to address important job related material. Paying close attention when receiving or using formal communication will stop an employee from making a mistake and will also give them the information to be successful. However, when filtering through formal communications such as emails it is important to avoid information overload. Information overload takes place when, â€Å"so many different messages are impinging on a person that the person has difficulty making sense of all the information available.† (Kreps, 2011; pg. 174) Scanning email for the most important and relative messages is a skill that is necessary but recognizing formal emails for their importance will ensure that the information involved will be received. In understanding the nuances of informal communication an employee can avoid getting themselves in trouble by offending a supervisor or missing important information. In regards to organizational communication conflict resolution can be the difference in success or failure when working with others to meet company goals. Conflict is inevitable, and happens when people communicate. It can come from assumptions, miscommunications, or one way communication. The good news is conflict can be turned into a positive thing. A quote in  the book, says An Introduction to Leadership, that, â€Å"The most important single ingredient in the formula of success is knowing how to get along with people.† (Weis, 2011, pg 2) Working through conflicts can build better communication skills, as well as trust and understanding. In using conflict resolution steps new and better ideas can be generated for the organizations. A gentleman named Mr. Tim Scudder wrote a book in which he describes five steps to conflict resolution. An interview he gave he made the point that in conflict â€Å"both parties want the same thing.† (Scudder, 2011) He also stressed the importance of anticipating conflict. By anticipating conflict an employee will take time to think, and in thinking they will realize that the person they may have a conflict with wants the same thing. This puts the employee in a positive frame of mind and helps to come to a reasonable solution for both involved. In the article â€Å"How to Deal with Annoying Co-Workers† gives a suggestion to help in dealing with co-workers. It suggests that, â€Å"With most types of annoying co-workers, the solution is simply to be straightforward and assertive.† (Green, 2011) Working through a conflict helps co-workers to come to a better understanding of each other. When people understand and respect each other communication is smoother and more effective. Once again, smoother and effective communication benefits the organization. Formal communication, informal communication, and conflict resolution involve two parties. Each of these communications involves a time where another party receives information. In face to face communication active listening is a technique that will ensure that messages are received correctly and will allow the listener to formulate the best response. Active Listening is not only an important part of conflict resolution but communication as a whole. Active listening means, â€Å"being fully engaged in paying attention to your relational partner’s communication with you. It is not just hearing skills. It involves paying close attention to your partner’s verbal and nonverbal behaviors.† (Kreps, 2011; sec. 4.3) In other words, it’s a way of showing respect for those you are communicating with. It sounds as simple as just listening but it’s not that simple. It takes a conscious effort to begin with before it becomes habit. If you are fully engaged in what your partner is communicating then you will get all of the information being sent. It may also evoke the norm of reciprocity which will have your partner giving you  their full attention. The norm of reciprocity is, â€Å"the urge to act in-kind that often encourages these relational partners to provide you with information and treat you similarly to the way you treat them.† (Kreps, 2011; pg. 15) The importance to an organization of its members practicing active listening is participants receive all the information that is coming to them. This means that they have all they would need to know to complete their jobs successfully and meet organizational goals. Organizations have both formal and informal leaders. Formal leaders typically are ‘assigned their positions of authority within the organizational hierarchy and hold titles such as president, vice president, division leader, and manager.† (Kreps, 2011; pg. 19) Informal leaders are little harder to define by position or tile but â€Å"emerge with organizational life based on credibility (usually a combination of charisma, dynamism, expertise, and trustworthiness), ability to accomplish complex tasks, and access to relevant information.