Physician Assisted Suicide in the United States Research Paper

Physician Assisted Suicide in the United States - Research Paper Example The question then can turn to the reason for the action, whether passive or aggressive, that will end in death. One must contemplate whether or not it is always considered suicide if an action will inevitably end in death. If this is true, as Durkheim points out, then a soldier who bravely enters into a situation that is likely to end in death, but will save others, would also be committing suicide. However, the nature of the outcome is also not a part of the definition or the result of an action. In order to define a death a suicide, then, it is important to consider the intent of the action that will come to the result in death. In considering the different frames of action and thought when suicide is approached, it then shifts to consider the differences that can be appreciated in the reasons that one might wish to end their life. According to Holmes and Holmes, suicide is defined by taking an action that ends one’s life. They do not embellish or extend the discussion in th e way that Durkheim does, but they simply define the term as an active pursuit of the outcome of death. They further clarify the ambiguity of the term by saying â€Å"suicide is a behavior that differs from one person to another and from one time to another and has different motivations and anticipated gains† (2). Therefore, in defining suicide, one must understand that no clear definition applies, but that it is fluid and flexible depending on the variables involved in the event or events that lead to death. Every year, an approximate 30,000 people commit suicide within the United States. Suicide is the 11th most common cause of death, with homicide ranking at 14th. Suicide is the third leading... According to Hendin and Foley, â€Å"the World Health Organization recommendation (is) that governments not consider the legalization of physician-assisted suicide and euthanasia until they have demonstrated the full availability and practice of palliative care for all citizens† (2). This perspective of the argument does not completely deny the use of such assistance, but does suggest that because of inadequacies in the current system, the potential for abuse of assisted suicide does not allow for its use as a treatment.   Doctor Jack Kevorkian became the symbol for the other side of the debate in which the idea of helping people to pass more quickly when faced with a long term illness with no hope found a leader and a face in which to center the debate. In 1990, his first assisted suicide was conducted in which an Alzheimer’s patient named Janet Adkins was helped by Dr. Kevorkian to die. His methods were centered on devices that he built that made it easy for patient s to push a button and deliver a dose of medications that would end life. Therefore, when he was charged with murder tin the death of Adkins, Michigan, which had no laws against suicide at the time, had to release him as he did not, himself, deliver the medications that killed her (Nicol and Wylie 151).   Dr. Kevorkian aided more than 130 people towards self directed deaths and became known as ‘Dr. Death’ because of his activism and participation in assisted suicide (Nicol and Wylie 24). Dr. Kevorkian often become an adversary to the opposing opinion on the topic.

Welcome Address Essay Example for Free

Welcome Address Essay A warm and pleasant evening to all those who are present here. If there are no stars,there won’t be any beauty in the sky. If there is no difference of opinions there won’t be any creative and innovative ideas. Similarly if there is no Annual Function in our school, there won’t be any chance for our young and dynamic children to uphold the pride of the institute, to catalogue the challenges we face, the endeavors we made andthe success we achieved and to show what we were, what we are and what we will be. Here am I hence, much privileged to stand before you, to extend profound wishes andgreetings from the bottom of my heart, to bring the warmth of our affection, throughthe stream of love, to welcome each and every one of you.It is time for yet another day of the year to exhibit the talents of all our children, to bring to your kind notice their academic excellence, and the medals they bagged intheir outstanding performance in spots, and the grades they achieved in extracurricular activities, and in everything they speak and perform today as the cultural feastunfolds.We are extremely happy to have you with us today, to share in our joy and delightfulmoments of the day, and to be part of what we are. Wishing you all once again ahappy and memorable stay, I remain.Thank you. INTRODUCING THE CHIEF GUEST I am profuse elated to take an opportunity to introduce our chief guest of the day Rev.Dr. N. Ravichandran, the director of the IIM Indore. He is graduated from IIMMadras in 1980 with specialization in Applied Probability. He joined IIM Ahemdabadas faculty in Production and Quantitative Method Area in 1980.His teaching and research interest include Applied Probability, Business ProcessReengineering, Competitive Strategy, IT for Competitive Advantage, Logistics andSupply Chain Management, Operation Strategy, Quantitative Methods inManagement, Simulation and Stochastic Modeling.He had held several short term visiting positions in many European Universities. Hehas edited and co-authored 6 books, presented 80 research papers in national andinternational conference, 70 research publications in peer reviewed journals andauthored 40 management cases. He has designed 8 new  executive courses at IIMAhemdabad and introduced 7 electives in the PGA program of IIM Ahemdabad.Several companies in India and in abroad as well have sought his expertise, to evolve,tailor made executive programme, in the areas of general management, business process reengineering, information technology as a source of advantage, competitivestrategy, supply chain management, logistics, operation management and strategicsourcing.Since Nov. 2008, he is the director of the IIM Indore

Macbeth: The Vaulting Ambition

