Healthcare Reforms Essay Example | Topics and Well Written Essays - 1000 words

Healthcare Reforms - Essay Example e services available to customers; and to cut the healthcare costs (Kronenfeld & Kronenfeld, 2004). The Obama administration has introduced a range of far-reaching reforms of the healthcare system, the most comprehensive since the adoption of the Medicare act in 1965 (Parks, 2011). This paper will review these health care reforms since health care reforms would be beneficial by reducing the overall price per family requirement and medical treatment delivered. Having these basic necessities available would make living in this country easier on the mind as well as the wallet. Having the ability to use the hospital’s resources in a time of need is a common resource not readily available to all Americans.The combined public-private healthcare scheme that was in existent before the healthcare reforms of 2010 was one of the costliest systems globally, with the costs of health care being the highest per individual as compared to any other country (Parks, 2011). Besides, United States comes second, after East Timor, in terms of the percentage of gross domestic product (GDP) that is used on healthcare among the member countries of the United Nations (Parks, 2011). An independent research on global patterns of spending on health care indicates that United States uses more than any other member state in the Organization for Economic Co-operation and Development (OECD) (Williams, 2011). Regardless of the massive spending, the research indicates that usage of health care servicesis lower thanthe OECD standards by most indicators. In addition, the findings show that costs incurred by individuals for various health care services are appreciably greater in the US (Williams, 2011). Therefore, these healthcare reforms are a relief to most American families as they will have access to more affordable health care resources and services whenever they need them. For instance, they introducecost-free preventative services, prohibition of insurance companies from barring person s with pre-existing conditions from getting their policies among many other comprehensive benefits to citizens (Williams, 2011). Opponents of these reforms argue thatincreasing the hospital’s resources to the general public at a no-cost rate would spark greed. They suggest that these patients and hospitals alike would disregard the cost and expect the government to front the bill. However, this is not true; the fact is these reforms do not make the system a single-payer scheme in which the state has total control over the health care. The changes would still retain the private insurance system (Parks, 2011). The reforms are only intensifying government’s regulation over health care insurance providers. Besides, an alternative for a public insurance scheme, administered in a similar manner to Medicare, brings in additionalstatefinancing into health care and willchange the market whilstchallengingthe private insurers in an exchange (Parks, 2011). The fact is that a publi c schemeincreases the government’s regulation but it is not a takeover of system. Health care reform

Economy assignment ( apply econmoinc rational for health services) Essay

Economy assignment ( apply econmoinc rational for health services) - Essay Example Empowering the public through provision of goods includes provisions for vaccines and other preventive tools that the public can use, independently or with the help of care personnel, to reduce chances of infections. Similarly, the government can employ services to educate the public on possible self-base care that reduces prevalence of disease and infections towards a healthy society. All these initiatives involve economic concepts of generation of goods and services, their transfer and a final application to ensure achievement of healthcare goals. The most applicable economic tools that identify significance of the government’s role and how such a role should be played are scarcity of resources, and monopoly as a market structure (Folland, Goodman and Stano, 2012). Scarcity that defines limited supply of resources relative to demand is a universal factor among resources. The sensitivity of healthcare however demands that such a scarcity be overcome by ensuring that necessary resources are put in place for a healthy society. Consequently, the government should use its capacity to ensure availability of resources for healthcare preventive measures, resources that would otherwise be very scarce if left in the hands of the private sector. The necessary goods and services for educating and empowering the public would therefore be expensive due to market forces of demand and supply. The scarcity of healthcare resources and necessity of such needs therefore demands that the government provides the required goods and services, directly or indirectly, to ensure that the resources are available and are affordable for preventive measures (Folland, Goodman and Stano, 2012). Even though monopoly ensures quality, the lack of competition may lead to delays in supply. As a result, the government should promote a competitive market for the supply of intellectual services and goods for

What is Truth Essay Example for Free

What is Truth Essay Abstract â€Å"All truths are easy to understand once they are discovered; the point is to discover them. † Truth is education, but a person could never find the truth without being enlightened. The truth is the easiest thing to find, but many people do not care to find it. Most are more comfortable with the truth or afraid of what actually might be true. However, if they would just be optimistic and fearless they might actually experience and learn more. Anyone can find, learn, and appreciate almost anything that can be taught. And when a person can truly experience any one thing they become enlightened. Not only can this person share his experience but he can also spread the knowledge of what he had learned. Sometimes it is important to examine all possibilities because the amount you can learn can have huge impact on your life. In Mark Twain’s â€Å"Advice to Youths† and Plato’s â€Å"The Allegory of the Caves,† both authors portray that enlightening and experiencing are the two most important aspects of finding the truth. The Truth is in the Knowledge First of all, as a child, you can find more truths simply just listening to your parents then you could if you just ignore them. The amount of respect and trust you show your parents is directly related to the amount of freedoms and trust they give back to a child. The more a child can show they can listen and learn the more their parents enable them to broaden their experiences. [In Advice to Youth, Twain states, â€Å"Most parents think they know better than you do, and you can generally make more by humoring them that superstition then you can by acting on your own judgment †] Just because you do what your parents tell you, doesn’t mean you need to believe what they’re saying. Just watch your mouth while listening, and still form your opinion down the road. That way your parents will be happy, and still think they know more. While you can still be enlightened more later on down the road. Only one thing can even compare in importance to the truth, and that is a lie. Everyone sees lying as a bad thing, but it is a very important part of life. Every aspect of lie is important; they all have an impact on the outcome in the end. [In Advice to Youth, Twain says, â€Å"Now as to the matter of lying. You want to be very careful about lying; otherwise you’re nearly sure to get caught. †] Once someone catches you in a lie; your relationship changes for the rest of your life. Some might have the tolerance to forgive but they still will have lost faith in you as person. That is why Mark Twain is saying how important lying is in finding the truth in life. You must experience both sides of lies, and learn from them. You never know what a lie might cost you. A person can have a horrible experience the worst time in their life, but as long as they pick themselves up and learn from it; one achieves the best possible outcome from their situation. When someone is down it is pretty hard to cheer them up. You should help them realize they built character and knowledge from it, and the result is a stronger person. [In The Allegory of the Cave, Plato writes, â€Å"Build your character thoughtfully and painstakingly upon these precepts, and by and by, when you have got it built, you will be surprised and gratified to see how nicely and sharply it resembles everyone else’s. †] Sometimes a person cannot help what happens in their life. That is why a lot of people look at you differently as person after you react to controversy. Some would go as far as saying that helps build character and also shows toughness. The more a person is able to experience in life; the more enlightened and knowledgeable they become. First hand experiences are the easiest, and more often than not, the most effective way to educate. There is no better way to start building memory then hands on activities with whichever subject you want to learn about. [Plato also states, â€Å"Last of all he will be able to see the sun and not mere reflections of him in the water, but he will see him in the water, but he will see him in his own proper place, and not another; and he will contemplate him as he is. †] You cannot send someone out to do a job they’ve never done before. You will end up with a mess, which is why experience is just as important as learning anything. It is also why experiencing is just as important to truth as anything else. In closing, both Twain and Plato were saying that you need to learn if you want to find the truth about anything. And when they mean learn they are talking about every single thing around someone. You can simply enjoy life more by broadening skills and learning about things near and far. It is more important to find the truth rather than being scared or avoiding it. The truth can be something bad but you’ll never come out on the positive end of it if you don’t learn from it. Not everything is wrong just because everyone says that it is. A person needs to experience to find the truth and form their own opinion.