† (Kreps, 2011; pg. 19) Even if you are not a formal leader you can still have influence over others as an informal leader. Informal leaders are not defined by title but by quality of character. Understanding leadership strategies and what being a leader entails helps to motivate workers to meet organizational goals. It is important for organizational leaders be able to communicate in different ways for different situations. There are several different leadership strategies that can be employed for different situations. To understand leadership strategies it’s important to think about how leaders may see those under them. Douglas McGregor used X and Y models of leadership to explain the relationship between leaders and followers. Theory X makes the assumption about workers they do not like work and will do anything to avoid it. This model will make leaders be more directed because they think that is what workers prefer and need. McGregor’s Theory Y assumes that workers do not dislike work and will work hard if they feel the value of their effort. The Theory Y suggests that if workers are given a degree of autonomy and a chance to use their imaginations they will strive to be successful in their tasks. Depending on how leaders see workers can dictate their leadership strategies. One of three helpful leadership styles is the autocratic leadership style. This is a leadership style that would come from a leader who is a believer in Theory X. An autocratic leader â€Å"makes most  organizational decisions without consulting with others. The leader calls all the shots, tells workers what to do and how to do it.† (Kreps, 2011; sec 7.6) This type of leadership style would have little use for upward communication from those who follow. Upward communication is, â€Å"communication that travels up the power hierarchy.† (Kreps, 2011; pg. 10) This would be difficult for a leader who believes in Theory X because, â€Å"upward communication enables workers to express their concerns and ideas, to provide and ask for feedback, and seek clarification from managers.† (Kreps, 2011; pg. 10) The autocratic leadership style is best suited not for driving workers but in emergency situation where there is little time for collaboration. Organizational participants would appreciate a direct approach in times of pressure. On the opposing side of autocratic leadership is democratic leadership style. When using the democratic leadership style you, â€Å"share responsibility and involve other organizational participants in decision making, although the process for the final decision may vary from the leader having the final say to them facilitating consensus in the group.† (Kreps, 2011; sec. 7.6) This type of leadership style is something that followers respond positively to. It also bolsters the leader’s position because the workers feel a â€Å"buy in† to the process. This is something that Theory Y talks about. The ability of helping the workers feel that their efforts and work are valued, and helping them to see the value. The drawback to this type of style is that it is time consuming, and can lead to conflict if not used correctly and in the right situation. Lastly, there is the laissez-faire leadership style. The laissez-faire leadership style would have the leader, â€Å"share power with workers and delegate decision-making authority to those individuals who are directly involved in the decision-making situations.† (Kreps, 2011; sec. 7.6) This leadership style could be considered an extension of the democratic leadership style. In using this style it is important for a leader to know the capabilities of those under them. The employees under this leader must be experienced and skilled in the tasks that they are being given a degree of control over. This type of leadership style will help a leader delegate those things they have little time for. Delegation is an important skill. In the article â€Å"A Tool Kit for the Real World† it says that, â€Å"Business people don’t get accolades for being smart, but for being effective. That is measured in  things like increased sales, increased earnings and an increased number of licensing agreements. Not, alas, by the fruition of one employee’s great idea.† (Motluk, 2011) However, this should not be used as a way of having others do their work for them. This would be damaging to the leader and certainly the organization in that it can bring a degree of disorganization that would be extremely difficult to correct. The leadership strategies above are mentioned because they show the need for a leader to be able to decipher the right strategy for the right situation. Each has one distinctive way to deal with leading and each has its drawbacks when used outside of its best application. Therefore the situational model of leadership may be the best strategy when it comes to leadership. The situational model of leadership is, â€Å"based on the assumption that there is no right way of leading. Rather, the best leaders adapt to the unique situational constraints to exhibit the appropriate leadership style for the situation.