Discuss the primary business structure,functions and sub category of Essay

Discuss the primary business structure,functions and sub category of the NHS - Essay Example Thus health care is largely free for all patients ordinarily resident in United Kingdom, some set charges are payable for prescriptions, optician and dentistry services. Thus taxpayers actually fund NHS scheme to ensure that everyone has access to quality and timely heath care facility. Lately the concept of "internal market" has been introduces whereby the services are purchased from various sources either internal or other hospitals to make the system more efficient. In theory each division of NHS is supposed to break even, though practical picture is quite different many times. Repeated deficits and financial indiscipline can result in replacement of board of directors of the trusts of NHS The main function of NHS is to provide health care to all the ordinary residents of UK healthcare services free of cost funded through taxes. NHS operates through a complex web of trusts which act locally and are managed, monitored by Strategic Health Authorities (SHAs) to continuously improve the healthcare services. All the Primary subcategories are managed mainly by primary care trusts which overlook the GP, requisitioning other services like specialist, mental health, ambulance etc. SHAs have strategic role in managing the PCTs under their area. It is widely believed that NHS is the third largest employer in the world after Chinese Army and Indian Railways.

LOCAL VANCOUVER ISLAND TOURISM - PARTICIPATION AND ITS RELATIONSHIP TO Essay

LOCAL VANCOUVER ISLAND TOURISM - PARTICIPATION AND ITS RELATIONSHIP TO QUALITY OF LIFE - Essay Example The thematic exploration of local tourism with regard to the quality of life becomes significant as its findings could be exploited not only for enhancing the overall well-being of the local people but also in promoting new opportunities of growth across the Island population. The study had focused on the views of women in the age group 30-39 years. The main reason being that women’s outlook is linked to wider community encompassing friends, relatives, children etc. as they are perceived to be the epicenter of family. The thesis questions were very pertinent to explore and identify the factors that link local tourism to the holistic welfare of the people. The questions had focused on three major ideas: How women in 30-39 years perceive local tourism; their perception of ‘quality of life’; and how quality of life is related to local tourism. Local participation and sustainability have underpinned the research objectives which makes the study hugely relevant to the socio-economic development of the Island. The exploratory research has exploited the tenets of descriptive qualitative research methods using semi-structured interview schedule and focus group. Total numbers of participants were nineteen: six from the industry stakeholders; an d thirteen female participants representing diverse community across Vancouver Island. The thesis findings had revealed some very interesting aspects of human relationship that have wide ranging impact on local tourism. The quality of life had varying meanings for different participants but it was unanimously confirmed that it had positive impact on their life and happiness. It could broadly be divided into three categories: being a healthy and happy person and enjoy all amenities of life like good food, good work-life balance and being independent. The second category is linked to better social relations, safe environment, strong sense of pride and lifestyle choices. Lastly, cost effective peaceful

Health Risk Of Cell Phones

Health Risk Of Cell Phones The cellular phone is a pervasive technology that has evolved from a luxury item justified only by the rich businessman to a necessity to some and an addiction to others. According to Portio Research Limited approximately 4.344 billion cell phones are in use globally. Since the latter part of 2008 one fifth of households in the United States have chosen this technology as their sole method of voice communication, replacing traditional landline telephones. Source: Fram, (2009). A 2009 Marist Poll found that 87% of U.S. residents say they own a cell phone. So what exactly is a cellular telephone? History tells us that Alexander Graham Bell received the first U.S. patent for a communication device called the telephone in 1875. This device allowed a human voice to be transmitted across a cooper wire. We grew up with the telephone and in my generation every house had at least one telephone. The first patent for cordless phone technology was given in 1959 but the technology did not become commercially viable until the breakup of the Ma Bell monopoly in the early 1980s, it was then that several companies started manufacturing wireless phone systems. These cordless phone systems were still connected to landlines but in actuality were two way radios using RF or Radio Frequency technology. Radio waves are part of the electromagnetic spectrum of radiation. Todays cell phones use EHF (Extremely High Frequency) or microwaves which are the same technology our microwave ovens are based on. Because the telephone started out as a safe technology we grew up using, people do not even think about the possible negative health consequences of using their cell phone. Cell phone usage has negative effects to your health. However when it comes to the health risks associated with using a cell phone, there is conflicting research. Mobile phone technology is new and its effects are unknown. We have only been using wireless communication technology for the last thirty years. There are not large enough studies conducted over long enough periods of time to come to the conclusion that this technology is safe. Cigarette smoking and even X-Rays where once thought to be safe, until enough information came to light to prove the dangers of using them. Most of the major studies have been done in countries that have a financial stake in the manufacturing of cell phones. Interphone is one of the largest studies ever done. It took place over the course of ten years and included the research of 13 different countries, comprising subjects from the age of 30-59. Even with large studies such as Interphone (which included 14,078 cases), there are on going debates about what the data actually means, thus with no conclusive results the report remains unpublished. But one thing they all agree on is that more research is needed. (Reardon, 2009, para. 6). Another issue involved is that the te chnology being used is rapidly evolving; the current incarnation of the cell phone is less than ten years old. The Stewart Report from the International Experts Group on Mobile Phones claims (Stewart, 2000, 40) New Telecommunications technologies have been introduced without full provision of information about their nature and without prior discussion within the scientific community about the consequences for health. The research is static while the technology is dynamic. The use of Cell phones increases the risk of cancer. Using a cell phone held up against your ear can increase your risk of getting cancer or brain tumors due to the