Medical Aspects Of Disaster Management Health And Social Care Essay

Medical Aspects Of Disaster Management Health And Social Care Essay On December 26, 2004, a violent earthquake measuring 9 on the Richter scale struck off the western coast of northern Sumatra. It initiated several tsunamis (tidal waves) that took more than 200,000 lives. It was the deadliest natural disaster in the past quarter of a century. But as horrible as it was, it was but a ripple compared to some quakes in recorded history. In 1556, an earthquake in China took the lives of 830,000 people. In India, an earthquake in 1737 killed 300,000. Almost thirty years ago (1976), a massive quake in China left 655,000 dead. The Sumatra quake, which scientists have measured with modern instruments, was so powerful that it is believed to have moved some islands about 50 feet. In addition, seismologists think that it wobbled the earth on its axis, accelerating the rotation speed, thus shortening the length of our day by fractions of a second which is remarkable in view of the planets precision movements. The 2011 earthquake off the Pacific coast of TÃ…Â hoku (TÃ…Â hoku-chihÃ…Â  TaiheiyÃ…Â  Oki Jishin), often referred to in Japan as Higashi nihon daishin-sai was one of the five most powerful earthquakes in the world since modern record-keeping began in 1900.The earthquake triggered powerful tsunami waves that reached heights of up to 40.5 metres. The earthquake moved Honshu (the main island of Japan) 2.4 m east and shifted the Earth on its axis by estimates of between 10 cm and 25 cm. This earthquake claimed 15,878 lives, left 6,126 injured, and 2,713 people missing . The earthquake and tsunami also caused extensive and severe structural damage in north-eastern Japan . Japanese Prime Minister Naoto Kan said, In the 65 years after the end of World War II, this is the toughest and the most difficult crisis for Japan. Around 4.4 million households in northeastern Japan were left without electricity and 1.5 million without water. The tsunami caused nuclear accidents, p rimarily the level 7 meltdowns at three reactors in the Fukushima Daiichi Nuclear Power Plant complex, and the associated evacuation zones affecting hundreds of thousands of residents. The World Banks estimated economic cost was US$235 billion, making it the most costly natural disaster in world history. Besides these, there have been the super cyclone in Orissa, earthquakes in Latur and Gujarat all of which have caused massive loss of life, distress, discomfort, disease and disability. Inspite of all this, we still await the so called Diego Maradonnas Hand of God to bail us out of each natural crisis causing incident. DISASTER STATISTICS In the past fifty years more than 10000 natural disasters have been reported, more than five billion people have been affected, more than twelve million persons have been killed and the economic costs have been greater than US dollars four trillion. In India during the period 1990 to 2006 more than 23000 lives have been lost in six major earthquakes(Uttarkasi, 1991;Latur,1993;Jabalpur,1997; Chamoli,1999;Bhuj,2001;JK ,2005.) Enormous damage has been caused to property and public infrastructure. The twin super-cyclones that hit Orissa in Oct 1999 affected 24 Districts, 219 blocks and 18790 villages resulting in loss of 8495human lives, 450,000 lives of cattle and damaging two million homes and 23000 schools. The Bhuj earthquake was a terrible human tragedy in which13,805 lives were lost that included 1031 school children and around 167,000 persons suffered multiple injuries This was in the wake of two consecutive years of drought. Disaster defined At the cost of repetition in the text it is important for us to understand and comprehend the term disaster. Disaster is a term very often figuratively used in day to day parlance. For instance, if, as professionals, you are making a presentation on some of your work which you highly value and the response of the audience is not exactly as per your expectations despite your utilizing all available resources, you would generally refer to such a presentation as being a disaster. Thus disaster is an unexpected event in which there is a sudden and massive disproportion between the hostile elements of any kind and the survival resources that are available to counterbalance these in the shortest period of time. There is no generally accepted definition of disasters. A study by Debacker found greater than 100 definitions of disaster. The variations occurred with professional role. The commonalities in all definitions are that disaster is a sudden and an extraordinary event wherein the deman d for health care resources is greater than those that can be supplied, where outside help and resources are needed and which causes disruption of infrastructure, loss of life, material damage and distress. In short disaster is an event where the response needed is greater than the response available. One of the more professional definitions of disaster (Humberside County Council UK) would read as under:- Disaster is a major incident arising with little or no warning causing or threatening death or serious injury to or rendering homeless, such numbers of persons in excess of those which can be dealt with by the public services operating under normal procedures and which calls for the special mobilization and organization of these services. Natural Disasters As we are deliberating on natural disasters, it may be worthwhile bringing out the fact that the Indian subcontinent is amongst the worlds most disaster prone areas with approximately 60 % of land mass is prone to earthquakes of moderate to high intensity, 8% of land vulnerable to cyclones, 12% of land mass is vulnerable to floods and 68% of cultivable area is prone to drought. The hilly areas are constantly at risk from landslides and avalanches and flash floods. With its vast territory, large population and unique geoclimatic conditions, the Indian subcontinent is exposed to natural calamities and catastrophies. While the vulnerability varies from region to region, a large part of the country is exposed to natural hazards which often turn into disasters causing significant disruption of socio-economic life of communities and to loss of life and property. For the ease of understanding Natural disasters could be classified as depicted in the Figure. Classification of Natural Disasters (a) Natural phenomenon beneath the earths surface  Ã‚ ¬Earthquakes including Tsunamis  Ã‚ ¬Volcanic Eruptions (b) Natural phenomenon at the earths surface  Ã‚ ¬Landslides  Ã‚ ¬Avalanche (c) Meteorological/hydrological phenomenon  Ã‚ ¬Cyclones  Ã‚ ¬Typhoons  Ã‚ ¬Hurricanes  Ã‚ ¬Tornados  Ã‚ ¬Hailstorms  Ã‚ ¬Sandstorms  Ã‚ ¬Floods  Ã‚ ¬Sea-surge  Ã‚ ¬Droughts Characteristics of Disasters Before we proceed any further let us briefly enumerate the characteristic features of a disaster since these will help us subsequently in formulating an appropriate disaster management strategy. The overwhelming characteristic features of a natural or any other type of disaster are:- (a) Suddenness of Occurrence. (b) Vastness of Damage. (c) Loss of Life and Property. (d) Disruption of Communication. (e) Panic and Anxiety. First Day First Person Ground Zero Report From Military Hospital Bhuj GS Sandhu Masses of humanity, crushed and mutilated limbs dangling, heads split open, shattered bones, and people coming in endless streams, tugging at the doctors sleeves to leave the patients they were attending to come and see their near and dear ones, crying, sobbing, screaming. This is the lasting impression of 26th January 2001 which I will carry with me for the rest of my life.