Learning Outcomes Assessment for Student Nurse

Learning Outcomes Assessment for Student Nurse Learning Outcome 1 – Pre-assessment The ultimate goal of the pre-assessment is to assure that those patients identified as suitable for day surgery are properly identified while those considered unsuitable for a selected procedure are identified early enough in the process to allow for other treatment options (National Health Services, n.d.a, p. 13). Although ultimately it is a joint decision between the surgeon and anaesthetist who make the final determination (National Health Services, n.d.b), the nurse plays a vital role in the process and should be involved in the selection criteria (Royal College of Nursing 2004, p. 1). Pre-assessments of patients scheduled for day surgery are usually performed by an outreach nurse from a day surgery centre, by telephone screening, or by questionnaire (National Health Services, n.d.a, p. 9) or via appointments with day surgery staff or in specialized pre-admission clinics (Joanna Briggs Institute 2004, p.2). Many institutions are combining pre-assessment interviews with the opportunity to work with the patient in a preoperative education status in order to decrease patient anxiety, assess the needs of the patient and/or family members and to personalise information (Joanna Briggs Institute 2004, p.2). The National Health Services (n.d.a, p. 11) states this is an effective opportunity to also discuss the surgical procedure in greater detail with the patient, note special requirements for admission, surgery and/or discharge and allow the patient to choose their own date for surgery, finalizing and/or setting the appointment. According to the Royal College of Nurses (2004, p. 3), nurses performing the pre-assessments must have the option of being able to contact the anaesthesiologist of surgeon if a problem is identified that could potentially increase the risk during anaesthetic or surgical intervention.† This is critical; otherwise, there is no apparent reason for the assessment if the nurse cannot raise her concerns. The National Health Services (n.d.a, p. 9) day surgery guidelines state pre-assessments performed as soon as possible following the surgical consultation can allow for treatment of underlying physical issues that might preclude them from the day surgery procedure, such as high blood pressure and/or arrange for home care. If this is not possible, the National Health Services (n.d.a., p. 13) recommends that patients should then complete a â€Å"health-screening questionnaire before leaving the outpatient department.† According to the National Health Services (n.d.a., p. 11), incorporating the pre-assessment step in the day surgery process has been shown to reduce surgical cancellations and increase communication across the multidisciplinary team. Based on research, it is important to note that the day surgery pre-assessment is a valuable tool that can help the patient, the perioperative and surgical nursing teams as well as surgeons and anaesthesiologists. The pre-assessment is a way of initiating a comprehensive set of documentation for the entire team. Learning Outcome 2 – Effective communication According to the Joanna Briggs Institute (2004, p. 4), caseload can determine the staffing mix required. The staffing mix for a day surgery centre, however, can vary from a group of individuals who work together on a regular basis such as the case in a specialized clinic setting to a group of individuals who rely on departmental shift staffing for perioperative nurses and surgical residents in a busy teaching hospital. No matter what the group mix is, however, the need for communication is critical to patient care in all settings, especially surgical, where according to Cowen et al. (2005) communication is especially challenging for workers in environments that are high stress and time sensitive. Vazirani et al. (2003, p. 72) states that improving the level of collaboration, not just communication, can enhance job satisfaction among medical professionals while increasing the quality of care and patient satisfaction. While traditional communication techniques such as â€Å"active listening, positive voice tone, [and] reiteration to confirm understanding† are desirable goals, in the surgical setting other barriers often compound communication problems, including status and posturing between doctors versus the communication found between doctors and nurses or nurses and nurse practitioners. Vazirani et al. (2003, p. 72) discuss the care nurse practitioners took â€Å"not to violate the autonomy of residents or interns [and] did not admit patients on their own or write orders without the consent of a resident or an intern.† Essential to a multidisciplinary team is the need for collaboration, where decision-making is a shared event for doctors and nurses and that open communication between the two professionals exists (Vazirani et al. 2003, p. 73). It is important to note that research demonstrates physicians view collaboration differently than nurses, such that physicians believe collaboration implies â€Å"cooperation with follow-through† pertaining to following orders rather than sharing in the decision making process (Vazirani et al. 2003, p. 75). Vazirani et al. (2003, p. 76) also cited nurses as not being provided timely or accurate information regarding patient information when physicians autonomously make a change in their normal protocol, stating nurses need the information most as they are the ones at the patient’s bedside. Communication is a commonly sited problem and is one that, despite all the best suggestions and recommendations, from outlining roles and responsibilities, collaborating as a team or mutual team members each afforded appropriate professional respect (Vazirani et al. 2003) to developing Integrated Care Pathways (ICPs) as outlined by Fisher and McMillan (2004) is difficult to remedy. Ultimately, human emotions and professional pride create unnecessary friction that discourages open communication for fear of reprisal. Cowen et al. (2005) emphasize the need for an accurate flow of information between various disciplines as the most critical aspect in order to assure patient safety. Learning Outcome 3 – Patient selection criteria Patient selection criteria primarily focus on three primary factors: surgical, medical and social (National Health Services, n.d.a, p.11; National Health Services, n.d.b.). Surgical criteria assess whether the procedure will leave the patient dependent on others and/or if it has a statistically significant postoperative morbidity level. The National Health Service (n.d.b.) states that the surgical procedure should take less than 1 hour, involve minimal blood loss, be unlikely to produce severe post surgical pain or nausea and be unlikely to result in a loss of physical independence. When assessing social appropriateness, according to the Association of Anaesthetists of Great Britain and Ireland (cited by Joanna Briggs Institute 2004, p. 2), the pre-screening interview is an opportunity to assess the patient’s willingness to have surgery, the certainty of adult care in the home following surgery, telephone access and taking into consideration the patient’s home situation. For example, are there several young children and toddlers or infants at home requiring constant care; is the only adult available to help the patient an elderly or frail individual, or has the patient stated they feel they are being pressured into having the surgery. These are all reasons that should be presented to the surgeon, anaesthesiologist and the rest of the multidisciplinary team as reasons the patient should be precluded from day surgery. Additionally, patients with a social history of significant levels of alcohol consumption and/or who smoke are indications of potentia l preclusion or the need for additional counselling prior to surgery (National Health Service n.d.b.). The Royal of College of Nurses (2004) also states that the patient must have the availability of an escort home following surgery and that the travel time home must be within one and a half hours; and if small children are present in the home that a caregiver is available specifically to tend to the children. Medically, it is important to assess cardiac fitness, assurance of height/weight appropriateness and if they are â€Å"physiologically under 70 years of age[1].