proximity of the radiations source to the head and brain. There are many studies available which indicate a link between various types of cancer and cell phone usage. A study done in Sweden by Dr. Lennart Hardwell showed that the risk of acoustic neuroma and glioma are increased from 20% (low grade giloma) to 400% (high grade giloma) by long term mobile phone use (>10 years), highest risk category being ipsilateral exposure. Source: (Harwell, Carlberg, SÃ ¶derqvist, Mild Morgan, 2007). Dr. Ronald B. Herberman, MD and Director of the University of Pittsburg Cancer Institute and UPMC Cancer Center testified before the Domestic Policy Subcommittee Oversight and Government Reform Committee My attention was directed to a large body of evidence, including expert analyses showing absorption of RF into the brain and the comprehensive Bioinitiative Report, review of experimental a nd public health studies pointing to potential adverse biologic effects of RF signals, including brain tumors, associated with long-term and frequent use of cell phones held to the ear. Source: Herberman, R. (2008). Dr Herberman felt strongly enough about the connection between increased cancer risk and using a cell phone that he issued a warning to his staff which included 10 detailed steps to reduce exposure to the RF electromagnetic radiation. Cell phones do not cause cancer. Sources such as the US Food and Drug Administration and the American Cancer Society have found cell phone usage has not been directly linked to an increased risk of brain, and other cancers. The United States Food and Drug Administration is the government agency responsible for evaluating and regulating the safety of products that emit radiation. These products cover medical to entertainment electronics. The FDA website under the topic of Radiation emitting products, health issues, a simple question is asked and answered, Do cell phones pose a health hazard? Source: www.fda.gov (2010). The answer clearly states the scientific evidence has not proven that cell phones cause cancer or any other health issues. The American Cancer Society has evaluated close to 30 studies which were focused on the relationship between tumors and cell phone usage. The results of these studies have been similar. Most studies do not show a dose-response relationship a tendency for the risk of brain tumors t o increase with increasing cell phone use, which would be expected if cell phone use caused brain tumors. Source: www.cancer.org (2010). Certainly these organizations are credible and have no financial interest in the outcome of this controversial health topic. Mobile phones emit low-level RF. Because the RF levels emitting are so low, there is no direct link between mobile phones and health issues. According to the FDA cell phone levels of RF are low putting them into the range of microwaves. Microwaves produce non-ionizing radiation, not to be confused with ionizing radiation such as gamma or x-rays which does have a damaging effect on biological tissue. The Federal Communications Commission defines a biological effect as a measurable change in a biological system. The presence of a biological change does not translate into something that is biologically harmful. When the biological effect causes detectable impairment of the health of the individual or of his or her offspring it is categorized as harmful to ones safety. Source: U.S. Federal Communications Commission, Office of Engineering and Technology, (1999). These RF levels are only at their peak when actually transmitting and receiving, which limits the amount of exposure. The FDA stated that no prove existed that cellular phones are dangerous, however if people still have apprehension there many preventive methods that can be implanted to further decrease exposure to the already low level of RF energy. Cartoon Interpretation In this cartoon the author is suggesting that user is aware that using his cell phone is dangerous, by the comical way he attempts to protect himself with the metal helmet. In addition he appears to be discussing these concerns with his physician, who states If youre worried about the dangers of mobile phones why dont you use it less. As with any other type of radiation, the time of the exposure is one of the factors that determine the patient dose. By suggesting that the patient use his phone less the doctor is re-enforcing this principal. With the advent on new technologies such as mobile internet, text messaging and email people are using their cell phones for extended periods of time and carry them constantly. By turning the phone off when not in use the patient could further decrease his exposure. Another concept radiation protection uses is increasing the distance between them and the source of radiation. This patient could eliminate the need for his humorous helmet by using so me ear buds with a microphone. The ear buds would allow him to use his cell phone without having the phone pressed against the temporal bone, which is in close proximity to the brain. Most cell phones today included these ear buds in the box, I know my Blackberry did. The other option is to use the speakerphone which is my personal favorite, especially in the car. I would also recommend he not carry the phone on his person, he could simply turn the phone off or put it in Airplane mode when not using it. Conclusion Radiation protection is founded on the premise that there is no safe amount of ionizing radiation. We should apply this approach when thinking about how and when we use our cellular phones even though they emit non-ionizing radiation. All the negative health implications of long-term cell phone usage are still unknown. Brain tumors take at least 10 to 20 years to manifest themselves. Source: Khurana, G. (2008). Taking a lesson taught to us from history with the health issues associated with x-rays and cigarettes, we need to take a more conservative approach when using a cell phone. Cell phones are now rated for how much specific absorbed rate per kilogram (SAR) they emit. There are many sources on the internet that compare the specific absorbed rate of phones from various manufacturers. Choose a cell phone model which emits a low amount of radiation to begin with. As consumers we should demand that objective studies be done over a long period of time using a number of subjects signif icantly relative to the amount of people using this technology. These studies must be conducted by experts in the medical community familiar with studying the mechanism of the causes of cancer. We should pressure our lawmakers to put in place more stringent requirements when it comes to minimizing the specific absorbed rate and improve the design to minimize. While not within the scope of this paper, I would be negligent not to mention the importance of controlling the cell phone usage of our children; their bodies are far more susceptible to the effects of RF radiation. Source: Khurana, G. (2008). The biggest challenge is to make people understand that no one is asking them to stop using their cell phone. Cell phones are an invaluable communication technology. For your own well being and that of your family please be aware of the dangers and how to limit the effects of them.

