Monday, January 27, 2020

Performance Of Google And Its Management

Performance Of Google And Its Management Since Google Inc. was founded in 1998 and incorporated in 2003, it has been focused on technology innovations to help its users find the information with unprecedented levels of ease, accuracy and relevancy. Google primarily concentrated on the areas of search, advertising, operating systems and platforms, enterprise and hardware products. These programs include AdWords, AdSense, Google Display and Google Mobile, with Android and Google Chrome serve as its operating system and platforms. Google generate revenues primarily through delivering advertising to promote products and services for businesses. Currently, it moves to new area, except for providing specific features to mobile device users, Google also operates in mobile segment, as it made an acquisition of Motorola Mobility Holdings Inc. (Motorola) on May 22, 2012 (acquisition date). Industry Position: Google Inc. competes with other players in the Internet Information Providers industry within the technology sector. Although there are competitors worldwide, the key players are recognized as general-purpose search engines, such as Yahoo and Microsofts Bing, and social networks, such as Facebook and Twitter. Because of its years of focus on technology innovation and huge amounts of expenses in RD every year, Google has become the global technology leader and one of most well known general Internet search engine all around the world. Comprehensive Analysis Part 1: Liquidity situation analysis (see Exhibit 4 graph) Based on the statistics on Google Inc.s financial statements, there is a continuing increase in its revenues and net income, showing a tremendous and overall healthy growth path. Moreover, from the ratio exhibit, from 2008 to 2009, Googles current ratio (change from 8.77 to 10.62), quick ratio (from 8.03 to 10.08) and its free cash flow (from1754 to 2510) all have a big jump. However, we all know that the severe worldwide recession happened at the same time period, it seems Google didnt feel the shock if we only see from these numbers-but it is not true. On the one hand, the recession spread all over the world, even the mighty search giants cannot escape from it. If we put aside those annual numbers that only show final results, Google revealed its first quarter in 2009 web search declined in sales, which forced Google to make cutbacks in online advertisements spending. At the same time, Google announced two rounds of job cuts. Because of the actions of cutback on cost, Google finally beat its 2009 profit expectations -this can be shown in Googles income statement exhibit, the Total operating expenses of 2009 is $6494 million, which is lower than $6542 million of 2008, given Google is expansion scale, it proves the managements action of cutting cost sharply. However, on the other hand, even influenced by recession, Googles investors were relatively optimistic than others, since Googles slowdown still looked good compared with the other players. Moreover, some investors and observers believed that the recession gave a golden opportunity for Google to increase its value and gain more shares in the overall market-since almost all of Googles revenue come from advertisements that are placed next to customers search results, during recession, more and more businesses would choose cheaper advertisements to promote their products, such as Googles online Pay Per Click (PPC), rather than the traditional offline advertisement which used to work well before recession. From this point of view, as their competitors in traditional media cannot keep up, Google got this opportunity to effectively control the online space. As a result, during recession, Googles liquidity situation improved as shown the increase of their current ratio, quick ratio and free cash flow (as the reduced cost and shut down of some projects have released more capital that can be used to reinvest). However, after the recession, from 2009 to 2010, we can see a rapid decline of its liquidity ratios (e.g. Current ratio from 10.62 of 2009 to 4.16 of 2010), this is because after recession, Google continued to reap the growth of digital economy. It gave Google a huge opportunity to stretch in the market since the shift of consumers and advertisers from offline to online continued unabated, and it fueled Googles growth in its core business-search advertising. If we look deeper to seek the causes for the liquidity ratio declines, it is simply the management wanted to take full advantage of this opportunity, as Google decided to invest aggressively and heavily to achieve rapid innovations in its search technologies. It also made big investments to make notable enhancements to search including Instant Previews, Google Instant and Place search. During 2010, Google invested $1.8 billion to acquire products, services, companies and technologies. As a result of these