† (Kreps, 2011; sec. 7.6) A leader must be able to analyze situations, those involved, the choices, and the preferred outcome. If it’s an emergency and little time involved then use the autocratic leadership style. When time is available to employ upward communication, and bolster workers self esteem and organizational value a leader should employ democratic leadership style. If a leader is feeling overwhelmed or they are feeling pulled in too many directions, perhaps a laissez-faire leadership style might help to delegate tasks to that can handle them. Understanding leadership strategies helps to use communications with workers that will work best in certain situations. The most important thing about communication in the work place is awareness. As the book â€Å"Communications in Organizations† points out, â€Å"Organizations and the way they communicate play critical roles in our lives.† (Kreps, 2011; pg. 25) The key to effective communication is awareness. All of the five concepts of organizational communication mentioned above have some type of awareness piece built in. Communication is smoothest when those communicating are aware of those they are communicating with, their culture, and their style of communication. Thinking before speaking, anticipating change and conflict, and knowing what actions to take will help a leader communicate effectively with workers. After presenting the five concepts for successful communication within an organizational setting above it is clear to see their necessity for  successful communication. References Kreps, G. (2011). Communications in Organizations. San Diego: Bridgepoint Education, Inc. Green, A. (2011, January 6). How to Deal With Annoying Co-Workers. Retrieved from http://money.usnews.com/money/blogs/outside-voices-careers/2011/06/06/how-to-deal-with-annoying-co-workers Motluk, A.(2011) A Tool Kit for the Real World. Retrieved from http://www.newscientist.com/article/dn19969-a-tool-kit-for-the-real-world.html?full=true (2011). Tim Scudder Interview. Retrieved from http://www.youtube.com/watch?v=P_E7YVkjJQ0 Weiss, J. (2011). An Introduction to Leadership. San Diego, Bridgepoint Education, Inc.

Lack of Rule of Law in China Essay -- International Law

Aristotle once stated, â€Å"The rule of law is better than that of any individual.† The essential characteristics of rule of law are: the supremacy of law, meaning both the government and individuals are subject to the law; a concept of justice that emphasizes interpersonal adjudication, based on importance of standards and procedures; restrictions on discretionary power and exercise of legislative power by the executive; independent judiciary, judicial precedent and common law methodology; prospective, not retrospective legislation; and underlying moral basis for law. (Cooray) In China, the justice system has been based on rule â€Å"by† law, also known as â€Å"rule of men† instead of rule â€Å"of† law. In other words, law has been an instrument of the government, which holds itself above the law as opposed to law being supreme. The goal of laws here are to protect the interests of the state, not the individual, and to keep stringent social control. Ch ina’s leaders are beginning to realize that establishing the â€Å"rule of law† is critical to China’s ability to sustain its rapid economic growth. The lack of legal knowledge and transparency, the complex judiciary and legislative system and cultural barriers rooted deeply in society are just a few main reasons responsible for an inadequate rule of law in China. Due to the lack of tradition of rule of law and the Chinese Communist Party rejection of the kind of liberal democratic government associated with it faces multiple challenges in its establishment. Understanding the importance of modernizing Chinas culture has had leverage on the political and economic level have substantially increased the progress of reform towards the use of rule of law. Being the oldest continuous major world civilization... ...accountability of the Chinese police." Policing -Bradford- 20, no. 1: 113-135. British Library Document Supply Centre Inside Serials & Conference Proceedings, EBSCOhost (accessed March 25, 2012). Wong, Kam C. 2009. Chinese Policing: History and Reform. New York: Peter Lang. Wong, Kam C. 2011. "Reform to police accountability." In Police Reform in China, by Kam C. Wong, 299-363. CRC Press. Wong, Kam C. 2004. "The police legitimacy crisis and police law reform in China: Part I." International Journal Of Police Science & Management 6, no. 4: 199-218. Academic Search Complete, EBSCOhost (accessed March 25, 2012). Wong, Kam C. 2005. "The police legitimacy crisis and police law reform in China: Part II." International Journal of Police Science & Management 7, no. 1: 1-14. Academic Search Complete, EBSCOhost (accessed March 25, 2012).