Capitalism and the Common Man :: Economy Economics Essays

Capitalism and the Common Man There are some arguments, having a faint measure of plausibility, that have served politicians, charlatans and assorted do-gooders for well for over a century in their quest for control. One of those arguments is: capitalism primarily benefits the rich and not the common man. That vision prompts declarations such as: Congressman Richard Gephart's assertion that high income earners are "winners" in "the lottery of life." Then there's, Robert Reich, former Secretary of Labor, who says high income earners the "fortunate fifth." These nonsensical visions lead to calls for those who've been "blessed" to "give back" either voluntarily or coercively through the tax code. While demagogic statements like these have high emotive worth, they reflect resolute, near incurable stupidity about the sources of income. Listening to some of the talk about income differences, one would think that out there somewhere is a pile of money. People who are wealthy just happened to get there first and greedily took an unfair share. Justice requires that they "give back." Or, there's talk about income distribution. The way some people talk, unequal distribution of income means that there is a dealer of dollars who shells out $1,000 to one person, $100,000 to another and a million dollars to yet another. Thus, the reason why some people are wealthy while others are not wealthy is that the dollar dealer is a racist, sexist, a multi-nationalist, or just plain mean. Economic justice requires a re-dealing of the dollars, income redistribution, where the ill-gotten gains of the few are returned to their rightful owners. In a free society, for the most part, people with high incomes have demonstrated extraordinary ability to produce valuable services for, and therefore please their fellow man. Sam Walton, founder of Walmart, Bill Gates, founder of Microsoft, and singer Michael Jackson provided services deemed highly valuable by their fellow men who voluntarily took money out of their pockets to purchase those services. Their high incomes stand as unambiguous proof of that service. Their high incomes also reflect the democracy of the market place. For example, millions upon millions of independent decision makers decided to fork over $200 or $300 for Microsoft founder Bill Gates' "Windows 98" operating system. Those who think Bill Gates is too rich, and want to redistribute his income, are really registering disagreement with the democracy of the market place and want to cancel or offset the market "vote.

Student Spirituality - Got Jesus? :: Philosophy Religion

Student Spirituality - Got Jesus? You may have an idea of what’s coming here. Yes, this is an essay about religion and spirituality. When you finish reading this essay, you might say, â€Å"It’s 2005; why in the world do you care about religious crap anymore?† Or maybe, â€Å"Get down off your crucifix, man.† Or, â€Å"You’re gay. Get a life.† That one’s my favorite. But before you bust out the Bible jokes, you could try to pinpoint the reason as to why you find religious people to be odd or ridiculous. Let’s see if this sounds familiar. Let’s start when you’re little. Your parents take you to a church, mosque, synagogue, or whatever their place of worship is, and you may not really want to go. You may not even know why they take you there. All you know is that it’s more fun to go home and play video games, watch television, or play with your friends. So already, this religion crap is a pain. Strike one. It also teaches you all this garbage; that you shouldn’t lie, steal, disobey your parents, or use those nasty four-letter words. And when you’re old enough, it tells you that you shouldn’t engage yourself in some activities. You know what they are. Well, where’s the fun in any of that? Strike two. Then, when you want acceptance from the â€Å"popular kids† in middle school, you learn that they all feel the same way. They hate going to church, and following those dumb little rules, and they don’t see the point either. So that makes it official. Religious crap is a waste of time. Strike three. Then you encounter people who follow that junk like it means something. They let those ideas influence or even completely control everything they do in their life. What better a target for ridicule? Those people are so funny, the way they actually follow that crap. It makes you want to laugh. Well, if you need something to seal the deal, that’s it because you can’t bear to be ridiculed by anybody. That would be sacrilegious to your self-esteem. No pun intended. Strike four. We’re not playing baseball. That may explain it, and it may not. If not, it probably comes pretty close. Take all of that, and put it on a college campus, where beer or sex is king in some circles, and career aspirations of financial success pop up. Hopefully. The idea of even making fun of those weirdos gets buried beneath all of that. Student Spirituality - Got Jesus? :: Philosophy Religion Student Spirituality - Got Jesus? You may have an idea of what’s coming here. Yes, this is an essay about religion and spirituality. When you finish reading this essay, you might say, â€Å"It’s 2005; why in the world do you care about religious crap anymore?† Or maybe, â€Å"Get down off your crucifix, man.† Or, â€Å"You’re gay. Get a life.† That one’s my favorite. But before you bust out the Bible jokes, you could try to pinpoint the reason as to why you find religious people to be odd or ridiculous. Let’s see if this sounds familiar. Let’s start when you’re little. Your parents take you to a church, mosque, synagogue, or whatever their place of worship is, and you may not really want to go. You may not even know why they take you there. All you know is that it’s more fun to go home and play video games, watch television, or play with your friends. So already, this religion crap is a pain. Strike one. It also teaches you all this garbage; that you shouldn’t lie, steal, disobey your parents, or use those nasty four-letter words. And when you’re old enough, it tells you that you shouldn’t engage yourself in some activities. You know what they are. Well, where’s the fun in any of that? Strike two. Then, when you want acceptance from the â€Å"popular kids† in middle school, you learn that they all feel the same way. They hate going to church, and following those dumb little rules, and they don’t see the point either. So that makes it official. Religious crap is a waste of time. Strike three. Then you encounter people who follow that junk like it means something. They let those ideas influence or even completely control everything they do in their life. What better a target for ridicule? Those people are so funny, the way they actually follow that crap. It makes you want to laugh. Well, if you need something to seal the deal, that’s it because you can’t bear to be ridiculed by anybody. That would be sacrilegious to your self-esteem. No pun intended. Strike four. We’re not playing baseball. That may explain it, and it may not. If not, it probably comes pretty close. Take all of that, and put it on a college campus, where beer or sex is king in some circles, and career aspirations of financial success pop up. Hopefully. The idea of even making fun of those weirdos gets buried beneath all of that.