huge investments made in 2010, Google liquidity ratios have a big drop, as well as its free cash flow. But this doesnt mean its competitive situation is weakened, on the opposite, these investments may have opened the doors for large amounts of future profits for Google Inc. and its stockholders. From 2010 to 2012, its current ratios and free cash flow have an overall increasing trend but are much lower than 2009 numbers. The quick ratio in 2012 is lower than that of 2010, this is because Google started to sell real goods, e.g. mobiles, so it had to rely on the inventory to be sold to convert to cash, so this reduced quick ratio. This might indicate that Googles ability to cover its current liabilities by those assets (which are expected to be converted to cash in the near future) is weakened, however, using benchmarking to compare with the industry average (industry average: current ratio 3.2, quick ratio 1.52), Googles liquidity situation still plays as competitive advantage. Part 2: Asset management analysis (see Exhibit 4 graph) From 2008 to 2012, Googles days sales outstanding (DSO) has increased from approximately 44days to 57days. DSO normally represents the average number of days it takes for a company to collect outstanding receivables. The increasing DSO of Google indicates that there is a bigger amount of customers owing payments on its sales; this will make Google unable to collect cash on its sales in time, also expose the risk of ending up with bad debts. It would also limit the companys ability to make reinvestment due to lack of cash. Moreover, DSO is a component of the Cash Conversion Cycle (CCC), which is usually used to determine how long cash is tied up in working capital. Thus, a big DSO contribute to make a larger CCC, it will also deteriorate Googles growth and its value in the long run. While the reason that longer DSO appeared, it is mainly because the growth of international business in this search advertising market, competition is getting awful that some of its powerful customers are testing the paid search model, and they request longer payment terms. By this way, credit terms of the company tend to be longer, as well as extended credit to certain big customers. This is a common issue for all the major players (e.g. Yahoo!), so it should not degrade the management performance just by the increase of DSO. For the asset turnover ratios, we can see that the changes of it correspond with the liquidity ratios as analyzed before: they go up in recession since a good use of the opportunity, decline sharply in 2010 as the huge investments for growth, and continuing increase from 2010 to 2012. This indicates Google is on a healthy growing path with its management making proper decisions to deal with problems, and to invest for greater future profits. Part 3: Profitability analysis (see Exhibit 4 graph) As shown in exhibit, Googles Return on Assets (ROA) ratio goes up in 2009 as a peak, while decline all the way till 2012 after the peak. ROA shows the rate of return (after tax) that is earned on all of Googles assets regardless of its financing structure (debt/equity), it measures the management effectiveness using all stakeholders assets to earn profits for investors. The same trend shows in ROE ratios. For Google, this indicates that Google continues to dedicate a lot of money to new ventures that are not paying off, as the declining shows that assets are growing much faster than profits. For example, Google acquired Motorola and expect to make money off the patents in the way of exciting hardware. Also, Google+ is relatively unprofitable and potentially will be a cash cow, although Google+ is used as a defensive weapon to Facebook and other social networking business. These kinds of segments of Google are dragging down its ROA and ROE ratios. However, we can conclude that the declining ROA and ROE is basically derived from its aggressively expansion and investment, and Google is still showing growth every year, but the uncertainty of the profitability of these investments will bring bigger risk for Google. At the same time, the decline in its returns can also indicate that revenues need to grow much quicker in the future to achieve its expected earnings. Other profitability indicators of Google, such as operating margin and basic earning power are showing the same trend, exemplifies the causes analyzed above. Part 4: Debt management analysis (see Exhibit 4 graph) Googles debt to asset ratio shows a small drop in 2009 and an overall increasing trend from 2009 to 2012. Combined with the asset management analysis in part 1, its reasonable to explain Googles higher profits and faster growth in recession compared with other companies result in its assets increase more than debt. Also, after 2009 recession, continuing expansionary strategy adopted by Google has driven large amounts of investments, as Google has to borrow more from its investors and creditors to reach