Post-CABG Nursing

Coronary heart disease is a major physical illness and one of the main causes of death in Western society People who do not die an early and sudden death may have to consider a major surgical treatment, the most prevalent being coronary artery bypass graft surgery (CABG). More than 350,000 such operations are performed annually in the United States alone. This operation prolongs the life of patients in cases of triple-vessel disease It also improves patients' quality of life), thus providing them with the opportunity for successful rehabilitation (Ben-Zur, 2000).The postoperative complications of CABG include the following: high anxiety or depression, central nervous system damage (CNS), and atrial fibrillation. In this paper, we will discuss the postoperative complications of CABG and how they impact nursing practice. . During the first several weeks after CABG surgery, states of high anxiety or depression are usually observed (see, for example, Pick, Molloy, Hinds, Pearce, & Salmon , 1994; Trzcieniecka-Green & Steptoe, 1994).In long-term research (that is, approximately one year after the operation), the results present a more positive trend in terms of elevation in positive moods (King, Porter, Norsen, & Reis, 1992; King, Reis, Porter, & Norsen, 1993), as well as an increase in quality of life (Kulik & Mahler, 1993). Such outcomes can be accounted for by illness severity factors. In addition, in recent years, the individual's personality and coping characteristics have been investigated as important determinants of post-CABG patients' emotional reactions and rehabilitation (Ben-Zur et al., 2000). Research studies indicate that depression is prevalent in approximately 20% of CAD patients, and has a significant effect on post-surgery morbidity and mortality. (Remedio, 2003). One major type of morbidity following CABG is central nervous system (CNS) dysfunction (. Barbut D, Hinton et al. 1985)]. Of all the adverse neurological outcomes that may be incurred posto peratively, stroke is one of the most serious.However, due to technological and surgical improvements the incidence of stroke is now reported to be as low as between 0. 8 and 5. 8% [McCann GM, et al. 1997) Duke University Medical Center study published in 2001 indicated that fully half of people undergoing bypass surgery developed memory or thinking problems in the days following it, and that these problems were usually still evident five years later. (Bypass surgery and memory, 2005) Consequently, the rate of post-CABG stroke is no longer a sufficient index of CNS dysfunction.Neuropsychological research suggests, however, that a considerable proportion of all patients who undergo CABG sustain some degree of cerebral damage and that this manifests as mild cognitive impairment. Although these cognitive deficits rarely disturb activities of daily living, they are still considered cause for concern. Therefore, it is these less severe forms of neurological injury, which are now targeted for reduction in what has been described as an age of quality improvement (Stump D. A. 1995; Stump D. A. , Rogers A. T. , and Hammon , J. W. 1996;].Cognitive impairment following coronary artery bypass grafting, Neuropsychological tests are valuable tools in the assessment of brain dysfunction as they provide a method of systematically and quantitatively studying the behavioral expressions of this dysfunction (Lezak, 1995) .As there is now only a low risk of stroke following CABG, milder forms of cerebral damage have become a greater focus of concern. Consequently, neuropsychological assessment has become more important within the domain of cardiac surgery. The advantage of neuropsychological tests is that they are capable of detecting subtle changes in cognitive function.In comparison, conventional neurological assessment techniques, such as the Mini-Mental State Examination, are less sensitive and therefore less able to detect subtle CNS changes In addition, neurological assessme nt techniques do not lend themselves as readily to quantitative analysis [Heyer E. J, et al. 1995) Cognitive decline has been observed by many researchers using batteries of neuropsychological tests, usually administered to patients before and after surgery. A patient’s pre- and postoperative scores are then compared. In this way, intersubject variability is minimized as the subjects act as their own controls.While cognitive deficits have been consistently reported in the immediate postoperative period, some researchers have readministered test batteries in the immediate postoperative period, typically within 5–10 days of surgery (Aris A, et al, 1986; Clark et al. , 1995; . Newman MF, Croughwell