Practicum Evaluation Summary Essay

The practicum learning agreement created between the masters of Science in nursing (MSN) student and the instructor was approved for the goal to perform in the role of a nurse educator at the Domiciliary Rehabilitation Program at the Orlando Veterans Affairs Medical Center (VAMC). The population of the Domiciliary Residential Rehabilitation Program is veterans with multiple and severe medical conditions, mental illness, addiction, or psychosocial deficits. Military-related posttraumatic stress disorder (PTSD) can negatively affect the veteran’s well-being (Health Services Administration, 2010). The care needs of the nursing staff were assessed to identify the need for the educational program in the rehabilitation program. Further development, implementation and evaluation of a program to improve the veteran’s quality-of-life were the objectives to provide the best outcomes of a teaching/learning program. The learning agreement included the strategies to accomplish the objective with an established time-line and self-reflective journal to meet the best outcomes. Professional relationships were established with a mentor and networking with the organization improved professional advancement capabilities at the Orlando VAMC. Evaluation of the effectiveness of the project produced positive outcomes to improve the veterans’ quality of life. The role of a leader used evidence-based decision-making and applied ethical standards. The importance of nursing theory provided the principles to generate nursing knowledge and create practices to help the veterans who are affected by PTSD. The practicum experience enhanced the role as a nurse educator to improve cost-effective nursing practices for the veterans at the VA Medical Center. Effectiveness of Project The project began with an idea using a practicum project brainstorm worksheet (Appendix A). The learning objectives were established, and a timeline was used to maintain a deadline for completion (Appendix B). Each learning objective used Bloom’s taxonomy for three learning domains: cognitive/knowledge (mental learning), affective/attitudes (growing feeling learning) and psychomotor skills (manual/physical learning) (DeYoung, 2009). The first learning objective analyzed peer-reviewed literature and evidence-based research to identify the disease process and formulation of  best practices (Burns & Groves, 2009). An extensive reference base was conducted and used to draft a needs assessment that was discussed with the mentor, mental health team, nurse manager, and educator (T. Russell, H. Ortiz, D. Hopson, personal communication, Summer, 2013). Their experienced feedback was practical in completing an effective outcome to the objective. The next learning objective was to design the educational program using a PowerPoint presentation, hand-outs, knowledge test, and final evaluation. A teaching plan guideline with learning objectives followed Veteran Affairs Health Administration procedures for quality and performance (Orlando VAMC, 2013). A summary of the program was presented and approved by administration. Implementation of the learning program was coordinated with approval of management. A flyer was created to announce the class dates and times. All three shifts on the rehabilitation department were provided a verbal pre-test and lectured on the topic. Many opportunities for open-discussion helped the staff explore their own beliefs and experiences to improve their knowledge and skills. The post-tests were scored and found a positive correlation to learning and accomplishing the program objectives. The VAMC evaluation tool was used to score the course and instructor. Self-reflective journaling helped to identify strengths and weaknesses of the program and teaching techniques used. The results were shared with the mentor who provided encouragement to learn from the experience and build knowledge of performing as an educator. The outcomes of implementing the teaching program was completed and found to be successful in improving nursing knowledge by providing evidence-based practice to enhance the veteran’s well-being. A final evaluation of the practicum learning used the Orlando VAMC evaluation form. The teaching program method was appropriate for learners. A detailed reflective analysis in the portfolio included results from a final meeting with the mentor, administration, mental health team, and educator. All favored the educational program to improve nursing standards of care for veterans with PTSD in the rehabilitation program. Encouragement to expand the teaching to nursing staff on all mental health departments and in the orientation program for newly hired nursing personnel was made by the mental  health chief nurse. The outcome had few strength and weaknesses in which to learn from. The weaknesses are personal areas of improvement that can be enhanced with continued experience as an educator, optional training aids available at the VAMC and continued evaluations for improvement. Another weakness of the project was the small learning experience as compared to the nursing population at the VAMC. MSN Program Student Learning Outcomes A quality assessment process from up-to-date journal reviews can provide the decision-making for new interventions in patient care. Evidence-based decision-making requires the integration of the best available research evidence addressing specific clinical questions (Kranke, 2010). A systematic review of literature was pooled to obtain data about PTSD issues. Prepared health professionals use evidence to inform safe practice and account for positive patient care outcomes are the aim for delivery of health care. Competence, education and skills play a critical role in achieving safe patient care in a complex health care system. Nursing professionals have the role to ensure the translation of evidence into practice while evaluating outcomes. The demand for improved patient care and a safe health care delivery system is taught at the University of Phoenix and the Veterans Health Administration. Nurses have a direct effect on patient care outcomes and quality (McLaughlin & Kaluzny, 2006) . Influencing change is essential in any organization and a good change agent is required as a leader (Tomey, 2009). Analyzing and identifying the need to implement an educational course to teach nursing staff how to better care for veterans with PTSD requires the collection of data, using the right tools, preparing objectives, and evaluating the process of change. Advance nursing education has helped to gain the skills to diagnose and plan positive change to improve patient care outcomes. The principles of successful leadership are important in affecting change. Leadership skills are necessary to drive and maintain change. Views on diversity can bring change to programs. Veterans bring their own set of beliefs and values to a diverse and multicultural environment. Providing relevant care is important for nurses to understand their own beliefs, culture and values as well as understanding the veteran’s views. Their rights to confidentiality and privacy are trusted by patients to be maintained by medical personnel. A code of