You Decide Virginia Pollard Essay Example

You Decide Virginia Pollard Essay You Decide Project Virginia Pollard worked as a cashier and clerk for Teddy Supplies, a family-owned chain of film production equipment supply stores in Pennsylvania and New Jersey. During a routine performance evaluation, Virginias supervisor at Teddys complained that she made too many personal phone calls when she worked in the West Orange store. The supervisor noted this on Virginias annual review, and warned her to keep personal calls to a bare minimum while at work. Soon thereafter, Teddy transferred Pollard to guard film equipment in the main warehouse behind the storefront; Virginia couldnt make personal calls there, and her work became exemplary. Her performance evaluation three months after her transfer was meeting expectations with no negative comments. Virginia Pollard was the only woman working in the warehouse, and she was often the victim of pranks perpetrated by her six male colleagues. Her co-workers taped her drawers shut, locked her out of the guard shack she sat in to watch the inventory, filled the guard shack with trash, and backed a forklift up to the door and made it backfire in her ear. One day a Teddy delivery driver sat in Pollards chair and, when she tried to push him out of it, he bent her over his lap and spanked her. Pollards new supervisor, Steve King, rarely enforced Teddys rules against smoking, horseplay, foul language, and sexual harassment, and often indulged in such behaviors himself. We will write a custom essay sample on You Decide Virginia Pollard specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on You Decide Virginia Pollard specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on You Decide Virginia Pollard specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Teddys had a written sexual harassment policy which included a method for employees to report sexual harassment the method included filing a complaint with the direct supervisor unless the direct supervisor was the perpetrator. In that event, the employee was to file the complaint online at www. ReportTeddysafely. com. The form for reporting was a one page document. A copy of the policy which Virginia Pollard signed is located here. The policy specifically states, In the event of a violation of this policy, employees should report the violation to their direct supervisor, unless doing so would put the employee at risk of further discrimination or harassment. In that case, the employee should report using the company website form which will submit the incident to Human Resources. Pollard never filed a complaint with Steve King, her supervisor; she also did not file a complaint at the website, although she claimed she told King in July 2008 that she felt she was being picked on by the guys she worked with. She claims Steve King told her to grow some balls and to get over herself. She testified during the NJ Human Rights Commission hearing that she tried to file an anonymous complaint but the website wasnt working the day she tried to do so. In August of 2008, King and the other warehouse workers put a sign on a truck that read HARDHAT REQUIRED/BRA OPTIONAL. King and another employee called Pollard over to look at the sign and encouraged her to do as it said. She refused and tried to walk away. King promised not to report her to management, whereupon she lifted one side of her shirt in the back and exposed part of her bra on her backside. Upper management learned of the incident that October by a co-worker who filed an anonymous complaint online. After a brief investigation, Pollard was fired for exposing her bra. None of the men were disciplined. A man replaced Pollard in the guard shack. That November, Pollard filed a charge of sex discrimination with the New Jersey Commission on Human Rights. The Commission found that Pollard had been the victim of sex discrimination and that Teddys reasons for firing her were pretext, and awarded her back wages and damages. Teddys appealed to the circuit court, including in their case that Pollard had committed several infractions, including participating in the spanking incident. They reported that Pollard had failed to report any sexual harassment and included a copy of their sexual harassment policy as part of their defense case. The Circuit Court found that Teddy did have good reason to discipline Pollard but that firing her was in fact disparate treatment when compared with the utter lack of discipline given to King. The circuit court reversed the Commissions award of damages because it believed that Teddy had been right to discipline Pollard, but they ordered Teddys to reinstate Pollard to her old position. Pollard appealed to the New Jersey Court of Appeals and refused to accept her job back. Sexual Harassment Policy: Teddys Supplies Sexual Harassment Policy All employees of Teddys Supplies are required to read and follow this policy. This policy was implemented on January 1, 2002, and is in effect until further notice. Scope of Policy This policy prohibits any illegal discrimination or harassment of any employee by another employee, co-worker, supervisor, or vendor. All employees are entitled to a harassment and discrimination free environment. The company has a zero-tolerance policy with respect to harassment or discrimination. A safe work environment is the goal of Teddys Supplies. Responsibility and Reporting structure All employees are responsible for following this policy. In the event of a violation of this policy, employees should report the violation to their direct supervisor, unless doing so would put the employee at risk of further discrimination or harassment. In that case, the employee should report using the company website form which will submit the incident to Human Resources. Employees have the option of anonymously reporting incidents, but doing so does not provide the employee with any protection under the law. (Access the reporting form on the benefits page of the intranet. Behavior Banned All illegal, discriminatory, or harassing behavior is prohibited. Discipline invoked Employees found to violate this policy may be