ND, Blumenthal JA et al. 1994; Pugsley et al, 1994; Shaw PJ et al. 1986; Townes B. D. , Bashein G. , Hornbein T. F. et al. 1989; Symes et al, 2000).. Atrial fibrillation (AF), although t not life threatening, is one of the most common complications after CABG.Hospital stays oft en are prolonged due to intermittent hemodynamic instability of thomboembolic complications. During AF, loss of synchronous atrial mechanical activity response, and inappropriately high heart rates may have adverse effects o n hemodynamic functions and cause hypotension and hear failure. Of all the complications associated with postoperative AF< the most serious are throboemboic complications, which cause permanent morbidity in many patients. Risk of postoperative stroke has been found to be significantly increased with postoperative atrial tacharrhymias.Earlier studies shows that the incidence of AF can be as high as 50% in patients after the incidence of AF can be as high as 50% in patient after coronary artery bypass grafting (CABG), with a peak incidence on postoperative day 2 to 3. Atrial effective refractory periods (ERP) has been used a parameter to evaluate atrial repolarization and ERP and its dispersion are known parameters of atrial vulnerability that indicate enhanced at rial arrhythmogenesis, include a history spontaneous paroxysmal AF and easy inductility of atrial arrhthmias.( Solyu et al). Pleural effusion occurs in up to 80% of patients during the first week after CABG. Most of these effusions are small, self-limiting and do not require interventions. However, chronic, persistent post-CABG effusions have been reported. The etiology of these persistent effusions remains unknown. ( Lee et al, 2001) Sleep disturbances is another big postoperative complication The purpose of a 1996 Schafer et al study was to describe the nature and frequency of sleep pattern disturbances in patients post coronary artery bypass (CABG) surgery.An exploratory design using telephone interviews at one week, one month, three months and six months was used to describe the incidence and nature of sleep disturbances post CABG surgery. Forty-nine patients completed all four measurement times. More than half of the patients reported sleep disturbances at each measurement time . Sleep disturbances during the first month post CABG were reported to be the result of incisional pain, difficulty finding a comfortable position and nocturia. Although less frequent over time, these problems persisted for six months. . Miller et al (2004) discusses post CABG postoperative symptoms.At 1 week post-CABG, symptoms were incisional pain, wound drainage, chest congestion, shortness of breath, dizziness, sweating, swollen feet, and loss of appetite; incisional pain and swollen feet were reported by a few patients at 6 weeks after CABG. The incidence and frequency of postoperative symptoms declined over time. There were several age-related differences in symptom reports prior to and at 1 and 6 weeks after the procedure (Miller et al, 2004. ). Nursing interventions A wide variety of interventions have been tested for recovery of CABG patients. These 19 studies tested 20 interventions.Most of the interventions were educational in nature and dealt with preoperative or dischar ge instructions or counseling provided to patients. Preoperative interventions to affect in-hospital recovery included preparatory information about cognitive dysfunction following surgery, preparatory information and counseling about physical and psychologic recovery, and psychiatric counseling. Two of the studies[Rice VH, Mullin MH, Jarosz P.. 1992. ] compared the effectiveness of preadmission versus postadmission preparatory instructions, and one study [Barnason S, Zimmerman L, Nieveen J. 1995; Gortner SR, Gilliss CL, Shinn JA, Sparacino PA, et al.1988); . compared the effects of music, relaxation, and structured rest on hospital recovery outcomes. One study tested the effect of in-hospital range-of-motion (ROM) exercises on arm ROM at discharge. Interventions for home recovery were delivered close to the time of discharge or within the first couple of weeks following discharge. Most of the studies involved tests of structured discharge preparatory information about home recovery using slide and tape programs,[ Gortner SR, Gilliss CL, Shinn JA, Sparacino PA, et al. 1988; Gilliss CL, Gortner SR, Hauck WW, Shinn JA, Sparacino PA, Tompkins C. 1993;.] telephone follow-up and counseling,[ Gortner SR, Gilliss CL, Shinn JA, Sparacino PA, et al.. 1988;13:649-661. , Gilliss CL, Gortner SR, Hauck WW, Shinn JA, Sparacino PA, Tompkins C. 1993; Beckie T. 1989; Barnason S, Zimmerman L. 1995;] outpatient group teaching,[ Dracup; 