Discussing The Restraint Autonomy Of Elderly Patients Nursing Essay

Discussing The Restraint Autonomy Of Elderly Patients Nursing Essay The use of restraint, whether physical or chemical, has always been a normal practice in the medical field when dealing with critical-ill patients and the elderly. Many would justify this act as a form of protection, in order to decrease the number and chances of self-inflicted harm. However, sometimes, it strips the patients autonomy in decision-making, resulting in a discussion on how exactly should restraint be approached. Introduction The number of elderly people in developed countries has gradually increased over the years. In Australia in the year 1991, 11% of the total population comprised of the elderly (65 years old and above). It has been projected that the 11% will increase to 18% in the next ten years. For people who are 85 years old and above, they comprised about 8% of the total population in 1991. It increased in 2001 to 11% (Australian Institute of Health and Welfare 2002). With this fact, nursing homes are needed to cater to older people. There are many reasons why the elderly would enter into a nursing home. It is unlikely that they are entering it because they like it (Harker 1997). Entering a nursing home would mean that the person has to give up his possessions and some of his freedom would be stripped away from him, like being able to go anywhere he wants. He would not be able to eat wherever he wants or walk in the park whenever he wants. A nursing home, for some, is like a waiting area for death. It is very rare for those who are admitted to the nursing home to go back to their homes after entering a nursing home. A persons poor health is one of the major reasons for entering a nursing home. They would need access to nursing care that is not available in their own homes. There are home-based nursing cares available but these are very expensive and they cost a lot to maintain. Long ago, when the elderly would need care or assistance, family members are usually available to assist with their needs. Their children would take care of them in their own homes, or some of them would move into their parents homes to take care of them. In present times, this situation is close to impossible because both husband and wife have to work, or a single child has to work in order to support himself. Because the immediate family could not offer any help to them, they have no choice but to go into a nursing home (Harker 1997). For some people, the decision to go into a nursing home lies in the hand of their children or other immediate family members because he or she might not be able to make a sound decision for himself or herself because of her sickness or disease (i.e. Alzheimers disease) or various handicaps. I chose this topic because I know that one day I will have to consider staying in a nursing home because I could not live on my own when I am old. There will be a possibility that my children could not take care of me because they will have their own families to support. This would help me prepare to be competent enough to decide for myself despite of old age or any unforeseeable sickness. Another reason why I chose this topic is because of my father. My father is currently in the hospital because he has cancer, in its last stage already. I could not be beside my father all the time to take care of him because I still have to work and go to school at the same time. Although I know that my father is in good hands with the hospital staff, I could not help but worry about him. With this paper, I hope to gain better understanding on restraint on the elderly. Restraint in Nursing Homes: Barriers in the Health Care System The elderly has mixed feelings regarding their experience with restraint (Gallinagh et al. 2001). For some patients, the practice of using restraints, like bedside rails or wheelchair bars, are sometimes positive. They tend to give them a feeling of safety and stability. Others do not always think of dependence as something negative. In fact, most elderly patients greatly appreciate the assistance that nursing home staff would offer. Unfortunately, a lot more elderly has negative feelings when it comes to restraint. The use of the methods for restraints has traumatic than therapeutic effects for many older people. Most of them lose their dignity, self-respect, and identity. They become embarrassed, anxious, and disillusioned (Gastmans Milisen 2005). Physical restraint is defined as the use of any object or piece of equipment that is attached to or near the body of a person and which that could not be controlled or simply removed by the person. It stops or intentionally prevents a person from moving on his own will. (Gastmans Milisen 2005) Examples of physical restraints are the following: vests, straps/belts, bedside rails, wheelchair bars, bed sheets that are tucked too tightly, etc. Another type of restraint is the chemical (or pharmacological) restraint. This involves the use of drugs to hold back a certain behavior or movement. Other than