The Scientific Method

The Scientific Method The Scientific Method is a way to document the results of an experiment. It isthe proper or correct way to write a formal scientific paper. It is really important that iftwo different people on opposite sides of the world both do the same experiment,they need to have a universal way of writing their research. That is why the ScientificMethod is so important. People need to be able to easily reference certain points inother's research without having to search they whole paper for it, some of thosepapers can be pretty long.The Scientific Method was created by some guy along time ago. I'm not sure ofhis name because I couldn't find it in my notes. It might have been DaVinci becausehe was "A smart dude." There is also a good chance that it was Pythagoras, he wasalso "A smart dude.‚" I do know that it was created a long time ago, because manypeople have used it for quite a long time.English: Pantothenic acid 3D structureThere was a total of 9 calories per gram of fat, 4 calories per g ram of carbohydrates and 4 calories per gram of proteins.3. The total calorie count was 508kcal for the serving of 7 that I chose previously.4. Some of the most common vitamins and minerals in this food item were 722mg of Sodium (Na), 472mg of Potassium (K), 458mg of Phosphorus (P) and 141mg of Calcium (Ca); 6.447mg of Niacin, 3.1 mg of Vitamin C, 0.735mg of Pantothenic acid, 0.286mg of Riboflavin, 0.271mg of Thiamin, although there were many more components contained in this particular item and will be discussed further along.5. Other important nutritional components of this food item were a significant amount of another important vitamin which was 15% Iron. Iron is helpful because it creates...