- Extract of authors interview in Indian Express dated 8th February 2001. 1. Though the Kutch district of Gujarat is located in Seismic zone V, there was a general lack of awareness of the seismic risk and its implications among all sections of the society. The earthquake struck without warning at 0846 hrs on 26 Jan 2001. The epicenter was located 30 km north-east of Bhuj and measured 6.9 on the Richter scale. The impact was sudden and devastating. The local community was overwhelmed by the magnitude of the disaster and its resources rendered non-functional. 2. Military Hospital Bhuj is a small peripheral hospital, providing medical cover in the basic specialties. In the aftermath of the earthquake, this hospital acted as the first and sole responder, despite having suffered severe structural damage and its personnel and their families also being victims of the natural calamity. The principal task was to ensure operational readiness of the hospital for mass casualty management. A number of concurrent activities were initiated. Multiple reception, triage and resuscitation stations were set up. Indoor patients were moved out because of recurring aftershocks. Salvage of equipment and stores from collapsed buildings was commenced. An improvised surgical zone with makeshift operation tables was set up on hard standing. Pre and post operative areas were marked adjacent to this zone. Patient holding and evacuation areas were demarcated. Doctors from the town came to help in looking after the sea of injured humanity pouring into this sole medica l facility functioning in the disaster zone. The local army formation provided generator sets, water tankers, tents and personnel for crowd control. 3. A simple standardized patient management protocol adapted to the locally available resources and skills was devised. The aim of this protocol was to standardize treatment, save lives, prevent major secondary complications and prepare casualties to withstand evacuation to hospitals outside the disaster zone. Graded assessment was carried out, to cope with the sudden massive influx of casualties. Paramedical personnel did the initial assessment by grading the casualties into major and minor injuries. All patients with major injuries were resuscitated with IV fluids and exhibited antibiotics and parenteral Diclofenac analgesia. The physician and medical officers carried out airway management. The gynaecologist, who was also the administrative leader of the team, triaged the patients into those whose injuries could be handled locally and those who would require definitive management at specialized facilities. The final decision as to the salvage of limbs was performed by the surgeons at the operating table itself. 4. An idea of the difficult circumstances in which this emergency humanitarian action was executed can be gauged by the following situation in the immediate aftermath of the earthquake a) Collapse of the civil command and control structure in face of the magnitude of the disaster b) Structural damage to Military Hospital Bhuj c) Suboptimal / Inadequate surgical conditions d) Lack of communications e) Lack of water and electricity supply 5. Despite these constraints approximately 3000 casualties were handled at MH Bhuj before the first relief teams arrived around 2300 hrs on 26 Jan 2001. The problems encountered in handling casualties in these large numbers related to a) Crowd control b) Documentation c) Shortages of essential supplies d) Biomedical waste disposal e) Monitoring of the seriously injured f) Disposal of dead bodies g) Evacuation to specialized facilities 6. No country or community can be fully prepared to deal with sudden impact disasters. During the first few hours or even days, the affected community is isolated and must cope up the best it can. In a disaster situation the functions of the armed forces closely parallel those of the emergency services. The armed forces are trained to develop quick response capabilities. Their management and administrative systems function in a self contained, self sufficient and coordinated manner. The armed forces medical services have contingency plans and training to cater to mass casualty management. These capabilities allowed a small peripheral hospital to act as a sole responder to a disaster of overwhelming magnitude. The author was commanding the military hospital at Bhuj, Gujarat on 26th January 2001 Medical Role and Organization As we can see the management of natural disasters involves a host of disciplines working together to combat the ills and adverse effects of the disaster incident .This text will, however, be restricted to the medical role and organization during disaster incidences. This, however, in no way, is meant to malign the importance of other public services and agencies which are equally essential and play a vital role in the management of natural disasters. In fact these agencies contribute immensely towards successful and effective implementation of any disaster management strategy and are complementary to the efforts of the medical organization. The medical role will depend upon :- (a) Nature of the Disaster (b) Medical organisation set up for combating the natural disaster (c) The degree of involvement of the elements of the medical organisation in the Disaster incidence ie whether a hospital providing relief and rescue assistance is involved or not involved in the disaster situation The primary element of any health care delivery system that comes into operation during a natural disaster is the hospital. The role of a hospital will vary, depending upon the prevailing scenario :- (a) The hospital itself is not involved in the disaster. (b) The hospital is directly involved in the disaster. (c) The hospital is indirectly involved in the disaster. (d) The disaster affects the hospital only. In case the hospital is not itself involved in the disaster situation it can be geared up fully to meet the demands of such an eventuality. In case the hospital is directly affected by the disaster situation it will then be affected in the same manner as the general population and will then have to reorganize itself to provide medical aid not only to the community but also its own inmates and staff. In situations where