Macbeth: The Vaulting Ambition Shakespeares Macbeth is considered to be one of the best plays ever written. It is set in Scotland in the medieval times, around the 11th century. The play focuses on the psychological effects performed on the main character Macbeth. Macbeth shows us how dramatically his representation changes. Macbeth at the beginning is a highly respected and well-known war-hero. However the seed of change is planted when he meets the three evil witches who predict his future of becoming the king of Scotland. This sudden event makes Macbeth ambitious and he kills Duncan, the current king. Macbeths vaulting ambition rapidly accelerates but he becomes careless which leads to his death. Macbeth starts as a normal noble man who has feelings, friends, a wife and he is a war-hero. As time and tragic events elapse, his time as a ruthless killer begins. As soon as he meets the witches and learns of his future as king, he falls for Lady Macbeths charm and begins to plot and to think of murder. My thought, whose murder yet is but fantastical (1.3.9) (Macbeth Ambition Quotes Page 1, 2, 3, 4) After the witches predict that Macbeth will become king, he thinks of murder, even though the witches had not said anything about murder. This brings to question whether the witches are to blame or that the thought of murder had always been there. MACBETH [Aside] The Prince of Cumberland! That is a step On which I must fall down, or else oerleap, For in my way it lies. Stars, hide your fires; Let not light see my black and deep desires.(1.4.4) (Macbeth Ambition Quotes Page 1, 2, 3, 4) When Malcolm is proclaimed to be the heir to the throne of Scotland, Macbeth sets aside his morality. He knows that killing Duncan to become king is wrong, which is why he doesnt want any light to à ¢Ã¢â€š ¬Ã‚ ¦see my black and deep desires. MACBETH [à ¢Ã¢â€š ¬Ã‚ ¦] I have no spur To prick the sides of my intent, but only Vaulting ambition, which oerleaps itself And falls on the other. (1.7.1) (Macbeth Ambition Quotes Page 1, 2, 3, 4) Macbeth realises that his vaulting ambition is all that motivates him to murder Duncan. To him this is not enough to kill a king, which is why after this speech he decides not to go through with it. But of course we know that Lady Macbeth convinces him to murder Duncan later on. When he is set in front of Duncan at his bedside, Lady Macbeth convinces him to realise that this is the only way. However in doing this evil deed it had made the townspeople suspicious of the other 2 heirs who ran away as they thought they would be next. This meant that Macbeth had to kill Malcolm who was next in line for the iron throne. At this point Macbeths experiences a series of breakdowns as he begins to lose his mind and his human dignity. After the murder of Duncan, Macbeth falls into the trap of a murderous rage. He believed that this would clear his name, but it only made it worse. Each person he kills results in another. With each kill Macbeth loses his feelings of right and wrong. Macbeths principles are soon deteriorated to nothing as his killings become numerous. MACBETH [à ¢Ã¢â€š ¬Ã‚ ¦] For mine own good All causes shall give way. I am in blood Steppd in so far that, should I wade no more, Returning were as tedious as go oer. (3.4.24) (Macbeth Ambition Quotes Page 1, 2, 3, 4) After going on his killing spree, Macbeth suggests that once a man has killed for gain, it is impossible to stop. Macbeth at this point is willing to do anything in order to help himself as he finds it easier to kill. Macbeth believes that hes got to look out for himself. After killing Banquo and confronting his ghost, Macbeth breaks down for the last time. At this point Macbeths last shred of his morals are gone. Lady Macbeth sudden dies and he shows no remorse. Instead of stopping his killing spree he orders Macduffs family to be killed. Macbeth at this point has lost complete control as he starts to believe only in the witches prophecy and visions and that he cannot be killed by any man, giving him a false sense of security. He then plans to send assassins to the castle of Macduff which is in England in order to kill his family. On his way to confront and murder Macduff, Macbeth kills a young soldier without question as he does not care. Here he has nothing but become a cold blooded killer. Near the end of the play, and Macbeths killing spree, his transformation is complete as he loses all of his human thoughts and feelings. Macbeth changes from a man of honour to a man of fear and anger as he loses his ability to make decisions and his morality. In conclusion I believe that this play explores the tragic demise of a good man because of his vaulting ambition because we can see how corrupt a good person can become if one is twisted by the evil supernatural. This is shown through how forces become so powerful over Macbeth that they confuse him and force him into making drastic decisions that change his mind. He has tyrant qualities in the last stages of the play, but the power overwhelms him to succeed and condone these evil deeds. He once was a noble man who has now become a vulnerable and weak target for the desire for power. As a highly respected war-hero to become a cold-blooded killer we can see how the effect of power and his vaulting ambition to become king can lead to the tragic demise of a good man. Word Count = 970

Molecular Aspects of Biofilm Essay -- Aquatic Engineering Systems

Biofilms occur extensively in aquatic engineering systems, where they are implicated mainly in biofouling and corrosion. Biofilm cause nosocomial infections by forming persistent growth in catheters and other body implants and medical devices; they also increase drug resistance and dental caries (Donlan, 2001). On the other hand, biofilm development followed by biofouling in cooling water system causes serious blocking of the coolant pipelines in power plants thereby increased load on pumps, microbial induced corrosion and substantial economic loss (Boffardi, 2005; Flemming, 2002; Oliveira, et al, 1993 and Rao et al. 1993). In waste treatment systems such as trickling filters, wet biofilms are used for catalyzing pollutant transformations (Wyndham, 1995). Microbial world is extremely diverse and so is their life style and adaptation to survive in any environment (Staley et al, 1997). Different bacteria acquire different mechanism to adhere and initiate the biofilm development depending upon their environment. Some bacteria use their pili or flagella to establish primary attachment (Virji et al. 1993). In the present work we investigated the role of a surface protein (Bap) in S. aureus in establishing biofilm on glass surface and the topological changes in response to Ca2+ concentration from 1 mM to 20 mM on the biofilm morphology. Earlier work by Arrizubieta et al. (2004) showed that expression of Bap is not affected in presence of Ca2+. We provide information on changes in surface protein mediated growth in the presence of various concentrations of Ca2+. Calcium is an environmental variable which influence the biofilm formation of certain bacteria (Geesey et al. 2000; Patruchan et al. 2005). In a previous report Arrizu... ...erent environment containing varying calcium concentrations. Conclusions: From the present investigation we established the following salient points; (1) Bap mediated biofilm development in S. aureus V329 is inhibited ï‚ ³ 5 mM Calcium (2) Other bap negative strains of S. aureus, SA7 and SA33 do not show any inhibition due to the presence of calcium even up to 50 mM. (3) Structurally similar BapA harbouring A. baumannii did not show any inhibition in biofilm formation in response to calcium. (4) CSLM study showed that varying Ca2+ concentrations significantly influenced the architecture and topology of the biofilm. CSLM study also shows that chelating of calcium by EDTA can inverse the effect calcium on biofilm development. (5) This study also specifies that the presence EF hand motif in Bap makes V329 strain responsive to Ca2+ presence in the milieu.

