Study Of Symptom Management Strategies For Palliative Care Nursing Essay

Study Of Symptom Management Strategies For Palliative Care Nursing Essay This essay revolves around Claire, her symptoms, her ability to cope as well as her husband Andrew. More precisely, it will focus on strategies which can be employed for symptom management. Central to any form of management strategy for Claire is a holistic assessment of her circumstances followed by planning, implementation and evaluation. This can often be accomplished by with the assistance of an assessment model which are all, to a large extent, broadly based on this plan, but each can analyse the problem from a different perspective. (Fawcett J 2005) If one first considers the situation under the aegis of the Roper Logan Tierney model (Roper, Logan Tierney 2000), this model analyses the major issues of patient management in terms of solving the patients difficulties in adapting to and coping with daily living, particularly if such coping is affected by either a physical disability or a disease process. In terms of those with malignant disease, this is clearly one of their major issues. Even a brief overview of the literature demonstrates that this model is extensively utilised and is possibly one of the most widely accepted models of patient management (Holland, Jenkins, Solomon Whittam 2003). One of the major weakness of this model can be seen in the fact that it is not particularly effective in producing management strategies that can be effective in dealing with patients who are frankly manipulative or are presenting with symptoms that are overtly psychological in nature. Whilst there is no suggestion that Claire is overtly manipulative, Johnson points to the fact that the management of psychological issues in palliative care is every bit as central to a successful outcome, as dealing with ostensibly more obvious symptom features such as pain control (Johnson 1999.) Management of such patients can be better if the healthcare professional views such functional behaviour as a adaption process to the illness role as described by the Roy adaption model. (Roy 1991) which seeks to describe patient behaviour in terms of the ability of the patient to adapt to whatever stimulus is generating the behaviour. In the case of the patient with malignant disease, knowledge of a terminal diagnosis is a potent stimulus for behaviour change. Utilisation of this model allows for the nursing management decisions to respond to the evolving trajectory of the illness. This model can prove useful insofar as it determines why the patient tends to exhibit different behaviour patterns or coping strategies in response to their illness trajectory but it is of no real value in circumstances where a patient enters a period of overt denial of their terminal situation. To use Claire as a case in point, it would appear that she is presenting her symptoms individually rather than as part of a spectrum associated with the primary pathophysiological cause. It is not uncommon, in such circumstances, for a person to present with an illness that is obviously terminal, but who insists on trying to continue their daily life pattern as if there was no immediate problem. To a degree, her expression of surprise at the fact that people have come out of the woodwork to visit her is an demonstration of this fact. In contrast to the other two models discussed, the adaption model would describe this as a variety of cognitive distortion rather than overt denial. Clearly the patient cannot adapt to something that they are choosing not to overtly confront. (Steiger Lipson 2005) Claire appears to be somewhere between these two eventualities. Obviously she is aware of her diagnosis, but is expressing surprise that people would suddenly want to visit her. The Johnsons behavioural model would probably be the most appropriate for this scenario as Claires behaviour pattern will almost certainly change as her symptomatology progresses. It follows that one has to take a view on the specific causation of the symptoms before one can take a rational view of the evidence base supporting any management strategies. Prior to the active consideration of the management of the symptoms, in the context of the behavioural model of patient management, one must comment on the huge spectrum of skills and requirements that are currently expected of the modern professional nurse. Yura et al. state, in their authoritative overview paper, that to be functional and effective the nurse must understand the human condition from the viewpoint of the pathophysiology, the psychology, the human dynamic and socio-economic elements of the patients presentation and disease trajectory . (Yura Walsh 2008). In Claires case, this is particularly appropriate. In terms of exploring the evidence base for symptom control. If one uses a biomedical symptom model, then the only significant symptoms are increasing breathlessness, cough and fatigue. There is also an element of insomnia which leads to tiredness during the day. Other, harder to define symptoms, which nevertheless stem from the underlying pathophysiology, but are not generally described in biomedical terms, include her feeling of lack of control of her life, and, by inference there is the issue of her increasing dependence on her husband, Andrew. If one considers the evidence