Leadership Research Paper Example | Topics and Well Written Essays - 1250 words - 4

Leadership - Research Paper Example When in 1748, and aged 16, Washington enrolled with a surveying party on a mission organized by a land baron known as Lord Fairfax to the Shenandoah Valley. This would see him for the subsequent few years conduct surveys in Virginia as well as present day West Virginia making him gain a lifetime concern in the West. He would later in 1751-1752, for health reasons, make a visit to Barbados, West Indies accompanied by his brother Lawrence just before he died. The following year saw Washington start his career as a major in military when he was appointed by the royal governor to an adjutantship in the militia. The same year, Washington accompanied by a guide, journeyed to Fort Le Boeuf, within Ohio River Valley as an emissary of the governor to deliver to French ruling elite an ultimatum to stop settlement as well as reinforcement in English territory. While on trip, Washington attempted to improve British relations with different Indian tribes. He would in 1754 win the title of lieuten ant colonel then later colonel in the militia. He then guided a force that attempted to challenge French authority over Ohio River Valley, however, he faced defeat at Fort Necessity, PA-an incident that assisted in triggering the Indian and French War(1754-63).Washington ,later in 1754,annoyed by the demotion of his title due to forthcoming coming of British regulars resigned his commission. He would that same year lease Mount Vernon, which he have inherited in 1761(Ellis, 2008). This is just but a brief introduction of what kind of a leader Washington was. Washington would later emerge as one of the most significant leaders in the history of the founding of USA, even to the degree of being referred to as the Founding Father of America. One of the contributory factors that made Washington a great leader was the fact that he worked as well as lived with brilliant thinkers, philosophers,

Holistic Approach To Supporting Health Psychology Essay

Holistic Approach To Supporting Health Psychology Essay Emma and Kyle live in a home specialising in providing 24hr care for young pregnant women and their babies. Emma was looked after from being 4 yrs old when she was removed from her parents care. She was fostered for 10yrs by a caring couple until illness forced them to return her to social care services. Several placements broke down as Emma was unable to adjust to a new family and she was finally placed in a young peoples home run by social care services when she became pregnant at 15yrs old. She attended school until the birth of Kyle who was born 4 weeks premature. She moved into the mother and baby hostel when she was 6 months pregnant following referral by her social care worker. She has a good relationship with Kyle, although staff say they would be concerned if she were to leave the hostel and live independently. Kyle has recently started full time nursery which gives Emma the opportunity to attend college where she studies catering. Defining health can be a difficult task. The most famous definition is that of the World Health Organisation (WHO) which hasnt been amended since 1948. Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO 1948). There are many models of health that have been developed over the years, one being the biomedical model which focuses on physical symptoms such as pain. This concept scientifically measures a persons health to decide whether illness is present or not. Biomedical scientists claim that the body is a machine and can be fixed when a malfunction occurs. An improved model would be the Biopsychosocial theory which concentrates on whole life issues including emotional and spiritual aspects as well as social and family support. The holistic model improved further to include not only physical, psychological and social factors but also determinants such as nutrition, alcohol, nicotine, sleep, exercise and community life. The focus of this report is to examine and understand the physical, social and psychological influences upon health by using the case study and consider how things can be improved by using the holistic approach in contrast to the Biomedical and Biopsychosocial. The first thing that will be considered in this report is emotional issues during infancy. Individuals who suffer from broken or emotional relationships during infancy often develop into adults who experience problems understanding their own emotions and this may limit their ability to maintain a successful relationship in later life. In the case study of Emma, she was cared for by her parents till the age of 4years then removed and placed into a caring foster family. It is possible that the biological family suffered from dysfunctional tendencies which could mean child neglect or even child abuse within the home. An infant raised within this environment would imagine it to be normal behaviour therefore being placed in what society sees as a normal functioning family, would be difficult to adjust to. Several studies suggest that up to 80% of children in foster care have significant mental health issues due to the trauma of separation from the biological family in addition to experien ces of dysfunctional families (Smariga 2007). When a child is separated from their primary caregiver who is usually the mother, separation anxiety can