Everyday Healthcare Ethics Stress and Ethical Issues in Nursing Essay

The nursing is a fundamental sector in the provision of proper healthcare services to the individuals and the society as a whole. The importance of the sector is emphasized as it has a bearing on the health status of the economy. The state of health of the people forming part of the society today is of the essence. Improper health of individual workers affects the output of the workers negatively as they cannot effectively attend to their obligations at work. It results into a nation-wide loss of revenue. A healthy economy thrives in all the sectors as the workers are in a position to effectively deliver in their workplaces. A healthy economy earns good revenues. The inclusion of the issue of economic issues of the nation in the topic of health is of great magnitude. It shows the weight that the issue of healthcare has on the economic progress of the contemporary economy. The topic of nursing is one that cannot be avoided if the fate of the economy is to be established. The health se ctor in the contemporary society faces several ethical issues in the nursing sector (Baillie, 2013). A major aspect of the ethical issues that are subject to heated debates is the stress factor at the workplace. Critics postulate that the sector contains a large group of nurses who are burdened by stress. It is dreaded that the continuous contact of the nurses with stressful conditions can negatively impact on their delivery in the job set-up (Baillie, 2013). The extent to which stress affects service delivery in the health sector has not been established, and it attracts substantial attention in research. The stress that the paper capitalizes on is the stress that a nurse worker is exposed to in and off the workplace. It is noted that stress can lead to the sprouting of other ethical challenges (Baillie, 2013). The paper capitalizes on the various ethical challenges exhibited in the nursing profession. It discusses the possible effects of the ethical challenges, causation factors and their relation to stress as a major ethical issue in the provision of  healthcare services. The recommends the latest remedies that can be employed to minimize stress. Forms of ethical challenges and causes of stress in the nursing industry Nurses encounter challenges and dilemmas in circumstances that they cannot get the opportunity to undertake what they think is right (Luhanga et al., 2010). Such circumstances require steady thinking and making of substantial resolutions that can work. The urge of the nurses to be good professionals intensifies the need to meditate on a given situation clouded by dilemma. The circumstances that present the nurse with a tough question to answer often trigger the development of stress within the worker. The stress is experienced at the very stage of making a decision on a given critical issue and also after the decision is made in response to the tough situation. The nurses, therefore, experience a great extent of moral distress. The event of the experience triggers varied reactions in different nurses. Some of the nurses have the courage to speak out their minds while some lack such courage and they go around hiding their problems. Burden of Witnessing an Ailing Patient The forms of ethical challenges such as stress could be drawn based on the causation factor. There is a burden of witnessing the ailing of the patients in their hospital beds. There are many patients who suffer for a longtime in the hospitals and their conditions keep worsening to the point of death. Such scenarios affect the nurses who provide healthcare services if they are constantly exposed to the similar circumstances. The work of a nurse is to relieve the suffering of the patient. The complex intervention that are resorted to, often lead to more suffering of the patients. The nurses are, therefore, torn between effecting the remedy and letting the patient remain in the state of mild suffering. The thought of being unable to contain the situation when there is an available option that can be exploited poses a great challenge to the nurses. The mental burden of bearing the suffering in their minds for such long durations may affect their service delivery if a remedy is not effect ed swiftly (Luhanga et al., 2010) Ignorance of the Family Members of the Patient The ethical challenges obviously had to do with watching the patients suffer: a suffering that the nurses deem to be unnecessary. It is understandable that the available nursing interventions that may be effected may serve to increase the suffering of the patient without causing an outcome for improvement. The other form of challenge that nurses experience could be the stress caused by the ignorance of the family of the patient and the patients about the available treatment options that can be exploited in a given scenario. They do not know the clinical prognosis of the treatment option that is available and the family of the patient do not stop at establishing whether the voice of the patient is taken care of in most situations (Tully, 2014). The family members of the patient often press on the administration of treatments without the knowledge of the resulting repercussions of the said treatment to the patient. They also criticize and influence the decision that is made by the patient on the appropriate treatment to be administered. The indulgence of the external parties in matters of the patient’s medication or treatment stresses-up nurses and other medics too (Tully, 2014). The stress often comes up when they are forced to administer treatments based on past successful occasion on a patient with a different diagnosis. The problem also comes in after the controversial treatment is effected, and the effects appear to be detrimental to the patient. The latter scenarios are often characterized by fierce criticism of the nurse who participated in administering the treatment. The professionalism of the participating nurse is usually questioned and in some cases the nurse can even end up in a court of law. Such cases are major instances that causes mental stress and shapes the origins or forms in which the said ethical challenges arise in the course of provision of healthcare services. Co nflict of Interest Offering care to the patients presents another form through which stress emerges in the nursing profession. It is the kind of ethical challenge that emanates from a conflict between the interest of the organisation and interest of the individual nurses (Tully, 2014). The health providers including private clinics, public hospitals and other health institutions have their rules that they often regard as ethical. The health providers often strive to push for actions that serve their best interests in the  industry of health service. The most prominent organisation that have strict rules are the private entities. The issue of conflict here is usually the payment modalities. It is known that the economic capabilities of patients differ and the methods of making medical payments cannot be the same for all the patients. The rules of the medical institutions provide that payments should be made promptly to the institution for any service that is provided to the patient. Some patients ofte n have no ready cash owing to their economic circumstances and the high cost of medical healthcare. Organisation often insists that payments are to be made immediately before the commencement of treatment even in conditions where the patient is in critical conditions (Ulrich, 2010). The nurses are the intermediaries between the management and the patients. Therefore, they are the people entitled to further or to carry out the interest of the organisation. They often face the challenge of serving the organisation or providing services to the patient to save a life. The challenge exists in trying to strike a balance between being loyal to the employer and saving the life of an innocent patient in a critical condition. Seeing an innocent and helpless patient die in the event of serving the interest of the employer could be so stressful in real life. As much as money is needed to take care of the medical expenses of the medical provider, the interest of the patient of lower economic status must also be regarded to ensure that the nurses do not suffer from the challenge of divided interest (Ulrich, 2010). The work environment The contemporary society presents various complications in the field Medicare. The complications are witnessed in the structure of the organisation and in the communication channels that are used in the medical institution (Seedhouse, 2013). The structure of the leadership in a medical institution and the mode of communication can serve to frustrate the nurses in the workplace. Several nurses report difficulties in communication and instances of workplace bullying. The elements mentioned are part of serious work environment ethical concerns in the contemporary society. The present hierarchy of work structure in the management is designed in a manner that does not encourage communication among workers. Most organisation exhibit tall leadership structures. Tall leadership structures contribute to the  discouraging of vertical communication among the workers in a medical institution. The junior employees are placed in a circumstance where they can hardly initiate or communicate to the senior employees about any ethical issue that may arise. Nurses are the employees who are ranked at the lower topology of the leadership organogram just after the subordinate staff. Their placement does not allow them effectively to pass ethical issue to their bosses (Seedhouse, 2013). Stress comes in when the ethical issues such as gender violence at work, bullying at the workplace or any other related mistreatment issues cannot be passed to higher authorities for deliberation. The condition presents a scenario where several issue build-up beyond the control of the employee. The build-up of issues in the minds of the nurses causes them to be stressed up in their workplaces, and this has a negative influence on the quality of the services delivered. Understaffing The other issue causing stress is the issue of staffing. The society today is characterized by increased levels of ailments and various diseases that come up every day. The presence of chronic diseases, as well as, the occurrence of several accidents presents a scenario where the number of the patients in the health facilities increase tremendously. The increase in the number of patients causes the necessity for an increase in the numbers of nurses who can promptly attend to the patients. Despite the large increase, the nurse to patient ratio has not been any better (Maynard, 2011). The nurses are therefore overloaded with work in their work environments. Their bosses exert much pressure on them to deliver as per the job description that they signed. The process of striking a balance in attending to many patients is quite stressful and can cause them to deliver poor services to the patients. The nurses are, therefore, forced to dodge certain duties that are assigned to them in genuine terms. Some of the nurses suffer emotional disturbance in instances where they genuinely neglect a duty due to the fact that they were held up in delivering services to the other patients. Understaffing, therefore, causes stress to the nurses through the creating of a hectic working environment that is over-demanding to the nurses (Maynard, 2011). Prioritization of the Patients’ Needs The patients in the health care institutions do not only have health  problems, but they also have emotional disorders. The emotional needs of the patients also deserve to be addressed promptly as they also affect the healing process of the patients. The nurses are individuals specialized in the provision of Medicare services to the patients. They are not adequately trained to address the emotional needs of the patients. At times, situations that demand the addressing of an emotional condition of the patient arises and this calls for the attention of the nurses. Being that the nurses are not well trained in the field and that they have other health duties to attend to, they are often faced with the challenge of taking up the duty to provide emotional support to the respective patient (Mark, 2012). If they decide to avoid attending to the emotional duty, they may feel that they are not doing any good to the patients who do not receive optimal healthcare. They also feel that the family of the patient may give a negative feedback on their performances in the occasion that they did not get full support. Their attention is divided in prioritizing the nature of the duty to indulge in when such cases arise. The event can cause emotional distress and mental stress to the nurses, hence leading to the causation of other opportunistic ethical nursing problems. Advanced Technology in Healthcare Provision Technology used in the delivery of healthcare services are becoming more complicated with time. Almost all the tasks in the health institution are performed with the aid of a machine (Maynard, 2011). The nurses are, therefore, placed in a condition where they have no other easy alternative, but to learn how to use the technology. The patients under treatment at times could be more knowledgeable on the respective technologies that the nurse. The resulting situation can possible cause a challenge to the nurse as he will not be comfortable in the process of using the technology on such a patient. The nurses are, therefore, entitled to keep updating themselves on the new technology that is used in the field of healthcare provision. The process of maintaining a regular update on the use of the current technology could cause much stress to the nurses (Ulrich et al., 2010). Nurses are stressed when they cannot balance between learning new tricks at work and providing healthcare services eff ectively. Recommendation for Reduction of Stress The elements that cause stress to the nurses in the health organisations deserve to be addressed promptly. It is because stress as an ethical issue causes impacts that stretch to very many fields and varied stakeholders at play. Stress affects the delivery of the nurses in the health sector. The section provides remedies that should be considered in ensuring that the aspects that cause stress in the workplace are negated. The recommendation will also guide in the proper management of the stress whenever it is contracted by the nurses. The recommendations below are specifically tailored for containing the stress condition for the nurses. Research shows that a scheduled course of guided coaching in mindfulness deliberation or mediation practices, facilitated group discussion, yoga and stretching, home assignments and work, and individually tailored support and instruction can serve to minimize the effects of stress in a nurse (Ulrich et al., 2010). The remedy is justified from a demonstration in a research work that was carried out. The overall health and well-being of the nurses who participated in the demonstration was surveyed at three points namely 2 weeks prior to research, immediately after the program, and four months following the program. Results displayed statistical improvement in the wellness and overall health of the nurses at each point of intervention (Clark, 2010). The program can be recommended for use by the nurses. Stress prevention can be initiated through the initiation of measures that prevent the occurrence of other ethical issues as stress is indirectly connected to them (Opie et al., 2013). Mo st of the ethical issues cause stress and, therefore, their prevention results into minimization of the occurrence of stress among medical nurses. The administration of the health institutions should look for ways that encourage the realization of community obligation to the patient, with partnership in answering questions and conversing about ethical issues. It helps the families and the community at large to understand the circumstances under which the nurses undertake their obligation (Hussain, 2009). It will save the nurses from receiving intensive criticism when a given treatment responds negatively, hence the nurse concerned will be less stressed. The administration should ensure that the nurses are trained to provide emotional support to the patients who need such services to avoid the development of the feeling that shoddy work  has been done. Nurses should reflect on how they can manage to complete obligations. Nurses should call on their team members, for instance to help them balance between talking and tasks with a patient who is dismayed (Clark, 2010). As nurses develop and advance in experience, they become bett er. Relevant training must be done to the nurses on the usage of technology in the delivery of health services to clients so as to avoid embarrassing situations. The nurses can advocates for the availability of adequate staffing that is suitable for the patient population (Clark, 2010). They should also know how to resolve issues when there is inadequate staffing Conclusion The development in the contemporary society presents complications in various sectors. Health sector is not an exception. Many ethical issues that cause stress are seen to arise in the healthcare sector. The ethical issue arises from the unfavorable work environments of the workers, poor leadership structures, and lack of effective communication among workers, understaffing, and ignorance of the community among others. The effective implementation of the recommendation will serve to restore sanity in nursing as they will aid in preventing ethical conditions that cause stress to the nurses. As a result, the provision of healthcare services by the nurses will be improved to adequate levels. References Baillie, H. W. (2013). Health care ethics (6th Ed.). Boston: Prentice Hall. Clark, A. C. (2010). Anxiety and Stress Management Toolkit Anxiety and Stress Management Toolkit. Nursing Standard, 15(52), 29-29. Hussain, F. (2009). Handbook for Health Care Ethics Committees (review). Journal of Health Care for the Poor and Underserved, 20(3), 929-930. Luhanga, F., Myrick, F., & Yonge, O. (2010). The Preceptorship Experience: An Examination of Ethical and Accountability Issues. Journal of Professional Nursing, 26(5), 264-271. Mark, F. (2012). Posttraumatic Stress Disorder in Nursing. Journal of Neuroscience Nursing, 37(4), 179. Maynard, A. (2011). Ethics and health care ‘underfunding’. Journal of Medical Ethics, 27(4), 223-227. Opie, T., Dollard, M., Lenthall, S., & Knight, S. (2013). Occupational Stress in Remote Area Nursing: Development of the Remote Area Nursing Stress Scale (RANSS). Journal of Nursing Measurement, 21(2), 246-263. Seedhouse, D. (2013). What is the difference between health care ethics, medical ethics and nursing ethics? Health Care Analysis, 5(4), 267-274. Tully, A. (2014). Stress, sources of stress and ways of coping among psychiatric nursing students. Journal of Psychiatric and Mental Health Nursing, 11(1), 43-47. Ulrich, C. M., Taylor, C., Soeken, K., O. Donnell, P., Farrar, A., Danis, M., et al. (2010). Everyday Ethics: Ethical Issues and Stress in Nursing Practice. Journal of Advanced Nursing, 66(11), 2510-2519.

