Facilitating Change In Health And Social Care Social Work Essay

Facilitating Change In Health And Social Care Social Work Essay Change is a process of transitioning  from a current situation to a desired future condition. Whether we like change or not, we are all caught up in a never-ending cycle of change in our organizations. Some people welcome change and enjoy the uncertainty it often brings, thinking that it offers a new challenges and opportunities at work. Others are cautious about change, fearing that something valued will be altered or lost or that risk brings unnecessary stress. In care, health and social care services are essentially about people, both those who need to use services and those who provide services. People are sensitive to the impact of change and as a manager I have a particular responsibility to take care over how changes in services that are intended to deliver care within the organization. One of the reasons why change seems to be constant is that there are many potential stimuli for change and there are several factors driving change. The stimulus for change may come from inside an organization but it is more usual for it to come from outside. Change initiated within the organization is often a response to a force outside the organization that triggered the change. For example, factors that have a significant impact on health and social care services include government legislations and policies. Many aspects of health and social care are subject to legislation. New legal requirements emerge constantly as government seek to improve health and social care, often through introduction of systems to set standards and to control or modify service provision. Like the Health and Safety at Work Act 1974, this was enacted because of increasing numbers of accidents and incidents that happened in the past related to work. Its main purpose is to protect and minimize people from ha rm. It places a general duty on employers to ensure health, safety and welfare of all employees as far as is reasonably practicable. This legislation situates an impact not only on health care industry but all kinds of work. That is why until now it was expanded its scope, clarified responsibilities and responded to new circumstances as they have arisen without changing the overall principles of the original Act. Legislation also affects service provision though legislation relating to employment, health and safety, use of public funding and through related services including education and housing. Recently, the government commence key modification which affects the eligibility of all non-EU workers who wants to work in the UK. Those individuals must earn a minimum number of points. The new rules state the less points will be given for employees earning lower salaries in UK and no points to those who are paid less  £20,000 per annum compare to the old rules that give a minimum points for those workers having  £17,000 salary per year. It means the employer will have to pay new workers at least  £20,000. In addition, the care providers were enormously concerned about the present government removing the senior carers from shortage status because it might cause damage on the quality of care and in the business. Moreover, new technology is also a reason that is why change arises in health care setting. One great example is the development of internet. It change the way of sending information to the multi-disciplinary team through e-mail. Making it easier for senior staff to send and receive relevant information from GPs and other professionals and vice versa regarding service users condition while promoting privacy and confidentiality. It also change our ways of using records and libraries. Staffs in health and care services have access to an increasing range of information that is available to practitioners in health and social care. Service users expect us to make use of evidence in making decisions and database of best practice models are increasingly available. In my workplace, the management use the internet to provide trainings for staff which is more suitable and can be done in our own convenient time. For residence and relatives, its a fact that most of the relatives of our service u sers are far away from each other. However with the utilization of the internet, distance is not a big deal anymore. For relatives and services user who have personal computers or laptops can make conversation and see each other with the use of webcam and chat rooms through the internet. Service delivery is also influence by use of new developments in equipments. Like the new equipment acquired by Barts and The London NHS Trust the two state-of-the-art Lifeport organ transporters. It endow with a valuable sustenance for patients needing a kidney transplant. It stores healthy kidneys after they are removed from the donor before being transplanted into the recipient. This is a critical period for ensuring that the organ does not deteriorate and become unusable. Unlike before that they rely on ice to conserve the kidney, the new equipment maintains the organ in a fluid rich in nutrients and oxygen, which significantly extends the storage period. For the new equipments, it does change the old method to a new way that allows hope for more patients to have successful kidney transplants. In care home settings, the acquisition of new equipments like the air pressure mattress is indispensable equipment for anyone at high risk of developing pressure ulcers or who have existing pressure ulcers. The alternating pressure of the mattress depends on the weight of the service user allowing relieved on a regular basis and trim down the number of times a person needs to be turned, greatly enhancing the comfort of the very poorly or terminally ill. In addition, economic factors also drive change. These factors include the general prosperity of the country and its neighbourhood, the rate of unemployment, areas of poverty, the level of inflation and exchange rates in relationships involving other countries and currencies. The state of the economy affects the level of demand for goods and services, the prosperity of communities and the availability and cost of raw materials and labours. The economy tends to move in cycles, but these are not easy to predict. All services, whether public services, private services or charity provision, are affected by changes in the economy. At present, there were lots of changes in the health and social care sector due to the recent financial crisis that affects the economy of United Kingdom. As a result, the