occur. Infants younger than 4 years are particularly vulnerable and will experience high levels of emotional disturbances. Separation anxiety in infants can be treated with play therapy if recognised early enough. This type of therapy is a form of counselling which helps young children use alternative coping strategies to work through any existing problems and is probably the more favoured model theorised by biopsychosocial therapists. However, biomedical experts believe that an imbalance in neurotransmitters is the cause of anxiety and other psychiatric disorders such as depression and will recommend the child take a mild sedative to help reduce the trauma (Ponton 2006). The holistic model would argue that certain determinants play an important role in detecting and treating anxiety. Nutrition is vital as food influences the balance of chemicals produced and released in the brain therefore, without sufficient protein, the brain can become deficient in certain chemicals, resulting in anxiety and depression. Exercise is also very important as again this releases chemicals such as endorphins and serotonin which give a feel good effect (livestrong 2012) Depression is a very common disorder and females are twice as likely to suffer at some point in their lives as males. This is mainly due to changes in hormones in adolescence. Biomedical experts believe that these changes are obvious during puberty and pregnancy as well as after giving birth. According to the National Institute of Health, factors that increase the risk of depression in women include reproductive, genetic, or other biological factors. In addition, women who juggle work with raising a family and single parents suffer more stress that may trigger symptoms of depression (NIMH). A biomedical view would be to diagnose and treat depression by prescribing antidepressants. These types of medications increase the levels of serotonin within the body which go on to increase happiness. Recent studies suggest that side effects brought on by long term use of antidepressants can include digestive problems, sexual difficulties and even strokes and premature deaths in older people. Dr ugs that interfere with serotonin may cause developmental problems in infants, development in adults, digestive problems, diarrhoea, and indigestion and may also raise the risk of dementia (Naish 2012). There are a number of holistic methods which can help keep depression under control such as avoiding caffeine, nutrition and exercise. Caffeine reduces serotonin levels so reducing the drug will naturally increase happiness. Essential fats cannot be naturally produced in the human body therefore it is important that they are included in the diet. The richest source of omega 3 is found in oily fish and nuts. Many of the population are on low income or benefits and maybe see themselves to not be in a position financially to eat fresh food. Eating junk food will increase the levels of sugar found in the blood which will give symptoms of fatigue, irritability, dizziness, insomnia, depression and digestive problems. Since the brain depends on an even supply of glucose it is of no surprise to find that the above symptoms can appear. The best way to keep your blood sugar level even is to eat whole foods, fruits, vegetables, and regular meals (Food for the brain 2012) Some children will suffer with conduct disorders such as aggression, theft, deceitfulness or violation of rules. This can cause problems in school and in the family home which can lead to police involvement. Causes can develop from temperament, genetics (common in children of adults who had conduct problems), environmental (family problems and social pressures) or physical (problems in processing information). Anger affects your physical health and can cause hypertension, chronic lower back pain, stomach problems and heart disease. The biomedical view would be to treat each symptom individually with medication where as a more holistic method would be to practice relaxation techniques, engaging in physical exercise or by doing something that engages the mind such as drawing or painting. Another way to manage this would be counselling. Group therapy is a really good option for adolescents to learn from one another and social interaction is a vital part of the developmental process. Adolescent years can be very challenging for parents or professionals. Identities are forming, social lives are expanding and new behaviours are experimented with. This can involve alcohol, tobacco, drugs and unsafe sexual activity. A person who is intoxicated is more likely to engage in unprotected sex with a variety of sexual partners. The continued use of any substance can lead to substance abuse and addiction. Emma fell pregnant at 15yrs which could possibly be a result of excessive alcohol or drugs. A developing baby is exposed to anything that is put into the system so no safe amount of alcohol, tobacco or drugs exists during pregnancy. Nicotine is a vasoconstrictor which causes the blood vessels to narrow limiting the flow of blood to the baby. Also carbon monoxide will limit the levels of oxygen available to the foetus which can result in still birth, low birth weight or sudden infant death syndrome (livestrong 2012). The National Institute of Health advises pregnant women no t to drink during the first3 month in particular as this may induce miscarriage (NHS 2012) Another form of