Tort Reform Essay

Tort Reform Essay Free Online Research Papers Abstract In any reforms encouraged by a government, it has proven to create a great impact on the lives of people. In an increasingly litigious society, tort reform is a subject that had brought about great debate. With costs never ceasing their inevitable rise, especially in the medical field, tort reform discussion has increased. The cause and effect of lawsuits, the cure for huge settlements live in a world of gray, and not black and white. Truly, something needs to be done, but the implementation of legislative controls is a very touchy subject, with powerful lobbies on both sides. Is Tort Reform A Cure? Tort Reform had been a popular political issue, especially in the United States. With its aim to improve the efficiency of courts and limit the compensation and tort litigation among victims, its concept had become an issue in past presidential elections. According to an article written by Shrager, Spivey, and Sachs, the method of tort reform has the tendency to limit the rights of victims and may even promote injustice to the oppressed wherein tort reform is believed to have emphasized in protecting the people causing harm or damage upon the victim. (Shrager, Spivey and Sachs, 2007) The word tort came from the French legal term tort, which means ‘to have wronged.’ The cases under tort involve inflicting harm to a person’s reputation, security, financial sources or property. For instance, two of the main examples of tort cases are personal injury and medical malpractice, when a patient sues a surgeon; the surgeon would not be imprisoned. Instead, the surgeon is obliged to pay for the expenses and medical bills in order to recompense the suffering and damages caused to the patient. The tort law is described as disparate from criminal law or contract law because the purpose of a tort case is to find remedies and restore lost or damages through compensation. (Shrager, Spivey and Sachs, 2007) However, some people believe that tort reform is just a waste of time and it has the tendency to describe the plaintiff to be only interested in gaining financially instead of focusing in concerns that are more important. A report on medical malpractice in Pennsylvania stated some facts on torts such as the following, â€Å"Juries are often characterized as biased against doctors, incompetent and irresponsible, but research shows that doctors win in more than two out of three cases tried to juries and that the amounts of jury awards are positively related to the seriousness of the injury. Trial judges and neutral medical experts tend to agree with jury verdicts†¦jury awards constitute only a small fraction (between 5 percent and 7 percent) of all medical malpractice payouts; most cases are settled prior to trial.† â€Å"An examination of the jury awards over $1 million shows that the patients in these cases suffered very severe injuries or death.† â€Å"Research shows that caps on pain and suffering are unfair to patients with the most severe injuries, to women, to elderly persons, and to children. While caps reduce the amounts of payments to negligently injured patients, research does not support the proposition that caps reduce the liability insurance premiums of doctors.† â€Å"Despite claims that Pennsylvania is losing doctors to other states as a result of high liability insurance premiums, official statistics from the American Medical Association and from the Federation of State Licensing Boards show an actual per capita increase in treating physicians.† (Vidmar, 2006) Usually, the system of tort is compensating victims for damages done and those who suffered from accidental injuries. Even though compensation is given through legal claims, some believe that the tort system is still expensive and insufficient. An estimate of 46% collected from these rewards is given to the claimants or victims wherein it has been argued that the system would provide compensations to those who were insufficiently aided by social insurance programs. Also, another definition of tort reform is described as proposals limiting legal claims aided by personal injury lawyers and particularly a matter of common law and legislation. (newsbatch.com/tort.htm, 2006) On the other hand, although tort reform is often criticized and disagreed by opposed parties, it has shown a positive result of economic benefits especially in improving the legal system in America. It has been criticized for its policy of being too costly and its incapacity to bring fair awards. In addition, it has increased financial burdens in families and businesses due to higher insurance premiums, higher medical costs, and reduced incentives. Although the effect of a tort system to an economy would be hard to measure, many have been suffering from increased insurances and the high cost of commodities. For instance, most business is affected by higher prices charged to them for insurance costs. Excessive litigation due to slow productivity and growth also brings negative effects to an economy since it tends to lessen risk and innovation. (Saxton, 1996) However, there could also be benefits of saving money from tort reform through implementing the premise of contingency fee and Moore-Gephardt reforms and could be the basis on why tort reform is necessary. Under the contingency fee reform, the lawyer of the plaintiff would be able to receive a certain amount from the compensation of the client. It could also be a term referred to mechanisms used to compensate lawyers. An advantage of this reform is that it establishes a quicker and fairer settlement by only concerning on the manner of how lawyers are compensated. On the other hand, the Moore-Gephardt reform policy may be referred to as, â€Å"The framework of the Moore-Gephardt reform is as follows: If the defendant agrees to pay for all economic damages (as defined by state law) and reasonable attorneys fees, then that defendant is liable only for economic damages, and not for non-economic claims. Plaintiffs have the right to refuse such an early offer, but if they do so, it become s harder to prove pain and suffering or punitive damages.† (Saxton, 1996) The only weakness addressed by the Moore-Gephardt reform with regard to tort system is the encouragement to inflate damages in order larger amount or portion of awards. This reform reduces incentives by encouraging tort cases to be resolved quickly by making an early offer to injured or harmed victims, which make it hard to commit real justice. Both of these reforms have the ability to reduce tort costs, especially in the U.S., since it tends to propose an early offer which may exclude an individual from paying the most expensive costs of involving in tort cases that is the lawyer’s fee. The focus of these proposals is more on the tragedy such as professional mistake and on the fairness of a verdict and damage award. A probable benefit from these proposed reforms would be the following: Lawyers fees: Savings on payments to lawyers result for two reasons. First, these proposals would discourage many frivolous defenses as well as claims for example, if claimants lawyers know that an early offer by the defendant could reduce the claimants lawyers fees. Second, under Moore-Gephardt in cases where there is little dispute of economic damages, lawyers fees on