the hospital is indirectly affected by disruption in some of its facilities and services like water and electricity supply, communication facility it will have to appropriately modify its own plan of action. These aspects have to be built into the disaster plan of the hospital. Aims and Objectives of Medical Role and Organisation During Natural Disasters The aim of any medical organisation during a natural disaster is to provide prompt and effective medical care to the largest number of people needing that care in order to bring about early recovery and reduce the death and disability associated with the disaster incident. A paradigm shift is needed from traditional approach to a casualty under normal circumstances. The approach has to shift from the traditional ALL FOR ONE to ONE FOR ALL. The primary objectives of the medical organisation during natural disasters are :- (a) To prepare the staff and institutional resources for optimal performance in an emergency situation of certain magnitude. (b) To make the community and other counter disaster agencies aware of the capabilities, execution and benefits of the medical disaster plans. (c) To establish security, traffic control and public information arrangements. The medical role during a disaster incident includes (a) Sending Mobile Medical Teams / Quick Reaction Medical Teams / First aid teams to the site of the disaster. (b) Providing First Aid and Basic Life Support at the site of the incidence (Pre hospital stabilization) (c) Sorting out the afflicted victims into priorities for evacuation (Triage) (d) Safe and Speedy transportation from the site of incidence to the location of providing definitive care. (e) Providing Advance Life Support and definitive care at the hospitals (f) Provisioning of Rehabilitation Services to the affected individuals (g) Care of the dead and moribund individuals. (h) Prevention of Epidemics and other related health hazards (Environmental health management). (j) Epidemiological and Health-surveillance efforts (k) Setting up Communication Centres for providing relevant information to the public, community and other agencies. To carry out the above roles to perfection at the time of a disaster event it is mandatory that all concerned in the medical organization must be aware of their roles and responsibilities. Thus arises the necessity of having a well designed and integrated Disaster Plan. Failure to Plan is Planning to Fail when the event actually happens. Planning provides the opportunity to network and engage all participants prior to the event. It provides the opportunity to resolve issues outside of the heat of the battle. Experience tells us that thinking about and planning for disasters is not as painful as having to explain why we didnt. Principles of Natural Disaster Plan of a Medical Organisation The basic principles which form the template of a Natural Disaster Plan are :- (a) Simplicity It should be simple and operationally functional (b) Flexibility It should be executable for various forms and dimensions of different disasters (c) Clarity It should lay down a clear definition of authority and responsibilities and not use too many technical jargons (d) Concise It should be suitable for the type of hospital and not be so voluminous that nobody will read it (e) Adaptability Although the plan is intended to provide standardized procedures, it should have an inherent scope for adaptability to different situations that can emerge during disasters (f) Extension of normal hospital working It should be made in such a way that the plan merges with the normal functioning of the hospital (g) Practiced Regularly to make it work and to recognize and reduce and eliminate the shortcomings. (h) Permanent and periodically updated based upon the experiences gained from rehearsals and disaster situations faced (j) A part of a Regional Disaster Plan. The key issues involved in any disaster plan are Preplanning, Communications, Co-ordination, Training and Regular practice. Without these elements no amount of technical skills and modern technology can mitigate the sufferings of disaster victims. Pre-requisites for Disaster Planning There are certain pre -requisites that require to be deliberated before planning for and managing disaster events. These are briefly described as under :- (a) Hazard / Vulnerability Analysis: This is based on past experiences and the vulnerability status of the localities that are within the ambit of the administrative and clinical jurisdiction of the health care facility. For example if an area is prone to earthquakes it is important that the hospital building is earthquake proof and the Disaster Plan of the hospital is able to cater to the rescue and relief of the victims of the earthquake. It is also important to remember that Earthquakes, Accidents dont come with prior notice but Floods, Cyclones do. Pre disaster preparedness in later case can prove to be very useful. (b) The Role, Responsibilities and Work relationships amongst all the staff of the health care institution must be clarified. (c) Hospital Capability Analysis: It is also essential to be familiar with the hospital treatment capacity should mass casualties suddenly arrive without adequate prior notice. Generally as a thumb rule the Hospital Treatment Capacity is 3% of total Hospital Beds whereas the Hospital Surgical Capacity in an eight hourly shift can roughly be calculated as under:- No. of operating rooms x 7 x 0.25 (d) Hospital Community cooperation in Disaster Planning: This is also an essential precondition and the outside support must be kept on alert and must be signalled to move at appropriate time to be in position in affected area immediately before the arrival of the casualties. Who Should Make the Hospital Disaster Plan? This is the next obvious question as to who should be responsible for making a hospital disaster plan. More often than not it is felt that this is the responsibility of the Hospital Administrators only. Well, the hospital administrators do play a major role in framing, coordinating, rehearsing and implementing the disaster plan but no single individual can effectively make the disaster plan of any health care set up since making the plan is a multidisciplinary affair and all disciplines should be involved in framing a plan for the implementation and success of which they are ultimately responsible. Herein lies the importance of constituting the Hospital Disaster Management Committee (HDMC). The Suggested Membership of this committee is as under :- (a) Director/Executive Head of the Hospital. (b) Departmental Heads. (c) Nursing Supdt./CNO/SNO (d) Hospital Administrator (e) O I/C Casualty Services. (f) Maintenance and Engineering Staff. (g) Staff Representative. (h) Representatives from other support services and utility services as required. Functions of HDMC It has been commonly said that sitting on a committee is like sitting on a WC. One makes a lot of noise and