terminated, suspended from work without pay, or transferred. This document will be considered the warning in the event of termination. No other warning is required. In the event a suspension or transference is a result of a violation of this policy, any 2nd offense will be met with immediate dismissal. In the event a compla int against an employee is made, the employee will have the right of defense at a hearing prior to termination. This hearing will be held by the CEO and Director of HR, or by a committee created at their request or direction. No retaliation Employees will not be retaliated against making for valid complaints. In the event it is determined that an employee has filed a fraudulent complaint, this will be grounds for disciplinary action, including suspension without pay, transference or termination. Limitation period All complaints for violations of this policy must be made within 90 days of the occurrence of the behavior or they are waived under this policy. Signed: 2004 Virginia Pollard Date: 8-12- You Decide Question #1: Teddys Supplies CEO has asked you to advise him on the facts of the case, and your opinion of their potential liability. He wants to settle the case. Write a memo to him which states your view of whether the company is exposed to liability on all issues you feel are in play. Include in your memo any laws which apply and any precedential cases either for or against Teddys case which impact liability. Include in the memo your suggested offer of settlement to Virginia. Back up your offer using your analysis of the case against Teddys. (Points: 30) As an advisor, I would inform Teddys Supplies CEO the situation is Virginia Pollard, the only woman working in the warehouse, is filing charges against the company for sexual harassment. The fact of the matter is the employees in the warehouse are guilty of disparate treatment towards Virginia Pollard as warehouse workers put a sign on a truck that read HARDHAT REQUIRED/BRA OPTIONAL along with other discriminatory actions (pranks, spanking incident, etc. ). However, per the Sexual Harassment Policy implemented by the company, Virginia did not ever file sexual harassment complaints when given the opportunity to. As a conclusion, I believe Teddys Supplies as a company, is responsible for the hostile work environment created around Virginia Pollard; my advice would be to offer a settlement to Virginia Pollard in the amount of $5,000. I believe the $5,000 is a sufficient settlement because according to Burlington Industries v. Kimberly Ellerth case, I believe that Virginia Pollard was been a victim of a hostile work environment. You Decide Question #2: The Circuit Court overturned the decision of the NJ Human Rights Commission which had found that Pollard was the victim of Sexual Harassment and disparate treatment. Please answer these questions: A. Define sexual harassment, including both quid pro quo and hostile environment harassment. Which type(s) do you feel Pollard was a victim of (if either. ) Provide law or a case to support your position. If you feel Pollard was not a victim of harassment in this case, explain why you feel that way, and provide law or a case to support your position. (10 points) B. Name an appellate court case where an employer was found liable for either quid pro quo or hostile environment sexual harassment. Describe the facts of the case, and the decision the court came to in the case. Explain whether you think that case applies to Pollards case (why or why not) and whether you would want to use this case in Teddys favor or whether Pollard may use it in her favor. Include the citation to the case and a link to it online. (10 points) C. Do you agree that Pollard was disparately treated? Why or why not? In your answer, define disparate treatment. 10 points. ) D. Does the existence of a sexual harassment policy provide a defense to Teddys in this case? Why or why not? (Include the name and citation of at least two federal or state sexual harassment case(s) which provide precedential support to your defense statement. ) (10 points. ) (Points: 40) A) Sexual harassment is the act of inappropriate actions insinuating sexual conduct. The two types of sexual harassmen t are quid pro quo and hostile work environment. Quid pro quo is the action of getting something for giving something of value. Hostile work environment is when an employer engages in inappropriate behavior making the working place not up to reasonable standard. According to Burlington Industries v. Kimberly Ellerth, I believe that Virginia Pollard was a victim of a hostile work environment. In this case the Supreme Court ruled that workers can still bring sexual harassment cases against employers even if the harassment is not reported. B) A court case when the employer was found liable for sexual harassment is the Burlington Industries v. Kimberly Ellerth. In this case, Kimberly described her experiences at work as feeling humiliated and embarrassed. Kimberly also claimed to be an emotional and mental victim of sexual harassment by her supervisor but never reported the incidents to anyone at work. This case applies to Virginia Pollards case and I would want to use this case in her favor because she has been the victim to humiliation when her coworker bent her over his lap and spanked her. This case applies directly to Virginia Pollard because even though she never filed a complaint with her supervisor Steve King, nor did she file a complaint at the website online, she can still bring sexual harassment cases against employers even if the harassment is not reported. http://www. law. cornell. edu/supct/html/97-569. ZO. html) C) I do agree that Pollard was disparately treated. Disparate treatment is mistreatment of employees differently because of their membership in a certain protected class (Race, Color, Religion, National Origin, Sex). In this case, Pollards employees treated her with discriminatory conduct because she was the onl y woman working in the warehouse when the sign posted on a truck read HARDHAT REQUIRED/BRA OPTIONAL. This sign discriminated Virginia Pollard because she was the only woman in the warehouse amongst