Spirit Bound Chapter Three

THE NEXT COUPLE OF DAYS were strange. The other novices and I might have had the flashiest graduation, but we weren't the only ones finishing our education at St. Vladimir's. The Moroi had their own commencement ceremony, and campus grew packed with visitors. Then, almost as quickly as they came, parents disappeared–taking their sons and daughters with them. Royal Moroi left to spend their summers with their parents at luxury estates–many in the Southern Hemisphere, where the days were shorter this time of year. â€Å"Ordinary† Moroi left with their parents too, off to more modest homes, possibly getting summer jobs before college. And of course, with school wrapping up for the summer, all the other students left too. Some with no family to go home to, usually dhampirs, stayed year-round, taking special electives, but they were the minority. Campus grew emptier each day as my classmates and I waited for the day when we'd be taken to the Royal Court. We made our farewells to others, Moroi moving on or younger dhampirs who'd soon be following in our footsteps. One person I was sad to part with was Jill. I happened to catch her as I was walking toward Lissa's dorm the day before my Court trip. There was a woman with Jill, presumably her mother, and both were carrying boxes. Jill's face lit up when she saw me. â€Å"Hey Rose! I said goodbye to everyone else but couldn't find you,† she said excitedly. I smiled. â€Å"Well, I'm glad you caught me.† I couldn't tell her that I'd been saying goodbye too. I'd spent my last day at St. Vladimir's walking all the familiar sites, starting with the elementary campus where Lissa and I had first met in kindergarten. I'd explored the halls and corners of my dorms, walked past favorite classrooms, and even visited the chapel. I'd also passed a lot of time in areas filled with bittersweet memories, like the training areas where I'd first gotten to know Dimitri. The track where he used to make me run laps. The cabin where we'd finally given in to each other. It had been one of the most amazing nights of my life, and thinking about it always brought me both joy and pain. Jill didn't need to be burdened with any of that, though. I turned toward her mother and started to offer my hand until I realized she couldn't shake it while maneuvering the box. â€Å"I'm Rose Hathaway. Here, let me carry that.† I took it before she could protest because I was certain she would. â€Å"Thank you,† she said, pleasantly surprised. I fell in step with them as they began walking again. â€Å"I'm Emily Mastrano. Jill's told me a lot about you.† â€Å"Oh yeah?† I asked, giving Jill a teasing smile. â€Å"Not that much. Just how I hang out with you sometimes.† There was a slight warning in Jill's green eyes, and it occurred to me that Emily probably didn't know her daughter practiced forbidden forms of Strigoi-killing magic in her free time. â€Å"We like having Jill around,† I said, not blowing her cover. â€Å"And one of these days, we're going to teach her to tame that hair.† Emily laughed. â€Å"I've been trying for almost fifteen years. Good luck.† Jill's mother was stunning. The two didn't resemble each other much, at least not superficially. Emily's lustrous hair was straight and black, her eyes deep blue and long-lashed. She moved with a willowy grace, very different from Jill's always self-conscious walk. Yet, I could see the shared genes here and there, the heart-shaped faces and lip shapes. Jill was still young, and as she grew into her features, she'd likely be a heartbreaker herself someday–something she was probably oblivious to right now. Hopefully her self-confidence would grow. â€Å"Where's home for you guys?† I asked. â€Å"Detroit,† said Jill, making a face. â€Å"It's not that bad,† laughed her mom. â€Å"There are no mountains. Just highways.† â€Å"I'm part of a ballet company there,† Emily explained. â€Å"So we stay where we can pay the bills.† I think I was more surprised that people went to the ballet in Detroit than that Emily was a ballerina. It made sense, watching her, and really, with their tall and slim builds, Moroi were ideal dancers as far as humans were concerned. â€Å"Hey, it's a big city,† I told Jill. â€Å"Enjoy the excitement while you can before you come back to the boring middle of nowhere.† Of course, illicit combat training and Strigoi attacks were hardly boring, but I wanted to make Jill feel better. â€Å"And it won't be that long.† Moroi summer vacations were barely two months. Parents were eager to return their children to the safety of the Academy. â€Å"I guess,† said Jill, not sounding convinced. We reached their car, and I loaded the boxes into the trunk. â€Å"I'll e-mail you when I can,† I promised. â€Å"And I bet Christian will too. Maybe I can even talk Adrian into it.† Jill brightened, and I was happy to see her return to her normal overexcited self. â€Å"Really? That would be great. I want to hear everything that goes on at Court. You'll probably get to do all sorts of cool things with Lissa and Adrian, and I bet Christian will find out all sorts of things†¦ about things.† Emily didn't seem to notice Jill's lame editing attempt and instead fixed me with a pretty smile. â€Å"Thanks for your help, Rose. It was great to meet you.† â€Å"You too–umph!† Jill had thrown herself into me with a hug. â€Å"Good luck with everything,† she said. â€Å"You're so lucky–you're going to have such a great life now!† I returned the hug, unable to explain how jealous of her I was. Her life was still safe and innocent. She might resent spending a summer in Detroit, but the stay would be brief, and soon she'd be back in the familiar and easy world of St. Vladimir's. She wouldn't be setting out into the unknown and its dangers. It was only after she and her mother had driven off that I could bring myself to respond to her comment. â€Å"I hope so,† I murmured, thinking about what was to come. â€Å"I hope so.† My classmates and select Moroi flew out early the next day, leaving the rocky mountains of Montana behind for the rolling hills of Pennsylvania. The Royal Court was a lot like I remembered, with the same imposing, ancient feel that St. Vladimir's tried to impart with its towering buildings and intricate stone architecture. But the school also seemed to want to show off a wise, studious air, whereas the Court was more ostentatious. It was like the buildings themselves tried to make sure we all knew that this was the seat of power and royalty among the Moroi. The Royal Court wanted us to be amazed and maybe a little cowed. And even though I'd been here before, I was still impressed. The doors and windows of the tan stone buildings were embossed and framed in pristine golden decorations. They were a far cry from the brightness I'd seen in Russia, but I realized now that the Court's designers had modeled these buildings off the old European ones–the fortresses and palaces of Saint Petersburg. St. Vladimir's had benches and paths in the quads and courtyards, but the Court went a step further. Fountains and elaborate statues of past rulers adorned the lawns, exquisite marble works that had previously been hidden in snow. Now, in the full throes of summer, they were bright and on display. And everywhere, everywhere were flowers on trees, bushes, paths–it was dazzling. It made sense that new grads would visit the guardians' central administration, but it occurred to me that there was another reason they brought new guardians here in the summer. They wanted my classmates and me to see all of this, to be overwhelmed and appreciative of the glory for which we were fighting. Looking at the faces of the new graduates, I knew the tactic was working. Most had never been here before. Lissa and Adrian had been on my flight, and the three of us clustered together as we walked with the group. It was as warm as it had been in Montana, but the humidity here was much thicker. I was sweating after only a little light walking. â€Å"You did bring a dress this time, right?† asked Adrian. â€Å"Of course,† I said. â€Å"They've got some fancy things they want us to go to, aside from the main reception. Although, they might give me my black-and-white for that.† He shook his head, and I noticed his hand start to move toward his pocket before hesitating and pulling back. He might have been making progress in quitting smoking, but I was pretty sure the subconscious urge to automatically reach for a pack when outdoors was hard to get rid of so quickly. â€Å"I mean for tonight. For dinner.† I glanced questioningly at Lissa. Her schedule at Court always had assorted functions thrown into it that â€Å"average people† didn't attend. With my new and uncertain status, I wasn't sure if I'd be going with her. I sensed her puzzlement through the bond and could tell that she didn't have a clue about any special dinner plans. â€Å"What dinner?† I asked. â€Å"The one I set up with my family.† â€Å"The one you–† I came to an abrupt halt and stared wide-eyed, not liking the smirk on his face one bit. â€Å"Adrian!† A few of the new grads gave me curious looks and continued walking around us. â€Å"Come on, we've been going out a couple months. Meeting parents is part of the dating ritual. I've met your mom. I even met your scary-ass dad. Now it's your turn. I guarantee none of my family's gonna make the kind of suggestions your dad did.† I'd actually kind of met Adrian's dad before. Or, well, I'd seen him at a party. I doubted he had any idea who I was–my crazy reputation aside. I knew almost nothing about Adrian's mother. He actually spoke very little about his family members–well, most of them. â€Å"Just your parents?† I asked warily. â€Å"Any other family I should know about?† â€Å"Well†¦Ã¢â‚¬  Adrian's hand twitched again. I think this time he wanted a cigarette as some sort of protection from the warning note in my voice. Lissa, I observed, seemed highly amused by all of this. â€Å"My favorite great-aunt might stop by.† â€Å"Tatiana?† I exclaimed. For the hundredth time, I wondered how I had lucked out with a guy related to the leader of the entire Moroi world. â€Å"She hates me! You know what happened the last time we talked.† Her Royal Majesty had laid into me, yelling about how I was too trashy to hook up with her nephew and how she had great â€Å"plans† for him and Lissa. â€Å"I think she's come around.† â€Å"Oh, come on.† â€Å"No, really.† He almost looked like he was telling the truth. â€Å"I talked to my mom the other day, and†¦ I don't know. Aunt Tatiana doesn't seem to hate you as much.† I frowned, and the three of us began to walk again. â€Å"Maybe she admires your recent vigilante work,† mused Lissa. â€Å"Maybe,† I said. But I didn't really believe it. If anything, me going rogue should have made me more despicable in the queen's eyes. I felt kind of betrayed that Adrian had sprung this dinner on me, but there was nothing to be done about it now. The only bright side was that I had the impression he was teasing me about his aunt stopping by. I told him I'd go, and my decision put him in a good enough mood that he didn't ask too many questions when Lissa and I said we were going to do â€Å"our own thing† that afternoon. My classmates were all getting a tour of the Court and its grounds as part of their indoctrination, but I'd seen it all before and was able to wiggle out of it. Lissa and I dropped our belongings off in our rooms and then set out to the far side of the Court, where the not-so-royal people lived. â€Å"Are you going to tell me yet what this other part of your plan is?† asked Lissa. Ever since Abe had explained about Victor's prison, I'd been making another mental list of the problems we'd have breaking into it. Mainly, there were two, which was one less than I'd initially had since talking to Abe. Not that things were really much easier. First, we had no clue where in Alaska this place was. Second, we didn't know what the prison's defenses and layout were like. We had no idea what we had to bust through. Yet, something told me all of these answers could be found in one source, which meant I really only had one immediate problem: how to reach that source. Fortunately, I knew someone who might be able to help get us there. â€Å"We're going to see Mia,† I told her. Mia Rinaldi was a former Moroi classmate of ours–a former enemy, actually. She was also the poster child for total personality makeovers. She'd gone from a scheming bitch who was willing to crush–and sleep with–anyone in her quest for popularity to a down-to-earth, confident girl eager to learn to defend herself and others from Strigoi. She lived here at Court with her father. â€Å"You think Mia knows how to break into a prison?† â€Å"Mia's good, but I don't think she's that good. She can probably help us get intel, though.† Lissa groaned. â€Å"I can't believe you just used the word intel. This really is turning into a spy movie.† She spoke flippantly, but I could feel the worry within her. The light tone was masking her fear, the unease she still felt about freeing Victor, despite her promise to me. Those non-royals who worked and did ordinary things at Court lived in apartments far from the queen's quarters and receiving hall. I'd gotten Mia's address in advance, and we set out across the perfectly manicured grounds, grumbling to each other along the way about the hot day. We found her at home, casually dressed in jeans and a T-shirt with a Popsicle in her hand. Her eyes widened when she saw us outside her door. â€Å"Well, I'll be damned,† she said. I laughed. It was the kind of response I'd give. â€Å"Nice to see you too. Can we come in?