hypnotic or antidepressant drugs, institutions also use psychotropic drugs like chlorpromazine, diazepam, haloperidol and thioridazine. (Powell et al. 1989) Other methods like being locked in a room, electronic surveillance, and being forced or pressured to do medical examinations and treatments (Gastmans Milisen 2005). In taking care of older people in nursing homes, it is sometimes unavoidable to use restraint. This is usually done to keep them away from any accidents or harm they would inflict on themselves. But lately, because of the growing concern among relatives of elderly patients, long-term care services providers for old people are now required by licensure and accreditation agencies to have a restraint-free culture as a standard practice. However, many fail to achieve the intended result because of so many barriers. These different unavoidable barriers, which are also reasons for restraint on the elderly, are to be discussed in the following paragraphs. The main concern in using restraint on elderly patients is to make sure that they would be safe from any accident that would result to injury. Nurses, caregivers, and other institutional staff fear that the elderly patients might fall anytime. However, there had been a study that 67% of the patient falls from the bed were from those who are physically restraint. (Lee et al. 1999) In the same study, it was also mentioned that inadequate staffing was also another reason for physical restraint since the staff could not keep an eye on all the patients all the time. It was revealed that 36% of nurses confirmed that physical restraint was used when they could not closely monitor the patients. Ironically, when the elderly patients tried to resist the physical restraint imposed on them, it results to undesirable consequences, therefore, they will be needing more nursing care-the opposite result of what the nurses, who preferred physical restraints when understaffed, were hoping to achieve (V arone et al. 1992). There is no clear confirmation that restraints prevent injury in clinical settings. To continue such ways without thorough assessment of the situation is an outcome of not sticking to evidence-based practice. Staff could be charged with allegations of professional misconduct and legal actions from patients and their families (Cheung Yam 2005). Physical injury comes in two categories. First, it is related with the direct impact of the device used for restraint on the patient. Examples of these injuries are bruises, nerve damage, asphyxiation, and even sudden death. Second, it is associated to the injuries attained because of enforced immobilization. This includes loss of muscle tone, contracture, or reduced functional ability. The injuries in the second category are more intense for the elderly patients because this might extend their stay in the hospital, cause them to fall, and triggers pressure ulcers (Cheung Yam 2005). Robbins et al. (1987) reported that morbidity and mortality rates are eight times higher among restrained patients compared to those who are unrestrained. Restrained patients could also suffer from psychological harms aside from physical injuries. They often have negative responses like anger, fear, denial, demoralization, humiliation, depression, agitation and regressive behaviors (Gorski 1995). Other patients have complained about the loss of dignity. They have considered those kinds of experiences to be humiliatingly against their human rights. Apathy and depression become worse for many older, restrained people that they feel a sense of abandonment. Studies on social behaviors in different nursing homes showed that there is a big difference with restrained and unrestrained elderly patients. The former usually stops any form of social interaction (Folmar Wilson 1989). Other studies showed that nurses sometimes have a difficult time in facilitating treatment regimens that they resort to physical restraint. For example, a patient is confused and is having an intravenous infusion drip. He tries to pull out the drip, which may cause him to bleed. A nurse will have to strap his hands so that he would not be able to pull the drip out, and injuring themselves. (Lee et al. 1999) However, according to studies, the use of restraint in these kinds of situation increases the agitation of patients, which ironically again, makes them more susceptible to injury (Thomas et al., 1995). Incompetence, due to psychiatric diagnosis or cognitive impairment, is usually another reason for restraint among elderly patients. Staff could easily argue that the patient is too confused or demented to make a reasonable decision for his own welfare. They believe that competence is a medical issue and could be resolved only through scientific evidence. However, Leifer (1963) cited facts that showed inconsistencies between pathological and clinical findings for mental incapacity. In short, he tried to explain that there is no reliable connection between the state of the brain and the legal criterion for competency (Schafer 1985). A certain judge in the