base for symptomatic treatment, one should ideally first consider the four primary dimensions of palliative care as outlined by Cicely Saunders as they are particularly relevant to Claire, namely the physical, social, spiritual and psychological dimensions. (Saunders Regnard 1989). It follows that, although this essay will primarily consider symptomatic treatment of breathlessness, it must be understood that this should be delivered within the context of the holistic assessment of the patient discussed in the early paragraphs of this essay. In the words of Valente et al., The patient, whole and entire, has relatives, friends, beliefs and previous experiences all of which must be integrated into management strategy. (Valente Saunders 2010 Pg 25) Breathlessness, as a specific symptom, is the result of a complex interaction between the physical body and the conscious mind. It is the most commonly reported symptom found in association with lung cancer and one of the most potentially distressing. (Knower, Dunagan, Adair Chin 2007). Breathlessness, unlike the pain commonly associated with malignancies, is difficult to treat with any degree of success. The huge evidence level IIb Higginson trial of lung cancer patients clearly demonstrated that the prevalence of breathlessness rose as death approached and that treatment became progressively more ineffective (Higginson McCarthy 2008). In another large prospective evidence level IIb study by Edmonds et al. it was found that although clinicians and patients both tend to associate lung cancer primarily with pain, breathlessness has a similar incidence to the extent that 85% patients with lung cancer experienced pain and 78% had significant breathlessness in the last year of their li fe. (Edmonds, Karlsen, Khan Addington-Hall 2007) Treatment of breathlessness is particularly problematic. According to Knower et al. this is because the symptomatology is both varied and multifactorial. It is not simply a matter of too little tidal volume in the lungs, it is a multisystem disorder with many possible subtle neurohormonal abnormalities and interactions in skeletal and respiratory muscle structure and function. In addition, the experience is extremely subjective with the feeling of breathlessness being modified by not only previous experience of the symptom but also by pathways from a number of different areas within the central nervous system. Dorman et al. classify malignancy-associated breathlessness into four groups by their different causative mechanisms. An increase in the sense of respiratory drive or effort to overcome an imposed load (e.g. chronic obstructive pulmonary disease, COPD) An increase in the proportion of available respiratory muscle force required for breathing, observed in neuromuscular weakness in which respiratory motor output and the sense of effort increase (e.g. paraneoplastic syndromes) An increase in the patients ventilatory requirements (e.g. anaemia, hypoxaemia) The contribution of higher cortical experience to the sensation. Memory and previous experience as well as fear and anxiety will all modify the sensation of breathlessness. (Dorman, Jolley, Abernethy, Currow et al. 2009) The evidence base for treatment shows that one effective mechanism is to treatment any underlying additive cause, such as anaemia, hypoxia or bronchospasm. (Hatley, Laurence, Scott Thomas 2008) If one considers the physical elements first, a common factor in the experience of breathlessness in all these circumstances is anxiety. One common effective strategy to reduce the subjective sensation is for the patient to learn relaxation and calm breathing techniques and then to consciously use them whenever they feel anxious and breathless. Oxygen therapy is frequently useful in relieving the symptoms of breathlessness and the presence of a nasal catheter or mask is often reassuring for the patient. The main evidence base for symptomatic control however, comes from the use of the opioid and benzodiazepine group of medications. Opiates have by far the strongest evidence base with the evidence level Ib paper by Pharo et al. clearly demonstrating the reduction of both subjective and objective measurements of breathlessness in patients with lung cancer. (Pharo Zhou 2005). The authors point out that the side effects of opiates, as a class, must be carefully weighed against their probable clinical benefits. Careful examination of the evidence base supporting benzodiazepine use shows that it is less secure. Some authors (viz. Wotton 2004) reporting that they have reduced the sensation of dyspnoea in patients, the majority of randomised controlled trials (viz. Maher, Selecky, Harrod Benditt 2010,) have not been able to demonstrate any convincing benefit whilst showing significant side effects. They are also known to decrease respiratory drive and compromise lung function, worsening exercise tolerance. ( Franco-Bronson 2006). On balance, the evidence base does not support the use of the benzodiazepine group for t he relief of breathlessness in malignant disease. Anxiety and depression, both common associations of malignant disease, are commonly associated with increased perceptions of breathlessness. There is a substantial evidence base to show that aggressive treatment of both can produce significant improvement in subjective assessments of the symptom. Treatment of