† â€Å"Of course.† She stepped aside. â€Å"You want a Popsicle?† Did I ever. I took a grape one and sat with her and Lissa in the small living room. The place was a far cry from the opulence of royal guest housing, but it was cozy and clean and undoubtedly well loved by Mia and her father. â€Å"I knew the grads were coming,† Mia said, brushing blond curls out of her face. â€Å"But I wasn't sure if you were with them or not. Did you even graduate?† â€Å"I did,† I said. â€Å"Got the promise mark and everything.† I lifted my hair so she could see the bandage. â€Å"I'm surprised they let you back in after you took off on your killing spree. Or did you get extra credit for that?† Apparently, Mia had heard the same tall tale about my adventures that everyone else had. That was fine with me. I didn't want to talk about the truth. I didn't want to talk about Dimitri. â€Å"Do you think anyone could stop Rose from doing what she wants?† asked Lissa with a smile. She was trying to keep us from getting into too much detail about my past whereabouts, for which I was grateful. Mia laughed and crunched on a big chunk of lime ice. It was a wonder she didn't get brain freeze. â€Å"True.† Her smile faded as she swallowed the bite. Her blue eyes, always shrewd, studied me in silence for a few moments. â€Å"And Rose wants something now.† â€Å"Hey, we're just happy to see you,† I said. â€Å"I believe you. But I also believe you've got an ulterior motive.† Lissa's smile grew. She was amused by me being caught in my spy game. â€Å"What makes you say that? Can you read Rose that well or do you just always assume she's got an ulterior motive?† Now Mia smiled again. â€Å"Both.† She scooted forward on the couch, fixing me with a serious look. When had she grown so perceptive? â€Å"Okay. No point in wasting time. What do you need my help with?† I sighed, busted. â€Å"I need to get inside the guardians' main security office.† Beside me, Lissa made a sort of strangled noise. I felt kind of bad for her. While she could conceal her thoughts from me on occasion, there wasn't much she did or said that came as a true surprise. Me? I continually blindsided her. She had no clue what was coming half the time, but honestly, if we were planning on springing a renowned criminal out of prison, then breaking into a security office shouldn't have been that big of a shock. â€Å"Wow,† said Mia. â€Å"You don't waste time with the little stuff.† Her grin twitched a bit. â€Å"Of course, you wouldn't come to me with little stuff. You could do that yourself.† â€Å"Can you get me–us–in there?† I asked. â€Å"You're friendly with some of the guardians here†¦ and your dad has access to a lot of places†¦.† I didn't know Mr. Rinaldi's exact job, but I thought it was maintenance-related. â€Å"What are you looking for?† she asked. She held up a hand when I opened my mouth to protest. â€Å"No, no. I don't need details. Just a general idea so I can figure this out. I know you're not going there just to tour the place.† â€Å"I need some records,† I explained. Her eyebrows rose. â€Å"Personnel? Trying to get yourself a job?† â€Å"I–no.† Huh. That wasn't a bad idea, considering my precarious position with being assigned to Lissa. But no. One issue at a time. â€Å"I need some records about outside security at other places–schools, royal homes, prisons.† I tried to keep my expression casual as I mentioned that last one. Mia was on board with some crazy things, but even she had her limits. â€Å"I figured they must keep that stuff there?† â€Å"They do,† she said. â€Å"But most of it's electronic. And no offense, but that might even be beyond your abilities. Even if we could get to one of their computers, everything's password protected. And if they walk away, they lock the computers. I'm guessing you haven't become a hacker since the last time I saw you.† No, certainly not. And unlike the heroes of those spy movies Lissa teased me about, I had no tech-savvy friends who could even come close to breaking that kind of encryption and security. Damn. I stared glumly at my feet, wondering if I had any chance at all of getting more information out of Abe. â€Å"But,† said Mia, â€Å"if the information you need isn't too current, they might still have paper copies.† I jerked my head up. â€Å"Where?† â€Å"They've got mass storage rooms, tucked away in one of the basements. Files and files. Still under lock and key–but probably easier to get to than fighting the computers. Again, depends on what you need. How old it is.† Abe had given me the impression that Tarasov Prison had been around for a while. Surely there was a record of it in these archives. I didn't doubt the guardians had gone digital a while ago, which meant we might not find up-to-the-minute details on the place's security, but I'd settle for a blueprint. â€Å"It might be what we need. Can you get us in?† Mia was quiet for several seconds, and I could see her mind whirring. â€Å"Possibly.† She glanced at Lissa. â€Å"Can you still compel people into being your slaves?† Lissa grimaced. â€Å"I don't like to think of it like that, but yeah, I can.† It was another of spirit's perks. Mia considered a few moments more and then gave a quick nod. â€Å"Okay. Come back around two, and we'll see what we can do.† Two in the afternoon for the rest of the world meant the middle of the night for Moroi, who ran on a nocturnal schedule. Being out in broad daylight didn't feel particularly sneaky, but I had to figure Mia's planning here was based on the fact that there would also be fewer people around that time of day. I was trying to decide if we should socialize more or head out when a knock interrupted my thoughts. Mia flinched and suddenly looked uncomfortable. She rose to get the door, and a familiar voice drifted down the hall toward us. â€Å"Sorry I'm early, but I–â€Å" Christian stepped into the living room. He abruptly shut up when he saw Lissa and me. Everyone seemed frozen, so it looked like it was up to me to pretend like this wasn't a horribly awkward situation. â€Å"Hey, Christian,† I said cheerfully. â€Å"How's it going?† His eyes were on Lissa, and it took him a moment to drag them to me. â€Å"Fine.† He glanced at Mia. â€Å"I can come back†¦. â€Å" Lissa hastily stood up. â€Å"No,† she said, voice cool and princesslike. â€Å"Rose and I have to go anyway.† â€Å"Yeah,† I agreed, following her lead. â€Å"We have†¦ stuff†¦ to do. And we don't want to interrupt your†¦Ã¢â‚¬  Hell, I had no idea what they were going to do. Wasn't sure I wanted to. Mia had found her voice. â€Å"Christian wanted to see some of the moves I've been practicing with the campus guardians.† â€Å"Cool.† I kept the smile on my face as Lissa and I moved toward the door. She stepped as far around Christian as she could. â€Å"Jill will be jealous.† And not just Jill. After another round of goodbyes, Lissa and I left and set back off across the grounds. I could feel the anger and jealousy radiating through her bond. â€Å"It's only their fight club, Liss,† I said, having no need for her side of the conversation. â€Å"Nothing's going on. They're going to talk punches and kicking and other boring stuff.† Well, actually that stuff was pretty sweet, but I wasn't about to glorify Christian and Mia hanging out. â€Å"Maybe now nothing's going on,† she growled, staring stonily ahead. â€Å"But who knows what could happen? They spend time together, practice some physical moves, one thing leads to another–â€Å" â€Å"That's ridiculous,† I said. â€Å"That kind of stuff isn't romantic at all.† Another lie, seeing as that was exactly how my relationship with Dimitri had begun. Again, best not to mention that. â€Å"Besides, Christian can't be involved with every girl he hangs out with. Mia, Jill–no offense, but he's not really that much of a ladies' man.† â€Å"He's really good-looking,† she argued, those dark feelings still seething within her. â€Å"Yeah,† I conceded, keeping my eyes carefully on the pathway. â€Å"But it takes more than that. And besides, I thought you didn't care what he did.† â€Å"I don't,† she agreed, not even convincing herself, let alone me. â€Å"Not at all.† My attempts to distract her proved pretty useless for the rest of the day. Tasha's words came back to me: Why haven't you fixed this? Because Lissa and Christian were being too damned unreasonable, both caught up in their own pissed-off feelings–which were kind of pissing me off in return. Christian would have been pretty helpful in my illicit escapades, but I had to keep my distance for Lissa's sake. I finally left her to her bad mood when dinner came around. Compared to her romantic situation, my relationship with a semi-spoiled royal playboy from a disapproving family seemed downright optimistic. What a sad and scary world this was becoming. I assured Lissa I'd head straight back after dinner and that we'd go see Mia together. The mention of Mia didn't make Lissa happy, but the thought of a potential break-in did distract her momentarily from Christian. The dress I had for dinner was maroon, made of light, gauzy material that was great for summer weather. The neckline was decent, and little cap sleeves gave it a classy edge. With my hair in a low ponytail that did a decent job of hiding the healing tattoo, I almost looked like a respectable girlfriend–which only went to show how deceptive appearances were, seeing as I was part of a crazy scheme to bring my last boyfriend back from the dead. Adrian surveyed me from head to toe when I arrived at his parents' town house. They kept a permanent residence here at the Court. The small smile on his face told me he liked what he saw. â€Å"You approve?† I asked, spinning around. He slipped an arm around my waist. â€Å"Unfortunately, yes. I was hoping you'd show up in something a lot sluttier. Something that would scandalize my parents.† â€Å"Sometimes it's like you don't even care about me as a person,† I observed as we walked inside. â€Å"It's like you're just using me for shock value.† â€Å"It's both, little dhampir. I care about you, and I'm using you for shock value.† I hid a smile as the Ivashkovs' housekeeper led us toward the dining room. The Court actually had restaurants and cafes tucked away within its buildings, but royals like Adrian's parents would consider it classier to have a fancy dinner in their home. Me, I would have preferred being out in public. More escape options. â€Å"You must be Rose.† My assessment of the exits was interrupted when a very tall, very elegant Moroi woman came into the room. She wore a long, dark green satin dress that immediately made me feel out of place and that perfectly matched the color of her–and Adrian's–eyes. Her dark hair was pulled into a bun, and she smiled down at me with genuine warmth as she took my hand. â€Å"I'm Daniella Ivashkov,† she said. â€Å"It's very nice to meet you at last.† Was it really? My hand automatically shook hers in return. â€Å"Nice to meet you too, Lady Ivashkov.† â€Å"Call me Daniella, please.† She turned to Adrian and tsked as she straightened the collar of his button-up shirt. â€Å"Honestly, darling,† she said. â€Å"Do you even look in a mirror before you walk out the door? Your hair's a mess.† He dodged her as she reached toward his head. â€Å"Are you kidding? I spent hours in front of the mirror to make it look this way.† She gave a tormented sigh. â€Å"Some days I can't decide if I'm lucky or not to have no other children.† Behind her, quiet servants were setting food out on the table. Steam rose up from the platters, and my stomach rumbled. I hoped no one else heard. Daniella glanced off down the hall beyond her. â€Å"Nathan, will you hurry up? The food's getting cold.† A few moments later, heavy footsteps sounded on the ornate wood floor, and Nathan Ivashkov swept into the room. Like his wife, he was dressed formally, the blue satin of his tie gleaming next to the starkness of his heavy black suit coat. I was glad they had air-conditioning in here, or he'd have been melting in that heavy fabric. The feature on him that stood out the most was what I remembered from before: a distinctly silver head of hair and mustache. I wondered if Adrian's hair would look like that when he was older. Nah, I'd never find out. Adrian would probably dye his hair at the first sign of gray–or silver. Adrian's father might be exactly as I remembered, but it was clear he had no clue who I was. In fact, he seemed genuinely startled to see me. â€Å"This is Adrian's, ah, friend, Rose Hathaway,† said Daniella gently. â€Å"You remember–he said he'd bring her tonight.† â€Å"It's nice to meet you, Lord Ivashkov.† Unlike his wife, he didn't offer to put us on a first-name basis, which relieved me a little. The Strigoi who had forcefully turned Dimitri had been named Nathan too, and it wasn't a name I wanted to speak aloud. Adrian's father looked me over, but it wasn't with the appreciation Adrian had shown earlier. It was more like I was an oddity. â€Å"Oh. The dhampir girl.† He wasn't rude exactly, just disinterested. I mean, it wasn't like he called me a blood whore or anything. We all sat down to eat, and although Adrian kept his typical devil-may-care smile on his face, I again got the vibe that he really, really wanted a cigarette. Probably hard liquor, too. Being around his parents was not something he enjoyed. When one of the servants poured us all wine, Adrian looked immensely relieved and didn't hold back. I shot him a cautioning look that he ignored. Nathan managed to rapidly devour his balsamic-glazed pork medallions while still looking elegant and proper. â€Å"So,† he said, attention focused on Adrian, â€Å"now that Vasilisa's graduated, what are you going to do with yourself? You aren't going to keep slumming with high school students, are you? There's no point in you being there anymore.