the investment requirement, its debt grow more than assets and consequently increase its debt to asset ratio. Current performance of Google and its management Recently, after the acquisition of Motorola that bring Google the Mobile segment, Google is spending a fortune to expand its already huge Googleplex site, such as preparing to break ground on a 42-acre campus. Most obviously, Google continues to diversify its business to move to mobile and shift to social networks. Google expects Motorola patents that it acquired can be used to develop a phone to compete with some big players such as Samsung and Apple, it has already tried to feature its Android service. It is also moving into the Internet market with Google Fiber to help acquire advertisements. However, as the ratios and trends analyzed before shows that there are problems of short-term returns and higher risks, and fortunately the management has already recognized it. We can find that it has been revealed in Googles annual report that the management are making good efforts to prioritize their products, they shut down a number of products in 2011, including Google Buzz, Google Desktop and Google Labs. The management has learned a lot from those discontinued products and are putting that learning to work every day in new products. To conclude, during recession, Googles management reacted properly and took good use of its online ads advantage, to gain more market. However, the aggressive investment to grow bring uncertainties to the returns, its management should pay more attention to this issue and operate Google business with more caution and conservation, thus maximize its stockholders wealth in the long run. Googles Future Prospects Summarization It is obvious that Google has strong ambition to diversify and dominate its products in different fields, as shown from its many historical acquisitions and its recent moves. Because of its fast growth model, their short-turn foreseeable profits are shrinking, however, Google is still a technology leader in the field with unparalleled competitive advantages. If managed properly, Googles investments will bring optimistic returns in the future. Googles Corporate Governance Corporate governance mainly focuses on the way that top managers operate and interface with its stockholders. For Google, its code of conduct is well known as dont be evil. However, concerning its investors interests, the corporate governance in Google is not optimistic. Since Google initially made the IPO, it has been using dual-share-class structure, under which its shareholders can buy class A shares with one vote per share, while Google founders and co-president Larry Page and Sergey Brin and CEO Schmidt control the majority of its class B super-voting stock with ten votes per share. This makes it hard for outside parties to take over or influence Google. Even as Googles latest actions regarding corporate governance to make stock split via a new class of stock, this would not change its top management already overwhelming voting power, since the power would decay very slowly while Googles shares get diluted. This structure has advantages, as they can avoid hostile takeovers and allow Google to concentrate on its long-term strategies rather than obsessed by tactical short-term moves. But it has much more negative effects, as there is more risk that the CEO make bad decisions. For example, Google stopped its China mainland operations, and this decision made in haste by Mr. Brin, has caused huge loss for Google and its investors. This directly reflects a lack of input from investors on Googles decision-making. In conclusion, although Google has focused on core strengths to make profits, the really challenge right now is to change the way that pushing ideas top-down and improve their current corporate governance condition, because whatever industries Google break into, good corporate governance is the fundamental insurance of keeping all its operations on the right track. Recommendation for Google Investors Although Google bear potential problems in its management investment strategy, Googles business is rapidly evolving and intensely competitive. The overall optimistic attitude held by its current investors shows their confidence in Googles investment returns, but since Googles declining ROA and ROE as well as its shrinking margins reveals higher risk or probable late returns, investors should be careful when making investment, because Googles ongoing investment in new business, products and services is inherently risky, and may disrupt its ongoing business. Besides this, investors should be aware of its internal issues that may deteriorate their investment given its corporate governance situation. Exhibit 4 Representative graphs of ratios during five years Part 1: Liquidity graph Part 2: Asset management graph Part 3: Debt management graph Part 4: Profitability graph Cited References: (n.d.). Retrieved from