coalition government have wasted no time to save money in reshaping parts of the health services. According to the health secretary, the popular NHS direct services will be substitute with cheaper alternative. Under the governments plans, some strategic health authorities and hundreds of primary care trust are to be abolished affecting thousands of employees and service users. Examples of recent cost-cutting measures cited by professionals are hospital bed closures, pressure to give patients cheaper, slower-acting drugs, cuts to occupational health support, and reductions in community health services. Furthermore, according to a study, it make known that for the most part of job losses it involved frontline staff as patient services are withdrawn. Along with mounting numbers of patients are being deprived of treatm ent for conditions such as loss of sight, arthritis and infertility as the  NHS  increasingly rations healthcare in order to save money. But, the spending cuts done by the government does not only affect the health and social care sector but the life of Britons as a whole. It affects the sick, the disabled and Britains poorest families. Among the biggest cuts are only allowing claimants to have the replacement for Incapacity Benefit, the Employment and Support Allowance for one year, Cutting Disability Allowance for those people in care. Cutting Council Tax benefit by 10%. Reductions in the help given for childcare to working families, and slashing housing benefit for the under-35s by paying them the shared room rate instead of enough to live on their own etc., To be able to facilitate change in health and social care, as a manager I need to be able to understand the principles of change management. According to John Kotter, an authority of leadership and change, change has both an emotional and situational components and methods for managing each are expressed in his 8 step model. To value his model, as a managers there must be an understanding about the suppression and to cause employees emotion. During any period of change, a manager must deal with feelings of complacency, anger, false pride, arrogance, panic, exhaustion and anxiety among staffs. These are all emotions that can challenge and undermine attempts at promoting change. As managers I need to be able to turn these negative feelings into positive and proactive feelings such as faith, trusts urgency, hope, passion and enthusiasm which are emotions that promote change. On the first phase the model explained the phase of creating a climate for change. As a manager, there is need to develop a sense of urgency to staff. That action is needed regarding a foreseen difficulty. This can be done during meetings by explaining the situation through showing related videos and sharing stories. As the urgency grows among the staffs, as a manager, there is necessity to develop a guiding team that guide the change throughout the remaining steps. Members of the guiding team could be unit managers, senior carers or persons who have a relevant knowledge about the changes that occur in the organization, the ability to establish credibility and trusts to peers, the formal authority associated with managerial skill and the leadership. With the manager, alongside with the guiding team, must develop a vision expressed in a clear, concise statement about the direction in which the organization is headed. Engaging and enabling the whole organization is the second phase of Kotters model. Here, anxiety, anger, panic, among staff will rise because the manager or guiding team announces the impending change. Whenever, change is about to take place, people begin to wonder. That is why the guiding team needs to communicate to the individual or groups that are to be affected by change. And need to address these feelings and help staff to think and act in accordance with the new direction. An effective way to communicate the vision is to develop an engaging story that catches the attention of the change initiates. If there is a resistance to the staff at certain point, a dialogue between the guiding team and staff initiates a question and answer session. Staffs displays understanding when they realized the advantage, rewards and perquisites that they will gain once the change is completed. As the pathways to change are cleared, staffs must need to carefully choose and complete tasks that clear ly show that the change is succeeding. Tasks completed provide further urgency and momentum among the organization and lessen the impact of negative comments. At the final phase, the action plan is implemented fully allowing staff not to let up of the change. Collaboration occurs when staffs are willing to endorse or stand behind the change and displays commitment. As managers, at this phase, should sustain the change. It is done when a new way of operating has been shown to staff to succeed over the some minimum period of time Staffs at this point, displays advocacy that maintains the attitudes and behaviours supporting the change.. To relate this in my work, in my care home, there are recent changes that were implemented due staffs failing to do proper documentation. Firsts, the home manager scheduled a meeting and consultation to all the unit managers. At the meeting, to develop a sense of urgency among staff, she used a video based scenario regarding right documentation. The video shows the positive and negative effect of proper documentation to staffs, residents and management. In the meeting, everyone was asked about the ways to improve the situation. Then, decided that every staff should be knowledgeable and competent enough to do appropriate documentation at work through trainings and observations to make sure that they have the awareness, understanding and collaboration about the agenda of the meeting. On the other hand, the unit managers are to be the guiding team to lead, direct and show the proper way of documentation to unit staffs. Before the meeting ends, she makes sure that everyone understands ab out the directions in which the organization is headed and there would be recognition as the best unit that could implement the change. Finally, now every staff is confident regarding answering the forms in the care plans of every resident and certain to do the right documentation. The as proposed the guiding team use appraisal and supervision to measure the change. Plus the home manager monitored the change by evaluating the care plans of the residents with the help of a unit manager every end of the month for this change to become a culture in the care home.