ultimately drops the entire matter. Well, the function of HDMC goes much beyond this saying. For this committee to function effectively, its role and responsibilities and terms of reference must be clearly laid down. Broadly the role of HDMC is :- (a) To develop the Hospital Disaster Plan. (b) To develop Departmental Plans in support of the Hospital Plan. (c) To plan Allocation of Resources. (d) To allocate duties to Hospital Staff. (e) To establish standards for emergency care. (f) To conduct and supervise Training Programme. (g) To supervise Drill to Test the Hospital Plan. (h) To review and revise the Disaster Plan at regular intervals. Components of Hospital Disaster Plan The various components of a well thought out disaster plan are enumerated below. These components will vary from one health care institution to other depending upon the capability and capacity as well as the hazard and vulnerability analysis. Notwithstanding this, the components should focus on the following aspects (a) Efficient system of Alert and Staff assignments. (b) Unified Medical Command. (c) Mobilisation of Resources (i) Medical Nursing, Administrative Staff. (ii) Medical Stores Supply and Equipment. (iii) Conversion of useable space into clearly defined areas for Reception, Triage observations and immediate care. (d) Procedure for prompt movement of patients within the hospital. (e) Procedures for discharge/referral/transfer of patients including transportation. (f) Prior establishment of Public Information Centre. (g) Security arrangements for inpatients, casualties, property of patients and the hospital etc. (h) Evaluation of Hospital Autonomy in terms of water, electricity, food and medical supplies including gases. (j) OT utilization planning. (k) Planning for X-ray, Lab and Blood Bank. The HDMC is required to prepare a disaster manual which should be crisp, easily understood by all and should contain the details of the mode of execution of the Disaster Plan. The hospital disaster manual is a written statement of the disaster plan which is required to be activated during any type of disaster and is divided into five sections which though not sacrosanct and can be modified according to the needs and requirements but they form the template on which the hospital disaster plan can be prepared and executed. A prototype of the template is given below Section I :- Introduction (a) Disaster Alert Code. (b) General Principles of conduct. (c) Brief synopsis of total plan. Section-II :- Distribution of Responsibilities (a) Requirement and responsibilities of individuals and departments. (b) Action cards. Section-III :- Chronological Action Plan (a) Initial Alert. (b) Activate hospital Disaster Plan. (i) Notify key personnel. (ii) Activate key Depts. (iii) Give details of Resource Mobilisation. (iv) Pre-arranged wards/areas for casualties. (c) Formation of a command nucleus (i) Preferably near the casualty reception. (ii) Define roles of hospital controller. (iii) Senior Nursing Officer, Hospital Admin (iv) Clinical Principles of Management of Casualties. (v) Reception. (vi) Triage (vii) Admission of Patients. (viii) Utilization of supportive services. (ix) Principles of treatment of casualties.  Ã‚ ¬Basic Life Support  Ã‚ ¬Advance Life Support  Ã‚ ¬Definitive Treatment (d) Specific problems of Disaster Management. (i) Clinical Problems.  Ã‚ ¬Less, serious patients report first.  Ã‚ ¬Contaminated casualties. (ii) Administrative Problems.  Ã‚ ¬Documentation.  Ã‚ ¬Police Documentation Team.  Ã‚ ¬Communication.  Ã‚ ¬Friends and Relatives.  Ã‚ ¬Crowd control  ® Convergence   Ã‚  effect.  Ã‚ ¬Voluntary workers.  Ã‚ ¬Patients Property.  Ã‚ ¬Press and Media.  Ã‚ ¬Disposal of Dead. Section IV :- Check List Of Personnel And Items. (a) Designation of overall medical authority. (b) Establishment of communication network. (c) Notification rosters. (d) Triage centre with Triage Officer. (e) Personnel Assignments. (f) Designation of medical teams areas of operations. (g) Routes of disposal. (h) Criteria for patient categorization. (i) Rapid documentation cards (j) Security arrangements. (k) Plans for logistics and supplies. (l) Records. (m)Evacuation system. (n) Information booth / Help desk Section V :- Repeated Rehearsals. (a) To train (b) To test performance (c) To correct weaknesses and deviations. A brief explanation of the aforementioned template is given in the subsequent paragraphs for the ease of understanding Introduction The introduction should include disaster alert code, general principles of conduct and brief synopsis of total plan. When the alert is given all personnel must report to duty and takeover their assigned jobs. A sample synopsis is placed at the end of this chapter. Distribution of Responsibilities (a) Authority and Command Nucleus : A small disaster management committee consisting of (i) Executive Head of the hospital (ii) District Health Officer/Civil Surgeon (iii) Professor of Medicine/Surgery/Officer In Charge Accident and Emergency Services (iv) Matron (b) Action Cards : The duties of each individual and dept are clearly indicated on a Action Card. These cards describe in details the responsibilities and the actions to be taken by each and every member of hospital staff starting from hospital administration to stretcher bearers and ward boys. Action card can be carried at all times and/or kept at command centre. If the designated individual proceeds on leave / out of station, then it should be the responsibility of the stand in individual to be aware of his role as per the action card. Chronological Action Plan For efficient and effective implementation during a disaster episode the action plan must be listed in chronological order. The salient features of the Action Plan are briefly explained below (a) Initial Alert : (i) Source of Alert (aa) Accident and Emergency department itself (ab) Through telephones or (ac) Through authorities like police etc. (ii) Action to be undertaken. On receipt of information, the concerned person must gather information regarding the place, time and type of disaster incident , the estimated number and type of casualties and the source of communication. He should also have a callback number if possible to remain in constant contact with the reporting personnel. This would help in determining the time available to prepare (response time) for the emergency and the necessary reorganization of hospital services to cope up with the same. (b) Activate Hospital Action Plan : The designated hospital staff activates the disaster plan. All the departments and people involved get into readiness to attend to casualties and depending upon the nature and number of casualties, crisis expansion of hospital beds is undertaken, utilizing additional space, by discharge of minor /cold cases and transfer of cases to other hospitals/ health care centres. (c) Formulation of Command Nucleus : The command nucleus should be formed immediately and located either in or close