both sides would be significantly reduced. As to defense lawyers, the reform would extinguish the incentive of defendants in some cases to wear down the plaintiff through extensive legal proceedings. Alternatively, plaintiff’s attorneys would receive substantive contingency fee payments only when their efforts add value to the defendants early offer. It is likely that a significant portion of the over $45 billion in tort costs attributable to lawyers fees could be reduced by these proposals: Pain and suffering awards: The Moore-Gephardt reform does not cap or even necessarily eliminate pain and suffering awards. Rather, Moore-Gephardt encourages cases to be settled quickly based on the economic damages to the claimant. Nonetheless, there is room for considerable savings without having to deny such damages in cases stemming from egregious misconduct. Administration: Although most tort cases are settled out of court anyway, the early offer reforms would significantly speed up the process. With tort cases, often-lasting years before a settlement is reached or a final verdict is handed down, early offer reforms are one of the best ways to reduce the delays and attendant administrative costs of the tort system. Health care: Health care savings result from two sources. The first source of savings is the elimination of the collateral source rule, a change which would reduce the double payment of wage loss and medical bills. The second source of savings comes from changing the claiming behavior of accident victims. Without the incentive of $3 in awards for each $1 in medical costs, consumption of unnecessary medical services would be drastically reduced under Moore-Gephardt. (Saxton, 1996) In line with these reforms, not only would millions of money be saved but the lives of people as well, since it would encourage people to avail of insurance through discounts and it would also enable to correct certain systems that discourage innovation. These proposals on tort reform simply result in higher progressive savings, lower transaction cost, eliminate frauds and improve rights in injured parties. On the other hand, in an article written by Glauser, he stated that tort reform may be a form of marketing to the public, especially in medical care. For instance, some of its benefits may include preventing doctors and physicians from high-litigation specialties and states, enhancing access to health care, providing more health care services to people and producing defensive medicines for the federal government. (Glauser, 2004) Just like other reforms, the tort reform also has limitations, and this is due to insurance industries. It is known that the main business of insurance companies is to make money, else, if bankrupt, an insurance company is forced to close down the business. For some, tort reform ensures fairness among individuals whether the victim or the defendant. It allows not only better business conditions but also better job opportunities and healthcare to people. (Glauser, 2004) Usually, tort reforms occur when the legislators realize that the cost of compensation is higher than what an individual in the community can pay. It is important that the levels of damage be identified in order to ensure the affordability and availability of premiums. In some countries, the purpose of tort reform programs is to ensure that the liability of insurance is for the community at a reasonable cost, and not for profit organizations and small businesses alone. However, some argue that tort reform is, â€Å"Those who argue against tort reform believe justice dictates people who have been injured by the negligence of others should be able to claim damages. Some also assert that tort reform was not necessary in the first place, essentially by rejecting the actuarial evidence of claims costs and claims cost inflation.† (Booth, 2005) Conclusion In the world of tort, everybody seeks a fair and speedy conclusion. However, alas, money rears its ugly head. To have a meaningful attempt at tort reform, there will have to be a multi-pronged approach. While companies would like to see their insurance costs go down, when legislation is passed to help them, there is no guarantee that the savings are passed on to the consumer or customer. Many lawyers like to see huge awards since their fee is usually a percentage. There is probably a lot of improvement to be gained in this facet of tort reform. People have a hard time believing that a person could be awarded in excess of $100 million dollars for an accident in which they were partial to blame. On the other hand, people also have a hard time believing that a law firm deserves to get billions as their share of an award (tobacco). Juries are supposed to be a person’s peers. In modern society, jury selection has become a large part of cases, picking the â€Å"right† people can make or break a case. This brings up a vital point in tort reform; many people on juries believe that they should give large rewards because companies have deep pockets. Jury members need to understand that the costs of most cases are passed on to the consumer. Do they understand that some people are lost when it comes to common sense and that is no reason to punish the company or doctor? While jury selection should be an impartial event, I believe there are clearly instances where the information in the trial is way above their understanding. This side of tort reform would indeed be a touchy subject. I believe that one side of tort reform that should be advanced is criminal charges against the people responsible. If a CEO or other high executive knows that a potentially deadly defect exists and allows it to remain without adequate warning to the public, they should go to jail. Of course, there are many problems with this idea: Who knew about the problem? Were the warnings sufficient? What is a justifiable attempt at making a safe product?. There is no product or act that can be made completely safe or idiot proof. This part of the solution goes hand in hand with the abilities of members of the jury. I have not offered any concrete solutions to the area of tort reform, but some general ideas. Like anything else, ideas and laws have to be tweaked and improved over time since every potential problem cannot be foreseen. REFERENCES Booth, D., Tort Reform in Australia. 24 January 2005. http://s2kmblog.typepad.com/rethinking_structured_set/tort_reform/index.html Glauser, J. Does Tort Reform Work? Emergency Medicine News. Volume 26(10). October 2004. p 27 Saxton, J. Improving the American Legal System: The Economic Benefits of Tort Reform. Joint Economic Committee Study. March 1996 Shrager, Spivey Sachs. Understanding Tort Litigation and Your Legal Rights. 2007. shragerlaw.com/html/legal_rights.html Tort Reform. May 2006. newsbatch.com/tort.htm Vidmar, N. Medical Malpractice Litigation in Pennsylvania. A Report for the Pennsylvania Bar Association. Duke University. May 2006 What Is Tort Reform And Why Is It Bad For The Public? 30 October 2003. corpreform.com/corpreform/2003/10/what_is_tort_re.html Research Papers on Tort Reform EssayThe Fifth HorsemanPlastic Surgery EssayRacism and InjusticeThe Obama Presidency EssayLegalization of Same Sex MarriagesJim Crow Law EssayGovernment Funding EssayThe Legal ProcessA Molestation Epidemic EssayImplied Warranty Law Essay