Devil’s man Essay

This scene is also very captivating as there are so many different storylines and agendas going on in it, on the surface you have Elizabeth Proctor lying for her husband which results in them having a dire consequence, and Hales dramatic change of opinion. Underneath you have Abigail pushing Mary to join her by getting herself and her ‘tools’ (other girls from Salem) to act as if they are being possessed by Mary and Mary has transfigured herself into a yellow bird â€Å"Oh Mary this is a black art to change your shape.† Abigail knows she has to win Mary over to her side so all are ganged up against John Proctor as he has started violently accusing Abigail â€Å"Give me a whip, I’ll stop it† and Abigail realises these accusations have to stop. Abigail knows it will not take long for Mary to cave in, and this is what makes Abigail such an alluring character, as in this scene I cannot help but quite like her as she is so over the top and melodramatic, from a modern day reader of the play the ridiculousness but intelligence of her ideas provide a lot of the appealing aspects of the play and especially this scene. It would be a mistake to say Abigail is totally evil as in the same way it would be a mistake to say Proctor is totally good as although in the end of the play he dies a ‘martyr’ as he refuses to confess to witch-craft we cannot forget he did commit adultery and has had more than a few feuds with other members of Salem (most notably Parris). Abigail also witnessed her parent’s deaths and therefore was bought up with no family around her. She also is totally in love with John Proctor and would do anything to wed him and by accusing Elizabeth of witchcraft all she is doing is trying to get closer to John. Another engaging aspect of this scene is the fact that the audience watching the play experiences so many emotions. There is the anxiety and suspense felt when Elizabeth has to say if her husband was a lecher, and then there is the tragic, saddened emotion when you realise what is going to happen to John Proctor as Elizabeth said he had had no affair. There is the excitement when Abigail fakes Mary’s possession of her, and also the shock of Hales remarkable change in character. I believe what makes this play so popular, and what is particularly represented in this scene is all the characters are so human, their personalities so deep and structured. I feel this is for many reasons although predominately because Miller wrote the characters from ‘The Crucible’ from historic evidence in Salem town records- many of the characters names appear in the records and even Proctors affair is recorded. Also what makes these characters so realistic is there are no characters who are purely ‘good’ or purely ‘bad’ and what makes them so enthralling is they all have their little faults for example (Proctor to Elizabeth) â€Å"You ought to bring some flowers in the house. Oh I forgot! I will tomorrow.† This shows us Elizabeth can at times be forgetful which makes the audience able to relate to her and the rest of the characters as everyone has their own imperfections. John Proctor is an extremely enchanting character, however at times personally I felt he became a little tiresome especially during the end when he keeps on at Elizabeth whether she will forgive him if he confesses to witchcraft – and lies to God â€Å"I would have your forgiveness, Elizabeth.† In this scene though Proctor has an unnerving desperation about him pleading for his wife’s and his own lives. It only hit me when I had just finished the book the similarities between John Proctor and Arthur Miller himself as they were both persecuted and punished for things out of their control (Miller for not being anti-communist) and John Proctor (for being accused of trafficking with the Devil). They also both refused to confess as neither of them felt they were guilty of a crime and therefore were in effect Martyrs although Miller did not die. Principally, however the main reason I like this scene so much is from a dramatic point of view. It would be fantastic to perform as there is so much going on and the characters are so well formed by Miller. There is also a vast contrast of characters to play in the scene. What also makes it appealing from a theatrical aspect is the ‘roller coaster’ of emotions and changes of emotions, which happen so quickly. This passage is also a prime example of why Miller wrote the play, which is a further reason I admire the scene so much. This scene shows not only the persecution of a man who is innocent like the persecution of the communists, but also shows the power of religion, and how when the majority of people in a community believe something so passionately in this instance God and Christianity, arguing against it will do far more harm than good. It shows the dangers of living in a theocratic society where everything is kept behind closed doors, and when it is exposed the consequences can be literally in Salem in the seventeenth century, fatal. This scene is strengthened by the 17th century language, which adds a certain harsh quality to the way the line sounds. The ending of the scene is my favourite part of the passage, this is because the is when Mary sees Danforth is believing Abigail more and more and she knows that she will be hanged if she does not join Abigail. Therefore she admits to speaking with the Devil, but says to the court â€Å"(Mary pointing at Proctor) You are the Devil’s man!† This surprises everyone probably even Mary herself as she didn’t think she was strong enough to do it, but she realises fighting against Abigail was fighting a losing battle. Throughout the play there are many interesting and dramatic scenes, which captivated my imagination, however this scene stood out above all others largely because of the acting potential and the tremendous depth to the characters although the reasons above also played a part in why I enjoyed the scene. Recently Arthur miller was stated saying, â€Å"At least the play is still living† I believe it certainly is.