to the Accident and Emergency department. (d) Management of Casualties : This deals with (i) Admission of patients (ii) Triage and (iii) Organization of clinical services. (iv) Further treatment (v) Collection of information for management and for relatives and media (e) Hospital Management ; Once a disaster call is made and the hospital control unit established, the mobilization of the hospital services may proceed at the speed required with the minimum loss of time. Usually a number of designated areas will need to be created. (i) Reception An initial reception area acts as the first point of triage in the hospital and distributes patients to appropriate treatment zones. In addition, the initial reception will involve the documentation for casualties. The most experienced surgeons available should be responsible for triage. If staffing permits, assign specific members to care of each patient needing urgent attention. Ambulatory patients and those needing less urgent care should go to a separate area to await treatment at a convenient time. (ii) Resuscitation A large well lit open space is needed for effective resuscitation. Patients are prepared for surgery if required or sent to the wards as soon as their condition stabilizes. A senior anaesthetist is the best choice to supervise resuscitation and to prepare, with surgical advice, the theatre schedules. (iii) Operation Theatres Strict sorting is necessary to avoid blocking theatre space with patients with trivial injuries and who happen to arrive first. They may be treated in a separate theatre (Minor O.T) or at convenient times when other major problems are dealt with. Treatment in wards or Intensive Care units will need to be organized to follow initial care in accident department and the theatres. (iv) Radiology Proper radiology assessment is needed for the correct management of many casualties. Strict triage for radiology should be practiced by staff to avoid bottleneck in radiology department and over use and failure of X-ray machines or shortage of X-ray films. Portable X-ray machines will be preferred in orthopedic O.T. and image intensifiers sh

Bennet on Religion :: essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚  Bennett sets up an unsettling depiction of today’s society. However, it seems as though he is merely trying to draw pathos out of readers. He mentions the most heinous crimes, and extreme situations and attempts to pass it off as a normal occurrence in society. He states over and over that â€Å"something has gone wrong with us.† Though some of the situations he speaks of are accepted as socially deviant but most all of society, some of it is extremely relative. He speaks a great deal on out of wedlock births. And further, he goes onto to include them in a list of things that â€Å"are not good to get use to.† To some people, out of wedlock births are not a horrible things. It is common for single women to want to have a child before they are no longer able to. He loses some ethos when he attacks this perspective, especially being that this viewpoint is becoming more and more accepted. Also, he speaks a great deal about our low achievement sc ores on the secondary education level, but fails to mention how our educational institutions are set up differently than other countries. For example, we, by law, require all minors to attend school, where as many other countries do not, and only educate the more intelligent students. Equal education oppurtunities cannot be a bad thing, or credited to social regression. Bennett also lays a great deal of blame on the media. He makes the transition from Bach and Buddy Holly to Guns ‘n’ Roses and 2 Live Crew. However, he left out nearly two decades of music which, in essence had the same types of messages as these two examples. He does not note any â€Å"social regression† during this era, so it seems to be an indirect correlation between social deviance and music.   Ã‚  Ã‚  Ã‚  Ã‚  Bennett offers the solution of bringing religion back to educational institutes. He states that â€Å"we must have public policies that once again make the connection between our deepest beliefs and our legislative agenda.† It is unfair to assume that the morality set up by the ten commandments in the Bible is even an accurate distinction between what is and is not moral.

Essay --

Rerum Novarum refers to new beginnings. New beginnings refers to an open letter given to all Catholic bishops that addressed the circumstances of the working class. Written on May 15th 1891 by Tommaso Maria Zigliara, the Rerum Novarum examined the interrelation and duties between labor and capital. This document also covers the relationship between the government and citizens. The document begins with an introduction, as all documents do. The introduction opens with remarks on social issues of that time. The speaker continues to speak out against the Socialist motives, and those who allowed them to come about and prosper. The first issues to be discussed are rights and duties. Pope Leo introduces an idea that entails the rights every worker is to be afforded and the duties he then owes his employer. Pope Leo also states that this rule should go both ways and extend to the employer as well. The Pope states that workers are, â€Å"fully and faithfully to perform the work which has been freely and equitably agreed upon; never to injure the property, nor to outrage the person, of an employer; never to resort to violence in defending their own cause, nor to engage in riot or disorder; and to have nothing to do with men of evil principles, who work upon the people with artful promises of great results, and excite foolish hopes which usually end in useless regrets and grievous loss. (p20)† The duties a worker owes his employer are quite clearcut. As such, so are the duties of an employer to his workman. A decent employer is not to use their workers as bondsmen, they are to regard every man with self-respect. They are to treat each worker as a person aggrandized by a good Christian character. Employers are reminded that there is no shame... ... value them for their bodily functions, and not as people. However, if all employers were privy to the contents of Rerum Novarum that talk about how employers are supposed to treat their workers how they deserved to be treated, America’s poverty level would go down. Others who are not well read on the struggles of others should especially look into Rerum Novarum so that they may understand what it is like for others who are on the opposite side of the spectrum. It was paragraph twenty that spoke to me the most. As mentioned previously I really appreciate the fact that it is written somewhere that there should be a set of rights and duties between workers and their employers. All of the rights and duties are fair, and I believe that they should be followed by everyone. I also appreciate these rights because they should be followed whether or not someone is Christian.