† Exclusions are usually automatic if there is uncontrolled hypertension, recent history of cardiac failure, pregnancy, angina, asthma, diabetes or epilepsy. Additional issues that require notification of the appropriate medical personnel include prior difficulties with anaesthesia or current medications that would either preclude day surgery or require either a modification and/or temporary cessation of the pharmaceutical agent, particularly warfarin. The American Society of Anaesthesiologists’ (ASA) (cited by The Royal College of Nursing 2004) uses three classifications to assess physical status: Class 1: patient is mentally and physically fit and the surgical procedure is localized without systemic disruption, for example, removal of a uterine fibroid in an otherwise healthy female or the repair of an inguinal hernia in a healthy individual. Class 2: patient suffers from mild to moderate systemic pathology that is either caused by the pathology to be treated by the day surgery or by other pathology, for example anaemia or mild diabetes or slightly limiting organic heart disease. Class 3: patient suffers from a severe mental or physical disorder from whatever cause, such as angina pectoris, moderate to severe levels of pulmonary insufficiency, vascular complications from severe diabetes or significantly limiting heart disease. Criteria used for patient evaluation and assurance of fitness for day surgery as outlined above are focused primarily on the suitability for general anaesthesia without complication. It is essential however, to couple both the individual patient status as provided by the pre-assessment with the type of surgical intervention proposed. The medical professional cannot use the same set of pre-assessment criteria for all patients for all procedures; they must simply be a guide. For example, physiological trauma, anaesthetic requirements and post-operative pain are different for those having arthroscopy as opposed to a laparoscopic cholecystectomy or partial thyroidectomy. All three are considered day surgical procedures by the Royal College of Nurses (2004, p. 2). Patient selection criteria are important for nurses to understand from many aspects. The nurse has to understand the physician’s reason for suggesting day surgery for their patient, she needs to understand the surgeon’s belief in appropriateness and she has to understand the potential risks that are often overlooked by physicians and surgeons that now become her responsibility to ascertain. Although it is often a delicate position for the nurse to be in, it is essential that she bring to the surgeon or anaesthesiologist’s attention any patient not appropriate for day surgery. This is an issue of legal liability for all professions on the multidisciplinary team and for the clinic or hospital as well as one of ethical concerns for the patient’s overall care and wellbeing. Learning Outcome 4 – Pain management According to Lipp and Yap (2005, p. 64) prior to 2003, the responsibility for post-surgical pain was the sole responsibility of the anaesthesiologist and no routine or regular pain assessments were conducted. In 2003, pain management assessments and the nursing role in pain management in the day surgery setting became the standard. The Royal College of Anaesthetists (as cited by Lipp Yap 2005, p. 64) tell us that following a day surgical procedure, less than five percent of all patients should experience severe pain while up to 85 percent will have mild or no pain following surgery. Beauregard et al. (1998, p. 309) believes that it is not unusual for pain to persist during the entire week following surgery, but that the best predictor of significant post-surgical pain following hospital discharge was inadequate pain control during the first few hours of following surgery. Research has acknowledged that the longer an individual is experiencing pain that is not attended to or interrup ted in some way, the more sensitive to painful stimuli the patient becomes (Mukherji Rudra 2006, p. 355). Ultimately, the goal of effective post-surgical pain management is to be â€Å"safe and effective, produce minimal side effects such as nausea. It was stated that the criteria for patient selection should be individualized based on patient status and type of surgery. Similarly, Mukherji and Rudra (2006, p. 355) state that patients should be identified as potentially at risk based on â€Å"age, physical status, presence of pre-existing pain, site and extent of surgery.† Additionally, researchers believe that the amount of postoperative pain a patient experiences is also a factor of the surgeon and surgical techniques used ( Mukherji Rudra 2006, p. 356; Chung et al. cited by Beauregard et al. 1998, p. 305). Mukherji and Rudra (2006, p. 355) discuss several pain assessment tools: the visual analogue scale (VAS) where pain is rated along a continuum from â€Å"no pain at all to the worst pain imaginable† and the Oucher’s scale for children. Many patients themselves downplay post-surgical pain for reasons ranging from believing that pain is part of the natural recovery process and what they are experiencing is normal (Beauregard et al. 1998, p. 209). Post-operative pain management can take different forms, including pre-emptive analgesia and prophylactic analgesia (Mukherji Rudra 2006, p. 356). There are also pharmacologic and non-pharmacologic pain management interventions. Pharmacological interventions can be opioid or non-opioids. Opioids are centrally acting and systemic in nature whereas non-opioids are also centrally acting but have a peripheral mode of action, and include codeine, metamizol, paracetamol and non-steroidal anti-inflammatory (NSAIDS) (Mukherji Rudra 2006, p. 356). Another problem cited by the Joanna Briggs Institute (2004) is that of inadequate pain management techniques and/or follow-through by the patient place additional burdens on family caretakers and the community at large. For example, Girgis and Sanders (2004, p. 66) tell us that parents generally underestimate and under treat pain; this can be extrapolated to caregivers in the adult community as well. Home caregivers failing to recognize and/or intervene in pain management is often problematic and it is the responsibility of the nurse to assure that proper discharge information is adequately communicated to the patient and/or caregiver/escort, including proper pain management techniques and interventions. To assure there is no confusion, these should be clearly documented and reviewed with the patient and caregiver verbally. References Beauregard, L., Pomp, A. Choiniere, M., 1998. Severity and