United States District Court of New Jersey emphasized that one must not automatically assume that insane patients are not competent to give or hold back consent for treatment or medication (Schafer 1985). A patient has every right to refuse any treatment and the people around him should always respect that. There are three ways in determining the validity of a patients consent. First, the patient must have the capacity or competence to make a decision. Second, the patient must be thoroughly explained of all the pros and cons and other information that would help him reach a decision. Lastly, the patient must never be forced to make a decision. (Gert et. al. 1997) Until a court finds the patient incompetent, the patient must always be assumed to be competent. In some cases, psychiatrists often define this as a medical emergency, which would require compulsory treatment and intervention on the patients autonomy. There are times when the staff is really qualified to provide effective care but the patient is just too difficult to handle. (Schafer 1985) Issues with Restraints There was a study that pointed out that with physical and chemical restraint, nurses feel safer and they are more psychologically comfortable. It showed that the nurses were more concern of their own comfort than the welfare of the elderly. They were thinking that when they fail to restrain patients, they would become legally liable for any accident that might happen. This places the elderly patients at a higher risk of injury because of confusion, agitation, and pressures. It only gave the nurses a false sense of safety (Thomas et al., 1995). The attitude of the staff has a great effect on both the quality of treatment of older people and the consideration given to preserving their dignity and autonomy. By maintaining their dignity and autonomy, it minimizes the distress felt by the patients. Dignity refers to the self-respect maintained by an individual and valued by others. Autonomy refers to the control of making decisions, in any aspect of life, for oneself (Lothian 2001). In a research by Bernard in 1998, he found evidences that implied that a significant number of people working in the medical field hold pessimistic views on older people. An important way of tackling poor attitudes by staff towards the elderly patients is though extensive and continued training. Evidence showed that exposure to a more specialized training in geriatric care is beneficial. People, who still have grandparents as role models, have also been found to treat older people with better attitudes. (Haight et al. 1994) Staff, who are trained, becomes sensitive to the different issues around an older persons dignity and autonomy, are better equipped to treat older patients (Lothian 2001). In the UK, there are two major legal issues regarding both physical and chemical restraint. The first issue concerns about the law of assault, the threat of violence, and the actual and direct use of unlawful physical force on another person (also known as battery) even though they are not really harmed. The second one involves the risk of negligence (Trivedi et al. 2009). An example could better describe this. A court in Germany held a nursing home responsible for violations of obligations when an elderly female resident had a fracture. The patient fell off he toilet inside her room while the nurse went to the bathroom sink to wash the patients dentures. The nurse was not able to prevent or stop the fall because she could not see the patient from where she was. The patient was still mobile and could still walk with help days before the accident. In spite of this, she was already in her last stages of Alzheimers disease so her actions were more of a series of events rather than premeditated actions. The nurse should have anticipated any abrupt changes since she knew about the disease already. The court placed this error on the nursing home as negligence (Sammet 2006). Some other judgments have been made that are similar to the situation above. According to Sammet (2006), possible movements should have been anticipated and predicted. The nurses control should substitute the patients incapacitated will as a way of protection. In cases of serious dementia, the patients personal wish should not be taken into account. Since he or she could not make a reasonable wish at all. Sammet (2006) described this kind of care and protection as disease-centered. In this case, the medical data matters and not what the confused patients wants. Therefore, there should be a balancing of values. The nursing home staff should be in a position to restrain patients to safeguard them from harm and injury. Intervention is necessary and the elderly are often not given the privilege to refuse because they are usually not capable anymore of doing so (Sammet 2006). Strategies in Overcoming Restraint More focus should be placed on educating nurses to reduce the unfitting use of restraints on elderly patients. Thorough nursing assessment is especially needed before using any restraints (Lee et al. 1999). The