Historical Context Versus Human Behavior in “The Scarlet Letter”

â€Å"The Scarlet Letter† was set in Boston, Massachusetts in the mid 1600’s and follows the backlash of the sinful act between Hester Prynne and Boston’s own Reverend Arthur Dimmesdale. In an ironic and masterfully executed red-herring type twist, Dimmesdale himself publically calls for Hester to name her sinner-in-crime in the beginning of the story, which she adamantly declines to do. The reader, at this point, does not know that Dimmesdale is her adulterer, but knows that the game is afoot. Hester is given a scarlet â€Å"A† to wear upon her chest for her sin and bears the â€Å"A† with a sense of purpose and dignity, even embroidering it with gold thread. Hester and her daughter of sin, Pearl, end up living in a small cottage where Hester earns a living with her skillful needlework. And, in an attempt to show her shame, yet revel in it, Hester only dresses Pearl in scarlet dresses. Hester’s long-lost and presumed dead husband, Roger Chillingworth, returns to find Hester in prison for her deed and informs her that she is to tell no one of his identity. Much later, once he establishes himself in society with a false identity as a physician, he is summoned to help the ailing Dimmesdale. Chillingworth begins to believe that Dimmesdale might be suffering from a malady beyond the physical which brings him to discover that Dimmesdale is an adulterer and Pearl’s father. Enraged and seeking revenge, Chillingworth plots to destroy Dimmesdale. Dimmesdale is so fraught with guilt at this point that he punishes himself physically, fasts, and staves off sleeping for a constant vigil. He feels a deep sorrow and horror for what he has done to Hester’s husband and tells Hester, at which point she begins to see that Chillingworth must be behind Dimmesdale’s quickly declining health. Hester and Dimmesdale have a moment in the woods where she confesses that Chillingworth is actually her husband. Dimmesdale is willing to face the truth. They plan to set sail for the Old World immediately, and in an act of freedom, Hester removes her â€Å"A† and lets down her hair. Pearl becomes so distraught that Hester has to once again don her shame, and this time it is with true sadness. They must wait until after Election Day to set sail and Dimmesdale eagerly begins his final, enlightening, sermon. At the end, he brings Hester and Pearl up on stage and confesses everything to the town. This, of course, ruins Chillingworth’s plan to destroy Dimmesdale as he watches with fury while everything is revealed. As the story ends, Dimmesdale dies on the public platform after his confession, Chillingworth dies a year later, and Pearl inherits his fortune. Years later, Hester is buried next to Dimmesdale in the town cemetery. In 1841, Hawthorne wrote a letter confessing that he was beginning to despise life in Salem and asks, â€Å"dost thou not think it really the most hateful place in all the world? My mind becomes heavy†¦nothing makes me wonder more than that I found it possible to write all my tales in this same region of sleepy-head and stupidity† (Moore, 2). He wrote this letter to Sophia, his wife, and it represents very clearly what he thought of his town of Salem and his Puritanical upbringings. It is from this resentment that â€Å"The Scarlet Letter† was born. Going further back in Hawthorne’s life, his â€Å"father died†¦when he was four, an age at which, according to Freud, the male child forms a crucial attachment to his mother†¦consequently, he was able to supplant his father in his mother’s affections. His attachment to his mother became an impediment to his psychological maturation†¦especially when [she died]† (Kennedy-Andrews, 107-108). According to this information, â€Å"The Scarlet Letter† becomes an easy and remarkable parallel to Hawthorne’s own personal life. Hester’s husband dies while at sea, leaving her to believe him dead and free to seek new male companionship. A reader could parallel this to Hawthorne’s life in which his father died and his mother was left to seek new male companionship, albeit, with her own son. This parallel can be defined even further as â€Å"throughout the story Hawthorne continually defines Hester in terms of motherhood†¦and in the very beginning of the narrative, Hawthorne establishes Hester’s relation to the Oedipal underpinnings of the story† (Kennedy-Andrews, 108). As the Oedipal complex goes, the son seeks to supplant his father for his mother’s affections. In most cases, as Kennedy-Andrews remarks, the son is forced to contend with a very real father figure for these affections and becomes fearful and backs down (107). In Hawthorne’s case, without a father figure from such a young age, he became the man in his mother’s life and the Oedipal complex became fulfilled. In fact, Hawthorne’s work â€Å"aims to produce an invisible change, an internal deepening like that which transforms the letter even as its form remains identical† (Kennedy-Andrews, 81). Hester’s attitude towards the â€Å"A† is to wear it, not with resignation, but accepting it as part of her life. Embroidering it with gold and crafting scarlet dresses for Pearl to wear signify this transformation externally. It is internally, in Hester’s character, that the letter changes much more significantly. She wears it as part of her life, accepting what she did, but the shame she feels slowly transforms Hester into a woman respected within the community. And the shame she once felt for Pearl is transformed into pure, satisfying love for a creation—despite the fact that Pearl was consummated through sin. In the 1600’s the act of sin and breaking from religion became the greatest crime and the basis for Puritanical beliefs. In this, and perhaps only this, Hawthorne follows history and makes a poignant mockery of the human condition—most precisely, the value stripped from women when they fall so far from grace as to partake in human desires. The fact that Hester’s human desire happens to be a religious leader of the community only serves to highlight this point more. Hawthorne’s use of symbolism throughout further demonstrates how the mores and ideals of the Puritanical community practically destroyed the very reason that the Puritans came to America in the first place—for freedom, as we are taught in history, without persecution or tyrannical leadership. Instead, the characters within â€Å"The Scarlet Letter† created their own sense of justice: persecuting women who are not obedient and compliant, like Eve from Biblical lore (before she forces Adam to eat the cursed apple, of course). As a historical work, â€Å"The Scarlet Letter† cannot be trusted as to the accuracy of events or people involved. Hawthorne â€Å"attempts to undermine the Puritan community’s judgment of Hester