six other employees. D) The existence of sexual harassment policy does not provide a defense to Teddys in this case. Even though Teddys policy provides the opportunity for employees to report misconduct, it does not dismiss the employer from being liable for conduct of employees. Two cases that support this are the Burlington Industries v. Ellerth case and Burrell v. Star Nursery, Inc. Both of these cases state that the employer must be liable for the sexual harassing conduct of their supervisors even if they neither knew nor should have known that the misconduct was occurring. You Decide Question #3: Review the sexual harassment policy which Teddys has in place and which Virginia Pollard signed. Virginia Pollard claims she had planned to make an anonymous complaint but the website allowing that was down on the day she tried to do so. During the Human Rights Commission case, a review of the website statistics shows that Virginia accessed the website for downloading dental coverage forms at least three times during the time frame of the alleged discrimination. The commission determined that this ability of Teddys to track employees use of the site was a violation of their anonymity and therefore, refused to consider this information. The circuit court did consider this in their decision. Provide three recommendations to the CEO for a way to ensure that employees in the future can not claim technical issues for why they didnt make a complaint. Explain, in your recommendations, the legal consequences to an employee if they do not utilize the complaint mechanism of the sexual harassment policy. Support these recommendations with current case law. (Points: 20) Three recommendations I would make to the CEO of Teddys to ensure that employees in the future could not claim technical issues for why they didnt make a complaint would be providing alternative options in reporting this matter. The three recommendations I would give to the CEO of Teddys would be: 1) Create a drop box/1-800 number/multiple parties employees could contact in order to file their complaints into so anonymity still existed. The legal consequence to an employee for not utilizing the complaint mechanisms would be negligence. The addition of the additional options juxtaposed with the existing online reporting option gives each employee an additional opportunity to report any sexual harassment cases at the workplace or at home. Similar to Brenneman v. Famous Daves of America, the legal consequence to the employee for not reporting events of sexual harassment would be the employer being able to defend themselves from sexual harassment allegations having given the employee almost any opportunity to report this misconduct. ) Implement a periodic harassment training to supervisors and employees to ensure that they know and remember that they must take the appropriate action to avoid sexual harassment law suits. By training the employees and supervisors of this sexual harassment periodically, it constantly reminds them of the differences of appropriate and inappropriate behavior and what actions to take in the i nstances of misconduct. In addition to the training, prompt and swift implementation for correction action must be taken to those found guilty of misconduct. Moreover, due to Suders v. Pennsylvania State Police employers should also train their supervisors to know that the burden of proof dismissing them from any liability is also their responsibility in the case a sexual harassment suit. 3) Become more involved in every aspect of the company. Spend time with each department within the company to exercise reasonable care to prevent or correct any harassing behavior. By doing this, the employer may then claim affirmative defense because a) the company has an effective internal complaint procedure for reporting incidents of workplace harassment, and (b) the employee unreasonably failed to take advantage of that procedure. Upon any misconduct, the legal consequence for the employee not reporting the misconduct would be the employer using affirmative defense to his advantage. You Decide Question #4: How would Pollards case be impacted if her replacement had been a female? Would her case be different? Would her damages be different? Explain your answer. (Points: 10) Pollards case could be viewed differently if Pollards replacement had been a female, because Teddys had initially fired her for exposing her bra. If Pollard had been replaced by another woman, I dont think it would be viewed as disparate treatment because it would have been just seen as personal misconduct. In addition, if Pollards replacement had been a woman, the Circuit Court may have supported Teddys discipline to Pollard and still reversed the Commissions award of damages because it believed that Teddy had been right to discipline Pollard.

How the Trucking Industry Can Help End Distracted Driving

How the Trucking Industry Can Help End Distracted Driving Distracted driving is an epidemic claiming far too many lives each year. One company, KRST (Keeping Roads Safe Technologies, Inc.) is ready to take that epidemic on, and is currently looking for partners within the trucking industry to help them fight it. The Halifax-based company proposes to monitor how, when, and why truckers use their mobile phones while driving. The company has designed two devices to be installed in any company vehicles that would collect and analyze this information. The first, CellAware, would give trucking companies precise data about their employees’ cell phone usage on the road. The second, KRSTI, would actually delay all calls and text messages on a driver’s phone until his or her vehicle’s engine had been turned off.The devices could also provide valuable information about mileage, fuel consumption, and location-tracking, as well as distance travelled without incident, all the while monitoring and reporting any attempted calls, texts, or tampering with the vehicle in motion.KRST plans to manufacture 5,000 of these devices and kick off the program- at no charge to the participating companies- in January 2016. Companies wanting to get involved should call +1 844-993-4357.