† â€Å"I don't know,† said Adrian lazily. He shook his head, further tousling his carefully mussed hair. â€Å"I kind of like hanging out with them. They think I'm funnier than I really am.† â€Å"Unsurprising,† his father replied. â€Å"You aren't funny at all. It's time you do something productive. If you aren't going to go back to college, you should at least start sitting in on some of the family business meetings. Tatiana spoils you, but you could learn a lot from Rufus.† I knew enough about royal politics to recognize the name. The oldest member of each family was usually its â€Å"prince† or â€Å"princess† and held a Royal Council position–and was eligible to become king or queen. When Tatiana had taken the crown, Rufus had become prince of the Ivashkov family since he was the next oldest. â€Å"True,† said Adrian deadpan. He wasn't eating so much as pushing his food around. â€Å"I'd really like to know how he keeps his two mistresses a secret from his wife.† â€Å"Adrian!† snapped Daniella, a flush spilling over her pale cheeks. â€Å"Don't say things like that at our dinner table–and certainly not in front of a guest.† Nathan seemed to notice me again and gave a dismissive shrug. â€Å"She doesn't matter.† I bit my lip on that, repressing the urge to see if I could throw my china plate Frisbee style and hit him in the head. I decided against it. Not only would it ruin dinner, but the plate probably wouldn't get the lift I needed. Nathan turned his scowl back to Adrian. â€Å"But you do. I'm not going to have you sitting around doing nothing–and using our money to fund it.† Something told me I should stay out of this, but I couldn't stand to see Adrian dressed down by his annoying father. Adrian did sit around and waste money, but Nathan didn't have the right to make fun of him for it. I mean, sure, I did all the time. But that was different. â€Å"Maybe you could go to Lehigh with Lissa,† I offered. â€Å"Keep studying spirit with her and then†¦ do whatever else you were doing the last time you were in college†¦.† â€Å"Drinking and skipping classes,† said Nathan. â€Å"Art,† said Daniella. â€Å"Adrian took art classes.† â€Å"Really?† I asked, turning to him in surprise. Somehow, I could imagine him as an artistic type. It fit his erratic personality. â€Å"Then this would be perfect. You could pick it up again.† He shrugged and finished his second glass of wine. â€Å"I don't know. This college would probably have the same problem the last one did.† I frowned. â€Å"What's that?† â€Å"Homework.† â€Å"Adrian,† growled his father. â€Å"It's okay,† said Adrian breezily. He rested his arm casually on the table. â€Å"I don't really need a job or extra money. After Rose and I get married, the kids and I'll just live off of her guardian paycheck.† We all froze, even me. I knew perfectly well that he was joking. I mean, even if he harbored fantasies of marriage and kids (and I was pretty sure he didn't), the meager salary a guardian made would never be enough to keep him in the luxurious life he required. Adrian's father, however, clearly did not think he was joking. Daniella seemed undecided. Me, I was just uncomfortable. It was a very, very bad topic to bring up at a dinner like this, and I couldn't believe Adrian had gone there. I didn't even think the wine was to blame. Adrian just liked tormenting his father that much. The awful silence grew thicker and thicker. My gut instinct to fill conversation voids was raging, but something told me to stay quiet. The tension increased. When the doorbell rang, all four of us nearly jumped out of our chairs. The housekeeper, Torrie, scurried off to answer it, and I breathed a mental sigh of relief. An unexpected visitor would help ease the tension. Or maybe not. Torrie cleared her throat when she returned, clearly flustered as she looked from Daniella to Nathan. â€Å"Her Royal Majesty Queen Tatiana is here.† No. Way. All three Ivashkovs stood up abruptly, and a half second later, I joined them. I hadn't believed Adrian earlier when he said Tatiana might come. From his face, he seemed pretty surprised now too. But sure enough, there she was. She swept into the room, elegant in what must have been business casual for her: tailored black slacks and jacket with a red silk and lace blouse underneath. Little jeweled barrettes gleamed in her dark hair, and those imperious eyes peered down at us all as we offered hasty bows. Even her own family followed formalities. â€Å"Aunt Tatiana,† said Nathan, forcing what looked like a smile onto his face. I don't think he did it very often. â€Å"Won't you join us for dinner?† She waved a hand dismissively. â€Å"No, no. I can't stay. I'm on my way to meet with Priscilla but thought I'd stop by when I heard Adrian had returned.† Her gaze fell on him. â€Å"I can't believe you've been here all day and didn't come visit.† Her voice was cool, but I swear there was an amused twinkle in her eyes. It was scary. She wasn't someone I thought of as warm and fuzzy. The whole experience of seeing her outside of one of her ceremonial rooms was totally unreal. Adrian grinned at her. He was clearly the most comfortable person in the room right now. For reasons I never understood, Tatiana loved and spoiled Adrian. That wasn't to say that she didn't love her other family members; it was just clear that he was her favorite. It had always surprised me, considering what a scoundrel he was sometimes. â€Å"Aw, I figured you had more important things to do than see me,† he told her. â€Å"Besides, I quit smoking, so now we won't be able to go sneak cigarettes out behind the throne room together.† â€Å"Adrian!† chastised Nathan, turning bright red. It occurred to me then that I could have based a drinking game around how many times he exclaimed his son's name disapprovingly. â€Å"Auntie, I'm sor–â€Å" Tatiana held up a hand again. â€Å"Oh, be silent, Nathan. No one wants to hear it.† I almost choked. Being in the same room with the queen was horrid, but it was almost worth it to see her verbally bitch-slap Lord Ivashkov. She turned back to Adrian, face thawing. â€Å"You've finally quit? It's about time. I suppose this is your doing?† It took me a moment to realize she was speaking to me. Until that point, I'd kind of hoped she might not have even noticed me. It seemed the only explanation for her not screaming at them to remove the rebellious little blood whore. It was shocking. Her voice wasn't accusatory, either. It was†¦ impressed. â€Å"W-well, it wasn't me, Your Majesty,† I said. My meekness was a far cry from my behavior at our last meeting. â€Å"Adrian was the one who had the, uh, determination to do it.† So help me, Tatiana chuckled. â€Å"Very diplomatic. They should assign you to a politician.† Nathan didn't like the attention on me. I wasn't sure I did either, semi-pleasant or not. â€Å"Are you and Priscilla doing business tonight? Or just having a friendly dinner?† Tatiana dragged her gaze from me. â€Å"Both. There's been some inter-family squabbling going on. Not publicly, but it's getting out. People are making noise about security. Some are ready to start training up right now. Others are wondering if guardians can go without sleep.† She rolled her eyes. â€Å"And those are the tamest of the suggestions.† No question about it. This visit had gotten a lot more interesting. â€Å"I hope you're going to shut those would-be militants up,† growled Nathan. â€Å"Us fighting alongside guardians is absurd.† â€Å"What's absurd,† said Tatiana, â€Å"is having strife among the royal classes. That's what I want to ‘shut up.'† Her tone grew lofty, very queenlike. â€Å"We're the leaders among the Moroi. We have to set an example. We need to be unified to survive.† I studied her curiously. What did that mean? She hadn't agreed or disagreed with Nathan's stance on Moroi fighting. She'd only mentioned establishing peace among her people. But how? Was her method to encourage the new motion or squash it? Security was a huge concern for everyone after the attack, and it fell on her to figure it out. â€Å"Sounds pretty hard to me,† said Adrian, playing oblivious to the seriousness of the matter. â€Å"If you still want a cigarette afterward, I'll make an exception.† â€Å"I'll settle for you coming to make a proper visit tomorrow,† she said dryly. â€Å"Leave the cigarettes at home.† She glanced at his empty wineglass. â€Å"And other things.† A flash of steely resolve crossed her gaze, and even though it melted as quickly as it had come, I felt almost relieved. There was the icy Tatiana I knew. He saluted. â€Å"Noted.† Tatiana gave the rest of us brief glances. â€Å"Have a good evening,† was her only farewell. We bowed again, and then she headed back toward the front door. As she did, I heard scuffling and murmured voices. She'd been traveling with a retinue, I realized, and had left them all in the foyer while she came to say hello to Adrian. Dinner was quiet after that. Tatiana's visit had kind of left us all astonished. At least it meant I didn't have to hear Adrian and his father bicker anymore. Daniella mostly maintained what little conversation there was, attempting to inquire about my interests, and I realized she hadn't said a word during Tatiana's brief visit. Daniella had married into the Ivashkovs, and I wondered if she found the queen intimidating. When the time came for us to leave, Daniella was all smiles while Nathan retired to his study. â€Å"You need to come by more often,† she told Adrian, smoothing his hair in spite of his protests. â€Å"And you're welcome anytime, Rose.† â€Å"Thank you,† I said, dumbfounded. I kept studying her face to see if she was lying, but I didn't think she was. It made no sense. Moroi didn't approve of long-term relationships with dhampirs. Royal Moroi especially didn't. And royal Moroi related to the queen especially didn't, at least if past experience was any indication. Adrian sighed. â€Å"Maybe if he's not around. Oh, damn. That reminds me. I left my coat here last time–I wanted to get out too fast.† â€Å"You've got, like, fifty coats,† I remarked. â€Å"Ask Torrie,† said Daniella. â€Å"She'll know where it is.† Adrian went off to find the housekeeper, leaving me with his mother. I should have made polite, inconsequential small talk, but my curiosity was getting the better of me. â€Å"Dinner was really great,† I told her honestly. â€Å"And I hope you won't take this the wrong way†¦ but I mean†¦ well, you seem okay with Adrian and me dating.† She nodded serenely. â€Å"I am.† â€Å"And†¦Ã¢â‚¬  Well, it had to be said. â€Å"Tat–Queen Tatiana kind of seemed okay with it too.† â€Å"She is.† I made sure my jaw didn't drop to the floor. â€Å"But†¦ I mean, the last time I talked to her, she was really mad. She kept telling me over and over how she'd never allow us to be together in the future or get married or anything like that.† I cringed, recalling Adrian's joke. â€Å"I figured you'd feel the same. Lord Ivashkov does. You can't really want your son to be with a dhampir forever.† Daniella's smile was kind but wry. â€Å"Do you plan on being with him forever? Do you plan on marrying him and settling down?† The question totally caught me off guard. â€Å"I†¦ no†¦ I mean, no offense to Adrian. I just never–â€Å" â€Å"Planned on settling down at all?† She nodded wisely. â€Å"That's what I thought. Believe me, I know Adrian wasn't serious earlier. Everyone's jumping to conclusions that haven't even happened. I've heard of you, Rose–everyone has. And I admire you. And based on what I've learned, I'm guessing you aren't the type who would quit being a guardian to be a housewife.† â€Å"You're right,† I admitted. â€Å"Then I don't see the problem. You're both young. You're entitled to have fun and do what you want now, but I–you and I–know that even if you see Adrian off and on for the rest of your life, you aren't going to get married or settle down. And it has nothing to do with what Nathan or anyone says. It's the way of the world. It's the kind of person you are. I can see it in your eyes. Tatiana's realized it too, and that's why she eased up. You need to be out there fighting, and that's what you'll do. At least if you truly intend to be a guardian.† â€Å"I do.† I was staring at her in wonder. Her attitude was amazing. She was the first royal I'd met who hadn't immediately freaked out and gone crazy over the idea of a Moroi and dhampir match. If other people shared her view, it would make a lot of others' lives easier. And she was right. It didn't matter what Nathan thought. It wouldn't have even mattered if Dimitri had been around. The bottom line was that Adrian and I wouldn't be together for the rest of our lives because I'd always be on guardian duty, not lounging around like he did. Realizing that freed things up†¦ yet it made me a little sad too. Behind her, I could see Adrian approaching down the hall. Daniella leaned forward, pitching her voice low for me. There was a wistful note to her words when she spoke, the tone of a concerned mother. â€Å"But Rose? While I'm fine with you two dating and being happy, please try not to break his heart too much when the time comes.†