ethics, moral philosophies and  effective communication is learned in advance nursing education to help guide the decisions in meeting patient care needs (Burkhards & Nathaniel, 2008). Theory provides the framework to structure and builds knowledge (Walker & Avant, 2005). Models can help to link research, education and practice. The change process is complex. Nursing practice theories provide the framework for interventions and prediction of outcomes. Theories can guide practices in nursing that focus on the difference and similarities in respect to human care. Nursing theory provides the foundation to assess, evaluate and plan interventions. A theoretical perspective can help to meet the challenges of health care delivery and provide guidelines for nursing practices (Fitzpatrick & Whall, 2005). Nursing theory is essential in nursing research, education, practice, and development. Nursing theory helps to decide what is known and what needs to be known. The benefits include better patient care, enhanced professional status, improved communication, and guidance for research and education. Because care cannot be measured, theory can analyze it. Nursing models and theo ry are beneficial to the nursing practice. Development of Professional Nursing Career The project provided the opportunity to perform as a nurse educator and gain experience for advancement in this specialty. Involvement with nurse administrators, the mental health team, the nurse educators, and adjunct staff provided valuable opportunities to network. My work on the practicum project has advanced to expanding the program I created and the formal invite to join the mental health and rehabilitation team. The educational program has also advanced best practices of nursing personnel to perform with higher knowledge and skills. Years of nursing experience, expertise knowledge in mental health and gerontological nursing and the learning experience gained from the practicum project exposed me to knowledge and skills to take responsibility in leadership and advance my nursing career to a management level in the near future. Conclusion The practicum project was a success in improving patient care for veterans who have PTSD at the rehabilitation program. The experience from achieving personal learning objectives was a rewarding experience. Performing as a  nurse educator using evidence-based decision-making in creating and implementing a program at the Orlando VAMC was evaluated as effective and safe in teaching best practices. Leading and advocating for ethical principles, addressing diversity and applying theory contributed to full development of my professional nursing career. The practicum experience has provided the knowledge, skills and experience to further advance my career in professional nursing. References Burkhards, M.A., Nathaniel, A.K. (2008). Ethics & Issues in contemporary nursing (3rd ed.). Clifton Park, NY: Thomson Delmar. Burns, N., & Groves, S. K. (2009). The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence (6th ed.). St. Louis, MO: Elsevier. DeYoung, S. (2009). Teaching Strategies for Nurse Educators. Upper Saddle River, NJ: Prentice Hall. Fitzpatrick, J. J., & Whall, A. (2005). Conceptual Models of Nursing: Analyisis and application (4th ed.). Upper Saddle River, NJ: Pearson Prentice Hall. Health Services Administration. (2010, November). Veterans have unique needs: VA program to be specific to vets. Mental Health Management Advisor, 15(11), 126-128. Retrieved from CINAHL database Kranke, P. (2010, September). Evidence-based practice: how to perform and use systematic reviews for clinical decision-making, 27(9), 763-772. doi: 10.1097/EJA.0b013e32833a560a McLaughlin, C. P., & Kaluzny, A. D. (2006). Quality improvement in healthcare (3rd ed.). Sudbury, MA: Jones and Bartlett Publishers, Inc.. []. doi: Retrieved from Orlando VAMC. (2011, January 22). Quality management sy stem (Medical Center Policy 00Q-12). Orlando, FL: VA Medical Center. Tomey, M. (2009). Guide to nursing management and leadership (8th ed.). St. Louis, MO: Mosby. Walker, L., & Avant, K. (2005,). Strategies for Theory Constructions in Nursing, (5th ed). Upper Saddle River, NJ: Prentice Hall. Appendix Practicum Project Brainstorm Worksheet This worksheet must be completed prior to the first class meeting for NUR/590A. Identify a goal for the practicum project and more than one potential project idea. Practicum Goals: To perform in the role of nursing educator at the Orlando Veteran’s Administration (VA) Domiciliary (Rehabilitation) Program by assessing and identifying learning needs of nursing staff related to assessment of, and caring for, veterans with military-related post-traumatic stress disorder (PTSD). To develop, implement and evaluate a nursing educational program for nursing staff that will address these learning needs and hopefully improve quality of life for these veterans and their families. Description of Project Potential Mentor and AgencyDraft Objectives (completed in Week One class) Project Idea # 1 PowerPoint presentation and lecture Create a program to educate nursing staff to learn and understand how to care for veterans with PTSD at the rehabilitation center using classroom lecture with PowerPoint presentation for all shifts.Michele Reed, JD,MSN,RN Orlando VAMC-Conduct a review of literature to use evidence-based nursing practices -Design a teaching/learning plan using a PowerPoint presentation, handout and test -Implement the program to the nursing staff at the Rehabilitation Center -Evaluate the teaching/learning program and practicum experience Project Idea #2 Self-learning guide and test Create a program to educate nursing staff to learn and understand how to care for veterans with PTSD by developing a self-learning guide to PTSD care for veterans at the rehabilitation program.Michele Reed, JD,MSN,RN Orlando VAMC(Same as listed above)

The Korean War: Tactics and Logistics

The Second World War officially ended in the year 1945. It was a devastating war that many hoped that it should be fitting to end all wars and for a change give the world a breathing space, to be granted that very elusive peace. Yet, perhaps those who wished for a world in harmony after World War II may have underestimated mankind’s appetite of some leaders who wanted to be supreme rulers of the globe. So, five years after the guns were silenced in the Great Theater of war in Europe, another dangerous conflict is brewing in Korea. Here, one can see a display of things to come because Vietnam and Afghanistan are still future events.  