Why You Should Write Practice Tests While You Study

Why You Should Write Practice Tests While You Study One of the best ways to score high grades is to create your own practice tests. It’s a little extra work while you’re studying, but if that investment results in higher grades, it’s definitely worth it. In their book, The Adult Student’s Guide to Survival Success, Al Siebert and Mary Karr advise: Imagine that you are the instructor and have to write some questions that will test the class on the material covered. When you do this for each course you will be amazed at how close your test will match the one your instructor creates. Creating a Practice Test While youre taking notes in class, write a Q in the margin beside material that would make a good test question. If you take notes on a laptop, assign a highlighter color to the text, or mark it in some other way that is meaningful to you. You can find practice tests online, but these will be tests for special subjects or exams, like the ACT or GED. These wont help you with your particular test, but they can give you a good idea of how test questions are stated. Remember that your teacher wants you to succeed. The best way to find out what kind of test he or she gives is to ask. Explain to him or her that you want to write your own practice tests, and ask if they will tell you what format the questions will take so you can make the most of your study time. Siebert and Karr suggest that as you read your textbooks and lecture notes, jot down questions that occur to you. You’ll be creating your own practice test as you study. When you’re ready, take the test without checking your notes or books. Make the practice as real as possible, including giving partial answers when you aren’t sure and limiting the time allowed. Suggestions for Practice Tests In their book, Siebert and Karr make a few practice test suggestions: Ask at the beginning of the course when tests will be given and in what formatWrite your practice tests in the format your teacher will use (essay, multiple choice, etc.)Ask the librarian if there is a collection of old exams you can studyFind out if there is a student manual that accompanies your textbookAsk former students about the kind of tests your teacher givesAsk your teacher for suggestions for test prepAsk a friend, family member, or fellow student to quiz you Test Question Formats Familiarize yourself with the different kinds of test question formats: Multiple Choice: You are given three or more choices and must select the correct answer. Sometimes, all of the above is a choice.True or False: These are usually used when you are being required to memorize facts. They are often tricky. Read them carefully.Fill-in-the-Blank: These are similar to multiple choice except that you must know the answer without being given choices.Essay or Open-Ended: These questions test your comprehension of a subject. Youll be given a question that you must answer at length, giving specific examples, or you may be given a statement to agree or disagree with. These may sound challenging to you, but if you know your stuff, this type of test question also allows you to shine. Be ready and make the most of the opportunity. Source Siebert, Al, Ph.D. The Adult Students Guide to Survival Success. Mary Karr MS, 6th edition, Practical Psychology Press, July 1, 2008.

The importance and value of crossing of disciplinary and artistic Assignment

The importance and value of crossing of disciplinary and artistic borders - Assignment Example As seen in the interview, this is not anew strategy because it has been in use for a long time now. Its invention, as evidenced in the artist’s argument really revolutionized art. By combining the elements of traditional art to the new found media, the artist managed to produce amazing oil portraits, an aura that played a very significant role in making art to be perceived to be having a political influence in the society. However, for this kind of artwork to be properly made, a proper choice of the sturdy foundation should be made for all the layers included in the artwork. Indeed, mixed media art is a noble idea because it has lots of benefits to the artists and consumers of artwork. Its first advantage is that it is const-friendly. As compared to the traditional art, mixed media art is a very cheap initiative as it does not have many expenses. Since it is not restricted to the use of only one particular medium, the artist is free to choose to use a variety of objects including newspapers, oil paint, clothes, sculpture, textile, ink, pieces of wood, graphite or household glue. All of these do not necessarily need to be bought because a large number of them like newspapers and pieces of wood can be easily found and collected from the immediate environment. Besides, mixed media art can be used in expressing political views. Over the years, art has been used as a very powerful tool in politics. As indicated in the article, the use of oil portraits played a very significant role in the political scene. By combining randomly found objects and traditional media, the artist managed to create appealing portraits for Margaret Thatcher. This is a clear indication that a proper use of mixed media can greatly help in the political engagement of art. It makes it easier for art to go beyond political borders by creating a political content in them. Lastly, mixed art is more aesthetic and

Ethics in Entrepreneurship Essay Example | Topics and Well Written Essays - 1750 words