Lifeguarding: Swimming Pool and Associates Professional Lifeguard

Cortny Handorf Professor Richey English 1301 December 4, 2012 Life Savers Growing up, the job title â€Å"lifeguarding† said it all to me. Swimming pools and aquatic attractions were always the most fun places to go with the family. I always looked up to lifeguards as if they were some sort of a hero. They made me feel secure and safe although I've always been an excellent swimmer. It seemed as if they had the ideal job, so when I got older I took the first opportunity to become my own hero. I started out being just a lifeguard and then soon advanced quickly to a lifeguard instructor.I even was promoted to becoming the facilities Aquatics Director. Through this journey, I had the chance to experience how rewarding being a lifeguard truly is and was able to be many of others hero. There are several specific techniques on how to be an Ellis and Associates professional lifeguard. The first step in how to be an Ellis and Associates professional lifeguard is to pass all the prerequ isites. This includes being able to swim 200 yards and to tread water for two minutes. After passing those, people must take the international lifeguard training course through Ellis (ILTP).This program prepares them for what it takes to be professional. This course also teaches how to anticipate, recognize and manage aquatic emergencies. It is a requirement that Ellis lifeguards be accountable and responsible. After all, they are the crucial, front line components of water safety at an aquatic facility. Being prepared, pleasant, vigilant, knowledgeable, and always in proper uniform reflect upon the professional image of a lifeguard. When a lifeguard looks and acts professional the facility will reflect upon their actions, and the guest will respond to their request more efficiently.Lifeguards should also speak with authority to insure rule enforcement. The second step in how to be an Ellis and Associates lifeguard is to learn the variety of rescues. Each lifeguard is assigned a spe cific zone of protection. This is commonly referred to as their station or position they are responsible for. Within the zone of protection, each Ellis lifeguard is required to keep a vigilant 10/20 protection standard. This means they have 10 seconds to spot a guest in distress, and 20 seconds to reach the guest to administer aid.There are several different ways to scan a zone of protection, and everyone’s technique will be different. Practicing these techniques will assure vigilance, and help the guard stay focused. During an emergency, lifeguards have to be able to keep calm, speak loud and clear to be able to control a surrounding crowd. All Ellis lifeguards will also have to be CPR certified through Ellis. The lifeguards preform CPR until EMS shows up to take over. The third step in how to be an Ellis and Associates lifeguard is to know each facilities emergency action plan (EAP).Every aquatic facility has an EAP and should be practiced daily. It is important for all emp loyees to know their role in the state of an emergency. Communication becomes very crucial when an EAP has been activated. Most lifeguards use their whistles to communicate in this process. For example, the waterpark I was at used two long whistle blasts to activate an emergency. However, EMS is not always going to be called for a tiny scratch or slight sunburn. That means all lifeguards also have to know how to render first aid. By the end of the course, some people learn they are not cut out for this type of job.Therefore, after they have completed the 24 hour course and have passed the written exam at least by 80 percent, then they will be certified lifeguards. After they complete this, they now have to attend weekly in-services to keep their skills sharp. In conclusion, these are brief techniques on how to be an Ellis and Associates professional lifeguard. Being a lifeguard is harder than what some people may think. At the end of each day, lifeguards must be able to prioritize t heir actions in order to save lives when needed. They may not be doctors or nurses; however, they are life preservers.

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Perennial Insurance - Case Study Example .. Start Living Now!" encapsulates our philosophy that the insurance that Perennial offers enables optimum life choices that allow you, our valued customer, to start living your life in the way that you choose. It is due to this commitment to your needs that Perennial Insurance has decided to introduce you to our top three summer insurance packages. Each package contains a wide variety of benefits, which can be tailored to suit your individual needs, and each is available at an extremely competitive price. In addition, with the summer holidays just around the corner, each has been designed to ensure you peace of mind, leaving you to just relax and have fun. However, best of all, Perennial Insurance is offering you a full 10% discount on all policies during the 14 days following the reception of this letter. So, what are you waiting for Take a look at these exceptional offers and then contact us for an interview. Overseas medical expenses, following either an illness or injury, you policy will cover any medical, hospital, and/or ambulance needs and treatment. Individuals are covers up to 5,000,000 and families up to 10,000,000. Emergency dental treatment up to $500 per person. In case of death, your policy covers your burial or cremation overseas, or for the transportation of your remains to your country of residence. Cancellation due to unforeseeable circumstances. Theft or damage to your personal belongings, including travel documents Should you have to interrupt your voyage due to either injury or illness, you are covered for additional accommodation, travel and evacuation expenses. Standard packages from just $18.99! Rest assured than Perennial Insurance will continue to strive to be the number one insurance provider within our town, through delivering a premier service that offers high quality products that are designed to meet your needs. As such, we look forward to a mutually

Biometrics Term Paper Example | Topics and Well Written Essays - 1250 words

Biometrics - Term Paper Example 3). The biometric facial recognition process The process of facial recognition occurs in five steps. The first step involves capturing the image. The image can either be a scan of a previously captured image or a photograph that has been captured live by the use of a digital video camera. Videos are also possible sources of facial images. The second step involves searching for the location of the face within the image. This process involves using the mouth and two eyes positioned in the shape of an oval. In the third stage, the face is removed from the rest of the image. To do this, various optional methods are available. When the face has been extracted it is now known as a template whose characteristic data is in a reduced form. The fourth stage involves the comparison of the already obtained templates with other pre-recorded faces on a database. The fifth and final stage is a declaration of matches based on the strength of the scores generated from the comparison (Woodward et al. 8) Security of biometric facial recognition Despite the many benefits associated with the use of this technology there are also some risks pertaining to its use. Like any other technology requiring the use of the internet for data transmission, privacy is a major concern. The social media sites are the major areas where privacy of the images generated through this technology may be used inappropriately leading to violation of user’s privacy rights. The biometric data may also reach the wrong people leading to problems such as identity theft or online stalking (Iowa State University 1). Application of biometric facial recognition Access control Facial recognition has been used to deny access to unauthorized persons to restricted locations or systems. It can be used to control entry into computer systems in place of a user password whereby the computers are provided with an inbuilt camera with the capability to identify faces. The technology has been used to control access to r estricted documents as well as authorization to carry out certain transactions. A good example is the use of face verification in cheque-cashing kiosks. Automatic Teller Machines are also fitted with cameras for the purpose of authentication. Financial institutions such as banks also use this technology for the purpose of access control (Senior and Bolle 108). Identification In combination with human identification and demographics, face recognition has found application in enrollment of applicants whereby it has been used to prevent double or multiple enrolment by use of different identities. It is also used in the process of issuing licenses and other legal documents to avoid the problem of people having multiple identities. Surveillance Video surveillance footages of certain occurrences such as crime have been used as sources of the images which can be analyzed through face recognition to identify individuals involved. Live images of face recognition surveillance have been used t o identify interesting persons within a group (Senior and Bolle 109). Pervasive computing The passive nature of face recogniti