1982. Dissertation. ,32] and homegoing audiotapes Interventions to promote risk factor modification behaviors included four studies[Dracup KA. 1982. ] that assessed the effect of structured versus unstructured teaching programs designed to increase knowledge of risk factors and enhance compliance with risk factor modification behaviors.Another study tested an education program that included a behavioral component as well Various outcome variables have been used to evaluate CABG recovery. The most frequently used outcome was mood states; 10 of the 19 studies used mood states as an outcome measure. The most frequently used measurement point for hospital recovery outcomes was the first day following surgery and discharge. Home recovery outcomes were usually measured at 1, 3, and 6 months following discharge. Outcomes associated with risk factor modification most often were measured at 6 weeks and 3, 6, and 12 months following surgery.What is the effectiveness of the interventions? Preparatory information was the intervention most frequently tested. In the two studies[Rice VH, Mullin MH, Jarosz P. 1992;, Anderson EA. 1987;] assessing its effectiveness to reduce analgesia use during hospital recovery, preoperative preparatory information was not found to be effective. Preoperative preparatory information was found to be effective in increasing patients' comfort and control when experiencing postoperative delirium.There was no support for the ability of preoperative preparatory information to reduce anxiety during in-hospital reco very] Discharge preparatory information also was found not to be effective in three of the four studies evaluating mood states during home recovery; this finding was noted even when individual counseling and telephone follow-up were added to the initial information provided Preadmission preparatory information about activity resumption during hospital recovery was found to be effective in one study (Cupples 1991. ] but not in another. [ Rice VH, Mullin MH, Jarosz P. 1992).Activity resumption at home was found to be significantly increased by the provision of discharge preparatory information in two[Gilliss CL, Gortner SR, Hauck WW, Shinn JA, Sparacino PA, Tompkins C. 1993; Moore SM. 1996] 33 of three studies. Discharge preparatory information aimed at families was not found to be effective in improving family functioning (family cohesion and family communication) during the home recovery periodGiven the small number of studies addressing the effect of preparatory information on phys iologic outcomes (blood pressure, heart rate, angina), no conclusions were made about its effectiveness on these variables.Similarly, no conclusions were drawn about the effectiveness of ROM exercises, music, and visual imaging to enhance CABG recovery because of the small single studies testing each of these interventions. There was clear evidence that information interventions designed to increase individuals' knowledge about managing recovery experiences during the first home recovery month and about coronary artery disease risk factor modification was effective; three of the four studies evaluating this intervention found significant effects.Similarly, tests of the effectiveness of structured versus unstructured instruction indicated that structured information was more effective in increasing knowledge. Education to enhance compliance with medical regimens and risk factor modifications was found to be effective for some risk modification behaviors but not for others. It appears that information alone does not change behaviors. Allen's[Allen. 1996;. ] study of an intervention to increase self-efficacy using both counseling and behavior modification techniques represented an important departure from previous interventions that were based solely on education and counseling.Although Allen found a positive effect for only one of the risk modification behaviors studied (dietary intake), the addition of a behavioral component is an important change in cardiovascular health behavior modification interventions. Gender differences have been widely explored by nurses. Investigators have identified that gender can constitute a form a biculturalism (that is, women view surgery as a minor inconvenience, whereas men view it as a major life event). Postoperative symptoms vary, with males experiencing more fatigue, incisional chest pain, and atrial dysrythmias.Conversely, women have more numbness and breast discomfort, heart failure, and functional impairment. The 2 areas wherein the most work has been done are pain and sleep. A number of descriptive studies have been done on patients' self-report of pain, their satisfaction with treatment, and