Achieve Success Now Essay -- GCSE Business Marketing Coursework

Achieve Success Now We all want to have a life full of success. Many people assume without question that success is essentially material, that it can be measured in money, prestige, or an abundance of possessions. These can certainly play a role, but having such things is no guarantee of success. The success that we should strive for is the ability to love and have compassion, the capacity to feel joy and spread it to others, the security of knowing that one’s life serves a purpose, and finally, a sense of connection to the power of the universe. All of these are what create the dimensions of success, which will bring inner fulfillment. We as human beings are made of mind, body, and spirit. Of these, spirit is the most important, for it connects us to the source of everything. In other words we can describe it as our conscience. The more clearly that we think, the more we will enjoy the abundance of the universe. Our conscience is broken down into many different layers, the most important being our self-esteem. Our self-esteem is portrayed by our interactions with others. â€Å"Some simple examples of how we should use are self esteem is:  · Always greet people with a smile. As simple as it sounds, a smile establishes your own self-worth and shares it with others.  · Always say â€Å"thank you† when you are praised. A simple thank you is the universal mark of an individual with self-esteem.  · Surround yourself with people who enjoy their work. People with self-esteem seem to radiate it to others.† The second most important layer of the conscience is our attitude. 2â€Å"A positive attitude means everything†. Have you ever noticed when you enter a room with a huge smile on your face, give someone a c... ... right and expand them. In other words we must learn to give a hundred and ten percent and never give up. Remember the first step to success is to think BIG and always believe in yourself in whatever you do. Bibliography: Applegate, Jane. Succeeding In Small Business. New York: Plume, 1992. Boone, Louis E. Boone & Kurt’s Business. Fortworth: Oryden Press, 1995 Davenport, Rita. Making Time, Making Money. New York: St. Martin’s Press, 1982. Griffen, Ricky W. How To Succeed In The Business World. 2nd ed. Boston: Houghton Mifflin Co., 1988 Jassinowski, Jerry, and Robert Hamrin. Making It In America. New York: Simon & Schulster, 1995. Pride, William M. Business. New Jersey: Prentice Hall, 1989. Vesper, Joan, and Vincent Ryan Ruggiero. Contemporary Business Communication. New York: Harper Collins College Publishers, 1993

The Vampire Diaries: The Struggle Chapter Nine

â€Å"I know I'm going to be sorry I asked this,† Matt said, turning red-rimmed eyes from their contemplation of I-95 to Stefan in the passenger seat beside him. â€Å"But can you tell mewhy we want these extra-special, not-available-locally, semi-tropical weeds for Elena?† Stefan looked into the back seat at the results of their search through hedgerows and rough grass. The plants, with their branching green stems and their small-toothed leaves, did look more like weeds than anything else. The dried remains of blossoms at the ends of the shoots were almost invisible, and no one could pretend the shoots themselves were decorative. â€Å"What if I said they could be used to make an all-natural eyewash?† he offered, after a moment's thought. â€Å"Or an herbal tea?† â€Å"Why? Were you thinking of saying something like that?† â€Å"Good. Because if you did I'd probably deck you.† Without actually looking at Matt, Stefan smiled. There was something new stirring inside him, something he hadn't felt for nearly five centuries, except with Elena. Acceptance. Warmth and friendship shared with a fellow being, who did not know the truth about him, but who trusted him anyway. Who was willing to take him on faith. He wasn't sure he deserved it, but he couldn't deny what it meant to him. It almost made him feel†¦ human again. Elena stared at her image in the mirror. It hadn't been a dream. Not entirely. The wounds in her neck proved that. And now that she'd seen them, she noticed the feeling of light-headedness, of lethargy. It was her own fault. She'd taken so much trouble to warn Bonnie and Meredith not to invite any strangers into their houses. And all the time she'd forgotten that she herself had invited Damon into Bonnie's house. She'd done it that night she had set up the dumb supper in Bonnie's dining room and called out into the darkness, â€Å"Come in.† And the invitation was good forever. He could return any time he liked, even now. Especially now, while she was weak and might easily be hypnotized into unlocking a window again. Elena stumbled out of the bathroom, past Bonnie, and into the guest bedroom. She grabbed her tote bag and began stuffing things into it. â€Å"Elena, you can't go home!† â€Å"I can't stay here,† Elena said. She looked around for her shoes, spotted them by the bed, and started forward. Then she stopped, with a strangled sound. Lying on the dainty crumpled linen of the bed there was a single black feather. It was huge, horribly huge and real and solid, with a thick, waxy-looking shaft. It looked almost obscene resting there on the white percale sheets. Nausea swept over Elena, and she turned away. She couldn't breathe. â€Å"Okay, okay,† Bonnie said. â€Å"If you feel that way about it, I'll get Dad to take you home.