use of restraints should always be the last resort, not the first option. When healthcare providers do not have any other choice but to restrain the elderly patients, utmost care and attention should be provided. Nurses and caregivers should also acknowledge that they have an ethical duty to clarify and give details to elderly patients and their families the purpose for making use of restraints and should always get an informed consent as much as possible. Coordinating with other healthcare professionals should be promoted since combined efforts will allow them to identify other means or approaches to care apart from using restraints (Lee et al. 1999). Ethicists have created a list of principles for the right way of using restraints on demented patients. This list is usually used by government agencies. Moss and La Puma (1991) suggested the following guidelines: (1) mechanical restraints should never be ordered in a regular manner and should not be used as a replacement for careful patient surveillance; (2) arrangements for restraints should start a medical investigation for the purpose of pointing out and correcting the medical or psychological complication that triggered the order of the restraint; (3) the patients representative who is involve in decision-making should agree to the restraints and be fully informed of the different risks and benefits; (4) mechanical restraints should be used carefully (and only for a temporary time), making use of the least-restrictive device as much as possible; and lastly, (5) chemical or pharmacological restraints should only be prescribed by the proper professional, should be in the lowest ef fective dose, and the patients status must be frequently reassessed. Clinical ethics is about considering the ethical values and standards that acts as guidelines for clinical actions. Every elderly should be treated as a person (Janssens 1980-1981). This serves as the first value. Human dignity could not be given up, not even through disease, disability or approaching death. Caregivers and nurses should always respect the dignity of patients (Gastmans Milisen 2005). As a second value, one should always take into consideration that each human being is a responsible individual. Humans act base on their conscience, in a free but responsible means (Janssens 1980-1981). The elderly, as human beings, should be allowed to make choices and should be respected. A high regard for the overall welfare is the third value that should be secured. When it comes to a time when decisions for physical restraint have to be made, social, psychological, and moral aspects of a persons wellbeing are all considered. (Gastmans Milisen 2005). The fourth ethical value is about promoting self-reliance among the elderly. This could, in many cases, postpone or prevent the use of any restraint on the elderly. Nursing homes could help by specific measures (lowering the bed to avoid or prevent painful falls, using shock-absorbing and non-slip floor covering, walking aids, hip protectors), by measures to optimize the environment (using ample lighting without glare, familiar surroundings orientation, prevent or minimize sensory overload), by individualized care (by encouraging social interactions by talking and listening to them and motivate them to participate in activities), and by preventing or decreasing factors for fall like nutrition management, routine toilet ing, stimulating mental processes, balance training and exercises (Gastmans Milisen 2005).

Local-Color Regionalism in Tennessees Partner Essay -- essays research

The literary movement of local-color regionalism in American literature is a very distinctive and interesting form of fiction writing that effectively combines regional characteristics, dialect, customs and humor. In Bret Harte’s Tennessee’s Partner, these characteristics helped the story jump off the page, allowing the reader to understand the â€Å"times† rather than just the characters. And, for that reason, I feel that this is an outstanding piece of work. One of the most distinguishable characteristics of local-color regionalism writing is the usage of authentic dialect based on the story’s setting. In Tennessee’s Partner, Harte uses this tactic best when quoting the title character. For example, when Tennessee’s Partner suddenly appears in court on behalf of his best friend, Tennessee, his words are carefully written based on how they sounded from his mouth – not on how they should be, grammatically speaking: â€Å"†¦Tennessee, thar, has played it pretty rough and expensive-like on a stranger, and on this yer camp. And now, what’s the fair thing?...Here’s seventeen hundred dollars in coarse gold and a watch, -- it’s about all my pile, – and call it square!† Such talk effectively captures the typical conversation of the Old West and the Gold Rush and gives the reader a feeling of authenticity. Tennessee’s speech is similar, though not nearly as rough. Although not one hand of poker was played throughout the entire story, Tennessee revealed, through his use of words in his every...