these conditions are complex and specialised and therefore will not be considered in detail. Kunik et al. have demonstrated in an evidence level IIa study that both anxiolytics (buspirone ) and psychological relaxation techniques are capable of producing significant decreases in levels of both anxiety and dyspnoea, as well as improved exercise tolerance among breathless patients. (Kunik, Azzam, Souchek, Cully, Wray, Krishnan, et al. 2007) In the interests of providing a comprehensive and balanced argument, note should be taken of the recent evidence level IIa paper by Lewith et al. which noted the positive, but not statistically significant effect of acupuncture on patients suffering from breathlessness. It should also be noted that these were patients with breathlessness as an all-cause symptom rather than specifically from malignant disease. (Lewith, Prescott Davis 2006) The evidence base relating to treatment of cough, a common symptom in lung cancer. It is generally taken to indicate involvement of the airways rather than the lung parenchyma, primarily because of the location of cough receptors. Kvale published a particularly helpful Medline review in 2008 which explored the evidence base for treatment options. (Kvale 2008). The paper itself is both extensive and comprehensive. Confining the discussion to the relevant portions of the paper shows that both surgery and radiotherapy (where appropriate) are both effective in reducing troublesome cough symptoms. A patient undergoing chemotherapy is less likely to have their cough symptoms reduced. There is a substantial evidence base to support the view that the use of inhaled bronchodilators and corticosteroids can be useful, but not in all cases. Specific antitussive centrally acting drugs that have been subjected to randomised controlled trials include codeine, hydrocodone, and dextromethorphan. Each of these has a strong supporting evidence base and minimum side effects. Dihydrocodeine has been specifically noted as having the dual purpose of both pain relief and cough suppression. (Homsi, Walsh, Nelson 2001). The opiate group in general, in addition to relieving pain and breathlessness are also strongly active in cough suppression. The authors make the point that many trials have noted the cough suppression effect of placebos in randomised controlled trials. This has not only the effect of adding an element of bias into the results, but also offers a line in management of cough in resistant cases. Fatigue is a common symptom associated with malignancies and certainly with lung cancer. This latter association is postulated to be related to the levels of chronic hypoxia in the later stages of the disease. (Higginson, McCarthy 2008) The Dagnelie et al. study is particularly useful in this respect as it considered the effect of fatigue on the quality of life of patients with lung cancer and found that it has clear statistical associations with the stage of the disease process, the degree of support that the patient has and also the mental state of the patient. (Dagnelie, Pijls-Johannesn, Lambin Beijer 2007). They found that those patients who had good support networks, and who were not depressed and who were able to maintain a good level of physical activity were the ones who were least likely to report significant levels of fatigue. A substantive literature search has failed to reveal any good quality trials which support these findings from a therapeutic perspective but intuitively, one might suggest that including the maintenance of a support network and direct assessment for depressive symptoms into a holistic management plan is likely to reduce levels of fatigue experienced by the patient. In passing, one can consider the very recent Breitbart study which looked at the use of psycho stimulants in cases of malignancy-related fatigue and found promising results from Modafinil, which is a new category of psychostimulant commonly referred to as wakefulness-promoting agent in the literature. It appears to be well tolerated and with few side effects. The results are too new to have yet been replicated with a larger randomised controlled trial and the authors also point to a large possible placebo effect in their trial. In these circumstances, the evidence base should perhaps be considered unproven until further evidence emerges. (Breitbart Alici 2010) The case study makes reference to passing reference to Andrew, Claires spouse, who retired two years ago and is clearly the main carer in this scenario. He does the shopping, cooking and various other domestic duties for Clare. Although we are told that this makes him feel useful the experienced and empathetic healthcare professional should be aware that the levels of occult depression in cancer-afflicted patients spouses is extremely high. (Kim, Duberstein, Sorensen Larson 2005) It has commonly been found to be the case that as the focus of care and intervention is generally targeted towards the patient, the carers, and particularly the spouses, do not have their needs either explored, considered or addressed. (Braun, Mikulincer, Rydall, Walsh Rodin 2007) It is part of the holistic assessment of the patients situation that the carers should be actively considered and managed as actively as the patient. This has the direct effect not only of trying to optimise the overall levels of care for