† â€Å"You have to come, too.† It had just dawned on Elena that Bonnie was no safer in this house than she was. Youand your loved ones , she remembered, and turned to grasp Bonnie's arm. â€Å"Youhave to, Bonnie. I need you with me.† And at last she got her way. The McCulloughs thought she was hysterical, that she was overreacting, possibly that she was having a nervous breakdown. But finally they gave in. Mr. McCullough drove her and Bonnie to the Gilbert house, where, feeling like burglars, they unlocked the door and crept inside without waking anyone up. Even here, Elena couldn't sleep. She lay beside Bonnie's softly breathing form, staring toward her bedroom window, watching. Outside, the quince branches squeaked against the glass, but nothing else moved until dawn. â€Å"Stefan!† She had never been so glad to see anyone in her life. She flung herself upon him before he could even shut the car door. He swayed backward with the force of her impact, and she could feel his surprise. She wasn't usually so demonstrative in public. â€Å"Hey,† he said, returning the hug gently. â€Å"Me, too, but don't crush the flowers.† â€Å"Flowers?† She pulled back to look at what he was carrying; then, she looked at his face. Then at Matt, who was emerging from the other side of the car. Stefan's face was pale and drawn; Matt's was puffy with tiredness, with bloodshot eyes. â€Å"You'd better come inside,† she said at last, bewildered. â€Å"You both look awful.† â€Å"It's vervain,† said Stefan, some time later. He and Elena were sitting at the kitchen table. Through the open doorway, Matt could be seen stretched out on the family room sofa, snoring gently. He'd flopped there after eating three bowls of cereal. Aunt Judith, Bonnie, and Margaret were still upstairs asleep, but Stefan kept his voice low just the same. â€Å"You remember what I told you about it?† he said. â€Å"You said it helps keep your mind clear even when someone is using Power to influence it.† Elena was proud of how steady her voice was. â€Å"Right. And that's one of the things Damon might try. He can use the power of his mind even from a distance, and he can do it whether you're awake or asleep.† Tears filled Elena's eyes, and she looked down to hide them, gazing at the long slender stems with the dried remains of tiny lilac flowers at the very tips. â€Å"Asleep?† she said, afraid that this time her voice was not as steady. â€Å"Yes. He could influence you to come out of the house, say, or to let him in. But the vervain should prevent that.† Stefan sounded tired, but satisfied with himself. Oh, Stefan, if you only knew, Elena thought. The gift had come one night too late. In spite of all her efforts, a tear fell, dripping onto the long green leaves. â€Å"Elena!† He sounded startled. â€Å"What is it? Tell me.† He was trying to look into her face, but she bowed her head, pressing it into his shoulder. He put his arms around her, not trying to force her up again. â€Å"Tell me,† he repeated softly. This was the moment. If she was ever going to tell him, it should be now. Her throat felt burned and swollen, and she wanted to let all the words inside pour out. But she couldn't. No matter what, I won't let them fight over me, she thought. â€Å"It's just that – I was worried about you,† she managed. â€Å"I didn't know where you'd gone, or when you were coming back.† â€Å"That's all.† Now she would have to swear Bonnie to secrecy about the crow. Why did one lie always lead to another? â€Å"What should we do with the vervain?† she asked, sitting back. â€Å"I'll show you tonight. Once I've extracted the oil from the seeds, you can rub it into your skin or add it to a bath. And you can make the dried leaves into a sachet and carry it with you or put it under your pillow at night.† â€Å"I'd better give them to Bonnie and Meredith, too. They'll need protection.† He nodded. â€Å"For now – † He broke off a sprig and placed it in her hand. † – just take this to school with you. I'm going back to the boarding house to extract the oil.† He paused a moment and then spoke. â€Å"Elena†¦Ã¢â‚¬  â€Å"Yes?† â€Å"If I thought it would do you any good, I'd leave. I wouldn't expose you to Damon. But I don't think he'd follow me if I went, not any more. I think he might stay – because of you.† â€Å"Don't eventhink about leaving,† she said fiercely, looking up at him. â€Å"Stefan, that's the one thing I couldn't stand. Promise you won't; promise me.† â€Å"I won't leave you alone with him,† Stefan said, which was not quite the same thing. But there was no point in pushing him further. Instead, she helped him wake up Matt, and saw them both off. Then, with a stem of dried vervain in her hand, she went upstairs to get ready for school. Bonnie yawned all the way through breakfast, and she didn't really wake up until they were outside, walking to school with a brisk breeze in their faces. It was going to be a cold day. â€Å"I had a very weird dream last night,† Bonnie said. Elena's heart jumped. She'd already tucked a sprig of vervain into Bonnie's backpack, down at the bottom, where Bonnie wouldn't see it. But if Damon had gotten to Bonnie last night†¦ â€Å"What about?