Ethics in Entrepreneurship - Essay Example But in performing such type of operations, Ethics is extremely essential. It is known as the philosophy that an entrepreneur or business organization adheres in its dealings. This means, each and every business organization or entrepreneur comprises of certain rules and principles that its employees need to follow at the time of tackling its operations. Otherwise, the entire business organization might lead to downfall of productivity and profit margin. Apart from Ethics, Morality is another essential term offering high value towards business. Morality is mainly concerned with varied types of values, norms and beliefs that help an individual to detect the right or wrong actions. Thus, the behavior of an individual is highly influenced by such values, beliefs and norms that vary from person to person. With the help of such behaviors, an entrepreneur or individual enhances the prospects of a business organization. So, such values are extremely essential for an entrepreneur. Discussion The characteristics of Ethics in business are as follows: Ethical decisions differ from one person to another. It is mainly due to different views, values, norms and beliefs of varied types of individual. However, each and every types of ideas and values need to be apt for the customers or employees of the organization. Ethical decisions need to be at par with the cost incurred and the profit margin of the business. In order to do so, the entrepreneur needs to offer the products and services in such types of prices to its customers. The decisions of the employees in a business are voluntary their own deeds. So, it is essential for the employees to present ethical decisions that might prove effective for the business in long run (Shaw, 2010). Ethics is a trait of human being that needs to be ethical. Otherwise, being an employee of an organization, he might not be able to take any type of ethical decisions. Not only in his professional life, but ethics is also essential in oneâ€℠¢s private life. If he or she fails to take the ethical decisions, then he or she might never prosper in life in future era. Side by side, due to an unethical decision, not only the image or productivity of the organization might get reduced but also the reputation may decline. The range of customers might get reduced slowly and slowly leading to downfall of the entire profit margin of the organization. Thus, the rate of loyalty over the brand or the entrepreneurial image might get faded among the public day by day. So, it is extremely essential to maintain a strong status and supremacy in the market for the brand and its products on the basis of ethical decisions. Only then, an entrepreneur might prosper. Ethics is a type of characteristics feature of a human being that varies from one individual to another. Moreover, working in a group or an organization, the ethical views and norms of an individual also gets highly influenced by others. Some of the aspects by which, ethics within an organization gets affected are stated below: Religion- as numerous individual works within an organization or under an entrepreneur, some due to diverse religious traditions and norms, ethical decisions also get affected. Thus, sometimes, due to religious variations, the decision making of the individual gets influenced to a certain extent. But still, serving the human being in a best way is the only view

Patients With Neurologic Dysfunction Health And Social Care Essay

Patients With Neurologic Dysfunction Health And Social Care Essay Keshin Himura is a 42-year-old patient diagnosed with pituitary prolactinoma, a benign tumor that arises from the pituitary gland, resulting in a decrease in libido and impotence and increased milk production of the breast. The patient also has complaints of headache and drowsiness and the presence of visual field changes and papilledema preoperatively. What postoperative care should the nurse provide the patient? The nurse should provide the following postoperative care to the patient: Evaluate gag reflex and ability to swallow Offer semisoft diet Perform neurologic checks Monitor vital signs Maintain neurologic flow chart Reorient patient when necessary to person, time and place If with seizures, carefully monitor and and protect from injury Check motor function at intervals Assess for sensory disturbances Evaluate speech The patients family asks the nurse how will they know that the problems the patient had before surgery have stopped; what is the nurses best response? Through observation, conducting series of test that will be provided by the physician (e.g. MRI, CT scans) to check if the tumors are already diminished, because presence of tumor will still inhibit the signs and symptoms of the disorder. The primary objective of the surgical intervention is to remove or destroy the entire tumor without increasing the neurologic deficit and to relieve symptoms by decompression. And if there is no evidence of tumor, the normal levels of hormone would return in usual, the patient will no longer experience the symptoms of the disease. What management strategies should the nurse anticipate will be ordered to care for diabetes insipidus if it occurs? The objective of the therapy is: To replace ADH To ensure adequate fluid replacement To correct the underlying intracranial problem (pituitary prolactinoma) A fluid deprivation test is ordered by the physician to confirm for the diagnosis of diabetes insipidus by: withholding fluids by 8 to 12 hours Patient is weighed frequently during the test Plasma and urine osmolality studies are performed at the beginning and end of the test. The inability to increase the specific gravity and osmolality of the urine is an indication of Diabetes insipidus Pharmacologic Therapy Administer Desmopressin (DDAVP) intranasally, BID as ordered Nursing Management Establish baseline data ( weight, BP, I/O patter), Monitor BP and weight frequently throughout therapy and report sudden changes to physician Monitor I/O and specific gravity and serum osmolality as ordered If patient has Coronary artery disease, use this drug with caution as this drug causes vasoconstriction Avoid concentrated fluids as this increase urine volume What discharge instructions should the nurse provide the patient and family? Most patients will spend at least one night in the intensive care unit (ICU) and then typically 2 or 3 additional nights on a regular (non-ICU) ward after surgery The patient will likely have some incisional pain and mild to moderate headache for which he will be given pain medication. A CT scan or MRI will be ordered before discharge Ask patient to return 2-3weeks after surgery Inform patient to return 2-3months after 1st check-up Inform family to watch out for signs of DI (intense thirst, frequent urination). Refer