http://news.techeye.net/business/google-plans-enormous-real-estate-expansion (n.d.). Retrieved from http://www.aqueous-seo.co.uk/sem/seo/did-googles-profits-increase-despite-the-recession-or-because-of-it/99787 (n.d.). Retrieved from http://www.businessweek.com/stories/2009-04-17/google-the-recession-takes-its-tollbusinessweek-business-news-stock-market-and-financial-advice (n.d.). Retrieved from http://ycharts.com/companies/GOOG/return_on_assets (n.d.). Retrieved from https://ycharts.com/companies/GOOG/days_sales_outstanding (n.d.). Retrieved from http://baike.baidu.com/view/105.htm (n.d.). Retrieved from http://seekingalpha.com/article/506281-what-google-s-split-means-for-investors (n.d.). Retrieved from http://www.preservearticles.com/2012010319733/here-is-your-short-essay-on-corporate-governance.html (n.d.). Retrieved from http://en.wikipedia.org/wiki/Takeover#Tactics_against_hostile_takeover (n.d.). Retrieved from http://www.businessweek.com/the_thread/dealflow/archives/2006/01/why_is_dso_risi.html (n.d.). Retrieved from http://en.wikipedia.org/wiki/List_of_mergers_and_acquisitions_by_Google#cite_note-63 (n.d.). Retrieved from http://www.marketwatch.com/investing/stock/goog/profile (n.d.). Retrieved from http://www.google.com/about/company/ (n.d.). Retrieved from http://www.reuters.com/finance/stocks/financialHighlights?symbol=GOOG.O (n.d.). Retrieved from http://www.marketwatch.com/investing/stock/goog/insideractions (n.d.). Retrieved from http://www.hoovers.com/company-information/cs/company-profile.Google_Inc.fb3f79c4d1791506.html#megamenu.html (n.d.). Retrieved from http://finance.yahoo.com/q/ct?s=GOOG+Components (n.d.). Retrieved from https://www.google.com/finance/related?q=NASDAQ%3AGOOGei=FIozUbDVCNG30AHxRQ (n.d.). Retrieved from http://seekingalpha.com/article/236438-google-is-still-a-consumer-services-and-tech-leader (n.d.). Retrieved from http://seekingalpha.com/article/506281-what-google-s-split-means-for-investors (n.d.). Retrieved from http://seekingalpha.com/instablog/1101721-james-demasi/252598-don-t-rely-on-corporate-governance-ratings (n.d.). Retrieved from http://seekingalpha.com/article/580961-behind-google-s-smoke-screen (n.d.). Retrieved from http://seekingalpha.com/instablog/3774191-ecpofi/1483231-beware-google-s-drop-in-margins-roa-and-roe (n.d.). Retrieved from http://seekingalpha.com/article/1114161-google-not-a-buy-suffering-from-declining-return-on-assets (n.d.). Retrieved from http://business-ethics.com/2012/08/14/10058-is-22-5-million-dollars-a-big-enough-penalty-for-google/

Saturday, January 18, 2020

St Jude Childrens Research Hospital Health And Social Care Essay

St. Jude Children ‘s Research Hospital is a not-for-profit infirmary located in the bosom of Memphis, Tennessee. It is an internationally recognized infirmary that pioneered research determination remedies and salvaging kids with malignant neoplastic disease and other ruinous diseases. It treats patients from all 50 provinces and around the universe, without respect to ability to pay, ne'er necessitating households to pay for intervention non covered by insurance ( St. Jude Children ‘s Research Hospital, 2010 ) . St. Jude remains the first and merely paediatric malignant neoplastic disease centre designated as a Comprehensive Cancer Center by the National Cancer Institute ( St. Jude Children ‘s Research Hospital, 2010 ) . It is presently ranked foremost in Children ‘s Hospitals for malignant neoplastic disease attention ( U.S. News and World Report, 2010 ) . St Jude Children ‘s Research Hospital encompasses an extended and impressive mission, vision, and set of values. The mission of St. Jude Children ‘s Research Hospital is to progress remedies, and agencies of bar, for paediatric ruinous diseases through research and intervention. Consistent with the vision of our laminitis Danny Thomas, no kid is denied intervention based on race, faith, or a household ‘s ability to pay. ( St. Jude Children ‘s Research Hospital, 2010 ) St. Jude has a vision to be a universe leader in the intervention and bar of ruinous diseases in kids ( St. Jude Children ‘s Research Hospital, 2010 ) . They aim to run into this by supplying exceeding patient attention and extended clinical research to better understand the ruinous diseases of childhood, enhance results of intervention, prevent diseases, minimize hurtful effects of intervention, and educate health care and research professionals on such findings ( St. Jude Children ‘s Research Hospital, 2010 ) . The overall end of these undertakings is to happen a remedy and heighten the quality of life for the kids they treat. To make a larger part of the affected population, they work to spread out and portion this cognition to heighten the intervention of kids with ruinous diseases worldwide, working towards a scheme for disease bar ( St. Jude Children ‘s Research Hospital, 2010 ) . St. Jude extremely values their patients, households, and givers that enable them to