depression is postnatal depression (PND) which is common in both men and women. PND is different to depression and the onset usually occurs after the birth of a baby but can also appear during pregnancy. Women can become more tearful and moodier than usual in this time. Some women experience thoughts of harming their baby which is quite common affecting almost half of women with the condition (Roberts 2012). PND can be undetected and left untreated which may lead to aggression and possible harm to the baby. Teenage mothers suffer from poorer mental health in the three years after their birth compared with other mothers therefore Emma needs as much support as she can possibly get during the early years of being a mother. She has no family around to support and help her. The feeling of isolation is the most stressful aspect of being a mother. Holistic therapies can be helpful to combat the stress of being not only a new mother but a teenage and single mother. Massage, r eflexology and herbal remedies may be useful to aid in relaxation. Talking therapies are also very popular and can help with identifying underlying issues that may be occurring. Any medication that may be prescribed should be taking with caution as it could interfere with breastfeeding. Teenage parents often drop out of education because of the pressures they experience, including stigmatization associated with pregnancy, isolation from peers, and lack of needed support from family, friends, schools, social service agencies, and other organizations (SEDL 2012). In 2001 the government set up a programme called Sure Start which was intended to provide holistic support to teenage mothers and fathers. The program has been very successful in providing support during emotional times, educational needs and family support to young parents. Sure Start was developed to reduce the risk of social exclusion associated with teenage pregnancy by providing support for parents and their child to help them with housing, health care, parenting skills, education and child care (Sure Start 2012) Emma has managed to obtain a place in nursery for her son while she continues to participate in education. This alone will create a more stable lifestyle for them both while building a future. The focus of this report is to discuss the different approaches to health and to reinforce that a holistic approach to illness is by far the most improved and widely used method. A more natural approach can help, prevent or improve many health issues before they occur. Many medications can help cure illness and in some cases this is the only way to treat a disease such as cancer however, a large proportion of health problems can be linked to generated issues such as asthma, and stress. Tobacco, alcohol, drugs, poverty, employment, income, education, social, environment, lifestyle choices are all determinants and wider determinants in what define the concepts of health. The body is an impressive machine and treated holistically there are no reasons why many issues should be part of life. Throughout our lifetime, stressful situations and emotional traumas are constantly presented. As we grow, our interactions with other people generate stress such as gaining approval, pressure at school, or work, forming relationships, relationship breakdowns or bereavement. It can have many detrimental effects on our health physically and emotionally.

love :: essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚  Throughout life, we undergo many changes. As time progresses, styles of writing develop new form. However, emotions remain constant. Feelings, which are expressed through writing, can be identified with in the present, as well as the past. Emotions, unlike writing styles, are unable to be controlled. Love is one emotion that may vary in the way it is described, yet remains uniform in the way it is felt.   Ã‚  Ã‚  Ã‚  Ã‚  Elizabeth Barrett Browning expresses her innermost thoughts and feelings through her poetry. In the sonnet, â€Å"How Do I Love Thee?,† she describes the intense emotions that are brought about by the act of love. Her passion reaches the depths of her soul and she has the ability to love unconditionally, with every ounce of faith possible. The love that she possesses comes naturally and can be described with ease. She demonstrates that love, in a way an â€Å"opiate,† which takes over the minds of those who experience it.   Ã‚  Ã‚  Ã‚  Ã‚  Brian McKnight is a man of great words. In his song, â€Å"Still In Love,† he stresses his eternal love for another being. He shows that his love will never die and is simply perfect. It is unbelievable to him that such love is possible. However, he has the privilege of expressing such emotions. He explains that no matter what happens, his love will still prevail. He is obsessed with the feeling of love and feels that he needs love to survive.   Ã‚  Ã‚  Ã‚  Ã‚  Despite the time difference between these works of literature, they possess the same emotions. Both express the strong feeling of undying love. This feeling will deepen over time and continue to grow, even after death. This demonstrates that, no matter what events may take place, their love will remain forever. This powerful emotion has the ability to control every thought and feeling within an individual.   Ã‚  Ã‚  Ã‚  Ã‚  Love, in itself is something that will never fade away, no matter who falls in and out of it.