Black Market Essay Example | Topics and Well Written Essays - 2500 words

Black Market - Essay Example When foreign currency is set below the market rate, an excess demand is created for acquiring foreign currency. A government usually responds by devaluing the currency or setting quotas on purchase of foreign goods. A parallel underground economy emerges by manipulating the forces of supply and demand. A black market can also emerge if trade creates an artificial scarcity of goods which in the process causes high returns on their investments by profiteering. The black market generates unreported wealth and income. Officially allocated foreign exchange is resold in the underground market (Atkins, 609). Black market transactions are disruptive to society. They undermine the ban on goods and services which have been banned by the government. Legitimate businesses are at a disadvantage because goods and services are sold in the black market to avoid taxes. The underground market can also affect public revenues and delimit national productivity. It can also drain the balance of payments and distort equity concepts of economics (Atkins, 609). Black market transactions usually involve cash which is easy to evade detection by governments. It also bypasses complex financial operations. There is some dispute about the size of the black market. Economists look at the volume of cash which is circulated in a black market economy. The internet has emerged as the major indicator of the extent of the underground economy. eBay has 40 million users. Sellers are responsible to pay taxes but there is no study which details if the sellers pay taxes and whether governments have intervened to ensure they do (Atkins, 609). Goods sold in the black market can either be cheap or more expensive than normal prices. If goods are stolen than they can be cheaper than normal prices. However illegally supplied goods may be more expensive because of difficulties in production and dangers associated with trying to smuggle such goods in countries. Black markets thrive if consumer demands for goods which are not available through legal channels are unavailable (Bagnasco, 157). Underground markets can be reduced by removing the legal barriers for goods. Some people advocate that products like drugs should be legalized and government should focus on more dangerous elements of society. This has been countered by critics as legalizing crime. Removal of legal restrictions reduces the prices of goods. If products like drugs are legalized their prices would drop and most people would access trustworthy legal sources. Black market also consists of legal activities which are not reported to government tax authorities. Many corrupt officials in developing countries avoid paying taxes. Black money is the outcome of this practice. The black market has some important functions. It is a cash economy which is liquid and fast. It increases the flow of money. It injects foreign exchange into the economy and increases the money supply. It can also provide employment, create economic activity and encourage labor mobility. It is important for countries which face economic hardship. Developing countries have backward economies. Their technological expertise is primitive. Unemployment, dilapidated machines, dysfunctional infrastructure are rampant in such economies. Trade deficits, crime and budget deficits rise sharply in such economies

The Effects of Tourism on the Small State of Monaco Research Paper

The Effects of Tourism on the Small State of Monaco - Research Paper Example detrimental ecological and environmental effects from tourism has resulted in the development of policies for sustainability in Monaco, termed sustainable tourism . 5 Social and Cultural Effects 6 Tourism has significant effects on the social environment of the area where it is occurring. It separates those who are involved in the tourism industry from those who are not, and limits the choices that the population can make, as any decisions must take into consideration the effect of the decision on tourism . This is particularly true for Monaco, which has focused on tourism since before the Second World War. Now, tourism and banking are the two major sources of income for the state, and any decisions that the state makes need to carefully take into account their effects on the tourism industry. In addition, there are specific effects that the form of tourism in Monaco has on the people and the community. Gambling is often associated with crime and prostitution, even in expensive casin os, such as those in Monaco . 6 Research Design 7 Problem Statement 7 Tourism in Monaco is a booming industry that is the focus of much of the activities of the state for more than 100 years. While there is significant evidence in the literature of the impact that the industry has had on the state as a whole, such as increasing economic output, allowing the state to be self-sustainable, the creation of many jobs, and a high standard of living. There have also been negative effects, such as tourism aiding in the spread of an invasive species, the financial reliance that the state has on tourism, and the potential alienation of citizens that are not part of the tourism industry. There has not been much discussion in the literature about the reaction of citizens to the industry, whether they... The state experiences a Mediterranean climate with hot, dry summers and wet, mild winters. In is two square kilometers in area, making it the second smallest independent state in the world, with only Vatican City being smaller. It is almost entirely urban, with a high standard of living and currently has the longest life expectancy at birth of the independent states. As well as attracting tourists through its gambling facilities, the state is also a major banking centre, and acts as a tax haven with no income tax and low taxes for business. The country is a constitutional monarchy, having a head of state as well as a head of government and a cabinet (Central Intelligence Agency, 2011). The state has little to no natural resources, which limits its ability to develop sustainably (D'Hauteserre, 2005). The rapid growth of tourism worldwide has been a consequence of advances in transportation, with global transportation no longer being a complex venture, as well as being cheaper, safer and more convenient. In addition advances in communication and in technology have played a substantial role as well as other factors, such as the prevalence of people with high disposable incomes that are seeking pleasure, relaxation and comfort (Smith & Eadington, 1992). The first real influx of tourism to Monaco was in 1863 when a performer known as the Magician of Monte Carlo began to manage a new gaming company. This provided most of the revenue for the state until World War II began. Currently the state now hosts millions of visitors a year and has many investors (D'Hauteserre, 2005). The production of a world famous casino during this period was one of the key methods that the state benefited from tourism.

Signal transduction Essay Example | Topics and Well Written Essays - 500 words

Signal transduction - Essay Example romolecules such as glycogen, protein and triglycerides, and the uptake of nutrients like fatty acids, amino acids and glucose by liver, muscle and adipose tissue. Insulin starts its action by binding to a receptor on the outer surface membrane of the cell membrane of its many target cells. This triggers the activation of insulin receptor, which signals the target cells on the regulation of chemical mediators. There are two types of subunits in the insulin receptor - ÃŽ ±-subunit and the ÃŽ ²-subunit. The ÃŽ ±-subunit is where insulin binds, while the ÃŽ ²-subunit cross the membrane and jut into the cytosol. The ÃŽ ±-subunit activates the protein tyrosine kinase, which is associated with the ÃŽ ²-subunit. The ÃŽ ²-subunit subsequently phosphorylates tyrosine into a number of residues like Tyr-960 and to a number of enzymes found inside the cytosol. The phosphorylation of the tyrosine residues stimulates an interaction between the isoforms and receptor of the insulin receptor substrate 1 (IRS-1). This substrate then recognizes and attaches to various signal transduction proteins in sections known as SH2 domains. Many of the physiological responses to insulin engage the IRS-1 through complex mechanisms involving intensive investigation. The action of adrenaline on liver cells and muscles was the first process to be used to describe the signal-transduction mechanism. Adrenaline is attached on receptor molecules in the cell membrane. It speeds the breakdown of glycogen in liver cells. Its molecules connect to the receptor molecules in the cell membrane. The guanine nucleotide-binding protein (G-protein) found in the membrane is activated by the formation of a hormone-receptor complex. The protein acts as a relay between an enzyme called adenyl cyclase and the hormone-receptor complex. The enzyme helps in catalyzing the conversation between ATP and cyclic adenine monophosphate(cAMP) in the liver cell. cAMP is a small molecule that acts as an intracellular mediator or a second

Business Essay Example | Topics and Well Written Essays - 750 words - 15

Business - Essay Example We understand that these days multinational companies have a tendency to transfer their manufacturing facilities to third world countries, where working conditions do not always reflect the global principles of human rights. In order to fight the problem of discrimination all of the four businesses of our company - Veolia Water, Veolia Environmental Services, Veolia Energy and Veolia Transport – are promoting diversity at work, as well improving labor relations and fair compensation. A "Diversity Label" award of France we received in 2010 serves us as a signification of the fact that our efforts have brought the desired results. We are eagerly employing and developing careers of women, older people, people with disabilities and people of different ethnical backgrounds (An attractive social policy 2011). Unfortunately, the situation is not similar in all the companies. The famous Wal-Mart case firing a disabled man who had worked for the company for eight years is an example of totally irresponsible treatment of employees (Convey 2011). The company was sued and, as a result, customer loyalty got decreased, respect of stakeholders lost and social disapproval arose. As for promoting greater environmental responsibility, Veolia has developed and is implementing biodiversity and resource conservation and health and living environment protection programs. Veolia Water reduces the waste of water and develops the recycling technologies of water. Veolia Environmental Services focus on reducing the pollutant load of waste and protect environment. Veolia Energy focuses on pollution emission treatment, and Veolia Transport ensures the order of public transport (Business Activities 2011). However, we do understand that, though we take actions for protecting the environment, we should pay more attention to actual promotion of greater environmental responsibility. A good example of

A machine for living Essay Example | Topics and Well Written Essays - 4000 words

A machine for living - Essay Example This aspect of phenomenology in architecture is referent to both a philosophy that had a significant influence on contemporary architecture, as well as an experience of building materials and built space in sensory aspects. The environment in phenomenology is defined concretely as the place, while what occurs within it â€Å"Take’s place†. The place is made up of concrete things that have material color, texture, shape, and texture, which coalesce to create the character or atmosphere of the environment. In turn, this atmosphere enhances specific spaces to embody variant properties according to the unique environmental and cultural functions that they exist in2. This research paper will seek to evaluate the meaning of the architectural phenomenology experience in terms of conscious and unconscious vision. Interpretation of the phenomenological experience using these two aspects will be carried out using two works by Le Corbusier; the Villa Savoyet started in 1928 and the Ronchampe in 1945. The two works by Le Corbusier show marked difference in terms of integrating conscious and unconscious vision in their architectural concepts. The Villa Savoyet was a masterwork in purist design and acts as one of the best achievements of Le Corbusier in creating a house that was a machine for living in3. Along with other Villas created by le Corbusier during this period, the Villa Savoyet was demonstrative of precision architecture in which every feature of the design is justified in urban and design terms, emphasizing conscious vision. However, his work in the mid to latter part of the 20th century, including the Ronchampe, testified to a shift in this concept of visual precision, instead showing a duality of architectural experience with regards to conscious and unconscious vision, which is a major element of architectural phenomenology4. Le Corbusier’s early work, especially in the 20s, was a lighting rod for many architectural