move out their Mission. To adequately adopt their Mission and vision, the organisation has outlined an expressed set of values and criterions to steer their day-to-day actions and determinations. To guarantee attachment, ongoing preparation and rating is conducted ( St. Jude Children ‘s Research Hospital, 2010 ) . The values include: advancing ethical behaviour, supplying the highest quality of medical and supportive family-centered attention, esteeming ethical, cultural, spiritual, and lifestyle differences of all those involved in the infirmary, advancing wise disbursement of every dollar donated back to the attention and research for the patients it treats, keeping a committedness to a civilization of excellence, invention, and creativeness in all that they do, holding a thrust and sense of urgency to win, being honest and accountable for actions and determinations, and cultivation of an env ironment of trust, teamwork, and regard ( St. Jude Children ‘s Research Hospital, 2010 ) . St. Jude does a antic occupation adhering to their Mission, vision, and values as noted through their increased endurance rate of all paediatric malignant neoplastic diseases, high quality attention, repeated ranking of the figure one infirmary for paediatric malignant neoplastic disease attention, and run intoing fiscal demands of the constitution with ne'er inquiring households to pay for interventions that insurance fails to cover. This last part has remained highly of import to the infirmary since first gap as most patients who enter through infirmary doors have already maxed out their life-time insurance caps and lack the support to go on paying for the apparently eternal infirmary measures ( St. Jude Children ‘s Research Hospital, 2010 ) . To be accepted as a patient at St. Jude, a kid must hold a diagnosing particular to a current disease in survey and be referred by doctors. The patient must be no older than 18 and by and large non hold received extended intervention elsewhere. ( St. Jude Children ‘s Research Hospital, 2010 ) . While the St. Jude Children ‘s Research Hospital campus is an independent wellness attention system, their ace research integrates them with kids ‘s infirmaries throughout the universe ( St. Jude Children ‘s Research Hospital, 2010 ) . St. Jude conducts all research and primary surveies within their campus but freely portions this research with infirmaries throughout the universe ( St. Jude Children ‘s Research Hospital, 2010 ) . Because of this cooperation, there is minimum fight from other installations but instead a system that works together for the interest of the kids enduring from ruinous diseases. St. Jude is the national coordinating centre for the Pediat ric Brain Tumor Consortium and the Childhood Cancer Survivor Study ( St. Jude Children ‘s Research Hospital, 2010 ) . On top of the exceeding research and attention provided for paediatric malignant neoplastic disease, St. Jude is a leader in reaping hook cell disease research and has become a primary research centre for grippe throughout the universe ( St. Jude Children ‘s Research Hospital, 2010 ) . St. Jude is internationally recognized for open uping the research and intervention of paediatric patients enduring from malignant neoplastic disease and other ruinous diseases ( St. Jude Children ‘s Research Hospital, 2010 ) . Because of the work St. Jude has done, research protocols have helped to force overall survival rates of childhood malignant neoplastic disease from less than 20 per centum when the infirmary opened, to over 80 per centum today ( St. Jude Children ‘s Research Hospital, 2010 ) . They have treated patients from across the Earth that are accepted and respected without respect to ethnicity and cultural differences ( St. Jude Children ‘s Research Hospital, 2010 ) . St. Jude has impacted the households by supplying hope to households with a inexorable forecast, deficiency of funding, and nowhere else to turn. St. Jude is the exclusive paediatric malignant neoplastic disease research centre that accepts patients without respect to ability to pay. Families are ne'er asked to pay for intervention non covered by insurance, and no kid is denied intervention because of inability to pay. ( St. Jude Children ‘s Research Hospital, 2010 ) . The American Lebanese Syrian Associated Charities ( ALSAC ) has been the sole fund-raising organisation of St. Jude since 1957, assisting raise financess to construct the constitution with laminitis Danny Thomas and his vision ( St. Jude Children ‘s Research Hospital, 2010 ) . In the 2009 Fiscal Year, ALSAC raised $ 682 million through voluntaries, corporate spouses, and givers to run into the day-to-day St. Jude runing cost of $ 1.5 million a twenty-four hours ( ALSAC/St. Jude Annual Report, 2009 ) . These operating costs include patient attention services, research outgos, instruction, preparation, and community services to suit staff and disposal of the infirmary. Patient