Btec Buisness Level 3 Unit 1

BTEC LEVEL 3 IN BUSINESS UNIT 3: INTRODUCTION TO MARKETING Assignment Brief Tesco’s and Oxfam’s Concepts of marketing- marketing= a social and managerial process by which individual and groups obtain what they need and want through creating and exchanging products and value with others. Core marketing concepts Markets Exchange transitions & relationships Value satisfaction and quality Products Needs wants and demands B. define aims and objectives Aims: A purpose or intention; a desired outcome Objectives c. Private companies may issue stock and have shareholders.And are invested by individuals. However, their shares do not trade on public exchanges and are not issued through an initial public offering. In general, the shares of these businesses are less liquid and the values are difficult to determine, an example of a private sector is Warburton’s, their aims are to maximise profits or increase value of shares. Public sectors offer shares to the general public, A Public sectors stock can be acquired by anyone and holders are only limited to potentially lose the amount paid for the shares.An example of a public sector would be Tesco’s because they provide a service to the community, another example for Tesco’s being in the public sector is so they can expand internationally, private sectors however would only be able to stay nationally because it s easier to control shares. Tesco’s aims would be to boost the national economy and also to maximise profits. Non profit companies would be charity and sometimes government run organisations. Any money earned must be retained by the organization, and used for its own expenses, operations, and programs.An example of a non profit sector would be Oxfam because they use the money invested in their organisation to help people suffering poverty poor housing in third world countries globally and to invest also using the money to use on their expenses programs etc. Their aims are to imp rove poverty and lifestyle in third world countries. Introduce and explain the two businesses you will be investigating. Refer to their business activity i. e. what they do to make their money, their size and history. Refer to task C and state which sector they belong within. Focus upon and explain one product or service provided by each business.D. i will be investigating Tesco’s and Oxfam. Tesco’s is the third most successful retailer in the world, and they sell all general products needed in a household including, food, clothes, furniture, mobile phones etc they also sell luxury items like gaming equipment, broadband etc, Oxfam is one of the biggest charities globally, they sell clothes, books, board games, etc to make money so they can put it into their company so they can cover expenses and support programs, they also accept donations so they can help other third world countries that are suffering from poverty poor housing etc.Tesco’s was founded in 1942; T esco’s was founded in 1919 by jack Cohan in east London. Oxfam belongs to the non profit sector, they provide products that are cheap so they can provide for programs across the world and supply their organisation with important resources. Tesco’s belongs to the public sector and offer basic products and necessities such as food, housing etc. And services like broadband and banking etc. E. tescos: they want to make cheaper prices so they would be able to get a larger quantity of products sold.Oxfam: more of a variety of products to sell, so customers have more of a choice, this will increase the variety of customers. F. organisational objectives are different from marketing objectives . Marketing objectives are giving a time frame in which they should achieve it, organisational objectives are the overall objectives and are the ones that are the most important. g. The marketing objectives can make you get closer to an organizational objective because it might lead to th e same path. For example marketing objectives are like little steps towards organizational objective. h.Tesco’s marketing objectives is to make prices fair for customers and beneficial for Tesco’s, and also expand their business into different companies. Oxfam’s marketing objectives would be to open more Oxfam shops across the u. k, so they can benefit their programs resources etc. i. Tesco’s might expand their brand into different retailers so it’ll gain more popularity and might even be a leading bran in food clothes etc ii. Oxfam might open stores internationally so will lead to make more money so they can use it so they can run more charitable programs and lead to improve poverty, housing in third world countries around the world. . Explain and justify which of