underuse of analgesics. Limited research on interventions to relieve pain has been reported. Despite these studies on pain outcomes, more exploratory work is required for pain associated with minimally invasive cardiac surgery, pain, and discomfort at discharge, and subsequently identification and trialing of interventions to provide pain relief.The relationships between exercise behavior and functional status of men and women 5 to 6 years after CABG have not been examined in a representative patient sample. This study (Treat-Jacobson & Lindquist, 2004). compared the 5- to 6-year recovery in a cohort of 184 patients at the Minnesota site of the Post CABG Biobehavioral Study. Data were collected by telephone interview and self-administered questionnaires. Results showed that women had lower physical (p ? .004) and social (p = . 001) functioning scores; men were more likely to participate in regular exercise (p = .01). Exercisers had higher functional status scores. ANCOVA demonstrated that differences in measures of functional status by exercise category were maintained even after controlling for age, sex, and symptom severity (p ? .01). In conclusion, individuals who exercised had more positive functional outcomes 5 to 6 years In general, nurse investigators have conducted sufficient studies within each of the generic outcome categories to allow for identification of cardiac surgery-specific outcomes that can be considered nurse sensitive.Artinian (1993) demonstrated that in the early recovery phase, only 62% of women spouses felt they were prepared for discharge, with key concerns being the availability of social support, use of coping strategies, personal resources, and knowing what to expect. At 6 weeks after discharge, women's concerns were most often regarding their husband's self- care activities, uncertainty, and husband's physical and mental symptoms. At 1 year after surgery, women reported less social support and greater role strain than they did at earlier time periods.48 Other investigators have shown that positive psychosocial adjustment to illness is influenced both by the quality of the patient's marriage and level of dysphoria. 49 Nursing interventions to improve family functioning have been reported by a number of investigators. Family members of ICU patients, who were recipients of care from nurses who attended educational sessions and who used checklists to assure provision of information and support, reported lower anxiety and higher satisfaction levels than did families not provided with this level of care.50 Other reports of a controlled trial with a nurse-led psychoeducational intervention51 and follow-up phone calls33 demonstrated no differences in improving patients' recovery or family functioning. Further research in this field should focus on determining if these findings persist across different demographic and economic groups Studies of functional status outcomes have focused on general activity and activities of daily living (ADLs). Specific findings have included that high levels of self-efficacy and decreased tension and anxiety at 4 weeks after surgery are predictive of greater activity at 8 weeks.Women report greater disruption of ADLs at 1 than at 3 months, while disruption of their recreational activities is similar at both times. Need during home health visits include maximum assistance with meals and laundry but only partial assistance with bathing and dressing. One randomized controlled trial comparing usual care with supplemental hospital education and weekly telephone follow-up to improve self-efficacy demonstrated that patients in the experimental group developed higher expectations for walking, lifting, climbing stairs, and working than did patients in the control group.(Whitman, 2004). Conclusion Cor onary artery bypass graft (CABG) surgery is regularly performed in most major hospitals, reflecting the high prevalence of coronary artery disease in western countries. A number of studies have identified cohorts of patients undergoing CABG and other cardiac procedures who experience a higher than expected rate of mortality and morbidity. Increasing age, poor left ventricular function, urgent/emergency procedures, complex operations and reoperation procedures have all been identified as risk factors resulting in prolonged hospital stays and increased morbidity.Subsequently, with current emphasis on both better clinical management and more cost-efficient practice, it is becoming increasingly beneficial to identify low-risk patients who can be safely ‘fast tracked’ to reduce postoperative management costs. The current, eclectic mix of topics studied reflects early resolution of specific