impact of pain after day surgery. Canadian Journal of Anesthesia, 45 (4), pp. 304-311. Fisher, A. McMillan, R., 2004. Integrated care pathways for day surgery patients. British Association of Day Surgery [Online]. Available from: http://www.bads.co.uk/pdf%20files/IntegratedCarePathways.pdf [cited March 17, 2007]. Girgis, M. Sanders, D. 2004. Are we giving our children the right dose? The Journal of One-Day Surgery, 14 (3), pp. 65-68. Joanna Briggs Institute, 2004. Management of the day surgery patient [Online]. Joanna Briggs Institute Best Practices. Available from: http://www.adsna.info/attachments/BPISSup.2004.pdf [cited March 17, 2007]. Lipp, A. Yap, H, 2005. Is our pain relief protocol effective? The Journal of One-Day Surgery, 15 (3), pp. 64-66. Mukherji, S. Rudra, A., 2006. Postoperative pain relief for ambulatory surgery. Indian Journal of Anaesthesia, 50 (5), pp. 355-362. National Health Services, n.d.a. Day surgery pre-assessment: A brief guide [Online]. Available from www.wise.nhs.uk/surgery/NationalGoodPractice/downloads/14/14d4.doc [cited March 17, 2007]. National Health Services, n.d.b. Day surgery: A good practice guide [Online]. Available from: http://www.wise.nhs.uk/sites/crosscutting/access/Access%20Document%20Library/1/Day%20Surgery/Day%20Surgery%20Guide.pdf [cited March 17, 2007] Royal College of Nursing, 2004. Day surgery information: Selection criteria and suitable procedures [Online]. Available from: http://rcn.org.uk/publications/pdf/daysurgery_selection.pdf [cited March 17, 2007]. Society of Critical Care Medicine, 2005. Tools for effective communication [Online]. Society of Critical Care Medicine. Available from: http://www.sccm.org/SCCM/Publications/Critical+Communications/Archive/February+2005/communicationsfeb05.htm [cited March 17, 2007]. Vazirani, S., Hays, R. D., Shapiro, M. F. Cowan, M., 2005. Effect of a multidisciplinary intervention on communication and collaboration among physicians and nurses. American Journal of Critical Care, 14 (1), pp. 71 – 77. 1 Footnotes [1] According to the National Health Service (n.d.b), the phrase refers to a patient who is â€Å"independent, active and compos mentis.†

Support for the Current Placement of the Confederate Flag in South Caro

Support for the Current Placement of the Confederate Flag in South Carolina There is an old saying that says you can please all of the people some of the time, or you can please some of the people all of the time, but you can’t please all of the people all of the time. Never is this truer than in the state of South Carolina as it pertains to the flying of the Confederate Battle Flag. It is obvious at this point that no solution will make everyone in the state happy, but a compromise does need to be made that can satisfy a majority of the people. I think that a satisfactory compromise, or at least as satisfactory as can be realistically attained, was made when the flag was relocated to the statehouse grounds last year. This may have brought on a lot of griping from different political action groups and other outspoken pundits, but for the common citizens that make up the majority of the state I think that this will prove to be sufficient if outside organizations can quit aggravating the situation. In preparing a compromise on the flag issue, one must consider the different sides of this debate. One group, the opponents of the flag, would wish it to be banished completely. First of all, not only is this simply not possible because of the sheer number of supporters who would wield the flag anyway, but it simply does not do justice to the men who fought and died under that flag. If we were to call for the complete prohibition of all Vietnam War remembrance ceremonies because it offends some of the Vietnamese-American citizens of the country, or the ban of all nationally recognized Christian holidays because it offends the Muslims of the country, it would never happen. It must be recognized that we live in a diverse nat... ...ys tribute to the people it was meant to venerate. This seems to be the best solution to this very passionate and historic dispute. There will always be trouble and unrest surrounding the Confederate Battle Flag; it is a symbol charged with great emotion on both sides. There is no â€Å"right answer† to this quandary, and I’m sure that this debate will rage for generations to come just as it has for generations past. As far as a solution is concerned though, I think that the decision makers in South Carolina have solved the problem as well as it can be solved. It is impossible to make everyone happy with any decision, but for the time being, I think that this solution makes the most people happy. Works Cited: Darby, Joseph A. â€Å"Darby Responds to Most Recent Allegations Against Sanctions.† Editorial. The Post and Courier [Charleston, SC] 16 May 2001: A7. Support for the Current Placement of the Confederate Flag in South Caro Support for the Current Placement of the Confederate Flag in South Carolina There is an old saying that says you can please all of the people some of the time, or you can please some of the people all of the time, but you can’t please all of the people all of the time. Never is this truer than in the state of South Carolina as it pertains to the flying of the Confederate Battle Flag. It is obvious at this point that no solution will make everyone in the state happy, but a compromise does need to be made that can satisfy a majority of the people. I think that a satisfactory compromise, or at least as satisfactory as can be realistically attained, was made when the flag was relocated to the statehouse grounds last year. This may have brought on a lot of griping from different political action groups and other outspoken pundits, but for the common citizens that make up the majority of the state I think that this will prove to be sufficient if outside organizations can quit aggravating the situation. In preparing a compromise on the flag issue, one must consider the different sides of this debate. One group, the opponents of the flag, would wish it to be banished completely. First of all, not only is this simply not possible because of the sheer number of supporters who would wield the flag anyway, but it simply does not do justice to the men who fought and died under that flag. If we were to call for the complete prohibition of all Vietnam War remembrance ceremonies because it offends some of the Vietnamese-American citizens of the country, or the ban of all nationally recognized Christian holidays because it offends the Muslims of the country, it would never happen. It must be recognized that we live in a diverse nat... ...ys tribute to the people it was meant to venerate. This seems to be the best solution to this very passionate and historic dispute. There will always be trouble and unrest surrounding the Confederate Battle Flag; it is a symbol charged with great emotion on both sides. There is no â€Å"right answer† to this quandary, and I’m sure that this debate will rage for generations to come just as it has for generations past. As far as a solution is concerned though, I think that the decision makers in South Carolina have solved the problem as well as it can be solved. It is impossible to make everyone happy with any decision, but for the time being, I think that this solution makes the most people happy. Works Cited: Darby, Joseph A. â€Å"Darby Responds to Most Recent Allegations Against Sanctions.† Editorial. The Post and Courier [Charleston, SC] 16 May 2001: A7.