these your business may use when marketing their product or service (one of the businesses products/services you have explained within task d). j. if Tesco’s was marketing a certa in food product Tesco’s would use a marketing technique for example Tesco’s would advertise the product on wallpaper, leaflets ,TV etc also they would put special offers on the product e. g. 2 for the price of one k. Identify and describe the limitations and constraints upon marketing activities.For example if Tesco’s was making a new product and they were given a limited amount of money to invest in this product, this would limit how advanced this product and how useful this product would end up to be. A constraint for tescos would be the price war, all supermarkets, retailers etc want the best prices for their customers and the best prices for customers means more profit for themselves, this would subdued customers to shop at Tesco’s more than other retailers tacos is always making cuts and budgets to make low prices for customers its is a constant restraint for Tesco’s L.For each limitation and constraint explain how this may affect the marketin g operations of your two chosen businesses. The operations wouldn’t run as smoothly because you are not making enough profit to achieve those operations. The price war will affect their special offers new programs because they would have to cut those in making a better price for customers, prices are one of the top priorities for a retailer. m. Produce a comparison table stating and explaining in detail the similarities and differences between the chosen product/service of each organisation across a range of market techniques. Similarities | Differences | | |

Health Policies in Relation to Nurse to Patient Ratio Essay

One suggested approach to ensure safe and effective patient care has been to mandate nurse staffing ratios. In 1999 California became the first state to mandate minimum nurse-to-patient ratios in hospitals. California is not the only state to enact minimum nurse staffing ratios for hospitals, over the past four years at least eighteen other states have considered legislation regarding nurse staffing in hospitals. Policymakers are forced to consider alternatives to nurses ratios due to nurse shortages. Whether minimum staffing ratios will improve working conditions enough to increase nurse supply is unknown. The United States healthcare system has changed significantly over the past two decades. Advances in technology and an aging population (baby boomers) have led to changes in the structure, organization, and delivery of health care services (Spetz, 2001). Low nurse staffing levels in acute care hospitals are jeopardizing the quality of patient care and is the leading cause for Registered Nurses (RNs) to leave the profession (Spetz, Seago, et al., 2000). Apprehension for the nursing workforce and the safety of patients in the U.S. healthcare system now has the unprecedented attention of healthcare policy leaders at every level (Spetz, 2001). One suggested approach to ensure safe and effective patient care has been to mandate nurse staffing ratios (Donaldson, FAAN, Bolton, Janet, Meenu Sandhu, 2005). In 1999 California did just that, it became the first state to enact legislation mandating minimum nurse-to-patient ratios in acute care hospitals (Donaldson, FAAN, Bolton, Janet, Meenu Sandhu, 2005). Assembly Bill 394 (1999), directed the California Department of Health Services (DHS) to establish specific nurse-to-patient ratios for inpatient units in acute care hospitals. This was done by creating a hospital Licensed nurses classification to include both RNs and licensed vocational nurses (LVNs) also referred to as licensed practical nurses (LPNs) (California, 2002 July). This was not the first time a legislation had contemplated a nurse-to-patient ratio. In 1996, proposition 216 would have established staffing standards for all licensed health care facilities in addition to creating a statewide health insurance system (California, 2002 Janurary). The ballot proposition  that was rejected by the voters in 1996. Again in 1998, Assembly Bill 695 was introduced and approved by the state legislature but vetoed by then Gov. Pete Wilson (California, 2002 Janurary). Intense lobbying by unions representing California nurses would change everything with the passage of Assembly Bill 394 (California, 2002 July). The intense lobbing paid off with the election of a new governor, Gray Davis, in November 1998, who was endorsed by unions representing nurses and other workers (Spetz, Seago, et al., 2000). California DHS proposed the minimum nurse-to-patient ratios (California Hospital, 2004). Thus ranged from one nurse