immediately Management of Patients with Neurologic Dysfunction  Ã‚   Case Study 2 Hiehachi Nishima, a 22-year-old patient who weighs 150 pounds, presents to the emergency department (ED) after being thrown from his horse and passing out for a few minutes; he regained consciousness. The friend who was also riding a horse called the squad. The patient presented with a GCS of 15, and the neuro exam was within normal limits (WNL). The ED physician wrote the orders for a CT scan without contrast of the head, CBC, renal and metabolic profile, PT, PTT, and INR. The nurse sent the labs and had the IV of NS at keep-open rate per ED protocol hanging. The nurse was awaiting radiology to call for the patient to go for the CT when the patient had an epileptic cry, became unconscious, stiffened his entire body, and then had violent muscle contractions. The respirations are very shallow, and the lips and nail bed became blue. The patient lost control of bladder and bowel. The patient bit his tongue and blood is coming from the mouth. The radiology department calls and is ready f or the patient. List in the correct order the actions that should be taken by the nurse. Before and during a seizure, the patient is assessed and the following items are documented: The circumstances before the seizure The occurrence of aura The first thing the patient does in the seizure where movements or stiffness begins, conjugate gaze position, position of head The type of movements in the part of the body involved The areas of the body involved The size of the pupils and whether the eyes are open Whether the eyes or the head are turned to one side The presence or absence of automatisms Incontinence of urine or stool Unconsciousness and its duration Any obvious paralysis or weakness of arms or legs after the seizure Inability to speak after the seizure Movements at the end of the seizure Whether or not the patient sleeps or not afterwards Cognitive status after the seizure In addition to providing data about the seizure, nursing care is directed at preventing injury and supporting the patient not only physically but also psychologically. Consequences such as anxiety, embarrassment, fatigue, and depression can be devastating to the patient. After the patient has a seizure, the nurses role is to document the events leading to and occurring during and after the seizure to prevent complications. Explain what type of seizure the patient is having, and describe the three phases of the patients seizure and the specific nursing care for each stage. The patient had a tonic-clonic (gran mal) seizure. There are three phases namely the aura, the tonic and the clonic phase. In the aura phase is the forewarning of an epileptic attack. It characterized by episodes of Dà ©jà   vu or Jamais vu. The client may also have auditory, olfactory, or even visual hallucinations, abnormal tastes, and tingling sensations. Physical symptoms include dizziness, headache, lightheadedness, nausea, numbness. Though in this case, the client did not show signs of the aura phase. *Nsg Mgt: Provide privacy and protect the patient from curious onlookers Patients who have an aura may have time to seek a safe, private place Ease the patient to the floor, if possible Loosen constrictive clothing Push aside any furniture that may injure the patient during a seizure If an aura precedes the seizure, insert an oral airway to reduce the possibility of the patients biting the tongue The next is the tonic phase. It is usually the shortest part of the seizure, lasting not more than only a few seconds. In this case, it is when the patient had an epileptic cry, became unconscious and stiffened his entire body. *Nsg Mgt: Protect the head with a pad to prevent injury from striking a hard surface If the patient is in bed, remove pillows and raise side rails The last is the clonic phase. It is when the client had violent muscle contractions, very shallow respirations, the lips and nail beds became blue, lost control of bladder and bowel and bit his tongue. *Nsg Mgt: Do not attempt to pry open jaws that are clenched in a spasm or to insert anything. Broken teeth and injury to the lips and tongue may result from such an action. No attempt should be made to restrain the patient during the seizure because muscular contractions are strong and restraint can cause injury If possible, place the patient on one side with head flexed forward, which allows the tongue to fall forward and facilitates drainage of saliva and mucus. If suction is available, use if necessary to clear secretions. The ED physician orders the following: Valium (diazepam) 10 mg every 10 to 15 minutes prn for seizures (maximum dose of 30 mg). Once seizures stop, administer Dilantin (phenytoin) 10 mg/kg IVPB. ECG monitoring continuously, VS, GCS, neuro checks every 30 minutes. Explain what meds the nurse should provide, in what order, and how they should be administered. The nurse should provide Valium injection (diazepam) 10 mg IM PRN every 10 to 15 mins. (max 30mg) for his seizure to relief the muscle spasm. For the long term relief, administer Dilantin (phenytoin) 10 mg/kg IVPB loading dose STAT, once the seizures stop. Dilantin (phenytoin) is an anti-seizure medication (anticonvulsant), especially to prevent tonic-clonic (grand mal) seizures and complex partial seizures (psychomotor seizures).We use piggyback to administer different IV drugs at different times. Dilantin can cause irritability to the veins and can cause serious tissue and/or nerve damage if it infiltrates. So we should administer it with normal saline. Draw up the drugs in a syringe and attach it to the piggyback port on the IV tubing cassette, which is run concurrently with the primary IV fluid (normal saline). Run it slowly and keep an eye on the ECG monitor. This ECG monitoring should be done continuously to help identify irregular heartbeats. For the vital signs, Glasgow coma scale and neuro V/S, it should be check every 30 minutes to provide reliable, objective way of recording the conscious state of a person for initial as well as subsequent assessment. Group Assignments Have each member address nursing management related to caring for an unconscious