by employing a sentimental nineteenth-century narrator, uninformed about the spiritual complexities of the story he tells† (Thickstun, 133). This is where Hawthorne’s work loses all credence as a historical work of the 1600’s. His narrator is fully nineteenth-century, exposing views that simply did not exist within society until Hawthorne’s own time. While his views make for a compelling and entertaining story, they falter in historical truth. However, if this work is looked at closely, it becomes clear that Hawthorne’s life in the mid 1800’s actually serves as a greater historical reference for the morals and attitudes presented in the story. Historically, it can be said that yes, there were inhabitants in Massachusetts during the 1600’s, and they did profess Puritanical beliefs, much like the inhabitants of Boston where â€Å"The Scarlet Letter† takes place. However, the story within â€Å"The Scarlet Letter† is not that of history, it is that of human behavior and is better studied for a glimpse into humanity than for historical truths. In fact, â€Å"The Scarlet Letter† should not be read if the reader is hoping to find strong roots in historical context, but can be studied, to great reward, if a reader is in search of a tale inspired by true human emotions brought on by the politics enforced by a strong Puritanical society. Hawthorne used the politics and resulting changes in humanity from his own time period to form the characters and interactions in his work. In looking at the characters, Hawthorne â€Å"penetrates their subconscious minds and grapples with the secrets and compulsions he finds there. He too, plays master to his fictionalized slaves. And in recognizing this, he too, saw himself as a kind of spiritual villain, a marauder of the mind, and this perspective endows all of his work in both its technique and creation with an air of brooding and ineradicable guilt† (Reynolds, 50). It cannot be said that he ignored events from history or took a specific view on them; however he created his own history with the lives of Hester Prynne, Reverend Arthur Dimmesdale, their resulting daughter, Pearl, and the lives of those they touched. Historically, in an effort to determine whether Hawthorne’s descriptions are accurate, one can look at the values of the Puritans as a basis for study. Beyond the social, cultural, and actions of the characters, however, â€Å"The Scarlet Letter† leaves much to be desired for historical accuracy. In truth, Hawthorne based the story upon his own cultural times, placing his characters into a time period in which he knew prejudices against sin would make a marvelous tale. By his time, the Salem witch trials were well known, and his background in Puritanical beliefs would have made inserting characters into that background an easy feat. Hawthorne, it can be decided, focuses on the story within the backdrop—how the characters themselves shape history—and seems unconcerned with literal historical events within his tale. As to my opinion about historical events, no, Hawthorne did not change them. What he did was to make me see, very clearly, how easy it is for one person to become the focal point of sin within a community. To paraphrase Gary Scharnhorst’s â€Å"The Critical Response to Nathaniel Hawthorne’s ‘The Scarlet Letter’, the word â€Å"adultery† is never actually used within â€Å"The Scarlet Letter,† yet a reader understands very clearly by the attitudes of the characters that Hester has committed the worst of all sins and has to be physically, outwardly punished for all time. The one thing that separates humans from the other animals of this world is the ability to choose between right and wrong. Animals are unable to make this rationalization. But, as Hawthorne has so adeptly shown, the choice is often a non-issue when swept away by the driving force of a larger crowd. On their own, humans can choose between right and wrong without consequence. In a group, a dissenter would be punished just as Hester was—marked publically for all to see. In this, Hawthorne is a master. The fact that he based his work in a well-known time period serves no greater purpose than for dramatic effect. His story would be the same if set in any other time period, with any other sin. Imagine if Hawthorne had written about a young servant girl during the reign of King Henry VIII. She could have born his child or spoken out against Catholicism and been given the same fate. Her fate probably would have been death, and in his punishment, Hawthorne was delicate—if anything he is historically inaccurate here. Witches and women of less than perfect repute were often put to death, not degraded by wearing a public symbol. In this he was kind, but from the outcome of the story we know why. He wanted Pearl to grow up through the castigation of her mother and still prosper in the end. The object of sin became the reason for Hester’s being, and a powerful symbol of a different kind of justice. A pearl, after all, within a dark sea that appears to be full of tragedy and strife, can still become a most beautiful jewel. Truly, â€Å"The Scarlet Letter† is a work of fiction. The characters are not real and their lives did not play out in known history; however, what Hawthorne presents, and which I feel is more important, is what could have happened. The moral of his work is not to retell an unfortunate act, but to show the nature of human character and how there is a moment where a choice must be made between good and evil. The fact that Hawthorne was raised with Puritanical beliefs only seems to lend more weight to this theme. And this is what I enjoyed about â€Å"The Scarlet Letter. † Hawthorne’s life fills the pages of his work with a profound message for humanity. The scenes could have played out in any society, based upon any sin. Hawthorne even leaves a bit for the reader to infer about humanity with the final line of the book, â€Å"on a field, sable, the letter A, gules [or, is stained red]† (Hawthorne, 201). From this, we can ask: â€Å"does the scarlet letter stand for sin or for cleansing? Is the epitaph a word of despair or hope? In what direction did Hawthorne intend to lead our thoughts? If asked, he would have said, ‘read out of your own heart’ † (Scharnhorst, 131). And this, I think, is what readers should remember when studying his work. Being human means making choices based not only on who we are, but who others around us are and how they choose. Following the crowd, while most do so without thinking, is not always the best choice and does not, as in the case of Hester, serve the right kind of justice. In the end, once the truth is revealed, Hester finally finds peace, and the fact that her peace was granted, not by the town that punished her, but by her adulterer, is most striking of all.