Candid Communication Essay

Due to the costly failed attempt to expand to the European market, and recognition of the major underlying cultural problems which resulted in the unsuccessful expansion, our team has been tasked with proposing plans for revitalizing your corporate culture. Key personnel, who could have provided advice to avert the flawed expansion strategy, did not voice their concerns or advice because such actions were not culturally encouraged. As an executive management team, you have recognized that this failure to uphold a corporate culture which values candid communication at all levels was the ultimate cause of this setback. This proposal is designed to uncover potential obstacles to creating a culture which foster candid communication, and present a plan of action to alter the corporate culture from the ground up. Question 1: The obstacles of fostering candid communication can be categorized into three areas: personal, physical and cultural. When discussing personal obstacles, the outer layers peel back to find both interpersonal and intrapersonal barriers that your organization will find in their journey to value candid communication. For example, interpersonal barriers occur between team members, such as differences in personality styles or behavioral preferences. Ignoring or not addressing these differences can lead to rivalry, competition and fear of speaking up due to retaliation or further dislike from other co-workers. Though individuals in your company may not like or be willing to work with one-another, the major obstacle is to first get them talking to address their differences. Furthermore, even if your employees hold similar behavioral or personality styles, another obstacle may be that their relationships might not be strong enough to support constructive criticism from others, indicating a lack of trust. The absence of trust is the first dysfunction of a team, according to Patrick Lencioni. â€Å"Trust is the foundation of a team† and the lack of trust is the team’s inability â€Å"to understand and open up to one another† (Lencioni, pg. 43-44). Strong, trusting relationships support providing feedback to other employees and supervisors without fear of future scrutiny. Lack of trust within a group also holds a strong influence on intrapersonal barriers to speak freely. Intrapersonal barriers are those that occur within the individual self or mind but are strongly influenced by their surroundings. For example, without the feeling of trust, employees may revert back to their safety zone by keeping quiet and holding back opinions in order to protective themselves (Lencioni, pg. 195). Likewise, other intrapersonal barriers can be as simple as the individual’s self-confidence level or working with individuals who prefer not to provide criticism for fear of rejection from the group. In addition, another obstacle is the absence of individual’s sense of belongingness to the company, one of Maslow’s steps in his Hierarchy of Needs. Belongingness comes from the company support of employees through personal development and job enrichment which play a critical role for employees to recognize that they and their opinions are valued enough to be shared. Secondly, physical barriers of separation, such as the physical distance between locations, geographic barriers like oceans or even walls between offices, can also hinder the ability to communicate openly to employees,. For example, as your company expands internationally, it will face the creation of virtual teams. Virtual teams are at a disadvantage to build trusting, strong relationships because they do not have the luxury of sitting across the table from one-another to work out disagreements. And, even if they wanted to, it would be extremely expensive for the company to fund trips back and forth across the pond. On the other hand, co-located employees may still feel that physical barriers impede their ability to share from blocked areas and closed doors providing visual cues to employees that they are either not needed or wanted. Last, as your company grows it will face both society and company built cultural barriers. Societal barriers, such as international relations and generational differences can influence the effectiveness of conducting business and building relationships in the future. For example, do the companies that we are working with international hold the same emphasis on candid dialog? Do cultural barriers or age differences enable employees to provide productive feedback or criticism without violating a social norm or without fear of creating adversarial relationships? Both examples of societal based barriers greatly influence the ability of people to feel they can share openly. Likewise, company built cultural barriers continue to obstruct straight talk if the culture does not reward such behavior and the population contains individuals who do not fit the cultural mold. For example, Nordstrom employees who are not fanatic about how amazing you Nordstrom’s is will â€Å"be ejected like a virus† (). Employees who do not see rewards for behaviors or do not agree with the cultural behaviors will not be comfortable to share candidly. Question 2: In order to combat these negative obstacles the company must first create and communicate a solid value structure, mission statement and form committees to help implement and generate ideas. The assurance that people feel valued needs to be the primary focus of the company citing the well known fact that employees are the number one customers. A credo similar to the one mentioned in Built to Last (p. 9) for Johnson & Johnson, listed open for all to see, must be presented to the employees specifically listing core values including