the patient, but also promoting the spoken exchange of information, thoughts and feelings which are very likely not to be addressed of recognised, if not explicitly facilitated. (Kim, Schulz Carver 2007) The evidence base for these interventions is not strong. There is a considerable evidence base, from a large number of qualitative studies, which underlines the fact that spouses and carers, if supported, can improve the quality of life for the patient. It also appears to be the case that spiritual well being of the patient is improved if spouses and carers are encouraged and facilitated to talk about the situation, especially impending death, which is often regarded as a taboo subject in a household with a patient with a malignancy. Qualitative studies certainly strengthen the evidence base, but, in terms of guidelines and management strategies, they are generally not seen as being as robust as quantitative studies. (Gomm Davies 2008) In conclusion, the evidence base to devise a management strategy for Claire is dependent primarily on the mechanisms used to define her symptom base as well as her circumstances. It appears likely that Claire is adapting to her illness trajectory with a minimum of cognitive distortion, and is taking a rather fatalistic view of her situation. Management should clearly be primarily supportive, both of her and her spouse. The evidence base for symptom control is fairly strong. Pain is not a feature at the moment. Breathlessness could be tackled, initially by the instigation of anxiety-relieving behaviours and possibly by small doses of opiods. Cough can be helped by the use of dihydrocodeine if it is troublesome and fatigue needs careful evaluation to determine whether there is any depressive or psychological factors which are either primary of additive to the symptomatology. Claire may also need to be given permission to rest during the day and be told to pace herself with physical activity so that her fatigue is not such a problem for her. Healthcare professionals need to consider their interventions with the family very carefully. Claire perceives that they come out of the woodwork, which suggests that they are an unwelcome reminder of the fact that they are only there because she has a serious and ultimately terminal illness. Claire may need to be encouraged to talk and expand on this issue as the family may find it difficult if they are not welcomed, and Claire may need to be helped to confront the reality of her situation more directly. Andrew must not be overlooked when constructing a management strategy for this situation. It is a common finding for healthcare professionals to perceive that the spouse is being strong, but this may be a faà §ade for their partner. It is a useful strategy for the healthcare professional to make time to talk to Andrew on his own so that he can have the opportunity to raise issues that he may be unclear about. It may be that he does not know what to expect and is uncertain of the best way of handling the situation. Although possibly premature at the moment, part of the management plan should be to discuss how Andrew is going to approach a worsening situation. An essay such as this can only realistically consider the situation from a general approach. It is clearly the case that every strategy and intervention should be considered on the basis of a holstic assessment of the individual and the management tailored directly to the specific circumstances of the individual. Appendix I Classification of evidence levels Ia Evidence obtained from meta-analysis of randomised controlled trials. Ib Evidence obtained from at least one randomised controlled trial. IIa Evidence obtained from at least one well-designed controlled study without randomisation. IIb Evidence obtained from at least one other type of well-designed quasi-experimental study. III Evidence obtained from well-designed non-experimental descriptive studies, such as comparative studies, correlation studies and case studies. IV Evidence obtained from expert committee reports or opinions and/or clinical experience of respected authorities. (SIGN 2001) Appendix II Case Details Clares general practitioner has just referred her to the community palliative care service. Clare is a 65 year old woman, with lung cancer, an eventually fatal condition. She lives with her husband Andrew in their family home. Her two grown children are married and live interstate. Clare suffers from breathlessness, cough and fatigue. She gets distressed by her inability to catch her breath. Sometimes she has trouble sleeping at night and is frequently sleepy during the day. Clare says she doesnt have many strategies to help her manage her symptoms. She views her illness as a challenge as it impacts on what she can do and she doesnt feel in control of her life. Clare tells you that personal relationships are more meaningful for her now and she misses seeing her children, even though she keeps in frequent phone contact. She is surprised by the number of people who have come out of the woodwork and have come to visit her at home. Andrew retired two years ago so is able to do the shopping, cooking and other domestic duties for him and Clare. He says this makes him feel useful and its easier for him to do things than to talk about things. Andrew asks you if there is anything more he can do to help Clare.