Rights and Responsibilities of Employer and Employee Essay Example for Free

Rights and Responsibilities of Employer and Employee Essay The Trusts purpose is to provide the best possible health care to defined standards of cost, volume and quality. Generally all employees are expected to adopt values and standards of conduct consistent with the trusts purpose. Employees are expected, at all times, to deal politely, respectfully and use civilised language and behaviour with all patients, public and other employees. Aggressive, abusive, threatening or violent behaviour is not acceptable. Employees are also expected to be aware of the need for quite and calm movement and behaviour in many patient, public and office areas. And are not permitted to consume food or drinks in view of patients or the public in the workplace, unless it is part of the model care, or in the absence of appropriate facilities, the manager has given his or her permission. On the other hand, employees are expected to be considerate of others and present themselves with due regard to social acceptability, tidiness and personal hygiene. However, they are expected to help patients and the public feel confident and at ease with the services they provide, with this they are expected to comply with particular requirements regarding the dress applicable in their Department. Employees are required to handle patients humanely, respectfully, courteously and with physical care. Employees should not have sexual relationships with patients who are in care or receiving treatment. Employees are told that sexual behaviour with patients who are mentally ill or mentally handicapped is not acceptable, if an employee is caught or reported of any suspicions he or she would face the Mental Health Act, and carry a liability to prosecution. Finally, Employees are expected to be honest in all their dealings with the Trust, for example, making reports and giving information, presenting claims for payment (travelling expenses, attendance records, recording work done etc.).Dishonesty, making false claims for payment etc., is treated as a serious offence. All employees are also expected to comply with all legal requirements at all times (Discrimination, harassment, victimisation and bullying at work on grounds of gender, race, colour, ethnic or national origins, social group, marital status, pregnancy, disability, sexual orientation, religion or creed, age, and so on). All employees have got responsible to meet their terms and condition of their job description and job specification. Employees rights: To begin with all employees in the NHS are entitled to receive statutory sick pay if the individual earn more than à ¯Ã‚ ¿Ã‚ ½67 a week. In the NHS, majority of the female group tend to use their Careers leave. All employees are entitled a reasonable time off work without pay, to deal with an emergency involving a dependant. For example, if a dependant falls ill or is injured, to arrange or attend a dependant funeral. In addition to this all employee are entitled 28 day paid holiday a year, this depend to the individuals title and period of time theyve worked for the hospital (the longer youve been in the job the more days you are given). Moreover, all pregnant employees are entitled to time off with pay to keep appointments for antenatal care made on the advice of a registered medical practitioner, midwife or health visitor. Likewise all working mothers are entitled to 18 weeks maternity leave. Most women will qualify for statutory maternity pay or maternity allowance. Alternatively if an employee is been employed by the NHS for more than a year he or she is qualify for 13 weeks of unpaid parental leave to be taken before the new-born is five. Although the rules apply to mothers and fathers, few men are expected to take it since the leave is unpaid. It is important for employees to meet the terms of their contracts because, if an employee fails to comply with his or contract of employment or policies set by Barts and The London. For example, if an employ does not attend work for the hours stated in the contract, they will be dealt with in an appropriate manner depending on the circumstances. The mission of the hospital is to excel in patient care, staff employment, education and training and research into new cures and treatments. For almost, every member of staff have objectives relate to achieving Pathfinder priorities directly; others are about delivering the ambitious programmes that underpin Pathfinder. These include Clinical quality, Service efficiency, Patient experience, Systems, culture and partnerships, Patient access, Patient choice, the hospital environment , access to information, The performance of workforce and Financial management. There are supervisors that work with junior staff, at the (a month or three) they meet and discuses (review) whether they have achieved their targets or not. Health and Safety is Making the work environment safe for personnel, patients and the public. Health and Safety Management is the strategy for eliminating or reducing hazards so that people are not injured or affected by disease. It is important for employer to follow Health and Safety regulations because employers must comply with a request to establish a safety committee which has the function of keeping under review the measures taken to ensure the health and safety at work of the employees. As they have a duty to cooperate with safety representatives usually appointed by a Trade Union. A hazardous substance can be any substance, whether solid, liquid or gas that may cause harm to your health these substances (corrosive, flammable, explosive, spontaneously combustible, toxic, oxidising, or water-reactive) they must be identified in the work place by a coloured diamond symbol. Moreover, Hazards in the healthcare sector is identified by the European Agency for Safety and Health at Work such as, Working shifts, Needle stick injuries, Latex allergy; Manual handling; Psychosocial issues such as violence at work. In this case it may be necessary for the employer to resort to the legal process or to approach the emergency services for assistance, depending on the nature and imminence of the hazard. Alternatively employees have a duty under section 7 of the Act to take care of their health and safety, and the health and safety of their colleagues, and to co-operate to the extent necessary to enable the employer to comply with his duties under the Act. This could include maintaining or co-operating in the maintenance of safety equipment such as breathing apparatus or fire fighting equipment. Like wise all employees expect promotion and pay rise from their employer. According to the contract of employment, all employees in the hospital will be paid monthly by credit transfer. If an employee is paid less than the sum stated in their contract the individual can explain this to a manage and the manage will discuss the matter to the payroll manage. On the other hand, an employee can take legal action is her payment is not on time and the sum stated is not paid on her next payment. Anyone aged 22 or over must be paid at least à ¯Ã‚ ¿Ã‚ ½3.70 an hour. Those aged 18 21 get a minimum of à ¯Ã‚ ¿Ã‚ ½3.20. Some groups are excluded (prisoners and family members working in a family business). The advantages of minimum wage is that minimum wage laws have raise the level of unemployment and make those that do have a job work harder. It is also a means of reducing poverty and improving the well-being of low-income workers. The key responsibilities for work place health and safety are set out by the occupational Health and safety Act 1985. Employer should by law provide a healthy and safe working environment for their employees. It is important to provide employees with a safe working environment because an employer has control and management of the work place; they have the primary responsibility for ensuring it is safe. Alternatively employees must also take responsibility for looking after their own health and safety, and must not place others at risk by their actions (or by any failure to act which could result in an incident). However, if the hospital (employers) fails to provide employees with a safe working environment, they are liable to heavy fines and may receive bad reputation or publicity. The benefits of a safe and healthy working environment include; Better employee health and well-being, improved productivity and reduced legal pressures on employers, as many health and safety at work issu es come under statutory responsibilities. All nurses in Barts and The London belong to an association called The Royal college of Nursing (RCN). The Royal College of Nursing membership is the largest professional association and union of nursing staff and students in the UK. It is an influential voice for nursing at home and abroad. The RCN promotes nursing interests on a wide range of issues by professional bodies and voluntary organisation. The RCN provides a comprehensive range of services and benefits for its members, this include advice and support on a range of clinical, employment and welfare issues. The RCN also promotes research, quality and practice development through the RCN institute. The royal College of Midwives (RCM) is the only trade union and professional organisation run by midwives for midwives. It is the voice of midwifery, providing excellence in professional leadership, education, influence and representation for and on behalf of midwives. The RCM produces information and advice on a wide range of midwifery issues. The Trust encourages employees at all level of the organisation to belong to a Union and use their services. The Trust recognises UNISON, RCN, RCM, British Medical Association (BMA for doctors) and THE Chartered Society Physiotherapy (CSP). The Unions have sole recognition and bargaining rights to represent employees with the expectation of Directors, individual Senior Managers and Clinical Managers Contracts. The Trust promise not to recognise or negotiate with Unions that are not known to the Trust. However the Trust will comply with the Employment Relations Act 1999 on the recognition of trade unions which are not currently recognised. It is important for employer to train their employees appropriately because this can help to make employees more efficient at their jobs, and in return can help to make the business more competitive with other branches (hospital). For example, employer must HBV vaccination must be made available to employees within 10 working days with occupational exposure. Before the vaccination is given employees must receive the training required. If an employee has previously received the complete HBV vaccination series or antibody testing shows that the employee is already HBV-immune then he or she will not be vaccinate. Hepatitis B Virus is a virus that causes illness directly affecting the liver. It is a blood borne pathogen. In this case you can see that the well being of employees is taken into account. With this attitude the hospital is helping to stop the virus from spreading and protecting the employees. The consequences of poor trained can seriously damage a company, if an employee is affected (ill) due to hygiene problems or poor training. Replacing that employee can cost six months or more of that employees salary when all costs are taken into account. However, recruitment expenses (newspaper advertising) losing an employee will costs the hospital time spent by other staff interviewing, training, and doing the work of the former employee until a replacement is found. It can also result in lower morale and productivity as employees discuss the situation around the hospital as a result this will leave them with fear in their jobs. Employers must pay both men and women equally for doing the same work, unless one of the following exceptions applies, a valid seniority system is in place, when entry level salary is based on experience, or If the job title is the same, but the work involved is different, equal pay rules do not apply. However, if a wage inequity exists between genders, an employer cannot lower the higher-paid employees salary; the employer must raise the lower paid employees salary to equal the higher paid employee. The Trust recognises its responsibility to ensure that the terms of the Sex Discrimination Act 1975, the Race Relations Act 1976, the Disability Discrimination Act 1995, and other relevant legislation are observed. According to Barts and The London they said employee will receive less favourable treatment than another on grounds of sex, sexual orientation, race, age, religion, colour, ethnic origin or disability. Therefore, any direct or indirect racial or sexual discrimination or harassment will be treated as serious as a disciplinary offence. The N.H.S allows certain document to be access, base on under the Freedom of Information Act an employee client can access information base on the list below. 1. The NHS and how they fit 2. Who they are 3. Financial and Funding Information 4. Corporate Information 5. Aims, Targets and Achievements 6. Their Services 7. Reports and Independent Enquiries 8. Policies and Procedures 9. Public Involvement and Consultation 10. Regular publications and information for the public 11. Complaints 12. Human Resources 13. Communications with the Press and Media Releases 14. Environmental Information On the other hand, data protection laws are quite complex but generally they are base on principles. The first data protection Act came into force in the UK in 1984 to protect individuals who had information on them held on computers (meaning personal information must be obtained legally). This Act gave people the right to see their personal file, recently the data protection Act of 1998 was introduce because the previous Act does not apply to written data, therefore individuals had little control over the use of personal data. However the Act regulates the way personal is collected, stored, process and used. It applies to all data stored in a computer systems and paper based on manual records that are stored in a structure way. Within the N.H.S a person, called the data controller should take charge of the storage of all personal records. All managers are accountable to have good code of conduct of employees relations within NHS every effort should be made to resolve grievance without the need to put the law into use. It is in the interest of both parties that grievance should be resolve as quick as possible at its lowest level of management, and to the closest point of referral. For instance if an employee feels unhappy about a situation that he/she think the firm has acted unreasonable or failed to take his/her into account. This can then lead to complaint and may even lead to dispute. In the NHS all employees have the right to have their grievance fairly considered by a supervisor or manager, their grievance should be considered at a higher level of management, if it cannot be resolved at the first stage the individual should be accompanied by a Trade Union representative, a friend or colleague at all meetings convened under the procedure of grievance. ACAS offer employers, trade unions and individuals the opportunity to obtain unbiased assistance in solving disputes and negotiation. ACAS can offer advice to all sides in the disputes. It can also try to bring the sides together as it tries to conciliate and suggest ways to move towards a solution. Finally ACAS can list evidence from both sides and then provide a solution. Never the less, it will insist that both sides agree to abide by its decision before starting the arbitration process. Arbitration and conciliation involve, giving support to both parties in resolving disputes. Conciliation involves listening to both parties before suggesting solutions, whereas arbitration involves providing a solution given certain criteria that both parties are comfortable with. For instance, docking pay or dismissing the employee. The employee may then take the case to an Employment Tribunal. ACAS will be involved in trying to resolve these issues so that they do not go as far as the Tribunal or by creating codes of good practice and giving advice so that an employer can establish working relationships that do not lead to such disputes. ACAS will conciliate by working with the two parties. In addition to this, most of the disputes dealt with by an employment tribunal are for unfair dismissal. In this case the employee must first of all ask ACAS whether the case needs to be taken to an employment tribunal. The tribunal is made up of individuals who have specific knowledge of employment law. After listening to the evidence presented, the chair of the tribunal and other solicitors will make decision by simple majority verdict. Individual whose complaint are upheld are entitled to compensation, reinstatement or reengagement. For example, a deaf worker takes a case for disability discrimination to an Employment Tribunal and wins. A co-worker, who