but not limited to: welcome change, be honest/open, recognize success but not shun failure, treat everyone with respect and spend considerable amount of time nurturing culture. For maximum impact management needs to proactively practice (MBWA) by walking around displaying, encouraging and measuring the success of all these values. These values and structures need to be engrained early in the employees so that the culture will become second nature. The objective is for the employee to be culturally rooted early. This is why the processes of recruiting, hiring, socializing and training new employees is critical, similar to Nike within Built to Change â€Å"the company fostered a â€Å"just do it† identity that was reflected in its structure, the people it hired†(p. 46). Once hired, the cultural foundation has been set and injection into the company’s system will receive little resistance making it simple to promote candid communications. Disregarding early processes may allow people to slip into the company who don’t fit the cultural mold and/or they are not properly adjusted into the system. These outcasts have a possibility of being rejected from the system resulting in employee turnover or a multitude of other problems. Recruiters can ensure recruits fit into the open communication culture by various techniques of evaluation, starting at first contact, including socializing events and interview processes. Events that require potential employees to socialize with current employees at their peer level will help evaluate their compatibility within the system and the employees. Employees administering interviews are encouraged to ask more behavioral questions rather than job function related questions. This will also ensure that new candidates are on the right path to successful transplant into the company. Once hired, new employees are to be indoctrinated with the concept of free speech. In order to build relationships and foster vertical communication, all new employees regardless of position, are to attend a high level onboarding training that is done within one large room. Next they participate in a communication building scavenger hunt requiring them to find and speak to certain individuals within the organization. The new employees are then paired with existing employees in their own department for 3-6 months because it typically takes a while for employees to become situated and comfortable in their new environment. By training employees in this way you guarantee little deviation from expected culture and instill the free speech initiative, making it easier to have candid conversations. People tend to respond positively to change when they receive recognition from managers. Displaying exceptional behavior is often overlooked leading employees to believe that the attribute is not exceptional or essential to success. When establishing a system for rewarding positive behaviors, especially those that revolve around the core values and candid communication, the rewards need to be in high regard to the employee and not necessarily monetary, Microsoft shows this in Built to Change when it â€Å"employees have challenging work and, of course, one of the most highly rewarding stock plans around†¦. hereby attracted some of the country’s top software engineers and marketing geniuses†(p. 47). Equally important within the innovation process is having more time to develop new ideas shown in Built to Change 3M’s â€Å"policies and practices that give employees time to experiment, and its reward system recognizes innovative work† (p. 39). The rewards and time provided for ideas generated will bring about open communication but would be ultimately ineffective in the event that there isn’t a way to evaluate these ideas and innovations. Therefore a committee consisting of white and blue collar workers should be assembled to evaluate and investigate ideas that are submitted for validity or cost effectiveness. To instill a culture that embraces and utilizes open communication candidly the company must have a way to promote and judge the performance of the changes. A committee will be formed in order to set goals, establish who will be in charge, schedule mingling events, enrich communications and ultimately ensure that this initiative isn’t forgotten. The mingling events would serve as a tool to not only build relationships between employees, breaking down communication barriers, but to strengthen and reinforce ties to the company. Some examples of the events would include speed mentoring, company picnics, benefit fairs, blood drives and fundraising events. Next the committee would be responsible for enriching communications throughout the company by fostering goodwill, laying out company-wide changes and compiling and maintaining the medium for communication disbursement. Mediums of communication can vary from newsletters, memos, banners or blogs. In Corporate Culture and Performance, Tandem Computers practices this by displaying achievements â€Å"are regularly recognized on bulletin boards as Our Latest Greatests†(p. 16). Communication transmitted must be professional to avoid wasting time across the organization. Some additional information, including information about the CEO’s family, may be added to show that she is human and the message is genuine. The committee would also explain new product information, organizational issues that might be confusing and benefit changes that might seem to only benefit the employer. By doing this managers can build rapport to increase employee understanding of the company, products, ethics, culture, and external environment, showing that the managers are not hiding information. This builds trust and fosters open communication. In order