Public Administration Essay

Q1: The chief executive of the country, or President, holds the highest office.   He cannot make laws but he participates in the legislation process. Although he is the head of state, I agree that the chief executive cannot take for granted that the legislative body, which is Congress, would follow his will on any subject.   The President has to use all of his willpower, his charisma, and every advantages available to him to influence the outcome of the legislation process.  Ã‚   The constitution made sure that the chief executive won’t have absolute power to avoid dictatorship.   There are even times that Congress would overturn the President’s veto on a particular law. As an example, the current administration of President Bush has always been in favor of attacking countries that pose a threat to the United States, particularly those countries that are identified as havens for terrorists.   President Bush obtained Congress’ approval on attacking Iraq and Afghanistan because of what happened in 9/11.   Congress agreed with the President to redress a wrong-doing and because a successful conclusion to the war was imminent.   Years later, the victory in Iraq was indecisive.   Despite the President’s persuasion for the troops to stay in Iraq, Congress held out and the chief executive has to concede to the decision that the troops should be pulled out. Q2: If I have to end the state’s monopoly on liquor sales, my strategy is to engage in massive lobbying efforts employing the best lobbyists in every state.   The CEO said money is not a problem, so, it means that advertising and marketing strategies can also be used to slowly influence the mind of the voters.   Hard liquors, like tequila, are popular drinks in bars.   The campaign should first target those people who owns bars and their patrons.   Whether or not this strategy would work out remains on how effective the lobbyists are in influencing the right people.   The lobbyists I would need are those who would be good in promoting the benefits of privatization of hard liquor, particularly to the state’s coffers.   The country is in an economic crisis and many states are hard-pressed to meet many programs.   With the promise of big tax revenues from the privatization, state officials would find ways to relinquish control over hard liquor sales.   They would find a way to change the law without needing a 60% acceptance from the public. Calling to mind the reasons why the Prohibition was approved, and why hard liquor sale is regulated by the government agency, I would be reminded of the evils of unregulated alcohol selling.   In this regard, my personal recommendation is not to allow private businesses to sell hard liquors.   Giving up control on hard liquor could mean a return of the era wherein alcohol consumption caused many of society’s ills.   There are too many crimes as it is, and unregulated alcohol manufacturing and selling could worsen the current situation. Q3:  Ã‚  Ã‚  Ã‚  Ã‚   The elements of a bureaucracy are: – statutes legalizing the agency’s existence, as well as how it is structured, the type of activities it is in charge with, and the budgets for the agency’s operation; – determination of what legislative committee is to oversee an agency and what sector of society will the services be delivered to; – discretionary power; – resources, how big the agency should be and how will the organization be structured; – maintaining a close relationship with the legislative body for its continued existence and survival; and – the presence of skillful leadership and knowledgeable employees. The strength of a bureaucracy lies in its being outside of the limelight in the political arena.   An administrative agency has more influence in policymaking when it is not being closely watched.   The weakness of a bureaucracy is on its single-mindedness of purpose.   If it is created for a particular sector, like the National Labor Relations Board for the labor sector, the agency cannot accommodate other requests from the public.   While is this a weakness, it is also a bureaucracy’s strength.   By focusing on one aspect of society, an agency can better serve the needs of that sector.   Another weakness of the bureaucracy is its tendency to respond more promptly to queries from legislators compared to its response to a query from the public.   Since an agency is dependent on Congress, it needs to be liked by the members of Congress. The criticisms against a bureaucracy are centered on two things.   First, an administrative agency’s accountability for failures is comparatively less compared to private businesses.   Second, a bureaucracy’s performance is difficult to gauge because it provides services and creates policies.   It cannot be measured based on quantifiable metrics. In my opinion, the main benefit of having administrative agencies is the focus it could give to the community in terms of services.   For instance, a bureaucracy is needed to manage the country’s health care.   Without a particular administrative agency for health care, people could wait weeks and months before receiving medical service.   In terms of challenges, a bureaucracy’s main challenge is how to become independent from the influence of legislators.   It has to find balance with regards to its dealings with the public and the legislative body. Q4: Federalism is a form of governance wherein the power to govern the nation is not centralized.   In the United States, the federal government does not control how states should implement and interpret many laws.   They are independent from the federal government’s interference in many aspects, like utility regulation, zoning, divorce, and many others.   In other words, each state is empowered to a certain degree.   The federal government do not interfere with state matters unless it has reason to.   When the federal government needs bigger state control, it often provides grants-in-aid to obtain some concessions from the states.   Or conversely, the federal government can decrease federal aid to the states.   Like in the case of the Medicaid system, the current administration is proposing a cut on its contribution to the program. Federalism is effective in giving each state the decision on how to govern itself based on its people’s needs.   Federalism could also be bad when there would be an absence of cooperation among states and between the federal government and the states. Q5: The current high rate of divorce can be attributed to the lack of difficulty in obtaining one since law made it easy for married couples to separate legally and sever the ties of marriage.   This is one area where I would work on so that couples can’t just divorce one another to the detriment of their children.   In order to tighten the law, I would first seek the aid of the church, the local politicians and engage the community in a discussion of my proposal. Before going to these people I would already be ready with my own modifications so that we have something concrete to work on.   I would present to these people my proposal that I would call the divorce test.   The couple should pass this test before any court would accept their filing. The revised divorce law would require the couple to undergo marriage counseling at least twice before they can pass the divorce test.   Like in bankruptcy, divorce should be the last resort for couples to take.   I would expect some quarters to argue but instead of debating endlessly, I would ask them to present one of their own proposal.   So long as everyone keeps to the objective of keeping families together, a revision could be arrived at that would be fair and equitable to everyone.