Essay --

Question 1: Opening a new restaurant required many decisions. Pricing strategy is one of the vital ones that could make or break the restaurant. I would recommend the combination of value pricing and competitive pricing for the new restaurant. Value pricing strategy is to use the price to communicate the restaurant’s position, reflect the bundle benefits offered while competitive pricing gives the restaurant a competitive edge among the existing restaurants in the neighborhood. Ideally, the restaurant’s pricing should be high enough to place itself into the fine dinning categories in customers’ minds, but also competitive enough to attract customers from competitors. The decision for choosing these strategies is based on the following reasons. First of all, Center City Philadelphia is an up rising neighborhood that is home of many young professionals. This location offers the ideal market segment for the restaurant – the customers who are willing to spend extra bulks for better experience. Value pricing, in this situation, can be seen as prestige pricing. Prestige pricing plays on customer’s psychology principles of attaching quality with high price. Pricing the menu high, along with the innovative and modern look will easily put the restaurant into a good position. The key point of having value pricing is the actual value going along with the product. The restaurant has to make sure the food and service live up to the customer expectation. They should make sure the ingredients are fresh and the foods are flavorful. Having their supply delivered from local farms is a good strategy for quality ingredients with reasonable price. That is also a socially conscious effort by supporting local businesses and farms and building a long... ...arefully allocate our money and make sure we make a sustainable plan to expand but not affecting our current services. Other factor to consider is competition from other providers in the market. We need to be up to date, sensitive competitors’ move and flexible to adjust and deal with any changes. It’s better to be proactive than be reactive after the fact. Company customer base and loyalty is also a factor to be considered. Customers in cable industry are not too attached to the service provider but they tend to avoid the inconvenience of switching carrier. We need to put customer satisfaction our priority and make it effortless for them to switch over our company. Government rules and regulations are things we also need to be mindful of. Change in regulation can have either positive or negative impact on the company, and we stay alert to make any move accordingly.

What I Learned from My Stock Market Simulation Experience

What I Learned From My Stock Market Simulation Experience The stock market simulation has been a wonderful experience for me as a student in economics and as a person in today’s society. Knowledge gained in this project will give me the advantage to wisely choose the correct stock when I start investing my own money into the stock market. Different aspects of the simulation provided innovative and diverse ideas to propel me familiarity further into the grand realm of economics.When first assigned with the project I struggled a little on how best to allocate my funds into the best companies that would steady gain and gain through out the ten week period. Honestly I think I made a wise decision and used a financial advisor, Shibs, on which stocks seem to be rising in the troubled times we are in. With that aid I was able to deduce that WFC, JNJ, and XLF would produce the best results in the time given. Taking that step and using an outside source to assist in the determination o f stocks is a fine example of everyday situations.As always I found a way to express my individuality by seeing that eBay would give me an extra boost in standings with its ever climbing ascension. In looking for research I found out more on other companies that affected mine including my own; this gave me a broader view on where and how fast the market was going. Those articles also provided information on how the different companies I had invested in functioned; I learned that each company is more that meets the eye.Those clues provided insight in how fear and greed can sway the market back and forth resembling a see-saw never balancing but going good one minute to falling down the next. Besides that insight I learned a very valuable lesson in how one little paragraph in a article can make all hell break loose; it seems that when some hear just one little phrase they start running around like chickens with their heads cut off and making dumb mistakes left and right. Most of all, I learned that patience wins out and that the slow risers in the stock market will be out the day trades.In putting together this binder I also learned some things about investing and the mechanics of the stock market. One thing was that keeping order among all the essays, articles, graphs, and what not helped keep track of different trends in the various sectors that I had invested in. Also watching how my classmates invested and where they ended up in the rankings gave me the opportunity to see where different tactics succeeded or flopped around doing nothing. Finally, writing this essay gave me the chance to peel back the different layers of the stock market and how my investments truly benefitted.