† she said, bracing herself. â€Å"About you. I saw you standing under a tree and the wind was blowing. For some reason, I was afraid of you, and I didn't want to go any closer. You looked†¦ different. Very pale but almost glowing. And then a crow flew down from the tree, and you reached out and grabbed it in midair. You were so fast it was unbelievable. And then you looked over at me, with this expression. You were smiling, but it made me want to run. And then you twisted the crow's neck, and it was dead.† Elena had listened to this with growing horror. Now she said, â€Å"That's adisgusting dream.† â€Å"It is, isn't it?† said Bonnie composedly. â€Å"I wonder what it means? Crows are birds of ill omen in the legends. They can foretell a death.† â€Å"Yes,† Bonnie said. â€Å"Except for one thing. I had this dreambefore you woke us all up screaming.† That day at lunchtime there was another piece of violet paper on the office bulletin board. This one, though, read simply:LOOK IN PERSONALS. â€Å"What personals?† said Bonnie. Meredith, walking up at that moment with a copy of theWildcat Weekly , the school newspaper, provided the answer. â€Å"Have you seen this?† she said. It was in the personals section, completely anonymous, with neither salutation nor signature. Ican't bear the thought of losing him. But he's so very unhappy about something, and if he won't tell me what it is, if he won't trust me that much, I don't see any hope for us. Reading it, Elena felt a burst of new energy through her tiredness. Oh, God, she hated whoever was doing this. She imagined shooting them, stabbing them, watching them fall. And then, vividly, she imagined something else. Yanking back a fistful of the thief's hair and sinking her teeth into an unprotected throat. It was a strange, unsettling vision, but for a moment it almost seemed real. She became aware that Bonnie and Meredith were looking at her. â€Å"Well?† she said, feeling slightly uncomfortable. â€Å"I could tell you weren't listening,† sighed Bonnie. â€Å"I just said it still doesn't look like Da – like the killer's work to me. It doesn't seem like a murderer would be so petty.† â€Å"Much as I hate to agree with her, she's right,† Meredith said. â€Å"This smells like someone sneaky. Someone who has a grudge against you personally and who really wants to make you suffer.† Saliva had collected in Elena's mouth, and she swallowed. â€Å"Also somebody who's familiar with the school. They had to fill out a form for a personals message in one of the journalism classes,† she said. â€Å"And somebody who knew you kept a diary, assuming they stole it on purpose. Maybe they were in one of your classes that day you took it to school. Remember? When Mr. Tanner almost caught you,† Bonnie added. â€Å"Ms. Halperndid catch me; she even read some of it aloud, a bit about Stefan. That was right after Stefan and I got together. Wait a minute, Bonnie. That night at your house when the diary was stolen, how long were you two out of the living room?† â€Å"Just a few minutes. Yangtze had stopped barking, and I went to the door to let him in, and†¦Ã¢â‚¬  Bonnie pressed her lips together and shrugged. â€Å"So the thief had to be familiar with your house,† said Meredith swiftly, â€Å"or he or she wouldn't have been able to get in, get the diary, and get out again before we saw them. All right, then, we're looking for someone sneaky and cruel, probably in one of your classes, Elena, and most likely familiar with Bonnie's house. Someone who has a personal grudge and will stoop to anything to get you†¦ Oh, my God.† The three of them stared at one another. â€Å"We're so stupid; we should have seen it right away,† said Meredith. For Elena, it meant the sudden realization that all the anger she'd felt about this before was nothing to the anger she was capable of feeling. A candle flame to the sun. â€Å"Caroline,† she said, and clenched her teeth so hard her jaw hurt. Caroline. Elena actually felt she could kill the green-eyed girl right now. And she might have rushed out to try if Bonnie and Meredith hadn't stopped her. â€Å"After school,† said Meredith firmly, â€Å"when we can take her somewhere private. Just wait that long, Elena.† But as they headed for the cafeteria, Elena noticed an auburn head disappearing down the art and music corridor. And she remembered something Stefan had said earlier this year, about Caroline taking him into the photography room at lunchtime. For privacy, Caroline had told him. â€Å"You two go on; I forgot something,† she said as soon as Bonnie and Meredith both had food on their cafeteria trays. Then she pretended to be deaf as she walked rapidly out and backtracked to the art wing. All the rooms were dark, but the photography room's door was unlocked. Something made Elena turn the knob cautiously, and move quietly once she was inside, rather than marching in to start a confrontation as she'd planned. Was Caroline in here? If so, what was she doing alone in the dark? The room appeared at first to be deserted. Then Elena heard the murmur of voices from a small alcove at the back, and she saw that the darkroom door was ajar. Silently, stealthily, she made her way until she stood just outside the doorway, and the murmur of sound resolved itself into words. â€Å"But how can we be sure she'll be the one they pick?