A Short Note On Human Resource Management - 1160 Words

Task1 - Introduction This report will firstly consist of a short profile on the term human resource management. Secondly a description of the importance of three human resource functions that are suitable for the above mentioned business in the task scenario. Also taking into account the situation of the business in the task scenario an examination of two appropriate workforce planning methods that can be used in their organisation. Then recount the ways in which the overall performance of the business in the task scenario can be improved by developing their employees. Lastly giving reasons, figure any two key areas of employment legislation that need to be considered by the human resource department regarding the hotel business in the task scenario. Human resource management is used to report formal systems created for management of people within an organisation. According to the business dictionary human resource management is the process of hiring and developing employees so that they become more valuable to the organisation. Human resource management includes conducting job analyses, planning personnel needs, recruiting the right people for the job, orienting and training, managing wages and salaries, providing benefits and incentives, evaluating performance, resolving disputes, and communicating with all employees at all levels. Examples of core qualities of HR management are extensive knowledge of the industry, leadership, and effective negotiation skills. FormerlyShow MoreRelatedMBA semester 1 assignments970 Words   |  4 Pagesï » ¿Get Answers of following Questions on www,smuhelp.com Master of Business Administration- MBA Semester 1 Winter 2013 MB0038 - Management Process and Organizational Behaviour Q1. What do you mean by Span of Control? Differentiate between narrow span of control and wide span of control. Describe the factors that influence the span of control. Q2. Define the term controlling. What are the pre-requisites of effective control? Q3. Define the term ‘personality’. Describe Cattell’s Personality FactorRead MoreHr Assignement1023 Words   |  5 PagesINTRODUCTION A Brief History Human Resource Management (HRM) is the effective management of people at work. It examines what can or should be done to make working people more productive. HRM can be traced back to England where masons, carpenters, leather workers and other craftspeople organized themselves into guilds. They used their unity to improve work conditions. The human resource field further developed with the arrival of the Industrial revolution in the latter part of the 18th centuryRead MoreHuman Resource Management Functions Of The Company1635 Words   |  7 PagesHuman Resource Management Function Based on Bandag’s size, it is important for the company to look closely at the human resource functions of the company. Currently, Jim’s executive assistant handles the day-to-day human resource management. It is important to first ask if Jim’s executive assistant has the expertise to deal with the day-to-day human resource tasks or is this an additional burden on the assistant. It may appear as a burden due to the many problems the company is experiencing. Read MoreMGMT 479 UNDER ARMOUR Powerpoint Group Essay1065 Words   |  5 Pagesrarely discounting Current Situation *See note section for more details ïÆ'‘ Board of Directors ïÆ'“ ïÆ'“ ïÆ'‘ Included eight members within the timeframe of the Case period Varied backgrounds, most serving since 2004 or earlier Top Management ïÆ'“ ïÆ'“ ïÆ'“ ïÆ'“ Eight executives made up UA’s top management team Founder Kevin Plank was President, CEO, and Chairman of the Board Divided into operational departments Very experienced in the industry Corporate Governance *See note section for more details ïÆ'‘ NaturalRead MoreSummary of Human Resource Management1577 Words   |  7 Pagesvery important that human research management to transform from being primarily administrative and operational to strategic partner. The reason is it important is because the human resource department plays a crucial role in determining the culture of an organization. Human resources promote and implement policies and procedures. The key areas are hiring practices, compensation, management relations and employee conduct and behavior. The decisions made by the human resources department will effectRead MoreHRM - Best Practices and RBV1107 Words   |  5 PagesImproving organisational performance and create a sustainable competitive advantage. A. HARVARD MODEL (Beer at al 1984) Example: Google According to Armstrong (2003), the framework is based on the belief that, the  problems  of historical personnel management can only be solved when general managers develop a viewpoint of