attention services include all attention needed for active patients. This can include medical attention and life outgos for patients and households. Most patients are treated on an outpatient footing in the St. Jude clinics and are housed at one of the three lodging organisations in Memphis affiliated with St. Jude ( Target House, Grizzly House, Ronald McDonald House ) . Once remittal is achieved intervention can be transferred to a physician in the patient ‘s place community in coaction with St. Jude protocols ( ALSAC/St. Jude Annual Report, 2009 ) . In add-on to ALSAC, St. Jude has over 60 corporate spouses including: Target, the NFL, The Memphis Grizzlies, Kay Jewelers, and Chili ‘s, ( St. Jude Children ‘s Research Hospital, 2010 ) . In add-on to their corporate spouses, single givers and organisations help financially back up the work of St. Jude ( St. Jude Children ‘s Research Hospital, 2010 ) . Extra influences on St. Jude Chil dren ‘s Research Hospital include the American Medical Association and American Nursing Association who serve to steer the physicians and nurses employed by the infirmary. The policy and ordinance of St. Jude is in conformity with research policies nationwide to guarantee the safety of patients with the possible benefit of intervention outweighing the hazard. The infirmary adheres to put protocols in survey and merely deviates from them should extensive research prove the divergence to be more good and scientifically supported ( St. Jude Children ‘s Research Hospital, 2010 ) . The system at St. Jude is extremely supported by holding the research institute under the same roof as the patients with the scientists actively involved in the patient program of attention. In add-on to these ordinances, St. Jude has policies in topographic point to forestall infection spread to patients who are immunocompromised. These include non leting visitants under the age of 12, testing for illness prior to visiting, proper hand-washing instruction, and non leting visitants who have late received the rhinal flu vaccinum or unwritten infantile paralysis vaccinum with in the past four hebdomads. These policies guarantee the safety and overall wellbeing of their patients ( St. Jude Children ‘s Research Hospital, 2010 ) . The organisation of St. Jude Children ‘s Hospital is based on the vision of laminitis Danny Thomas to make a infirmary handling kids with ruinous diseases so no kid has to decease in the morning of life ( St. Jude Children ‘s Research Hospital, 2010 ) . In partnering with ALSAC, Danny Thomas was able to obtain support necessary to make this infirmary from the land up and work to make an environment welcoming to all who enter. His vision included a infirmary where kids did n't experience threatened by attention suppliers, where physicians and research workers ate alongside of patients, a infirmary where patients were allowed to go on their childhood while combating ruinous diseases ( St. Jude Children ‘s Research Hospital, 2010 ) . Harmonizing to Henry Mintzberg, an organisation can dwell of a upper limit of six parts including the strategic vertex ( top direction ) , the in-between line ( in-between directors ) , the operating nucleus ( primary workers ) , the technostructure ( workers who standardize and better work ) , the support staff ( those who work outside of the primary flow ) , and the political orientation ( beliefs, traditions, norms, values, and civilization ) ( Value Based Management, 2010 ) . The undermentioned diagram depicts the Mintzberg organisational construction of St. Jude Children ‘s Research Hospital and is explained below. ( Proven Models, 2010 ) The strategic vertex of St. Jude consists of the Boards of Directors and Governors for ALSAC-St. Jude Children ‘s Research Hospital. The Board is responsible for regulating the organisations by set uping policies and aims, choosing, naming, back uping, and reexamining the public presentation of the Chief Executive Officers, sing the handiness of equal fiscal resources, O.K.ing one-year budgets and strategic planning, and accounting for the moralss, conformity, and public presentation of the organisations ( St. Jude Children ‘s Research Hospital, 2010 ) . Below them St. Jude has the in-between line operations dwelling of the Chief Executive Officers, Senior Management Team, and the Executive Committee that straight oversee the operating nucleus. At the bosom of the infirmary are the operating nucleus of doctors, research and development squad, advanced pattern nurses, nurses, certified nursing helpers, child life specializers, psychologists, and households who collaborate to supply equal family-centered attention. The Support Staff of St. Jude consist of ALSAC as the primary fundraising organisation, the administrative organic structure, the environmental service employees, the cafeteria, the public dealingss section assisting advocator for ALSAC fund-raising enterprises, the