† That was Caroline. â€Å"My father's on the school board. They'll pick her, all right.† Andthat was Tyler Smallwood. His father was a lawyer, and on every board there was. â€Å"Besides, who else would it be?† he continued. † ‘The Spirit of Fell's Church' is supposed to be brainy as well as built.† â€Å"AndI don't have brains, I suppose?† â€Å"Did I say that? Look, if you want to be the one to parade in a white dress on Founders' Day, fine. But if you want to see Stefan Salvatore run out of town on the evidence of his own girlfriend's diary†¦Ã¢â‚¬  â€Å"But why wait so long?† Tyler sounded impatient. â€Å"Because this way it'll ruin the celebration, too. TheFells' celebration. Why shouldthey get the credit for founding this town? The Smallwoods were here first.† â€Å"Oh, who cares about who founded the town? All I want is to see Elena humiliated in front of the entire â€Å"And Salvatore.† The pure hatred and malice in Tyler's voice made Elena's flesh crawl. â€Å"He'll be lucky if he doesn't end up hanging from a tree. You're sure the evidence is there?† â€Å"How many times do I have to tell you? First, it says she lost the ribbon on September second in the cemetery. Then, it says Stefan picked it up that day and kept it. Wickery Bridge is right beside the cemetery. That means Stefan was near the bridge on September second, the night the old man was attacked there. Everybody already knows he was on hand for the attacks on Vickie and Tanner. What more do you want?† â€Å"It would never stand up in court. Maybe I should get some corroborating evidence. Like ask old Mrs. Flowers what time he got home that night.† â€Å"Oh, whocares ? Most people think he's guilty already. The diary talks about some big secret he's hiding from everyone. People will get the idea.† â€Å"You're keeping it in a safe place?† â€Å"No, Tyler, I'm keeping it out on the coffee table. How stupid do you think I am?† â€Å"Stupid enough to send Elena notes tipping her off.† There was a crackle, as of newspaper. â€Å"Look at this, this is unbelievable. And it's got to stop,now. What if she figures out who's doing it?† â€Å"What's she going to do about it, call the police?† â€Å"I still want you to lay off. Just wait until Founders' Day; then you'll get to watch the Ice Princess melt.† â€Å"And to say ciao to Stefan. Tyler†¦ nobody's really going to hurt him, are they?† â€Å"Whocares?† Tyler mocked her earlier tone. â€Å"You leave that to me and my friends, Caroline. You just do your part, okay?† Caroline's voice dropped to a throaty murmur. â€Å"Convince me.† After a pause Tyler chuckled. There was movement, rustling sounds, a sigh. Elena turned and slipped out of the room as quietly as she had come in. She got into the next hallway, and then she leaned against the lockers there, trying to think. It was almost too much to absorb at once. Caroline, who had once been her best friend, had betrayed her and wanted to see her humiliated in front of the whole school. Tyler, who'd always seemed more an annoying jerk than a real threat, was planning to get Stefan driven out of town – or killed. And the worst thing was that they were using Elena's own diary to do it. Now she understood the beginning of her dream last night. She'd had a dream like it the day before she had discovered that Stefan was missing. In both, Stefan had looked at her with angry, accusing eyes, and then he had thrown a book at her feet and walked away. Not a book. Her diary. Which had in it evidence that could be deadly to Stefan. Three times people in Fell's Church had been attacked, and three times Stefan had been on the scene. What would that look And there was no way to tell the truth. Supposing she said, â€Å"Stefan isn't guilty. It's his brother Damon who hates him and who knows how much Stefan hates even the thought of hurting and killing. And who followed Stefan around and attacked people to make Stefan think maybe Stefan had done it, to drive him mad. And who's here in townsomewhere – look for him in the cemetery or in the woods. But, oh, by the way, don't just search for a good-looking guy, because he might be a crow at the moment. â€Å"Incidentally, he's a vampire.† She didn't even believe it herself. It sounded ludicrous. A twinge from the side of her neck reminded her how serious the ludicrous story really was. She felt odd today, almost as if she were sick. It was more than just tension and lack of sleep. She felt slightly dizzy, and at times the ground seemed to be spongy, giving way under her feet and then springing back. Flu symptoms, except that she was sure they weren't due to anyvirus in her bloodstream. Damon's fault, again. Everything was Damon's fault, except the diary. She had no one to blame for that but herself. If only she hadn't written about Stefan, if only she hadn't brought the diary to school. If only she hadn't left it in Bonnie's living room. If only, if only. Right now all that mattered was that she had to get it back.