EU Rights to citizenship Essay Example | Topics and Well Written Essays - 1000 words

EU Rights to citizenship - Essay Example Karl and Gabrielle are the two visitors from Kazakhstan while Sylvia belongs to Hungary. Charles, Bill and Muriel play an intricate role in the lives of all three foreign individuals. The first character Gabrielle has a work permit which qualifies up to three months. Article 6(1) provides that EU citizens shall have the right of residence in another Member State for a period of up to three months without any restrictions or formalities other than the obligation to hold a valid identity card or passport. Also, according to Article 4 and 5 all EU citizens have the right to leave or enter another Member State by having a valid identity card or valid passport. According to Art 7(1) Gabrielle can exceed the three months period if (a) she is engaged in an economic activity in the host Member State such as UK on an employment or self-employed basis, (b) if she has health insurance and (c) if she is following a course of study in the host Member State. Article (8 a) does not provide every citizen of the Union with an open-ended right to reside freely within every Member State. Gabrielle may have obtained the right of permanent residence in UK after a five years period of continuous legal residence according to Art 16 (1). This is as long as the eviction decision has not been enforced against her by virtue of Art 21. Therefore, she is allowed the right to permanent residence without needing to oblige any conditions.

Slp4 599 Coursework Example | Topics and Well Written Essays - 1250 words

Slp4 599 - Coursework Example Through an effective understanding of the two, it becomes easier to develop a brand positioning tool that appeals to every segment of the market. Understanding the product The Clipboard tablets are diverse and built with the understanding of the shoppers. For the three years, the company has produced three serial products each having unique features but better than the previous. The X5 tablet is the most basic of the three. Its features are basic tablet features and possibly target the low income earners. Its buyers are not motivated by the performance of the product but by its relatively cheap price. Among its features are the 2G internet capabilities, a three megapixel camera and a 30 Gigabyte internal hard disk memory. For these three features and its target market, the product stays active in the market for three years, the longest in the history of Clipboard tablets. An upgrade version of the X5 tablet is the X6. This is performance oriented and has better features than those pr esented by its predecessor. With the 4G internet speed, Wi fi and one hundred and eighty gigabyte storage space, the machine is ideal for the modern day business person. The product targets the rich and wealthy members of the society. It stays active for two years, a feature attributable to the gullible nature of its target market. Infusing price and performance is not always easy. The notion shared by most shoppers is that an expensive product is always of the best quality. It thus became hard to produce a good quality product and sell it at a relatively low price. The X7 tried this resulting in the shortest market time in the history of the company products. It infuses a number of features of the X6 and has a better sleeker look. Understanding the market The market is easier to understand; tablet users prefer convenience and will always be on the move. They thus require a mobile device that offers longevity and extreme convenience. However, just like the rest of the market it is d ivided into two with every group having its own uniqueness and motivations to purchasing. The two groups are the price motivated shoppers and the quality motivated shoppers (Gilbreth & Lillian, 1978). The price motivated shoppers always buy the basics at the most competitive market value. They asses the products based on their prices and the basic features it promises. This market segment constitute of people from the lower and a bigger percentage of the middle social class, their revenue is constrained and they therefore account for every penny, over spending may result in severe inconveniencies in other aspects of their lives. They thus stick to the basics and would rather accommodate the little inconveniencies of a basic product than spend a penny more than they had budgeted for. Coincidentally this class of shoppers is always a majority in every market. The second category of shoppers is quality oriented. These people will always change gadgets with every newer and improved vers ion of the very product that enters the market. This group constitutes of the rich and the wealth members of the society, it may also include members of lower social classes but compelled by other preexisting circumstances to purchase the very products prescribed by either their employers or service providers. They are not scared of the rice of the product provided it

Prenatal and Post-Partum Scenario Essay Example | Topics and Well Written Essays - 500 words

Prenatal and Post-Partum Scenario - Essay Example Anxiety, fear and other intense emotions which are a part of stress cause exaggerated production of adrenaline which causes restriction of blood flow to the uterine area causing deprivation of adequate oxygen to the fetus. Thus stress can lead to premature delivery and its consequences. Stress in pregnancy also have long-term consequences like behavioural problems in childhood (Santrock, 2004). 3. The pregnant woman must undergo ultrasound examination for fetal anomalies between 18- 20 weeks of gestation. At this point of time, all organs are developed and it becomes easier to detect any obvious congenital anomalies through ultrasound at this stage. According to ecological theory, several biological and environmental factors affect the growth of the fetus and the child (Santrock, 2004). Thus a normal nutrition and a stress-free environment is essential for normal development of the fetus. 1. The child must be breast fed as much as possible. According to Freuds theory of development, infants are in the oral stage of development and derive gratification from sucking (Santrock, 2004). Derivation of such pleasure at this stage allows them to have satisfaction and facilitates growth and development. 2. The mother should shower affection on the child and not do any thing to harm the child. According to Eriksons first psychosocial stage, trust is developed at this stage and the infant sets stage for expectation that the world is a pleasant and goof place to live. the expectation which begins at this stage lasts life long. 3. The mother should allow the child to touch, feel and explore various things on his/her own. According to Pigets cognitive developmental theory, the first stage is the stage of sensorimotor stage during which time the infant develops and understanding of the world through coordination of various sensory experiences through various physical actions (Santrock,