how they wish to see employees involved in and developed by the enterprise, and of what HRM policies and practices may achieve these goals. To simplify the Harvard Model: 1. ThereRead MoreLooking Up and Looking Around’1397 Words   |  6 Pagesnot actually work in the field it will be interesting to see how true or false some of the points I make are. NOTE: The second half of the essay is on another one of my threads. Thanks Management is typically thought to be the place where calm, considered and well thought through decisions are taken. Drawing upon writings about the realities of managerial work and the nature of the management advice industry, why might we question this conventional view? Jackall’s (1988) text ‘Looking up and lookingRead MoreA Definite Link Between an Organisations Business Strategy and Human Resources Strategy Is Essential for Business Success1207 Words   |  5 PagesA Definite Link Between an Organisation s Business Strategy and Human Resources Strategy is Essential for Business Success The world of work as we know it today is changing rapidly from the introduction of new labour laws, globalisation, demographics, an ageing workforce. In the busy and demanding environments in which people work today it s not very often that we can take the opportunity to step back and look at the broader picture and overall direction in which we are heading. There are manyRead MoreThe Role and Responsibility of Company Leadership in Shaping Organizational Culture1712 Words   |  7 Pages was the need to follow the comprehensive, state of the art and award winning management control and governance systems (Free, Macintosh Stein, 2007). The successful implementation of management controls and corporate governance largely depends on an organization’s culture and top leadership. Jeffrey Skilling was required as the CEO of Enron to provide direction and leadership with regards following the management controls and corporate governance systems to the latter. He, however, did the oppositeRead MoreLimitations to Hr Planning1743 Words   |  7 Pages | Question: Examine the limitation to Human Resource Planning. What you advocate as the measures for dealing with identified limitations? Definition of Human Resource Management It is proposed that we take human resource management to be that part of management concerned with: All the decisions, strategies, factors, principles, operations, practices, functions, activities and methods related to the management of people as employees in any type of organisation (including

Stare Decisis Definition - Honor Past Precedents

Stare decisis (Latin: stand by the decision) is a legal phrase referring to the obligation of courts to honor past precedents.There are essentially two types of stare decisis. One is the obligation that trial courts have to honor the precedents of higher courts. A local trial court in Mississippi cannot legally convict a person for flag desecration, for example, because of a higher court—the U.S. Supreme Court—ruled in Texas v. Johnson (1989) that a flag desecration is a form of constitutionally protected speech.The other concept of stare decisis is the obligation of the U.S. Supreme Court to honor past precedents. When chief justice appointee John Roberts was questioned before the U.S. Senate, for example, it was widely believed that he does not accept the concept of an implicit constitutional right to privacy, upon which the Courts decision in Roe v. Wade (1973) legalizing abortion was based. But he implied that he would uphold Roe despite any personal reservations du e to his commitment to stare decisis.br/>Justices have different levels of commitment to stare decisis. Justice Clarence Thomas, a conservative jurist who often sides with Chief Justice Roberts, does not believe that the Supreme Court is bound by stare decisis at all.Stare decisis doctrine isnt always cut and dry when it comes to protecting civil liberties. While it can be helpful concept vis-a-vis the preservation of rulings that protect civil liberties, excessive commitment to stare decisis would have prevented such rulings from being handed down in the first place. Proponents of civil liberties hope that conservative justices support precedents set by the anti-segregation ruling Brown v. Board of Education (1954) on the basis of stare decisis, for example, but if the justices who handed down Brown had felt similarly about the separate but equal pro-segregation precedent set in Plessy v. Ferguson (1896), stare decisis would have prevented Brown from being handed down at all. Pronunciation: star-ray dee-sigh-sus Also Known As: adherence to precedent; stare decisis is also similar, albeit not identical, to the concept of judicial restraint Common Misspellings: stare dicisis, stare decises