Leadership and nurse retention: The pivotal role of nurse leaders Essay

The Massachusetts Department of Higher Education in collaboration with the CITATION Thu12 l 1033 (Thurston, 2012)organized a working sectional conference titled Effective Mentoring; Nursing Leadership Practices after Training Completion and development skills for charge nurses. Over 40 experienced professionals from major statewide stakeholders in the Healthcare industry were brought together during this session. Those in attendance included nurses from various practice sessions and representatives from the Department of Higher Education, the Board of Registration in Nursing, the Massachusetts Center for Nursing (MCN), the Massachusetts Association of Colleges of Nursing (MACN), the Massachusetts/Rhode Island League for Nursing (MARILN), other national accrediting agencies were also present like the National League for Nursing Accrediting Commission (NLNAC) and the Commission on Collegiate Nursing Education (CCNE). The keynote speaker for the conference was MD Welborn E. Crawford of Massachusetts Semin Hospital who has extensive experience in offering guidance on organizational leadership in the practice of medicine and is also chairman on the Commission on Collegiate Nursing Education (CCNE) board. Crawford also has several publications under his belt specifically discussing about how to boost development skills of leadership at the workplace. His past roles in professional development are inclusive of nursing peer review and advancement, teaching and the use of simulation. The current role he holds at the hospital as MD provides oversight on how various departments of the hospital are run including quality service provision and process improvement. The conference sought to ensure that, graduating nurses from nursing school to have a platform to ensure a seamless progression in their career by furnishing with necessary knowledge and skills that will ensure their development while practicing nursing after their graduation. Participation in the conference was on the consideration of the fact of holding a charge nurse position at my workplace and the constant need to make decisions and supervise ACRNs at the workplace needed a more astute approach of leadership. Analysis of Leadership Characteristics and Style Most of the conflicts in the nursing industry are as an increased inefficiency in leadership styles and practices. In many instances, personality traits often in one way or the other demonstrate a link with leadership behaviors and characteristics and in this instances are either inborn or easily learned. The main focus of Crawford’s speech was on the process of enhancing transformation of other nurses’ while at the workplace through meeting the needs of the pre-identified environment. The keynote speaker kept the participants going throughout the session through the asking of questions. Through the question and feedback process, a debating platform was created similar to the one encourage for organizational leaders where employees are allowed the opportunity to be engaged in the decision-making process of an organization. He reflected on Brooks and Andersons publications which suggested that a good number of nurses felt invaluable to an organization when they were not allowed the opportunity to participate in decision-making processes and their efforts at the workplaces going unrecognized. These ideology posters to core the need of as a leader to acknowledge a subordinate in the event they contribute something worthy at the work setting. The exchange of information and negotiation between people and their leaders has evolved over the years and this and this has similarly had an impact on leadership theories evolvement. In the conference setting, our keynote speaker had adopted the democratic style of leadership where all and sundry were allowed to measure in on the debate and from the information provided by the audience, the Crawford expounded further on their ramifications in ensuring success during task performance. Further from his speech, it became clear that apart from the democratic leadership style, there existed other two distinct styles that have always been adopted by leaders namely; authoritarian and laissez faire. Under authoritarian leadership, an employee were not allowed to make any decisions and in most cases handles all managerial duties and decisions all by themselves without any external interference from the employees. It is largely the opposite of democratic leadership. Lastly, there is the lais sez-faire leadership style where the leader is in total control of all aspects of an organization. Environments are also fundamental in determining what particular style of leadership will be a success but transformational leadership is mostly championed for in many leadership settings for it is particularly considered to create a conducive environment for not only nurses but also their respective patients. However, there still exists doubts on the credibility of these words for there exists little or no studies at all that pinpoint an exact correlation between leadership behaviors, patient outcomes and nursing practice environments. Charge nurses were therefore encouraged to adopt the transformational leadership style for the nurses that one is in-charge of are allowed to participate in any decision-making process. It has been established that nurses have positive response to transformational leadership because it ensures that build and develop themselves individually as a unit thus they are personally empowered to achieve their goals. In retrospect, in utilization of this kind of leadership, a leader is equally motivated a leader that allows the creation of synergetic environments where creativity can be easily managed. Considering the fact that a good number of nursing discords are in one way or the other related with the leaderships styles, it is important for charge nurses to adopt a stance of being facilitators for solutions as opposed to being problem creators. One important aspect fro transformational leadership is the participatory decision-making approach with employees to similar to what Dr. Crawford w as utilizing at the platform. The participatory decision-making approach allows an increased accountability of actions at the workplace by employees thus they are empowered and the same can be transformed to patients. Frontline charge nurses who not have effective leadership practices in most instances do not perform their duties for solving problems at the nursing unit, it therefore important for such leaders to adapt effective leadership skills so that they can be assured of achieving better outcomes. Communication skills In delivering speeches, it is important for a speaker to develop an interpersonal relationship with his audience for it is the foundation for all human interaction. Not only are effective communication deponents beneficial in delivering speeches but also it ensures the normal function of various systems of an organization. In the nursing workplace, as a charge nurse it is important to ensure that communication is two-way in the sense that not only are people listening to directives of their leader but also the leader allows them the opportunity to air their concerns. Whether an individual is traversing information in a formal or informal context, it is important for them to acknowledge their audiences, purpose for speaking, follow through in what one is putting across, have a broad array of presenting your information and utilization of several techniques in delivering information CITATION Ant13 l 1033 (Anthony, et al., 2013). It is also important to note one’s external enviro nment while putting across a