In the Korean War the world became witness to what happens when superpowers decide to play chess. Unfortunately, this game is not played the traditional way with wooden pieces and all. This time the chessboard is the Korean Peninsula and the pieces are either the native Koreans or imported as in soldiers coming in from all over the world. It is interesting to note that this is not a World War in the truest sense of the term, but the true players are global leaders who happened to confine their violent resolution in a specific location, Korea. The United States, Russia, North and South Korea, United Kingdom, Canada, Australia and other Asian nations were participants in this war of attrition. The battle lines were drawn and it was named the 38th parallel. This allowed for a little bearing in a very confusing time, hoping to give a little bit of clarity in a very agitating situation. According to Carter Malkasian, â€Å"It was the only occasion in the Cold War when the military forces of the People’s Republic of China (PRC), the Soviet Union, and the USA (plus its Western allies) met in combat [†¦] Thus, the Korean War was not merely a war fought between proxies of the major powers, like the latter conflicts in Vietnam or Afghanistan, but a much more significant conflagration† (p. 7). This paper seeks to understand the Korean War. This can be done by looking at a brief historical background before the war and the events that added fuel to the tension between two Korean governments. Since the Korean War like many conflicts is so complicated this study focuses on tactics and logistics, and less on the historical figures that played a major role in this important period not only for Koreans but for Asians in particular and the world in general. Historical Background The Korean War was sometimes called the â€Å"Forgotten War† and this may be so because like Vietnam there are only a few people who understand its significance. Yet an â€Å"†¦outpouring of books, articles and film in the last decade as well as an impressive memorial on Washington, DC’s Mal (and the realization that) †¦it would be practically impossible to understand the Cold War†¦Ã¢â‚¬  have created a revival of interest on this subject (Sandler, p. 1).  The conflict in this area of the world does not surprise the experts and the grizzled veterans of war. In fact the professional soldier can easily read the undercurrent of history and be able to predict what will happen in the struggle for power and supremacy. This was eerily demonstrated by a seemingly prophetic Commodore Matthew Perry when he spoke these words in the year 1856, a century before the Korean War: The people of America will, in some form or other, extend their dominion and their power [†¦] upon the eastern shores of Asia. And I think too, that eastward and southward will her great Russian rival [†¦] The antagonistic exponents of freedom and absolutism must thus meet at last, and then will be fought that mighty battle on which the world will look with breathless interest; for on its issue will depend the freedom or the slavery of the world (as cited in Huston, p. 200). It boggles the mind of the average person when analyzing as to how Commodore Perry was able to ascertain his claims. What is more amazing is the accuracy of his predictions. It is like looking in a crystal ball and seeing very clearly what will happen. And indeed what Perry prophesied came to pass. Russia became a superpower and just like what the Commodore had said, the Russian government exerted tremendous influence over China. And of course his final statement about the necessity of a crucial war that will showcase the fight for freedom as opposed to absolutism was also played out just as he predicted. This can only mean that even before the first bullet crossed the 38th parallel, there are already forces at work even as far back as the late 19th century. Perry was able to read the signs and the saw the root cause of conflicts in this part of Asia. Yet it was only in the 1950s when the seed planted by those who wanted to control this region grew and blossomed into a passion that could only be satisfied with conquest. Blindsided Commodore Perry was praised here because of his foresight, a very important talent that a general should possess. If only the leaders of the free world in the 1950s were as gifted, then things would have turned out differently. But as fate would have it, from the U.S. and UN side was able anticipate what is going to happen. Either they were blindsided by the Communists or they were preoccupied by their paranoia. And that paranoia is brought about by the fear of being overrun by a westward move by the Union Soviet Socialist Republic. Stanley Sandler remarked on this and he wrote: A Soviet thrust into Western Europe seemed a far more threatening contingency than a possible dust-up between two unattractive regimes in a bleak former Japanese colony that most Americans could not find on a map. But Americans [†¦] would become acquainted with Korea in a war that would turn out be the third bloodiest in their history [†¦] and which for Koreans themselves would prove the greatest catastrophe in their national history (p. 2). First Blood It depends which side is asked. For the U.S. and UN Command, it was the North Koreans who drew first blood and attacked without warning nor any form of declaration of war. It seems that history is repeating itself once again for Americans just like in Pearl Harbor. But according to the communist-backed regime they were just retaliating from what the South has been doing for the past several months. The truth of the matter is that both sides were engaged in skirmishes that were serious prelude to war. Sandler asserts that it was an, â€Å"†¦armed conflict between the Democratic People’s Republic of North Korea and the Republic of South Korea, which had been conducting mutual border raids for more than a year† (p. 2).  At any rate the U.S. led forces were caught by surprise that fateful day of June 25, 1950. Even if they will deny it, it is now clear that the North were prepared to launch an attack and the offensive move was purely intentional. Buildup Kim Il Sung the de facto leader of the newly established North Korean Regime began to make plans to invade South Korea. This plan was of course made in secret but nevertheless in close coordination with Russia’s Stalin and China’s Mao Tse-tung. According to Allan Millett the origin of this plan can be traced back to a change in the policy of Kim Il Sung’s benefactor to communize the whole Korean Peninsula (p. 102). It seems that Russia is no longer contented with being kept in check by a ridiculous 38th parallel and would like very much to gobble the whole Korean Peninsula. â€Å"The Soviets, however, came to realize that the goal of communizing the entire peninsula could not be achieved through such limited tactics, and decided to resort to more violent means† (Millet, p. 102). In December of 1948 the Soviets made the first tactical move to befuddle the U.S. by withdrawing their troops unilaterally out of North Korea. Then the Russian government turned around and invited the top brass of North Korea and China’s military for a buildup. Millet bared that the troika agreed to â€Å"†¦build up the strength of the North Korea People’s Army (NKPA), around 6 shock divisions, 8 combat and 8 reserve divisions, and 2 armored divisions and to complete the war preparations within 18 months (i.e., by June 1950)† (p. 103). The NKPA was able to do all of these like clockwork revealing a tremendous level of preparedness and dangerous intent. Level of Preparedness While the NKPA was psychologically and physically prepared to engage in battle the ROK (Republic of Korea) army though prepared for future skirmishes and for another round of border raids was not truly ready for a full scale war. The