How Lady Macbeth(TM)s language reveals changes in her role and mental condition Essay

Q: By close reference to the text, show how Lady Macbeth’s language reveals changes in her role and mental condition. In William Shakespeare’s Macbeth, the language of Lady Macbeth clearly reflects changes in her role and mental condition throughout the play. At the beginning, Lady Macbeth’s language is confident and controlled. However, by Act 5 Scene 1, she has undergone a complete transformation of character and is in a pitiful, pathetic condition. Shakespeare uses a variety of literary techniques such as iambic pentameter (or the lack of it), rhetorical devices, powerful imagery and varied sentence lengths to reveal Lady Macbeth’s disposition at different stages in the play. During Act 1, Lady Macbeth’s character is imposing and authoritative. This can clearly be seen by analysing her language and speech patterns. Shakespeare highlights the determination and control of her speech through the use of iambic pentameter. Iambic pentameter is a poetic device, wherein each line has 10 syllables with the emphasis on each even syllable. It is used to create a rhythmic quality and to reflect ordinary speech patterns. In addition, iambic pentameter is also a technique of indicating the control and dignity of a character. In the early part of the play, nearly all of Lady Macbeth’s lines are written in strict iambic pentameter. The lines: † (He that’s coming) Must be provided for, and you shall put This night’s great business into my dispatch, Which shall to all our nights and days to come Give solely sovereign sway and masterdom.†1 illustrate the fact that Lady Macbeth is a cunning, shrewd woman, who is in complete control of her mind. The iambic pentameter, coupled with what she actually says, establishes the fact that she is strong and capable character. Shakespeare leads the readers to come to the conclusion that she has the dominant role in the relationship, as she gracefully takes charge of all the decision-making. This is borne out by the content of the lines as well as the sophisticated vocabulary used. These distinctive character traits of Lady Macbeth may well have been inspired by Shakespeare’s contemporary Queen Elizabeth I, who was also a very commanding and influential entity. Shakespeare also makes use of rhetorical devices to establish Lady Macbeth’s domineering personality. Rhetorical questions, in particular, are heavily used. These are a speech technique used to persuade someone and sway their mentality. In Act 1 Scene 7, Lady Macbeth uses a ton of rhetorical questions to convince Macbeth to commit the regicide of Duncan. Questions such as: â€Å"Was the hope drunk/ Wherein you dressed yourself?†2, â€Å"Art thou afeard / To be the same in act and valour / As thou art in desire?†3, and â€Å"What cannot you and I perform upon / Th’unguarded Duncan?†4 are used to incite Macbeth and make him feel guilty. She is overly vituperative and malicious; accusing him of cowardice by saying things like he’s not a man, or that he doesn’t truly love her because he isn’t keeping his promise to her. The result is that she successfully manipulates Macbeth into doing something that she wants. This confirms the fact that she is an intelligent, influential woman. Another literary device that shows Lady Macbeth’s evil persona is the strong imagery used in her speech. Imagery is a technique used in literature to make the reader visualise a picture in their minds. The lines: â€Å"look like th’innocent flower/ But be the serpent under’t†5 creates a distinct image of trickery and deceit, and gives a clear reflection of Lady Macbeth’s character. Another piece of effective imagery is the lines: † I have given suck and know How tender ’tis to love the babe that milks me: I would, while it was smiling in my face, Have plucked my nipple from his boneless gums And dashed the brains out, had I so sworn.†6 The above lines form a rather disturbing image in our minds, and give us a terrifying indication of Lady Macbeth’s mental strength. It highlights the malevolence that is inherent in her personality, in addition to her determination and her willingness to make sacrifices. However, the nature of such a statement does provoke one to think seriously about Lady Macbeth’s sanity. No person in their right mind would kill a child with the brutality that was described, especially not the child’s own mother. The lines shown above are one of many subtle hints of flaws in Lady Macbeth’s character which Shakespeare intelligently incorporates. These serve as inklings towards the total collapse in her character and mental state that is about to follow. In Act 3 Scene 4, the rapid decline of Lady Macbeth begins to take shape. In contrast to the early scenes of the play, her sentences become very short and she seems emotionally exhausted. Earlier, she would make long, influential speeches, which boasted of control and supremacy. This is not the case any more, although she does regain some composure by continuing to speak in iambic pentameter. She is now content to let Macbeth do the bulk of the talking. This indicates a reversal of roles where Lady Macbeth is no longer the dominant partner in the relationship. She is excluded from decision-making, as shown by Macbeth’s killing of Banquo without even bothering to consult his â€Å"dearest partner of greatness.