Target, Grizzly, and Ronald McDonald houses and staff people, the ethical and legal commissions, and voluntaries who help throughout the infirmary. The technostructure of St. Jude consists of the specially named Faculty and Adjunct Faculty that standardize research in coaction with attention provided to patients. It besides includes the external advisory boards that help to standardise protocols and guarantee they are accessible and clearly stated to be shared worldwide. St. Jude has a surprisingly big technostructure of employees who work to standardise attention throughout the infirmary with respect to singularity of each patient in the research surveies. Any divergences from standardized attention are backed through the research conducted on the St. Jude campus. Because of this, the infirmary would be classified as a Machine Bureaucracy that has all constituents present and strong in their operation and passage towards the campus. The nursing function that will specifically be analyzed is the function of the Pediatric Acute Care Nurse Practitioner. Unfortunately, this function is non presently available at St. Jude Children ‘s Hospital and hence no specific occupation description or rubric is available for the specific function at St. Jude. Harmonizing to the National Association of Pediatric Nurse Practitioners ( NAPNAP ) , the Pediatric Acute Care Nurse Practitioner ( PNP-AC ) would work to supply direct patient attention direction, execute in-depth physical appraisals, interpret lab and diagnostic trials, order mediations, and execute curative interventions for kids who are acutely, inveterate, and critically ill ( NAPNAP, 2005 ) . The PNP-AC would be licensed as a registered nurse in the United States with a alumnus grade in nursing through an commissioned plan, and certified by the Pediatric Nurse Certification Board as a Certified Pediatric Nurse Practitioner – Acute Care ( PNCB, 2010 ) . To go certified one must run into certain competences and go through a board scrutiny that meets the National Council of State Boards of Nursing APRN standards ( PNCB, 2010 ) . To keep enfranchisement, one must finish go oning instruction hours and/or re-certification every three to five old ages, or as deemed by the organisation and province board of nursing ( PNCB, 2010 ) . The function of the PNP-AC would fall within the operating nucleus of the infirmary. They would work in coaction with other Physicians and Researchers at St. Jude to make a comprehensive program of attention for the patients. This would maintain everyone working towards the same end and guarantee overall patient wellbeing. They would besides work with the nurses, nursing helpers, child life specializers, and other healers to maintain them informed of advancement or hardships the patient may meet, and assist them understand the attentions that need to be provided to guarantee success of intervention protocols. They would besides work with unit directors and nursing managers should jobs or inquiries arise. They will be able to confer with with the in-between line direction or technostructure forces should inquiries or concerns arise. They would besides work with changing support staff members for outreach, dietetic consults and education-oriented undertakings. This function would strai ght interact with patients and households through their mundane undertakings. They may make outreach into the community, and behavior instruction for consumers and remunerators on current progresss the infirmary is doing. They would besides indirectly work with human resources and the finance section to obtain their payroll check. The function of the PNP-AC is really independent in impacting patient attention and results. They can name and handle conditions, prescribe medicines, obtain necessary consults and interpret consequences of ordered trials. They would supervise the advancement of attention and intervene should any alarming findings be made in response to the protocol under survey. The function would be strong in the sense that they are an independent and an independent member of the health care bringing squad that is capable of supplying a high-level of attention to patients. They have strong patient interaction accomplishments and a comprehensive cognition of attention that should be provided by the nurses. They are best able to understand the function of the nurse and depute appropriate undertakings to other members of the health care squad. The function weaknesses include the opportunity that they may non be as extremely respected as doctors or physician helpers, and the deficiency of advanced prep aration specifically in pathology and the physiology like doctors and physician helpers frequently have. Overall, the function of the PNP-AC would be a extremely operation advanced pattern function that can supply comprehensive and thorough attention to his or her patient ‘s and work as a productive member of the health care bringing squad.