patient. Preventing Urinary Retention Palpate bladder at intervals to determine whether urinary retention is present If patient is not voiding, an indwelling catheter is inserted and connected to a closed drainage system as ordered Observe for fever and cloudy urine for infection Observe the area around the urethral orifice for any drainage As soon as consciousness is regained, a bladder-training program initiated Promote Bowel Function Assess abdomen for distention by listening for bowel sounds (irregular gurgling sounds should be heard every 5-20sec) Measuring the girth of the abdomen with a tape measure. Monitor for the number and consistency of bowel movements Perform rectal examination for signs of fecal impaction as ordered. Stool softeners may be prescribed and can be administered with tube feedings Glycerin suppository may be indicated to facilitate bowel emptying May require enema every other day to empty lower colon Maintain Skin and Joint Integrity Monitor pressure areas for possible ulcerations Establish a regular schedule of turning to avoid pressure, which can cause breakdown and necrosis of the skin This provides kinesthetic, proprioceptive and vestibular stimulation Avoid dragging and pulling the patient up in the bed, because this creates a shearing force and friction on the skin surface Maintain correct body position Passive exercise of the extremities is important to prevent contractures Splints or foam boots may be used to prevent foot drop and pressure of bedding on the toes Trochanter rolls may be used to support the hip joints and keep the legs in proper alignment Providing Mouth Care Inspect mouth for dryness, inflammation, and crusting Cleanse and rinse mouth carefully to remove secretions and crusts and to keep the mucous membranes moist Administer petrolatum on the lips to prevent drying, cracking and encrustations. If patient has an endotracheal tube, the tube should be moved to the opposite side of the mouth and lips Perform routine tooth brushing every 8hrs to decrease ventilator-associated pneumonia Maintaining the Airway Elevate the head of bed to 30 degrees to prevent aspiration. Place the client in lateral position to allow the jaw and tongue to fall forward to promote drainage of secretions. Suction for secretions as needed Maintain oral hygiene Chest physiotherapy and postural drainage to promote pulmonary hygiene Auscultate the patients chest every 8 hours to assess for any deviated breath sounds. If the patient has a mechanical ventilator, maintain the patency of the endotracheal tube or tracheostomy, provide oral care, monitor arterial blood gas measurements and maintaining ventilator settings. Protecting the Patient Raise side rails up as always to prevent injury Ensure the patients dignity during altered LOC, speaking to the client during nursing care activities. Maintaining Fluid Balance and Managing Nutritional Needs Assess skin turgor and mucous membrane for dryness Monitor for intake and output and determine the needs for catheterization Preserving Corneal Integrity Patients eyes may be cleansed with cotton balls moistened with sterile normal saline to remove any discharge. For artificial tears (prescription by the physician), may introduce every 2 hours. Maintaining Body Temperature The environment can be adjusted (depending on the patients condition) to promote normal body temperature. If body temperature is elevated, a minimum amount of bedding is used. For geriatric patients and doesnt have any elevated temperature, a warmer environment is needed. Providing Sensory Stimulation Communicate with patient, and encourage the family members to do it so. Orient the patient to time, date, and place once for every 8 hours. Have each group member develop a nursing diagnosis related to a patient with an altered level of consciousness. Identify potential problems and complications related to the nursing diagnosis. Nursing Diagnosis Potential Problems and Complications 1. Ineffective airway clearance related to altered level of consciousness Aspiration 2. Risk for impaired skin integrity related to prolonged immobility Bed sore Pressure ulceration 3. Impaired Urinary elimination: retention related to impairment in neurologic sensing and control Bladder distention Infection Formation of stones 4. Impaired tissue integrity of cornea related to diminished or absent corneal reflex Periorbital edema Ulcerations Corneal abrasions 5. Deficient fluid volume related to inability to take fluids by mouth Dehydration Cerebral edema 6. Interrupted family processes related to changes in the cognitive and physical status of their loved one Crisis Severe anxiety, denial, anger, remorse, grief, and reconciliation 7. Risk for injury related to decreased LOC Falls 8. Ineffective thermoregulation related to damage to hypothalamic center Hyperthermia 9. Impaired oral mucous membrane related to mouth breathing , absence of pharyngeal reflex and altered fluid intake Dryness Inflammation Crusting 10. Bowel incontinence related to impairment neurologic sensing and control Abdominal distention Diarrhea Frequent loose stools As a group, identify potential complications that may arise in the postoperative phase of cranial surgery. Increased ICP Monro-Kellie hypothesis states that, because of the limited space for expansion within the skull, an increase in any one of the components causes a change in the volume of the others.because brain tissue has limited space to expand, compensation typically is accomplished by displacing or shifting CSF, increasing the absorption or diminishing the production of CSF, or decreasing cerebral volume resulting to an increase ICP. Bleeding and hypovolemic shock An accumulation of blood under the bone flap (extradural, subdural, or intracerebral hematoma) may pose a threat to life. A clot must be suspected in any patient who does not awaken as expected or whose conditions deteriorates. Fluid and electrolyte disturbances IV solutions and blood component therapy for patients with intracranial conditions must be administered slowly. If they are administered too rapidly, they can increase ICP. The quantity of fluids administered may be restricted to