†7 This scene is quite a significant one, as it marks the turning point of the deterioration in Lady Macbeth’s role and mental state. By Act 5 Scene 1, the language of Lady Macbeth has completely disintegrated. She is ridden with guilt and remorse, and this clearly affects her conscience immensely. Her psychological weakness at this point is illustrated by the use of prose, as opposed to iambic pentameter. This implies that Lady Macbeth has thoroughly lost all control and power which was typical of her in the first few scenes of the play. Her speech, which now mainly consists of incoherent phrases like: â€Å"Out, damned spot! Out I say! One, two. Why then ’tis time to do’t. Hell is murky†8, lacks the equanimity that she possessed in Act 1. She also uses a lot of imperatives and exclamations like â€Å"O, O, O,†9 which show that she is uneasy and deeply distressed. She dwells over the murders committed by herself and Macbeth, making it obvious that these incidents have been haunting her and causing her much disquiet. All the stress that had been bottled up in her mind is released while she is sleepwalking, and by the end of the scene, she is in a dismal condition, muttering a whole lot of useless drivel. It is no surprise that she later decides to do away with herself, as her body and mind have both crumbled to bits. Lady Macbeth’s language visibly reflects her role and mental state at different parts of the play. At the start, she is shown to be powerful and domineering which is demonstrated by uses of iambic pentameter, rhetorical devices and strong imagery. She undergoes a steady deterioration and by the end, she is weak and depleted, as reflected by the breakdown of her language. The stark contrast between her mental state at the start and end of the play is clearly demonstrated by comparing two sentences spoken by her at these times: â€Å"A little water clears us of this deed†10 when her hands are covered in blood after the killing of King Duncan, and â€Å"Here is the smell of blood still, all the perfumes of Arabia will not sweeten this hand†11 while she is sleepwalking. The remarkable fall from grace of Lady Macbeth is wonderfully presented by Shakespeare, and plays a big part in the play as whole. Since it was Lady Macbeth’s ideas and persuasive techniques which led Macbeth to the throne, and set the foundations of his reign; her weakening, and subsequent death, is one of many indicators of Macbeth’s imminent downfall. Shakespeare’s use of various literary devices was excellent, and he is able to successfully draw attention to the decline of Lady Macbeth, and its overall significance. 1 Act 1 Scene 5 – lines 64-68 2 Act 1 Scene 7 – lines 35-36 3 Act 1 Scene 7 – lines 39-41 4 Act 1 Scene 7 – lines 69-70 5 Act 1 Scene 5 – lines 63-64 6 Act 1 Scene 7 – lines 54-59 7 Act 1 Scene 5 – lines 9-10 8 Act 5 Scene 1 – lines 30-31 9 Act 5 Scene 1 – line 43 10 Act 2 Scene 2 – line 70 11 Act 5 Scene 1 – lines 42-43

The Effects Of Facebook On Romantic Relationships

The Adverse Effects of Facebook on Romantic Relationships Around the world people are updating their statuses on Facebook, double tapping pictures on Instagram, tweeting, snapping, following, blogging, creeping, and commenting on posts. People do these things so often that they have become second nature. More often than not, if you ask any random person on the street if they have a form of social media they will say yes and will have at least one type, if not more. As social media has grown, the habits that come with it have been incorporated into many people’s everyday lives’. However, many people fail to think about how the things they do everyday on their social media are affecting their relationship with their romantic partner. According to one study done by Fox and Warber, Facebook could lead to negative effects, such as drama and jealousy, on romantic relationships (Fox and Warber 5-6). Another article by Seidman and Robertson supported this claim, agreeing that Facebook can lead to conflict and confusion, jealousy and anxiety, less time spent with a partner, and deteriorating relationships with others (Seidman and Robertson). This has been a controversial issue since the dawn of social media; however, Facebook has definitely been seen to have negative effects on relationships by giving people more access to monitor others, increasing jealousy and anxiety in relationships, and by simply taking away time from a relationship. Since the beginning of mankind, humansShow MoreRelatedNegative Effects of Facebook in Romantic Relationships835 Words   |  3 Pagesget a Facebook account to feel more connected to their friends and to people in general. Sense of belongingness to an individual is an obvious psychological need, yet more so when a person is always working with little time for socializing and to get together with friends. 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