Plato and Aristotle Essay Example for Free

Plato and Aristotle Essay 1. What are the major differences between Plato and Aristotle? Make sure you provide examples. Basically, Plato and Aristotle are highly different in their philosophical beliefs and their various teachings.   The main philosophy of Aristotle is to possess virtue in order to achieve the ultimate goal which is happiness. In order for people to possess virtue, he also believed that everything should be done in moderation only and not too sparse or too excessive. On the other hand, Plato used logic and dialogue as his main tools together with the aid of mathematics in order to arrive with rational conclusions so as to know the universal truth. Moreover, Aristotle strongly believed that acts of good must be habituated in order to become a virtue while Plato believed that merely knowing what is good is enough to be able to do good even without actually doing it. Another major difference between the two is their beliefs in metaphysics. Plato’s believed that there are higher or ideal forms that can only be acquired through knowledge while Aristotle believed that form and matter are inextricably bound and coexist. 2. Are you a Platonist or an Aristotelian? Provide specific examples to help illustrate your points. I am basically a Platonist simply because there are more of this teachings that are applicable today than Aristotle such as his theory of the universal ideal forms. For example, when looking for an ideal friend, that person I am searching for must possess the qualities that I desire. However, it is a well-known truth that there is no such thing as â€Å"perfect† or â€Å"ideal.† But since I know what an ideal friend is, I now have a pattern which I will use as a basis as I search for my ideal friend. I may not be able to find that person but I would definitely meet someone close to that, which is like the shadows that Plato described in the Allegory of the Cave. In addition, I know that the both the sky and a pair of blue jeans are both color blue. Although, in reality, they are not of the same color, I somehow have an idea of what blue is because it preexists in my mind.   Another reason that I also consider myself as a Platonist is because I do not believe in Aristotle’s idea that by possessing virtue, once can achieve happiness. For me, his belief is too idealistic, although his use of formal logic and scientific methods such as deduction and observation is still applicable today.