to facilitate information sharing, the company must utilize various ways of mentoring. Level mentoring should be skipped so that employees get an opportunity to meet with someone above the direct management. Reverse mentoring will be also instilled in the company as the younger person might have some fresh ideas and new tools. Sometimes, a new set of ideas might be the solution to a lingering issue in the company. Training sessions are organized by putting the management and employees on the same teams. Likewise, large group information sessions are implemented to talk about issues related to employees with management information similar to Merck’s communication meetings that are held three times a year. These meetings will have the full support of upper management and are used to open communication, improve the flow of information among all levels of management and to provide employees with information they need to do their jobs better. There could also be an improvement in information sharing by having no doors on offices or no physical barriers between management and lower level employees. Honda and Harley Davidson have an open door policy as described in Built to Change (p. 9). The company should clearly define fair policies and procedures. This will help the employees to know what is expected of them. If employees know what the company expects, it is easier for them to be accountable for their own behavior and contribute accordingly. Clear guidelines for professional conduct will be established by the company so that co-workers treat each other with respect regardless of their position in the company. Also, a process of performance review system will be implemented to ensure the employees are promoting the company’s value structure. A 360 degree review process will be utilized by the company which will help to provide on-going feedbacks to all the employees. This will enable all the subordinates, peers and supervisors to have their input towards the company. This will also help to assess all employees on a continual basis on how they are performing to business needs as well as adapting to the values of the company. The results from these reviews can be used to make administrative decisions as well as to plan for training and development in the future. The company should also not sway from their core values no matter what, as described in Built to Change (p. 4) in the Southwest Airlines example. This will enable the employees to stay loyal and feel comfortable knowing that their jobs are stable. Finally, the company will provide proper benefits to the employees including fair pay based on individual performance, team performance and seniority so that the employees feel valued. A proper organic organization structure will be designed to empower people and allowing them to make their own decisions. This will make the employees accountable with their decisions. A flatter organization structure will be designed in order to enable employees to speak freely to higher levels of management for advice. This will also enhance the mentoring process and help to build effective relationships. After assessing the culture and gathering input, the company should identify the system, policies and procedures that must be either changed or implemented to support the new culture. The new infrastructure should address role expectations, accountability, rewards and selection systems. The company will also have defined job descriptions and encourage people to switch departments so that employees won’t feel pigeon-holed. In other words, the company will also allow mobility within the organization in order to get the most out of their employees and employees will be more flexible. The employees should also understand other roles and jobs in the company to be able to relate to them and provide input for improvements. The company will focus more on team based design that will eventually help to elevate individual performance in the company. Individuals in the company will be cross trained or conditioned in order to improve the overall performance of the whole team. Although the word â€Å"team† is heavily used in the industry today, teams often play a major role in initiating organizational change. A cross functional team design will create mutual accountability for results and joint ownerships of work products. Above all, a properly designed organic organization structure will positively impact the ability to focus, directly affects the communication channels and empowers people by giving the employees a drive to make their own decisions. Question 3: While designing and implementing an effective, company-wide communication structure is vitally important, the activities performed by leaders at all levels are paramount to sustaining an effective communication culture. Managers are the face of your company’s culture and their interactions with their direct reports will be the frontlines of the company’s culture battles. Beginning with the hiring process, managers must be mindful that they are not only assessing the potential hire’s technical skills and abilities, but also their fit within the culture. They must abide by and practice recruiting and hiring techniques that will reasonably ensure that the company is hiring candidates that will express the desired behavior and align with the culture. These techniques could include maintaining relationships with contacts at local universities and recruiting firms. If these contacts are familiar with your company and culture they could aid in providing a stream of potential new hires and would be able to â€Å"pre-screen† for cultural fit. Mangers should openly discuss the company’s culture and ask explicit questions regarding how