minimize the possibility of cerebral edema. Infection The risk of infection is great when ICP is monitored with an intraventricular catheter and increases with the duration of the monitoring. Seizures Underlying cause is an electrical disturbance in the nerve cells in one section of the brain. An abnormal motor, sensory, autonomic, or physical activity that result from sudden excessive discharge from cerebral neurons. Have each group member identify a type of seizure. Describe clinical manifestations, diagnosis, and treatment of each. Generalized Seizures: This are seizures that mainly involves electrical charges in the whole brain, its clinical manifestations includes loss of consciousness for a short or long period of time. Types of Seizure Clinical Manifestation Grand Mal or Generalized tonic-clonic Unconsciousness Convulsions Muscle rigidity Absence Short loss of unconsciousness Myoclonic Irregular jerky movements Clonic Repetitive jerky movements Tonic Muscle stiffness and rigidity Atonic Loss of muscle tone Diagnosis: Physical examination particularly neurologic examination EEG For temporary and reversible causes of seizures: Blood chemistry Blood sugar Complete Blood Count Cerebrospinal fluid analysis Kidney function test Liver function tests Test to determine the cause and location: EEG (electroencephalograph) to measure the electrical activity in the brain Head CT or MRI scan Lumbar puncture-spinal tap Treatment: When a seizure occurs, protect the person from injury, make the environment safe for you and the patient. Protect the patients head Loosen tight clothing Place the patient into a side-lying position if vomiting occurs Stay with patient until she or he is fully recovered Monitor the patients vital signs Medications such as anticonvulsants may be given as ordered to reduce the number of future seizures. The DONTs During Seizures: Dont restrain the patient Dont place anything between the patients teeth during a seizure Dont move the patient unless he or she is in danger or near something hazardous Dont try to stop the patient from convulsing. Partial Seizures: This are seizures that mainly involves electrical charges in one part of the brain, its clinical manifestations includes abnormal muscle movements, automatisms, abnormal sensations, hallucinations, nausea, sweating, dilated pupils, rapid heart rate and pulse rate, changes in vision. Types of Seizure Clinical Manifestation Simple (consciousness is intact) Jerky movements Muscle rigidity, spasm Unusual sensation Memory and emotional disturbance Complex (consciousness is impaired) Automatisms: lip smacking, chewing, walking and repetitive involuntary and coordinated movements Diagnosis: CT scan MRI EEG EEG-video recordings Treatment: Vagus Nerve Stimulation in which a small battery is implanted in the chest wall which will program to deliver short bursts of energy to the brain. Corpus Callosotomy is a type of surgical intervention that will cut the connections between the two sides of the brain that will prevent drop attacks.. Multiple sub-pial transection which is a surgical technique that will cut a certain connection between nerve cells.

“Civilization Ends, Since Barbarians Erupt from It” by Karl Kraus

When given thought, barbarousness can be stated as a quality which is branched out from the carrying out of any of the cardinal sins. For example, greed numbs your conscience and energizes you to achieve whatever it is that you desire by corrupted means. On a quest to reach self-satisfaction, humans have proved to be able to cross all sorts of boundaries, forget all levels of logical reasoning and etiquettes and in short, become barbaric; exactly the right recipe for massive disorder. Adolf Hitler alone cost eleven million lives, six million of them belonging to the Jews amidst how he is considered by some to be one of the greatest generals of all time. The honorable titles given to him should have fed his pride, yet he brutally carried out the killing of many innocent people out of racism. The World Wars have had their adverse affects. With such a high casualty number, these two wars have been the deadliest known to man. And it all starts when such barbarians struggle to gain power. If a World War 3 indeed erupts, it may be just enough to turn this earth into ashes considering the effect that the rapid advancement of technology has on the creation of deadly weapons such as nuclear or biological weapons. Charles Ponzi was the man who made the Ponzi scheme famous, and hence the name. Meanwhile, it was Bernie Madoft who exercised this fraudulent method of earning money for the longest period of time in the market under the very noses of the investors. He managed to profit 65 billion US dollars, all by false stories. A similar scenario is evident in the public offices here in Bangladesh, where money speaks and every tongue remain silent. The officers in such workplaces see bribes as a ‘legal’ part of their earning. Bangladesh could have dealt with poverty and the million other problems it encounters far more easily if these parasitic and corrupt politicians and officials hadn’t stolen the large sum of money reserved for developmental purposes. Just because of them, the beggars roam the roads, stopping by every car window; traffic congestion is a daily sighting owing to the underdeveloped infrastructure and the poor communication system; the lack of education of the poor children, leading to an illiterate future generation. This list would go on like a bottomless pit. Today, to some extent, people have gained consciousness of the fact that the world is not progressing in the right direction. Hence, many different people and organizations have stepped in. United Nations is working to preserve peace among nations; to prevent wars, promote cooperation between countries. Pioneers like Sir Fazle Hasan Abed contributed greatly to alleviate poverty in Bangladesh. Nevertheless, the people still continue to suffer. Wars keep killing innocent humans. Safety of women remains unanswered. People remain greedy and still they live off others’ wealth. As long as such injustice remains in the society, Karl Kraus’ quote cannot be deemed wrong!