Costco Wholesale Corporation

Costco Wholesale Corporation, which was established in 1983 as a single store in Seattle, became the biggest membership warehouse club chain the world, employing the so-called â€Å"less-is-more† concept. With such concept, Costco Wholesale Corporation also looks upon themselves as the membership warehouse club that has the capability to sell top-quality food, hardlines, softlines, and other goods usually in a large number or bulk quantity at the lowest possible price. Costco now has over 457 stores which are situated in most parts of the United States and is still growing.Their success was mainly attributed to their sales volume, good consumer acceptance, generally good services and customer care, and the lowest possible price offered. Furthermore, Costco sells, provides or displays items or products from limited suppliers or from a small number of suppliers. Variety of items is also reduced and this is done to reduce the risk of purchase decision and encourages a consumer to buy such product or service. Another benefit of this is that loyalty on a certain product or service is created or improved.The corporation’s goal is to provide more discounts and cheaper prices to the customers, focusing more on the customers, rather than to the competition. It is able to provide lower cost and greater discounts because the corporation’s marketing style is to reduce overhead cost by reducing fancy outlet designs, taking almost everything to simplicity. Costco also pays to its workers and employees, giving them good salaries and benefits, resulting to the tremendous low rates of theft and turnovers by its employees.Since Costco is known for its cheap prices and sales in large or bulk quantities, it had created policies, just like other competing membership warehouse clubs, regarding merchandise returns and exchanges. Costco had been formulating and had been modifying its product guarantees in order for their goal and or concept to be followed. These g uarantees, in order to improve a business’ quality or to be used as stepping stones for a corporation’s growth, such as the Costco, must be effective.Costco Wholesale Corporation provides information regarding the guarantees that they offer on products and memberships, but it seems that their guarantees vary from one Costco branch to the other. In Costco found or established Japan, â€Å"What is Costco? † their guarantee states that: â€Å"COSTCO'S UNCONDITIONAL DOUBLE GUARANTEE on merchandise: We guarantee your satisfaction on every product we sell with a full refund. On membership: We will refund your membership fee in full at any time if you are dissatisfied. † With regards to the corporation’s guarantee, a policy regarding computer returns was created.This is in relation to Costco (Japan) unconditional double guarantee. Costco’s return policy, â€Å"What is Costco? †, states: â€Å"COSTCO'S COMPUTER RETURN POLICY Costco Wholesale 's return policy for all desktop and notebook computers is six months from the date of purchase. After six-months from the date of purchase, all services and technical support will be subject to the applicable remaining manufacturer's warranty. While on the other hand, the guarantee of Costco Wholesale Corporation in their online store, â€Å"Costco Returns†, states that: â€Å"Costco.com Costco guarantees your satisfaction with the merchandise you purchase from us. Costco. com products may be returned to any of our hundreds of Costco warehouses worldwide. Or, if you wish to return or exchange merchandise directly to costco. com, contact us at customer service. Effective November 4th, 2002, Costco Wholesale’s desktop and notebook computer return policy is six-months from the date of purchase. After six-months from the date of purchase, all service and technical support will be subject to the applicable remaining manufacturers' warranty. † According to Christophe r W. L.Hart, â€Å"effective guarantees must be unconditional, meaningful, easy to understand, easy to invoke, and easy to collect† (72). A guarantee is said to be easy to understand and communicate if the guarantee that is created is written in a simple manner, using concise language and directly state what the guarantee is about or what it offers. This is done in order for customers and employees to know or learn what to expect and what is expected of them, respectively. Evaluating the guarantee stated by Costco in Japan, it can be observed that it is indeed easy to understand, and is easily communicated.It clearly states in its guarantee on the merchandise, that they can provide satisfaction to the customers for every product that they sell and directly states a promise to give a full refund, in cases that the former statement is not fulfilled. Also, with regards to their membership, it was also directly stated that if a customer was disappointed or frustrated, they (Costc o), would give a full refund. Furthermore, with regards to some items or products they sell under the exemption of a full refund, the policy regarding these products is also clearly stated.Evaluating the guarantee given by Costco in their online store, though understandable, it is not easily understood as compared to the previous guarantee. It does not state the company’s promise, or what the company would do or give in return if a customer becomes dissatisfied with their goods and services. â€Å"Subject to the applicable remaining manufacturers’ warranty† seems vague and that customer’s would already think twice when it comes to invoking refunds. The guarantee stated at Costco’s online store (costco.com) should be stated in fewer words, pinpointing more on the necessary information, terms, and policies. With regards to a meaningful guarantee, two considerations or concerns are raised by Hart. A guarantee is said to be meaningful, first, if the gu arantee provided by the company or corporation addresses the service that is of most importance to the customers. Second, a guarantee is said to be meaningful or of good quality, if it is meaningful financially or that a guarantee should focus on what a customer would enjoy more.The guarantee stated by Costco in Japan, is indeed meaningful, as it noticeably indicates that it would provide full refund for both products and membership fees. In this guarantee, price, which is considered by Hart as the most important element for a meaningful guarantee, is evident. Costco’s guarantee is meaningful relative to the price of the product or service. Costco would return the price which the customer paid, in full, if the customers are not satisfied with their products or services.On the other hand, the online store of Costco only states or offers a return or exchange of a product bought by an unsatisfied consumer. One meaningful thing is that in the statement of their guarantee, the cus tomers are informed that they have several outlets or that stores where the customer could return or exchange the merchandise. This helps the customers by immediately identifying where customers could go or convey their problems. Again, better promise or customer return should be created, or if such promise or payback exists, it should be clearly declared in their guarantee or policy.In the further