South was not ready to face an enemy dead set in gobbling them up and desiring to unite the whole peninsula once again. It took at least five days after the initial offensive of NKPA for the U.S. to make a coherent response. â€Å"On June 30, US President Harry S. Truman authorized US ground forces to stop the North Korean attack† (Boose, p. 4). This led to losses in the early rounds of the fighting and led Boose to comment, â€Å"It was able to do little to delay the KPA, but additional forces were on the way† (p. 4). Aside from differing interests and the reasonably defective intelligence from the Western nations – or they would have known of an imminent attack – there is the psychological reason for being unprepared. Sandler made a comment why it was unlikely for the Korean Peninsula to be plunged into such a bloody conflict. And he wrote: In looking back (before World War II) †¦ it would be difficult to imagine a more homogeneous and united nation than Korea. [†¦] they are of the same culture with minor north-south variations throughout the peninsula, and the Korean language – Hangul – is universal. Korean cultural homogeneity can be illustrated in its place name, a source of confusion for non-Korean UN personnel throughout the war: Inchon/Ichon, Masan/Musan, Paengnyong/Pyongyan/Pyonggang Pyongchang, Taejon/Taechon, Pukchong/Pukchang†¦(p. 3). That and the eighteen month head start is creating a great advantage for the NKPA. In the end this advantage would create a stalemate and would result in the present division of Korea and the unexpected survival of this communist state even though its patron the great USSR had long been dismantled. NKPA Preparedness The North Korean and the communist forces were not only decisive and aggressive they were able to create a force enough to challenge U.S. and UN supremacy in the South. The book, â€Å"Communist Logistics in the Korean War† by Charles Shrader is an excellent source in getting an in-depth look at what happened on the other side. Too many times the victors or the presumed victors in the case of the Korean War are all too willing to gloss over their mistakes and hype their successes. The focal point of this book is the refutation of the myths perpetuated by the Americans and UN forces that were then passed on to people back home and unfortunately was taken in as gospel truth. Shrader asserts and this is quite a revelation: One of the more persistent myths of the Korean War is that North Korean and Chinese communist solders were able to subsist on a mere handful of rice per day obtained all their arms and ammunition from their enemies, and moved all supplies by animal cart or human porters. Although supply requirements of NKPA and CCF in Korea were amazingly low when compared to the requirements for equivalent UNC units, the Communist forces did generate substantial requirements for formal supply and transport forward of tremendous quantities of food, petroleum products, weapons, and ammunition (p. 89). The U.S. and UN led coalition were more technically advanced but this is not the most important thing in any given war. It is the level of preparedness that is important. That level of preparedness can only be gauged in relation to the environment where a battle will be waged. Let’s say for example that forces are slugging it out in a heavy-forested area with a very steep incline. No matter how sophisticated the military jeeps are, this kind of technology will be rendered effective. In another example where the passageway in a body of water is narrow and shallow no matter how technologically advanced the frigates are it would be foolish to attack using this route since one sunken vessel can immobilize the whole fleet. In other words tactics and logistics are the most important aspects to consider and not just technology. This is the bone of contention in Shrader’s books – the South Korean forces was wrong in thinking that they were technically superior. This led Shrader to remark that:  NKPA-CCF logistical doctrines and methods were characterized by flexibility and innovation, which allowed them to compensate for comparative lack of material resources and modern technology [†¦] NKPA and CCF logistical organizations were equally flexible and often exhibited great variation in form, strength, and equipment of the assigned service units (p. 25). What contributed well to the high level of preparedness by the NKPA – aside from the Soviet support of course – is the broad range of natural resources present in North Korea. This includes water, power, timber, rare strategic materials e.g. tungsten, zinc, graphite reserves, substantial iron ore deposits, copper, lead, cobalt, asbestos, molybdenum, nickel, gold and silver (Shrader, p. 60). This resulted to an almost miraculous surge in North Korea’s war time production of needed materiel that surpassed pre-1945 levels: 1) 166,000 tons of pig iron; 2) 144,000 tons of steel ingot; and 3) 116,000 tons of finished steel (Shrader, p. 61). Summing it all up the major source of military materiel came via USSR which supplied the NKPA with aircraft, tanks, vehicles, communications equipment, heavy artillery, and ammunition. In addition to that, a portion of their needs were supplied by third country suppliers (Shrader, p. 60).  Thus when the communist forces launched the initial attack in June of 1950 their combined forces produced the following massive force in the eve of the attack:  Ã¢â‚¬ ¦135,000 men in two corps comprising eight full-strength infantry divisions, two half-strength infantry divisions, an armored brigade, an independent infantry regiment, a motorcycle reconnaissance regiment, and five brigades of the Bo An Dae, or Border Constabulary (Shrader, p. 90). What is more amazing is the development of the NKPA forces after the 1950s. After suffering setbacks from the retaliatory attacks of the UN command, the NKPA in the middle of 1951 the â€Å"rebuild NKPA included 213,600 men in twenty-three infantry divisions, one mechanized division, one armored division, and two independent infantry brigades controlled by seven corps headquarters. NKPA strength peaked in October 1952 at around 266,000 men in eighteen divisions and six independent brigades† (Shrader, p. 90). If this was not enough to give the South Koreans and its allies a full plate, the Chinese and the Soviets entered the fray in the guise of helping a beleaguered brother-in-arms. The forces supplied by the People’s Republic of China was more than enough to bring this regional level conflict into World War scale. The following data proves the serious intent of the communist bloc: By late November 1950 some 300,000 Chines Communist troops were in Korea: 180,000 in the six armies (eighteen divisions) of the XIIIth Army Group [†¦] 120,000 in the three armies (twelve divisions) of the IXth Army Group [†¦] on 1 July 1952, fify-one CCF divisions with some 540, 200 men manned the line across Korea from the west coast to the central Taebaek Range and were supported by about 10,000 Soviet and Soviet-bloc advisors and technicians (Shrader, p.90).  