per patient in operating rooms to one nurse per eight infants in newborn nurseries. The DHS proposed that the minimum ratios for medical-surgical and rehabilitation units be phased in (California Hospital, 2004). They initially set minimum ratios for these units at one RN or LVN per six patients and within twelve to eighteen months the goal was to shift to one nurse per five patients (California, 2002 July). Prior California law regarding nurse staffing in acute care hospitals were extended under Assembly Bill 394 (1999). State and federal regulations affect the demand for licensed nurses. Under the 1976-77 state legislative session, California hospitals must have a minimum ratio of one licensed nurse per two patients in intensive care and coronary care units (California Hospital, 2003). Federally certified nursing homes are required to have a RN director of nursing and a RN on duty 8 hours a day, seven days a week (California state). If the facility has under 60 beds, the director of nursing can serve as the RN on duty (Harrington, 2001). This legislation also requires that at least half of licensed nurses working in intensive care and coronary care units be RNs (California state ,Title 22, Division 5, Chapter 1, Article 6, Section 70495(e).) Legislation enacted in the early 1990s requires hospitals to use patient classification systems to determine nurse staffing needs for inpatient units on a shift-by-shift basis and to staff accordingly (California state ,Title 22, Division 5, Chapter 1, Article 6, Section 70495(e)). In January 2004, hospitals also will face minimum licensed nurse-to-patient  ratio requirements in other hospital units, as established by Assembly Bill 394 (California state, Chapter 945, Statutes of 1999). Numerous estimates of the effect of these ratios on demand for licensed nurses have been published. The DHS analysis, conducted by researchers at the University of California, Davis, predicts that 5,820 new nurses will be needed in California hospitals to meet the staffing requirements (Kravitz, Sauve, Hodge, et al., 2002). Other analyses conducted by independent researchers have reported that the increased demand for nurses due to the ratios could be as low as 1,600 (Spetz, 2002). Growing numbers of research associates important benefits for patients and nurses will arise with the Assembly Bill 394 (Aiken, Clarke, Sloane, 2002). It has been argued that nurse staffing levels are now so low as to jeopardize the well-being of hospital patients (California. Office of the Governor, 2002). Supporting Assembly Bill 394, minimum nurse-to-patient ratios assure quality by establishing a minimum standard below which no hospital can fall (Assembly Bill 394, 1999). Researchers disagree with California’s statute requiring use of acuity-based patient classification systems because it is inadequate and difficult to determine whether hospitals are complying with this mandate (California Hospital, 2004). Instead they support a, simple minimum ratios to enable nurses, patients, and family members to easily identify and report inpatient units with dangerously low staffing levels (Donaldson, FAAN, Bolton, Janet, Meenu Sandhu, 2005). It is believed that working conditions have a large influence on the number of persons willing to practice nursing in hospitals (Kravitz, Sauve, Hodge, 2002). To most, minimum staffing ratios would improve working conditions, which would in turn reduce the numbers of nurses leaving hospital positions and the nursing profession (Donaldson, FAAN, Bolton, Janet, Meenu Sandhu, 2005). Creating a better work environment and conditions also may attract more young persons to nursing (Kravitz, Sauve, Hodge, 2002). Increased attention to nursing and rising salaries are already raising interest levels; the American Association of Colleges of Nursing reports that enrollments in baccalaureate nursing programs increased in 2001, for the first time in six years (American Association of Colleges of Nursing, 2001). The Assembly Bill 394 (1999), is great and will create a safer environment for patients, and staffing ratios would help to alleviate the nursing shortage but without nurses to meet the ratios one cannot uphold and follow the nurse-patient-ratios. This is why California Governor Gray Davis announced the Nurse Workforce Initiative in his January 2002 State-of-the-State speech (California. Office of the Governor, 2002). The purpose of the Nurse Workforce Initiative (NWI) is to develop and implement proposals to recruit, train, and retain nurses both to address the current shortage of nurses in California and to support implementation of new hospital nurse-to-patient staffing ratios also announced in late January 2002 (Seago, Spetz, Coffman, Rosenoff, O’Neil, 2003). The Governor made available $60 million over three years for the NWI (California, 2002 July). His goal is to use components designed to address the nurse shortage using both short and longer term strategies. This can range from working in partnership with local hospitals, scholarships for nursing students, career ladder projects, workplace reform efforts, and other strategies to increase the number of nurses (California, 2002 July). An evaluation will be done to determine which strategies to increase the supply of nurses are most effective and improve the understanding of the labor market dynamics for nurses (Seago, et al, 2003). Whether minimum staffing ratios will improve working conditions enough to increase nurse supply is unknown. The experience of hospitals in Victoria, Australia, one of the few jurisdictions to implement minimum nurse-to-patient ratios in hospitals, is instructive (Needleman, Buerhaus, Mattke, Stewart, Zelevinsky, 2001). Large numbers of nurses returned to the nursing profession after the minimum ratios were established. However, hospitals continued to face a shortage of nurses, because there were not enough returning nurses to meet demand, forcing hospital to close hospital beds (Needleman, Buerhaus, Mattke, Stewart, Zelevinsky, 2001). Besides, minimum staffing ratios address only one piece of the ‘  dissatisfaction with hospital nursing. Staffing is a major concern of many nurses, but RN job satisfaction indicates that they are also dissatisfied with other aspects of their work, including low salaries, lack of control over work schedules, lack of opportunities for advancement, lack of support from nursing administrators, lack of input into policy and management decisions, and inadequate support staff to perform non nursing tasks (Spetz, 2002). Maine and Massachusetts state affiliates cut their ties with the American Nurses Association (ANA) in 2001, in large part because they did not fully agree with the ANA’s opposition to minimum nurse-to-patient ratios (American Nurses Association, 2003). This led to the establishment of the American Association of Registered Nurses in February 2002, leaders of unions representing nurses in California, Maine, Massachusetts, Missouri, and Pennsylvania joined to establish a new national association (New England, 2005). The unions will join forces on national projects and support one another’s state legislative, collective bargaining, and organizing campaigns. Further research is needed to establish the number of states in which nurses’ unions have sufficient political power to enact minimum nurse-to-patient ratios. In the short term, the number of states is likely to be small. California’s rate of unionization among nurses, approximately 25 percent, is much higher than that of most states (Aiken, Clarke, Sloane, 2002). In addition, ANA affiliates are more powerful in other states than in California. Proactive ANA affiliates may be able to persuade policymakers to implement other reforms that address nurses’ concerns about hospital staffing (American Nurses Association, 2003). Other important variables include the political influence of state AHA affiliates and elected officials’ ties to organized labor (American Nurses Association, 2003). California is not the only state to enact minimum nurse staffing ratios for hospitals, over the past four years at least eighteen other states have considered legislation regarding nurse staffing in hospitals (New England, 2005). Twelve states have considered bills that would mandate minimum nurse-to-patient ratios in hospitals. Fourteen states have considered  legislation that attempts to address nurses’ concerns about staffing through other means, such as requiring hospitals to develop staffing plans based on patient acuity, mandating disclosure of nurse staffing ratios, and establishing a task force to study and monitor nurse staffing. Oregon, has enacted legislation that requires acuity-based staffing plans (New England, 2005). Policymakers in other states may wish to consider a well-designed acuity-based ratio system as an alternative to minimum nurse-to-patient ratios (New England, 2005). Many states have regulations that require hospitals to use patient classification systems to determine nurse staffing, but these regulations face much criticism, as discussed above. Although many of these regulatory systems do not function well today, they could form the basis for strong but flexible staffing regulations in the future (New England, 2005). States could mandate particular patient classification systems, develop methods of ensuring that staff and patients are aware of the required staffing