evaluation of a good guarantee, a guarantee is said to be easily invoked by customers if the process that a customer has to take is simple, trouble-free and undemanding. The process of invoking a full return of a good or service should be straightforward and uncomplicated or understandable. This will help customers who are already displeased, to favor or buy again such goods or services by the business establishment. In addition to an easily-invoked guarantee, Hart states that â€Å"customers should not be made to feel guilty about invoking the guarantee — no questioning, no raise d eyebrows, or â€Å"Why me.Lord? † looks. A company should encourage unhappy customers to invoke its guarantee, not put up roadblocks to keep them from speaking up† (5). Looking on Costco’s guarantee on this aspect, complains, letters and calls conveyed to the customer service of Costco can be used. How Costco responds to these complaints and the measures they take to help the customers and the process of invoking a refund can also looked into. The process of invoking a refund is easy. There are no forms to be filled or series of questions to be answered.A customer just needs to bring the product to the Costco warehouse. From the statement of the guarantee in Costco’s online store, it was stated that there are a lot of Costco warehouses where the customer can return or exchange the product, though a list of these warehouses were not given. Some reported complaints were about growing membership bills even if a customer had already left the list of Costcoâ €™s members. Also, there were some complains regarding Costco’s customer service or how Costco deals with complains or requests from customers.With regards to these complaints, Costco creates ways of helping these customers in other ways or that, in most cases, the managers send letters of apologies to unsatisfied customers. There was an incident that a customer was asking for the tires he bought to be installed in the front of his minivan (â€Å"Consumer complaints about Costco – tires†). Costco did not respond to this request and kept a firm stand that these new set of tires should be installed in the rears. Costco states that it is best for the tires to be installed in the rears, even if the vehicle was a front wheel drive.They offered a video and articles stating or defending their claim regarding the installation of tires on the rears. Major sales representative Chris Biggers, sent a letter in response to the complaint regarding the installation of tire s on the rears and stated that Costco aims or looks on the safety of both its employees and members (the consumers). With regards to the treatment of Costco employees and managers to the discontented customers, I think that Costco tries their best in addressing the complaints and that they still maintain a good relationship with the consumers.Other wholesale corporations such as the Wal-Mart experience the same complaints, worst, they have more. Wal-Mart had been continuously complained because of their â€Å"unfriendly† treatment with customers. Their customer service and care was insufficient and sometimes, there are incidents of discrimination. Costco on the other hand have strong principles that they apply for the benefit of consumers and that they humble themselves to maintain the good relationship that they have with the customers.It is just that customer’s are already irritated that they fail to see the efforts of Costco in helping them. Further personnel traini ng and teambuilding should also be exercised by the company in order to nicely and properly address disgruntled customers, most especially those with tempers. There were complains filed against Costco, stating that their refunds or certain products were not being received by the customers or that Costco is unable to give the necessary benefit or compensation for a poor service or low-quality product.If a refund was promised, the problem was that no certain dates of such reimbursement were given by the customer service, oftentimes resulting to unclaimed refunds. In terms of the refunds, Costco is at the losing end. Costco provides the cheapest price as much as possible, by keeping a mark up that is not higher than 14 percent for unbranded products or items and mark up not higher than 15 percent for non-private-labeled items, unlike its competitors who has mark ups up to 25 percent, or even 50 percent.Suppliers also exert pressure on Costco regarding product returns. I recommend impro ved customer service hotlines or more customer service centers that are accessible to the consumers for easier management of complaints and quick response to customer needs. Also, the policy regarding the guarantee they provide should be further developed, but taking importance not to render the guarantee impractical for both the company and its consumers. Works Citedâ€Å"Consumer Complaints About Costco – Tires†. 2004. ConsumerAffairs. Com Inc. August 31, 2007. . â€Å"What Is Costco? † Japan, 2005. Costco Wholesale Japan, Inc. and Costco Wholesale Corporation. August 31, 2007. . Greenhouse, Steven. â€Å"How Costco Became the Anti-Wal-Mart. † The New York Times, 2005. Hart, Christopher W. L. â€Å"The Power of Unconditional Service Guarantees. † The McKinsey Quarterly, 1989.

Inuit Art & Canadian Nationalism Essay

Inuit refers to a certain group of people who had acclimatized and inhabits the cold and harsh climatic regions of Canada. They are similar to Eskimos who live in Arctic regions of Russia and Europe and North America. Their art is a reflection of urbanization with elements of cultural experiences which denote the activities carried out within their daily life as dictated by the environment. A good Inuit art work is the one mended with vast landscape and traditional Inuit culture. Achieving such Inuit art work is sometimes challenging and controversial but it is a reflection of honest work. The Canadian Inuit art is a good example such as the one brought out by James Houston writings. James Houston was first artist to get involved in the Canadian Inuit art in 1948 with the objective of searching new land to paint. People living in the new land were very friendly, warm and the environment was vast, beautiful and cold. Interaction with the Indian and Inuit people in the Arctic provided the best opportunity for James to introduce Inuit culture to the world. Introduction of Inuit culture was made possible with the use of remarkable stories and art. There are four main particular exciting Inuit art work by James Houston in his writings. These include the White Archer, Akavak, Worlfrun and Tiktaliktak (Graburn, 2). The art work was collected in a good volume which illustrates the story about Arctic and nationalism. Many Canadian art and craft galleries, souvenir shops, and museum stores clearly confirm that tourist art is a measure of Canadian and Inuit work. Inuit art for the last say half a century has been appropriated by people living in the southern part of Canada. In addition, Inuit art is seen as one of the brightest jewels representing Canadian cultural mosaic. Inuit art is considered as one of the most important resource in establishment of Canadian identity. In many particular instances, Inuit images are