Friday, January 10, 2020

Analysis of Forgetfullness, by Billy Collins Essay

This poem is really easy to identify with. The first 4 stanzas are clearly relating the reader to the poem. Everyone at some point has to learn these general, seemingly useless facts. â€Å"A state flower† â€Å"The capital of Paraguay† so arbitrary, but so true in that this brings back memories of 3rd or 5th grade for almost all of us, it is bound to strike a chord with the reader. This is also coupled with a slightly nostalgic loss of these facts in the first stanza, as slowly the individual sections of a book (that you as the reader once clearly enjoyed) are systematically removed from your memory by time. Then the tone shifts from musing about facts we don’t remember, to our inability to remember them. It begins to get darker. This is useful contrast from the imagery that the reader experiences during the first few stanzas, remembering childhood, and innocence. Juxtaposed is the now darker â€Å"mythological river† described as vague that, dauntingly, is leading to oblivion. The hopeless tone thus has that much more impact as we make our way to our own â€Å"oblivion† or death, where we will join the dead: â€Å"those who have even forgotten how to swim and how to ride a bicycle.† Then Collins provides a justification for our wanting to remember, wanting to enrich our every moment, as soon memories will be pointless. Really, in the end this is providing a more inherent worth to memories than they ever had before, because of the fleeting nature of life that Collins describes. Not in a fun, youthful â€Å"carpe diem† way, Collins is showing how short we have to live. Only from this presentation can the reader then make the leap that we ought to cherish these good memories, and make good memories, such as the â€Å"moon (out of the) love poem† in the closing lines of the work.

Thursday, January 2, 2020

Biological Differences Between Males And Females - 1176 Words

Sex is defined as â€Å"the average, reliable, biological differences between males and females† (Auleb 1). One biological difference between males and females is in external genitalia: males have penises whereas females have vaginas. Sexuality refers to one s sexual orientation, sexual behaviors, and capacity for sexual feelings (YourDictionary.com). Someone who is not sexually attracted to anyone may identify themselves as asexual. And sexual identity is one s conception of themselves in terms of to whom they are sexually and romantically attracted, if they experience sexual or romantic attraction at all (Wikipedia.org). Someone who is attracted to people regardless of gender may identify as bisexual, or as pansexual if they do not adhere to the belief that there are only two genders. One s sexual behaviors and attitudes towards sex and sexuality may be governed by their values, of which there are two types. Formal values are what one says they believe; informal values are w hat one actually does (Auleb 3). If someone says that people should wait until marriage to have sex, that is their formal values. If they abstain from sex until marriage, that is their informal value. Ideally, one s formal values and informal values are in sync, for if they are not, one may find themselves in a situation in which they are unready or unwilling to participate. One s values do not form in a vacuum and are shaped by their society and culture. 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