issues. However, surgical procedures, recovery times, hospital length of stay, transit ional care facility length of stay, use of home healthcare, and patient characteristics have changed dramatically during the last decade, suggesting that new functional outcome recovery trajectories evolved.These new patterns for functional recovery and interventions merit new inquiry and reporting. The nursing studies have been well designed and have allowed the investigators to move, in many categories, through logical iterations of discovery (this is, from exploratory and descriptive work to predictive and correlational work and, finally, into interventional work). Future work in all categories needs to focus on moving through these stages and enhancing the current directions being taken so that patients achieve positive, optimal outcomes.Such information can be used to plan the care of patients undergoing CABG, to prepare them for normal recovery, and to determine the need for symptom management by health care providers References Allen J. A. . (2000) Coronary risk factor modifi cation in women after coronary artery bypass surgery. Nurs Res;45:260-265. Aris, A, et al.. Arterial line filtration during cardiopulmonary bypass. Journal of Thoracic and Cardiovascular Surgery1986; 91:526–533. Artinian N. (1993) Spouses' perception of readiness for discharge after cardiac surgery. Appl Nurs Res. ;6(2):80-88 Barbarowicz P, Nelson M, DeBusk RF, Haskell WL.A comparison of in-hospital education approaches for coronary bypass patients. Heart Lung. 1980;9:127-133. Barbut D. , Hinton R. B. , Szatrowski T. P. et al. Cerebral emboli detected during bypass surgery are associated with clamp removal. Stroke 1994; 25:2398–2402. Barnason S, Zimmerman L. (2000) A comparison of patient teaching outcomes among postoperative coronary artery bypass graft (CABG) patients. Prog Cardiovasc Nurs. ;10:11-20. Barnason S. , Zimmerman L. , Nieveen J.. Psychosocial aspects of cardiac care: The effects of music interventions on anxiety in the patient after coronary artery bypass grafting.Heart Lung 1995;24:124-132. Beckie T. A supportive-educative telephone program: Impact on knowledge and anxiety after coronary artery bypass graft surgery. Heart Lung. 1989;18:46-55. Ben-Zur, Hasida, Rappaport, Batya, Ammar, Ronny, Uretzky, Gideon. Life Style Changes, And Pessimism After Open-Heart Surgery Health & Social Work, 03607283, Aug2000, Vol. 25, Issue 3 Bypass surgery and memory. (cover story) Harvard Heart Letter, Aug2005, Vol. 15 Issue 12, p1-2 Clark R E. et al. (1995).. Microemboli during coronary artery bypass grafting. Journal of Thoracic and Cardiovascular Surgery; 109:249–258.Cupples S. A. Effects of timing and reinforcement of preoperative education on knowledge and recovery of patients having coronary artery bypass graft surgery. Heart Lung. 1991;20:654-660. Dracup K. A.. The Effect of a Role Supplementation Program for Cardiac Patients and Spouses on Mastery of the At-Risk Role. Ann Arbor, Ml: University Microfilms International; 1982. Dissertati on. Gilliss CL, Gortner SR, Hauck WW, Shinn JA, Sparacino PA, Tompkins C. A randomized clinical trial of nursing care for recovery from cardiac surgery. Heart Lung. 1993;22:125-133.Gortner SR, Gilliss CL, Shinn JA, Sparacino PA, et al (2000). Improving recovery following cardiac surgery: A randomized clinical trial. J Adv Nurs. 13:649-661. Heyer E. J. , Delphin E. , Adams D. C . et al. Cerebral dysfunction after cardiac operations in elderly patients. Annals ofThoracic Surgery 1995; 60:1716–1722. King, K. B. , Porter, L. A. , Norsen, L. H. , & Reis, H. 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The Best Model Of Teamwork Essay - 1235 Words

As a professional Civil Engineer, with a dense experience in project management, I would definitely agree with Belbin (Belbin Associates, (2012) that teamwork is the key to success in any project. As stated by Belbin:† A team is not a bunch of people with job titles, but a congregation of individuals,† The best model of teamwork is what is suggested by Dr. Belbin. Caring for the role requirement and fit in with the organization staff. Moreover, the successful project manager is the manager who designs the team members from the cream of the cream available in the organization. As stated by (Prabhakar, G. P. (2008)), the project manager has many responsibilities. Each undertaking has a solitary supervisor. The venture Director is the individual accused of arranging and booking firm and regular administration of task execution. He or she is additionally the individual with most prominent responsibility for the attempt s prosperity. 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