viewed as symbols for identification in part or whole of the Canadian identity. Many Canadians identify themselves with Inuit art as it is one of the unquestionable means of identity. The Canadian government is usually devoted to identify between non-Aboriginal and Aboriginal peoples. The rhetorical power is used to establish a body of identifications for national identity. However, there are other indigenous images used by Canadians to represent national identity but Inuit art is the most outstanding. Indigenous art also play a very important part in identification and act as a symbol for national community identification. Organizational, individual and institutional identification needs in Canada are served through striking graphic power, prints, carvings and ability to be recognized (Maryllbelle, 1). The good graphical work creates expressive symbols for federal government. This is a clear representation of Canadian symbolism in the form of art graphics. Successive governments have tried to recognize the construction of unique Canadian identity as one of the most critical part of their mandate. For purpose of maintaining consistency, the Canadian government has tried to distinguish Canada from other countries through the use of Inuit art. A line on map could have been used to differentiate Canada from other countries but since confederation, art graphics have been in use. There are certain drawbacks in any given state that result to individual division such as ethnicity, language or religion. The use of Inuit art has no negative effects as are related to religion, language or ethnicity. Canadians have tried to differentiate themselves from U. S and other countries through the use of symbols or identity with genuine characteristics. Canadian identity has been constructed by constant shifting rhetorical identification and division process that aim at bringing communities together. It also aims at separating communities from one another as history shows how Canadians have tried to negotiate the nature of the countries core values. Identification of core values is shaped by discursive resources which were developed in the course of European settlement in Canada. Association of parties with material objects creates a marker which supports a sense of nationalism. A wide or broad group of cultural producers creates relevant material objects that interprets objects deemed fit for forming cultural equipment. Artists, dancers, painters, filmmakers, musicians, writers and sculptors play a very important part in promotion of patriotic education. This has been performed since the early twentieth century whereby material objects are provided in styles which fit the service of nationalism. In addition, societies rely on advertisers, teachers, publishers, journalists and other opinion leaders to interpret material objects. The same artists and opinion leaders disseminate the interpreted information to people with a view of constructing an appropriate conceptual linkage between material objects and national feeling (Marryllbelle, 1). The Canadian government plays a very important role in promotion of art work through incorporation of educational programs in schools and other public social gatherings. The Canadian government officially clarifies stresses and introduces appropriate pieties for material resource assortment that reflects values of country through public presentations, campaigns and internet. The use of public campaigns is to familiarize people about cultural products which help to promote art work. Canadian citizens store have their confidence in attitudes relating to resources for future reference. The retrieval of cultural attitudes arises in instances when certain national institutions try to stir up patriotic passion. Vocabularies at national levels are considered as reasons for, results of, and development of identification constructions on the basis of common interests of the citizens. The Inuit art is a reflection of Canadian language which tries to emphasis on cultural values leading to diversity of human ideas. Language is one main tool of identification which provides individuals with self worth and a sense of belonging. In the event a small group of community living within a given state loses its language, the members of the community feel left out in their identity as a cultural group. To avoid loosing identity by certain minority groups, certain commissions are formed to fight for rights of such minority communities (Stern & Stevenson, 8). Other alternative way of preserving the dignity of minority groups is through the use of art work which reflects the cultural believes of the individuals. A close look on the Canadian native art reveals that it has contributed to international exposure over the past centuries. Huge budgets have been drawn by government to support promotion of art with a view of carving out a national identity. Promotion of Eskimo art is one relative example to reflect the level at which government is in support of the Inuit art. The history of Canada showed that establishment of a national identity figure was made to promote cultural features. The desire to establish an iconic identification figure arose since the 19th century. This is a time when the Canadians wanted to establish their own identity separate from that of United States and British. After the First World War, considerations relating to public opinions changed through the efforts of seven artists (Grabaum, 1). Although they had no roots in Canada many of them were trained in Europe, their exposure and expertise into artistic work made the group of seven to travel many parts of Canada and established became one of the most sought Canadian arts. The spirit of Canada was captured in the national art and a modern style was clearly identified as suitable and had unique features reflecting Canadian culture. A large number of young artists in Canada started painting in the same vein as the seven artists. The disbursement of the seven artists group led to promotion of art work in the entire Canada. The Second World War provided a chance for Canada to establish Canadians artists (Pupchek, 7). This marked the turning point in the category of Canadian art history. Canada was very enlightened and happy with their war time military in addition to artistic efforts. This led to a revival in Canadian nationalism in various fields of art and culture which has been depicted in many journals and magazines. Nationalization of the Canadian art was a step prompted by government position to increase its support to art work. James Houston’s travel to the North gave him the chance to meet with the Inuit’s where he collected some of their art work, crafts and souvenirs. He inspired other artists who eventually started to carve small figures using soapstone which were basically used to make pots and lamps. The Inuit art was very instrumental as it was used to establish Canada as a great Northern power. The favorable image of Inuit art being products of nature, creativity of artists in ecological matters, lack of competition with mainstream art and adept at creation of materials made it possible for Inuit art to be used as a sign of Canadian national heritage.