This is the extent of the level of North Korea’s preparedness and a sample of their resolve to win this war. ROK Preparedness Stanley Sandler in a few words was able to encapsulate the true state of South Korea’s forces before the attack by saying that June 25, 1950 was a Sunday and that fully one-half of the ROK Army was on leave (p. 48).  In the initial stage of the attack which was not at all done quietly and with any subtlety: heavy bombardment, followed by a blitzkrieg attack of some 150 Soviet-built T-34-85, 110 warplanes and a crossing of the 38th Parallel by a rampaging Korean People’s Army. Still there was an awfully delayed reaction to the events at hand. Sandler explained the reason for such a weak response due to the aforementioned soldiers who were on leave, the high number of civilian leaders who were out of the country and the mistaken notion that what just occurred was another border raid.  With regards to the presence of U.S. troops, Gordon Rottman lamented that fact that it was such in great shape a mere five years before the conflict and would have come handy in a time like this. But Rottman revealed that the U.S. government intentionally reduced its military strength not only in Korea but also in the Far East. Rottman comments on the closest source for help which are the forces stationed in Japan and he wrote: Tank companies stationed in Japan had only M24 light tanks as Japanese roads and bridges could not support heavier M4A3 and M26 tanks. M24s were no match for North Korean T-34s, one of the best tanks to appear in World War II. The divisions in Japan also lacked their reconnaissance, military police, and replacement companies [†¦] These divisions consisted of 12,500 to 13,600 troops rather than the full-strength 18,804 (p. 3). At first glance, South Korea does not stand a chance against the forces of Communism. Ironically, the same benefactor who gave NKPA a tactical and logistical advantage (USSR) became the source of their demise. Sensing that the North/South conflict is just a prelude for something bigger Russia’s enemies were banded together for a common cause, which is to prevent the USSR and Communism from expanding worldwide. This resulted in a pledge of commitment to provide support in a scale reminiscent of Word War II. When the NKPA was not able to achieve total victory, this gave the U.S. and UN led coalition to regroup and pose a decent defense of South Korea. Rottman expounded on this idea by saying that: The Korean War was to be the UN’s first commitment of armed forces to conduct and end a war [†¦] the UN called on all member nations to support the military effort in Korea. Fifty-three countries approved of armed action against North Korea: 15 committed ground combat forces, nine provided naval forces, six sent air force elements, and five contributed medical support, either military or civilian (p. 117). Bright Spot In general there is nothing that U.S. armed forces could be proud of in the Korean War. There was really no clear victor, no territory was gained and as mentioned earlier it was the third bloodiest in the history of war where casualties are at a significant high.  The only good thing that could be seen or learned from this incident is the demonstration of what bravery and commitment can do to an organization. Here one can also see the difference between a regular soldier in the U.S. Army as opposed to the brave and the few of the U.S. Marine Corp. Hugh Deane quoted Andrew Greer when describing the essence of being a marine, â€Å"In any small unit battle the outstanding behavior of a few men is always discernible over the others [†¦] The scale is tipped by a few – by the ten percent – who rise to the heights where the enemy and death can be met without a hesitant step† (p. 97). British historian Max Hastings remarked, â€Å"Most of the Eight Army fell apart as a fighting force in a fashion resembling the collapse of the French in 1940, the British in Singapore in 1942. But he reported the praiseworthy strong resistance of the U.S. Marines in the northeast† (as cited in Deane, p. 111). A particular example was raised by Deane when he commented on the enemy’s attack tactics that looked like suicide attempts characterized by sending small units that more often than not gets wiped out. This is followed by wave after wave of such small unit attacks against a selected point until a breakthrough is achieved and here comes the main force. This was effective in demoralizing troops. But according to Deane this would not work against the marines. â€Å"†¦but against the marines in the Northeast the results were often frustrating. The marines constructed strongly fortified outposts in the hilly-forested Chosin area and defended them fiercely with a good deal of success (p. 129). Conclusion Almost all wars are considered a waste of time, money, effort and lives of men. The Korean War was no exception. Considering the following statistics makes one shake hid head over the folly of war:  The North Korean armed forces lost approximately 600,000 men in the fighting, in addition to two million civilian casualties. The Chinese [†¦] an estimated 1 million casualties. Losses to the ROK are estimated at 70,000 killed, 150,000 wounded and 80,000 captured. One million South Korean civilians were killed or injured. The USA lost 33,600 men kiled nad 103,200 wounded (Malkasian, p. 88). What adds insult to injury is the futility of not having a clear victor, no territories were gained and nothing significant was achieved except perhaps for a few lessons in the book of tactics. The level of preparedness of both camps explained the reason for the stalemate. The South Korea side was backed up by a technologically superior U.S. and UN led coalition but it was not mentally prepared to wage this war. Almost every action done on the part of South Korea was mostly reactionary and defensive. Most importantly, the United States was treading on thin ice since a miscalculation and overkill can easily escalate the regional conflict into a global war. With the Second World War fresh from people’s minds there is no incentive to go full force. Although the NKPA was well prepared and very much flexible in their serious bid to unite the Korean Peninsula it does not have the technological edge to overpower the U.S. and UN forces. On a more important note, the attack on South Korea was a supposed to be a defensive act. Therefor the USSR could not be seen as fully involved and thus it can only work from the background.  That sums up the futility of this exercise but nevertheless it is a good prelude to understand the Cold War and the other similar conflicts that came after it like Vietnam and Afghanistan. References Deane, H. (1999). The Korean War. San Francisco, CA: China Books and Periodicals, Inc. Huston, J. A. (1988). Outposts and Allies: U.S. Army Logistics in the Cold War. New Jersey: Associated University Press. Malkasian, C. (2001). The Korean War. University Park, IL.: Osprey Publishing. Shrader, C. (1995). Communist Logistics in the Korean War. Westport, CT: Greenwood Press. Millet, A. R. (1997). The Korean War. Seoul: Korea Institute of Military History. Sandler, S. (1999). The Korean War: No Victors, No Vanquished. Kentucky: University of Kentucky Press. Rottman, G. (2002). Korean War Order of Battle. Westport, CT: Praeger Publishers.