is hearing, appears as a witness for the deaf worker. Later, the employer does not promote the co-worker and this was due to her support for her deaf colleague. This would be victimisation and, under the DDA, the co-worker could take a case to the Employment Tribunal. Moreover appeals made by an employment tribunal can be referred to the Employment Appeal Tribunal. Some cases can be taken further to the court of Appeal, and sometimes up to the final court of appeal in the UK, the House of Lords. Since the UK is part of the European Union, individuals and employers can take their cases to the European court of justice. For example, Customer Service Customer service is an organisations ability to supply their customers wants and needs. Excellent customer service is the ability of an organisation to constantly and consistently exceed the customers expectations. And customer satisfaction is a top priority at each point of interaction. Customers are demanding more service, more convenience and more personalised communications. Businesses a-days must maximise every interaction with their customers to make positive impressions and enhance loyalty and preference with good customer service businesses can position for long-term success. Excellent customer service is about being aware of customer needs and reacting to them effectively. Gain and retain customers Good customer service is good business. It costs much less to keep an existing customer than to win a new customer, so retaining existing customers is more profitable for business. If Barts and The London NHS Trust has effective customer complaints systems in place, many of those customers with questions or problems can be retained. Satisfied complainants can be nearly as, or even more loyal than, patients who did not have a problem. Even if things do not go badly, research suggests that some patients will still leave because they are not totally satisfied with the service. Never the less, Poor service drives patients away, and they will not always come back and give you the chance to put it right. Often businesses are the last persons to hear about their customers problem. They will talk to their friends and talk with their feet by taking their custom elsewhere. Even if they do complain to you, you could still lose a number of these customers after only their first complaint. Businesses can gain customer through advertising, public relations, press releases, direct mail, sales letters and promotional items. Whereas in the retail industry, businesses like Mark and Spencer, Tescos, Sainsburys, provide similar products and charge similar prices. Improving the quality of customer service can help their businesses to gain and retain customers. For instant, if Tescos opens for 24 hours and prices are low then Tescos will gain customers from other competitors and retain their own customers. Gain customer satisfaction and loyalty: Satisfying customers will help to make customers more loyal and less tempted to go to its competitors. Now a-days Customer loyalty matters because selling more to existing customers is easier, and cheaper, than finding and selling to new ones. Loyal customers tend to buy more, more regularly. And they will frequently recommend your business to others. In this case, the NHS will have to provide patients with good health service. But patients are less likely to move from the NHS; unlike if the patient would like to be treated privately. Improving the image and reputation of the business: Good customer service allows business to improve the image and reputation of the business by fulfilling or satisfying customers. Satisfy customers spread good news about the business service and attract new customers. However, customer reputation is more likely to win more customers in a business. Barts and The London NHS Trust would put patients interest first and by doing so they should not let patients be on the waiting list for a long period. It is important for businesses to recognise that the reputation of years can be determined and destroyed by 60 seconds of poor conduct at the front line service delivery level. Providing information about the product in use: Moreover, good customer service means the business listen to their customers, they can find out what customers think about their product or service that is been offered to them. This feedback can help find ways to improve goods or services for customer. For NHS the competition to get drugs prescribed is fierce. Sales and marketing managers therefore need to have confidence that their sales plan is having the maximum effect. In order to do this, sales and marketing managers should surround their sales representatives with the necessary training and development tools. By helping patients to make savings in their prescribing budgets the hospital will also have helped them to release money to spend on other products and services as a result, they may be more receptive to meeting the hospital representatives. Patients will see the hospital as a prescribing partner who understands and is responsive to their needs and resource pressures. Help your business to keep market share: By providing good customer service, customers who remain loyal and new customers won by quality service will decide to buy shares from the business and retain their shares in the market. In the NHS modern sales representative needs to have superior knowledge of the market; effective access to customers; and an accurate means of assessing their impact. The NHS is based around controlling the uptake of a product as appropriate given the evidence, priorities and resourcing. Increase your business sales revenue and profit: Good customer service will allow businesses to increase sales and profit because satisfied customers can encourage others to go for the same good or service. Extra days off from work mean more opportunities for customers to buy goods, and that most often translates into increased sales for retailers. As a result, businesses today are seeking ways to make returned goods enhance financial performance, rather than reduce it, retailers and consumer goods companies can turn the reverse supply chain into a powerful source of profit and customer satisfaction. In the NHS there are departments that serve as internal customers; their job is to check the service that will be provided for external customer. The internal customers help the NHS to provide high quality service to patients. For example, secondary care organisations are the internal customers of primary care, and operating departments are the internal customers of central sterilising units and linen services. Quality depends on all (external and internal) customers in a system getting what they need, when they need it. External customers are the people who the NHS provides their service to (patients), they are the final customer. Final customers could be in-patients or out patients, these patients are individual that go to hospitals for treatment To begin with value for money is very important in the NHS (for private patients, within the country and over sea patients). I will not conduct a customer survey, but will try and search for a survey that will be available in the internet from that survey I will try and explain the most important customer expectations of the NHS. Customer satisfaction is vital for the survival and growth of any business. Findings from the National Homeowner Satisfaction research study indicate that most customers of the participating investigation are very satisfied with the service offered to them. In fact, the average index score of all NHS study participants is an extraordinary 96. The study measures the following components of customer satisfaction: project design, quality of materials, quality of workmanship, work-site conditions, production schedules, budget, price/value of projects, sales process. The survey also asked respondents to rate their willingness to recommend their hospital. Each respondents score for this question is averaged with its overall satisfaction score to yield an NHS Index score. However, the survey has a great percentage of patients who would recommend it to family and friends. Patients like to know services the NHS provide and price that they are expected to pay if any. Clear labelling can help patients with to build their trust and loyalty to any business. The NHS can win new patients by offering specialised advice about their service. The NHS target is to improve patients time to excel in anticipating and quickly responding to customer needs, many patients are not happy for the time they spent in the waiting list. The NHS should try and treat patients on time of need. I also think the NHS should improve Document Management service, in line with best industry standards and good value for money. Add value by providing a wider range of products and services to patients. Personal believe that good Employer should be able to sustain a working environment that attracts, retains and develops committed employees and to improve by investing in people, technology and processes, at the moment the NHS is not fulfilling much of this. Never the less the NHS should be working to build on reputation as a strong and self-reliant business with customer focus, profit orientation, and professional outlook. Market research allows businesses to target customers, sell effectively, compete with suppliers and sport new opportunities. There are many ways in conducting market research, Depending what the business is and the group the business is hoping to aim its product at, particularly the resources allocated to marketing research, there are two main ways of carrying out market research. First and for most, a small business can do the market research personally. This is often in smaller businesses. Here, marketing staff do the research themselves. Sample sizes tend to be small which may be appropriate if there are a relatively small number of customers. Secondly, a business can employ a marketing research manager, as the business may benefit from specialist research skills. Barts and The London NHS Trust has recently conducted a patients surveys, questionnaires and suggestions. Most Market research uses quantitative techniques to discover answers to broad questions from questionnaires. Employees can ask patients questions to know out they think about the NHS or the service being offered to them. Normal this take place when nurses and doctors are in regular contact with patients that are having difficulties with staff or have being in the waiting list for years, sometimes it could be that they are not satisfied with the service theyve received. For example, a new born baby had heart problem and was put on the heart transplant waiting list and he was admitted to the Pediatric ICU at Saint Marys Hospital to wait for a donor heart. Years later the parents were told a possible donor heart had been found, he was taken to be prepared for surgery, after the surgery the baby was doing fine. Expect weeks later when his parents were told that infections could mean a serious illness for him and at a time hes already infected. This took a long period of time for him to recover (something that the hospital could have prevent from happening) finally his family was told that the boy have hope for the future. After many complaints managers may decide to research, managers may achieve this by observing and assuming staff as they deal with patients. Sometimes ward managers employ elderly people, parents to assess and report on how well their workers are doing. In the case of observation, it takes long for GP to put their patients on a hospital waiting, this is due to how many people that are sill waiting and GPs are told to observe the attitude of the patient. Meaning many patients have to be referred by their GP to attend an outpatient clinic where their need for an operation will be assessed. However, the common way to find information from patients is getting them to complete questionnaires, which they will send by post or a nurse will help a patient complete, like an interview. Alternatively the NHS have a committee where patients report about services they provide to the public. This committee gives their views on how the NHS should run and sometimes provide useful and detailed information on how communication can take place in the NHS (patients and workers). As we all know almost all big businesses have websites that are available to clients. Barts and THE London have a website that patients can use regarding the service they offer, most of the time the site have information about the hospital, recent achievements, health information and so on. The website also has an E-mail which patients can use to contract Barts and The London NHS customer service. This way gives patients the chance to offer their views on the NHS and it service it does provide. Patients can use this method (e-mail) to complain about unsatisfactory service or complete forms before visiting the hospital. Barts and The London NHS must supply high quality of service to patients; their service must be of high standard and reliable. Patients must be assured about safety when in the hands of specialists; for instant doctors must explain to patients about side effect of any treatment or medication they are taking. Information on medication must be clear to patients in order to avoid over-dose and help patients to be safe. Barts and The London should have employees with the right skills and attitude to work in other provide patients with right treatment. Nurses or any other work in the NHS are well trained to carry their duties as stated on their contract of employment. All staff wear their uniform this is to help patients recognise all employees in the hospital. As weve been hearing there have been many complaints that the hospitals are not clean enough for patient to be treated and patients often suffer from different sicknesses while in hospital, this is said to be that it is the spreading of disease. Never the less, Barts and The London NHS provide signpost so that patients can find their way around the hospital. By using technology effectively, its possible to do more with fewer resources and compete work in a larger field. Businesses that shy away from technology find themselves at a disadvantage; technology is best suited for customer interaction and information. E-mail is as important as the telephone for the average working man and woman, and in some cases, more important than any other communications, nowadays people send more email than postal mail, exchange drafts of reports via email, schedule meetings via email, and close deals via email. Workers who dont know how to make use of email servers will waste hours or lose information. And those that are content to continue with one-to-one communications will fall behind their competitors. Protecting the customer means making sure that the customer is receiving the actual goods or service he or she wants, and that they are in the right condition to work as expected. There are many laws that exist to protect the customer, on such things as the contents and labelling of food, consumer credit and claims about sale price. In addition, in some cases business has set up its own help for the consumer through such things as voluntary codes of practice. The Trade Descriptions Act 1968 makes it an offence for a trader to apply, by any means, false or misleading statements, or to knowingly or recklessly make such statements about goods and services. This means you have rights as a consumer for what you purchase to do what it says it will. As a consumer if you feel like you have been ripped off or treated unfairly by a shop or a manufacturer then you can speak to a Personal Adviser at your local Connexions or the consumer and trading standards business advice service. If a description has been applied thee a business is not sure about, If at all possible, the trade description should be removed forthwith. Customers should certainly be informed about any doubt about any significant description. The Health and Safety at work 1974 state that all employers were required keeping their workplaces healthy and safe. The act provides a strong framework for good. Never the less, the consumer protection Act 1987, improve the law on the sale of dangerous goods. Certain goods must be marked with warnings and safety advice (bleach). Other goods, including heaters and toys, are covered by safety regulations. The sale of goods Act 1979 set the principles of fit for the purpose, as described and of merchantable quantity. This means products must be as described, fit for purpose and of satisfactory quality. If goods do not conform to contract at the time of sale, purchasers can request their money back within a reasonable time. Weight and measures Act 1985, makes it an offence for traders to give short weight or measure. The Act was established to ensure that buyers receive sufficient and accurate information with which to compare quantity and price.