the potential hire feels he/she will fit within the culture. This will set cultural expectations of open and candid communication with all interviewees long before any are hired. Also, managers should use behavioral type interview questions to test the candidate’s attitudes, trust and ability to speak freely. Additionally, the interviews should be conducted by employees of varying levels of the company, both managers and non-mangers, with a single manager soliciting feedback from all other interviewers regarding their assessment of the recruit. Once potential employees are deemed to be a cultural fit and are hired it is important to continue the initiation process into the culture. Managers need to immediately begin teaching new employees about the open communication culture and submerging them in it. The Container Store, for example, submits all new hires to a weeklong orientation in which they are taught the inner workings and philosophy of the company (FoE, pg. 75). Socialization techniques can be utilized to build the relationships between the new and established employees, understanding that well socialized employees are more likely to share information freely. Managers can organize gatherings of new and current employees to introduce the new hires to their co-workers. Examples would be ice cream or pizza socials in which ice-breaker type games are used to introduce and socialize new hires to their peers. Mangers can also take new hires to lunch with a small group of their fellow employees in an effort to socialize the new employee in an environment outside the workplace. An emphasis should be made at these types of gatherings to learn about the employee’s life outside of the work environment. Other practices like a mentoring or buddy system could also be utilized to engage the new employee in an open communication culture. The focus of these activities should be to build trust and a sense of value within the new hire. Employees that perceive themselves as being valued and have strong trust relationships with their direct reports and co-workers are more likely to give of themselves, that is, to invest their â€Å"heads and hearts† with your company. While recruiting and initiating new hires into the culture is vital, most of a leader’s time will be spent maintaining the open communication culture. These tasks can be broken down into activities that build relationships, empower employees and provide reviews and feedback. Mangers should spend a considerable amount of time getting to know and nurture relationships with their direct reports. Leaders should adopt a Management by Wondering Around system where managers spend time with employees getting to know what they are doing, how they are doing it, what kind of problems they are facing, and what help is required to solve the problems (Dynamic Business Strategy, info from Vick). This type of communication should be seen as an integral part of managing people, not as an additional burden to a manager’s already busy schedule. An open-door policy should be utilized so that managers are available to their employees as much as possible. Leaders should also maintain a database of employee birthdays and employment anniversaries and recognize these occasions with cards and/or gifts. Management could also hold monthly get-togethers to celebrate the birthdays, anniversaries and milestones that occurred that month. Managers should be encouraged to spend time with their direct reports outside the work environment. Informal gatherings like lunches and happy hours could be utilized to get to know direct reports on a more personal level. Managers should hold occasional casual days in which employees are allowed to wear themed casual attire like university t-shirts to kick off football season or Hawaiian shirts at the start of summer. Additionally, leaders could send out daily or weekly e-mails informing employees of what is going on around the company.

The Performance Art Center On Texas State University s...

On the first of November I visited the Performance Art Center, on Texas State University’s campus. There I saw the Texas State Jazz Ensemble perform with guest, Steve Houghton. The performance began at 7:30pm and lasted for an approximate hour and a half. As I observed the stage I noticed that there were a variety of instruments played in the jazz ensemble. The instruments that were played included string (grand piano, electric guitar, electric bass, bass), brass (trumpet, trombone, French horn), woodwind (tenor sax, alto sax, baritone sax) and percussion instruments (six piece drum set, bongos). On the drum set was, special guest, Steve Houghton from the music school of Iowa. Overall, there were several different pieces of different sub-genres of jazz music. The pieces that were played in the ensemble included the following: Slide’s Derangement by Slide Hampton, BBC by Bob Florence, Dangerous Curves by Matt Harris, Blues for 70 by John Clayton, Jazz Crimes by Joshua Re den, Isotope by Joe Henderson, Basie’s Back in Town by Ernie Wilkins. Each piece named above had its own uniqueness. The characteristics of each musical piece will be described below: Slide’s Derangement started off with a solo performed by an alto sax. There were also solos performed by a trumpet and the drums. Each solo was accompanied by a melodic repetition of numerous crescendos performed by brass and woodwind instruments. The drums and the rhythm kept the upbeat tempo by the string instruments. TheShow MoreRelatedMoving To Arlington Essay723 Words   |  3 PagesMoving to Arlington Arlington is a city in Texas located to the Western side of Dallas and Eastern side of Fort Worth Metroplex. 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