Nietzsche

Nietzsche says, in effect, that between Plato, Augustine, and the Buddhist there's â€Å"not a dime's worth of difference. † What features does he see them as having in common? Why does he not share these points of view? Nietzsche viewed our values in life in a different way than most philosophers. He had a different perspective in the meanings behind â€Å"good† and â€Å"bad. † Most philosophers defined â€Å"good† as the weak and ill ones, by Judgement of ranking and high class to low class. Nietzsche believed that all philosophers lacked the â€Å"historical spirit itself.They all have the common Judgement of determining the concept and judgement of â€Å"good. † Nietzsche talks about how unegoistic actions were always praised as good even when they weren't naturally good. Nietzsche believes that the judgement in â€Å"good† does not stem from those who goodness is rendered. This means those to who goodness was shown weren't actually goo d. He believed that the noble and powerful ones, the ones who were ranked as good because of high- ranking, high-minded, and powerful ranked themselves and their doings of â€Å"good. The good good is compared to the word truth because the good is the truth and the ruth is the good.The rich, high ranking, strong, beautiful, brave and powerful are associated with the truth and good. As for the poor, ugly, common and low ranking, they are associated with cowardice and lying. Nietzsche blames the Jews for the views and how people defined â€Å"good† and â€Å"evil† because the Jews, who were poor, and common, were in Nietzsche words â€Å"the most refined hates in human history. † It is because of the Jews that people view the poor, and wretched as good and the powerful and noble as evil. This brings us to the conclusion that Nietzsche believes hey all have in common in what he calls the slave revolt in morality.The slave revolt in morality begins when resentment becomes a creative force. It gives birth to new values and causes a battle between power, values, and ranking issues. The slave revolt morality causes the slave to feel much resentment against its master, Resentment that turns into evil. Imaginary revenge builds up within a slave against its master, turning the slave to â€Å"bad/evil. † In the slave revolt morality, the slave see themselves as the good and their masters as the evil ones when in reality it urns into the opposite because of the resentment that builds up inside them against their masters.The man of resentment allows for hatred to grow in him and having to rely on secrets and scheming, becoming more clever than the noble man. Also, slave morality declines what is different, and not itself. It says â€Å"no† to an outside and anything that is different, this is a creative deed. It makes people realize the distinctions between things. This is important because it us a system that helps level everything out instead of promoting greatness. Nietzsche By rosast6 Nietzsche Perhaps the most convincing arguments Nietzsche makes for the idea that God is either dead or does not exist is the idea that God is a creation of Western society, a universal ideal of morality, truth and ethics. When he argues then that those things no longer exist, if indeed they ever did, as a unifying factor in European culture, he makes a convincing argument that God was merely a creation of humanity to fulfill a spiritual need for there to be a greater good or high purpose for life. In Nietzsche’s argument, the next step after the acceptance of the death of God is a step toward nihilism and the idea that life has no meaning. On a personal level, choosing to accept the idea that God does not exist gives the reader the ultimate freedom and responsibility for his own life. The reader can no longer blame personal decisions on some epic struggle between good and evil, but must acknowledge that his or her actions are his own, chosen based on her own wants, needs and perceptions. The idea that there is no higher power to answer to can be emotionally devastating or it can be liberating. For many the idea of God has always been a strange dichotomy as most religious preach a god of mercy and love and yet bad, often horrible, things happen, even to those who are devout worshippers of that god. Too often, the religious have tried to explain away why God allows bad things to happen. From hurricanes to the Holocaust, there has never been a logical explanation for a God of love and mercy to allow evil. Some have argued that evil must exist to show good for what it is, but that too is simply hiding behind the reality. One does not have to eat a good apple to know when one is bad and vice versa. Any act can be judged on its own merit without the benefit of the opposing force. Therefore, determining that God does not exist only matters when the person who discovers this decides it matters. For those with no faith, the death of God means nothing. For people of faith, it is a devastating conclusion. However,   it seems that it should be argued that people of faith, for whom seeing is not believing, should never become convinced that God does not exist and should be completely unaffected by Nietzsche. In essence, since God is a concept defined by man, its importance is likewise defined by man.    Nietzsche Nietzsche says, in effect, that between Plato, Augustine, and the Buddhist there's â€Å"not a dime's worth of difference. † What features does he see them as having in common? Why does he not share these points of view? Nietzsche viewed our values in life in a different way than most philosophers. He had a different perspective in the meanings behind â€Å"good† and â€Å"bad. † Most philosophers defined â€Å"good† as the weak and ill ones, by Judgement of ranking and high class to low class. Nietzsche believed that all philosophers lacked the â€Å"historical spirit itself.They all have the common Judgement of determining the concept and judgement of â€Å"good. † Nietzsche talks about how unegoistic actions were always praised as good even when they weren't naturally good. Nietzsche believes that the judgement in â€Å"good† does not stem from those who goodness is rendered. This means those to who goodness was shown weren't actually goo d. He believed that the noble and powerful ones, the ones who were ranked as good because of high- ranking, high-minded, and powerful ranked themselves and their doings of â€Å"good. The good good is compared to the word truth because the good is the truth and the ruth is the good.The rich, high ranking, strong, beautiful, brave and powerful are associated with the truth and good. As for the poor, ugly, common and low ranking, they are associated with cowardice and lying. Nietzsche blames the Jews for the views and how people defined â€Å"good† and â€Å"evil† because the Jews, who were poor, and common, were in Nietzsche words â€Å"the most refined hates in human history. † It is because of the Jews that people view the poor, and wretched as good and the powerful and noble as evil. This brings us to the conclusion that Nietzsche believes hey all have in common in what he calls the slave revolt in morality.The slave revolt in morality begins when resentment becomes a creative force. It gives birth to new values and causes a battle between power, values, and ranking issues. The slave revolt morality causes the slave to feel much resentment against its master, Resentment that turns into evil. Imaginary revenge builds up within a slave against its master, turning the slave to â€Å"bad/evil. † In the slave revolt morality, the slave see themselves as the good and their masters as the evil ones when in reality it urns into the opposite because of the resentment that builds up inside them against their masters.The man of resentment allows for hatred to grow in him and having to rely on secrets and scheming, becoming more clever than the noble man. Also, slave morality declines what is different, and not itself. It says â€Å"no† to an outside and anything that is different, this is a creative deed. It makes people realize the distinctions between things. This is important because it us a system that helps level everything out instead of promoting greatness. Nietzsche By rosast6