specific message for it determines how information seriated and perceived by an audience. In the case of Crawford, he focused mainly on the ensuring the comfort of his audience by constantly asking whether or not they were comfortable in the conference room and delved mainly on the progressive leadership in nursing for all those in attendance were knowledgeable of the topic being discussed. The speaker was also keen on ensuring that all the stakeholders and those in attendance were convinced of his thoughts on progressive leadership for nurses and how to develop this in graduation nurses form nursing school by ensuring that he gave a clear background information of the topic he was discussing then finally gave an in-depth analysis of the developmental ways for building leadership skills for junior nurses at the workplace. While communication his information across, his stands on leadership styles were backed up by facts and claims from other professional s in the healthcare industry with utmost clarity and simplicity which ensured a good number of those in attendance to comprehend the information that was being put across and the purpose of the conference was thus being achieved in an astute and prospective manner. MD Crawford made it his mandate to ensure that all relevant aspects of leadership in nursing and how to nurture young habits in graduating nurses could be attained which brought to core leadership issues that if neglected by one who is in-charge at the workplace could impact negatively on the functioning of a particular unit of a hospital CITATION Ame09 l 1033 (Association, 2009). Considering the fact that nurturing the graduating nurses was a new noble idea for healthcare practitioners, the idea therefore needs a lot of selling. The delivery of this message was efficient in the sense that it was being aimed at the correct audience who effectively act on it, this was ensured through constant repetition of the idea in the delivery of his speech and for sure he did deliver the message to its desired levels for a good number of participants after the conference signed up for a two month seminar that Crawford suggested for the 27th the same month where further leadership models would be discussed and how they could be applied at the workplace. With respect to the experience of Crawford and considering that he was getting delivering his speech to his peers, he adopted the good old boy presentation style. Basically, his presentation was divided into an introduction which gave a clear understanding of the problem that needed nursing practitioners’ attention. Secondly, he talked of the organizations which sponsored the event and their role in collaboration with the American Nursing Association in ensuring nurses developed well envisaged skills to be great leaders in their nursing careers upon graduation from school by ensuring there existed some sort of mentoring platform where they could interact and exchange ideas with experienced professionals in the industry CITATION Gir12 l 1033 (Girvin, 2012). Thirdly, using visual aid supports like chart drawings and diagrams, the speaker used supporting facts to put across information regarding leadership styles and how effectively communication can be achieved at the workplace. Most importantly, each visual aid used in the delivery of the speech fully gave an in-depth understanding of what was being discussed whose main purpose was to ensure that those in the audience were familiar with the topic being discussed by the end of his presentation. The conclusion of the presentation effectively showed that the proposal that was presented by the speaker could be made effective in hospital interstate and according to the interpersonal discussions among the participants; it was evident that the stakeholders present were eager to take up the initiative of pushing the recommendations into a reality. Upon conclusion of his speech, the keynote speaker allowed the participants to air their questions which were promptly answered Critical Reflections The speakers’ speech was outlined and delivered to the requirements of the Massachusetts Organization of Nurse Executives who had organized the conference. In clearly defined detail, the conference topic, â€Å"Effective Mentoring; Nursing Leadership Practices after Training Completion and development skills for charge nurses,† was extensively addressed and all the stakeholders present were given a challenge of developing some sort of mentoring program that will help in nurturing the leadership skills of graduating nurses. Guided by the conference topic, Crawford presented the leadership debate convincingly through diving his content into leadership issues and the most effective ways and the role played b communication in ensuring one was efficient in their position as a leader. The adoption of a Good Old Boy presentation style of communication was effective considering that the participants at the conference were his peers and this coupled with his use of visual aids t o deliver his speech ensured a good delivery CITATION Was10 l 1033 (Waskett, 2010). Implications for Professional Nursing Practice The conference proceedings were influential in answering good number of concerns that those in the nursing environment experience in their workplace which generally affect the outcomes of the job. A good number of problems are associated with the nursing charge position such as poor description of the jobs being delegated to others, irresponsibility experienced with the an increase in the duties appended to a particular individual at the workplace and most importantly the lack of necessary knowledge on how to undertake leadership positions. Personally, the conference furnished with important knowledge of I was previously ignorant on: the role of communication for leadership. It was evident that as a charge nurse, I need to be not only authoritarian when it came to decision-making situations but also involvement and listening to other nurses will help with ensuring that a diverse pool of ideas are available to ensure an easy decision-making process. At the same time, involving other i n decision-making ensured that they felt part of the organization that they were more motivated to perform their tasks effectively CITATION Gar09 l 1033 (Garvey, Stokes, & Megginson, 2009). As a leader, I have the mandate of ensuring and facilitating the learning process of other junior nurses at the workplace through the more refined method of mentoring. With respect to developing a mentoring platform for graduating nurses, it is important to ensure that all nurses at the workplace are under a senior guardian at the workplace who will ensure that the nurses are given lessons and guidance on how to communicate effectively at the workplace thus preparing them for future leadership positions. References   Anthony, M., Standing, T., Glick, J., Duffy, M., Paschall, F., Sauer, M., et al. (2013). Leadership and nurse retention: The pivotal role of nurse leaders. Journal for Nursing Adminstartion, 146-155. Association, A. N. (2009). Nurse leaders pass measures on disastser planning . Washington DC: American Nurses Association . Garvey, B., Stokes, P., & Megginson, D. (2009). Coaching and Mentoring: Theory and Practice. London: SAGE Publications . Girvin, J. (2012). Leadership and nursing: Part two: styles of leadership. Nursing and Managment , 20-22. Thurston, B. (2012, August 24). Annual Conference on Nursing leadership 2012. Retrieved November 14, 2014, from Massachusetts Organization of Nurse Executives : http://www.mooneleadership.org/ Waskett, C. (2010). Clinical supervision using the 4S model 1: Considering the structure and setting it up . Nursing Times , 12-14. Source document