during every shift, and establish effective enforcement mechanisms (New England, 2005). Alternatively, states could require that hospitals submit information relevant to their staffing needs every quarter and could mandate a ratio for that quarter based on an analysis of patients’ needs, availability of support staff, and other factors (New England, 2005). Texas is pursuing a totally different approach to the nursing situation that is tailored to the unique circumstances of individual hospitals. Under regulations issued 24 March 2002, hospitals are required to establish committees to develop nurse staffing plans and to use data on nurse-sensitive patient outcomes to assess and adjust staffing plans (Texas Nurses Association, 2002). At least one-third of the members of these committees must be RNs engaged primarily in direct patient care (Institute, 1999). The minimal nurse staffing on patient acuity or nurse-sensitive outcomes respond to nurses’ justifiable concerns about hospital staffing without imposing rigid mandates (Harrington, 2001). The flexible staffing approaches seem more appropriate than ratios, given the complexity and rapid pace of  technology changing the delivery of hospital care. (Harrington, 2001). Nurses’ job satisfaction and retention may enhance the opportunities for hospital nurses to play a more direct role in staffing decisions (Kravitz, Sauve, Hodge, 2002). The key is without more nurses no ratio can be met. So the focus needs shift on reaching as many young people as possible by showing them that they to could be a good fit in the nursing community. They need to know that nurses are people too, and the traits of a nurse, such as not being squeamish over the sight of blood comes with time. Stepping out into the high schools and broadcasting information about nurses can translate into only one thing, more students who pursue a nursing career. There is no better way to start, than by planting a seed in the mind of a young person who is about to step out into the world and choose a career. The more educating and qualified young people health care workers can get to chose a nursing career, the better off the nurse-to-patient ratio becomes, allowing for a safer environment for future patients, by permitting more effective health care. References Aiken, L., & Clarke, S., & Sloane, D. (2002). Hospital Restructuring: Does It AdverselyAffect Care and Outcomes? Journal of Nursing Administration, 30(10), 457-465. American Nurses Association. (2003). Nurse Staffing Plans and Ratios. Retrieved June, 10, 2007, from http://nursingworld.org/GOVA/STATE/2003/ratio1203.pdfAmerican Association of Colleges of Nursing. (2001, December 20). Enrollments Rise at U.S. Nursing Colleges and Universities Ending a Six-Year Period of Decline, Press Release, Retrieved 10 June, 2007, from www.aacn.nche.edu/Media/NewsReleases/enrl01.htmAssembly Bill 394. (1999). Retrieved 10 June, 2007, from http://info.sen.ca.gov/pub/99-00/bill/asm/ab_0351-0400/ab_394_cfa_19990628_171358_sen_comm.htmlCalifornia Hospital Association. (2004). California’s nurse-to-patient staffing ratios: Proposedmodifications. Retrieved March 14, 2005 from http://www.calhealth.org/public/press/Article/124/Ratio%20Modifications%20Fac t%20Sheet%20finaCalifornia Hospital Association. (2003, September). Hospital minimum nurse-to-patient ratios asrequired by AB 394. Retrieved April 13, 2005 fromhttp://www.calhealth.org/public/press/Article/113/Nurse%20Ratio%20chart.pdfCalifornia. Office of the Governor. (2002, January 22). Governor Gray Davis Announces Proposed Nurse-to-Patient Ratios. Press Release, Sacramento: Office of the Governor. California. Office of the Governor. (2002, July 15). Sets Nation’s First Safe Nursing Standards: Governor Davis Announces Nurse-to-Patient Ratios, Press Release, Retrieved 10 June, 2007, fromhttp://www.calnurses.org/nursing-practice/ratios/ratios_index.htmlCalifornia state legislature Retrieved 10 June, 2007, from http://www.legislature.ca.gov/Donaldson, N., & FAAN, B., & Bolton, L., & Janet E., & Meenu Sandhu, M. (2005, August 08). New study examines impact of nurse-patient ratios law, California. Retrieved 10 June, 2007, from Policy, Politics & Nursing Practice’s website: http://ppn.sagepub.comHarrington, Charlene. 2001. â€Å"Nursing Facility Staffing Policy: A Case Study for Political Change.† Policy, Politics, and Nursing Practice, 2(2), 117-127. Institute for Health and Socio-Economic Policy. (1999 September). California Health Care: Sicker Patients, Fewer RNs, Fewer Staffed Beds. Retrieved 10 June, 2007 from www.calnurse.org/cna/pdf/StaffingRatios6.pdfKravitz, R., & Sauve, M., & Hodge, M. (2002). 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