Management Of Diabetic Ketoacidosis Nursing Essay

Management Of Diabetic Ketoacidosis Nursing Essay Diabetes UK (2008) explains that Diabetic Ketoacidosis (DKA) occurs when blood glucose levels are consistently high. When there is lack of glucose in the blood, the bodys cells use fat stores to acquire energy, this process produces an acid called ketones. As ketones are potentially harmful to the body, it tries to get rid of them by excreting them in the urine. If the level of ketones in the bloodstream continue to rise, ketoacidosis occurs whereby the blood turns acidic. as a consequence, patients may feel nauseous, have blurred vision and have very rapid breathing. Because people vomit, the body becomes dehydrated and it is harder for the body to flush out the ketones, if this happens and is left untreated, the patient will fall into a coma which can be fatal. As Daniel was suffering from a chest infection, he was at high risk of developing DKA as his body was releasing more glucose into the bloodstream and stop insulin from working efficiently, this is a triggered response to the infection (Moore, 2004). How is DKA managed? Kisiel and Marsons (2009) explore the regime which is usually carried out in hospitals faced with patients like Daniel. Firstly, a diagnosis of DKA would have been made alongside hypoglycaemia (high blood glucose levels). His urine would have been tested for ketones as standard regime. Arteirial blood gas measurement may also have been performed to demonstrate the level of acidity. A series of blood tests would have been taken to measure Daniels urea and creatinine levels (measures of kidney function), markers of infection would also have been measured such as white blood cell count. Fluid replacement would have been commenced, insulin administered and his potassium level would have also been monitored in the high dependency unit. What could have influenced Daniels rising BMs? It should be taken into consideration that Daniels rising blood sugar levels could be influenced by a number of factors and Jo should take these into account. Jo should check the equipment supplying Daniels insulin as it may be faulty or the pump may not be functioning correctly. She should also ensure that the line is properly connected to the cannula and that it is not leaking or that there is no blockage along the line, or that the cannula has not tissued. Daniels cannula site should be inspected on every shift to check for Phlebitis using the Visual Infusion Phelbitis score (VIP) in line with local policy. Nursing decisions Many factors could have contributed to both Jo and the Senior Nurses decisions and the decision made either way could impact on Daniels condition. If Jo had decided not to increase the insulin and the senior nurse had not increased it either, Daniel may have slipped back into a coma as his blood glucose levels had been rising over time. This would have led to more complications and could have been fatal. However, increasing the insulin may also have had a negative result for Daniel. As it was not prescribed, it may have been increased too much and the blood sugar level could be reduced to an unsafe level and he may suffer a hypoglycaemic episode. Although this is unlikely, it should be mentioned that the senior nurses decision to alter the prescription without it being prescribed was wrong. Accountability According to the NMCs code of professional conduct (2008), as a professional, you are personally accountable for actions and omissions in your practice and must always be able to justify your decisions. As the senior nurses made a decision to alter the insulin infusion without it being prescribed, she is personally accountable to what happens to that patient as a consequence of doing so. On the other hand, Jo is also accountable for her omissions so it could be seen that both of the nurses are responsible for what they do or dont do in this situation. The senior nurse may have thought she was acting in the best interests of the patient, following the NMC code of conduct standard à ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦. Accountability is the fundamental aspect to professional practice (NMC 2008) and nurses need to be able to justify why they made any decision in practice. Nurses do make judgments based on a number of influences which include their professional knowledge/skills, evidence based practice and acting on the patients best interests. In this situation, the senior nurse may have been a nurse prescriber who had the authority to prescribe drugs from a limited group in the nurse prescribers formulary (McHale 2003). This would have allowed her to alter Daniels prescription without a doctor. She may also have had background knowledge of Daniels condition and thought the best decision to make was to change the insulin dose so that the patient would not have deteriorated further. The senior nurse should be working within her acquired job description which would have included expectations and limitations to what she was required to do as part of her job. Vicarious liability comes into mind in this instance; Richardson (2002) explains that as the employer is responsible for any torts which are committed by an employee during their employment. Torts are described as any legal wrongs for which the law provides a remedy. In this case, the senior nurse has preformed a tort and the person employing her is liable. As Jo was the nurse who was looking after Daniel that day, she also has responsibility to what happens to the patient whilst in her care. This raises the question of who actually is accountable for what happens to Daniel; the nurse looking after him or the nurse who performed the alteration. As it states that Jo is newly qualified, it can be assumed that she may need support from her peers. She would have had a supernumerary period, where she was allocated patients but support was there when she needed it. Also known as preceptorship, newly qualified nurses are accompanied by an experienced nurse who acts as a role model and resource (Ashurst 2008). If the senior nurse was Jos preceptor, she would not have been setting a good example to her. The NMC code of conduct states that you must work cooperatively within teams and respect the skills, expertise and contributions of your colleagues, the senor nurse was clearly not being cooperative with Jo and did not allow her to share her concerns. Castledine (1999) explains how newly qualified nurses are sometimes expected to fit into the system of the ward very quickly and in addition, adapt to a whole range of situations that they have never experienced before. Jo may have been feeling unsupported by her senior and her confiden ce may have been knocked due to the attitude and response of the senior nurse. Documentation As the senior nurse did change the prescription, it needs to be documented somewhere in line with the NMC code. In this situation it could be questioned who documents the alteration of the insulin and where in the nursing notes it should be written. Medication administration arguably carries the biggest risk for nurses (Elliot Liu 2010). This particular scenario could be described as a medication error as the change in prescription was not verified by a doctor. Elliot and Liu (2010) confirm the fact that nurses must only administer the dose prescribed by the medical officer, and that the nurse who administers the medication must sign the medication chart. It should also be documented in the nursing notes as well as signing the chart, and should include the reason for administration and the desired effect (Elliot Liu 2010). Woodrow (2007) stipulates that nurses should be aware of the legal responsibility of accuracy of documentation. So in this situation, the senior nurse should wri te in the nursing notes why she gave the unprescribed dose to Daniel, and Jo should comment why she did not, as well as outlining what happened. Incident Reporting Patient Safety Jo could think about writing an incident form in this situation to voice her concerns. The scenario could be seen as a near miss as the patient may well have suffered dire consequences from either of the decisions made by the nurses. The Reporting of Injuries, Diseases and Dangerous Occurances Regulations (RIDDOR 1995) places a legal responsibility to employers, self employed people and people in control on premises, to report any dangerous occurrence/near miss (Ashurst 2007). Jo could include on the form that she was not happy with the senior nurses decision to alter the insulin pump, and therefore cover herself. By completing an incident report, Jo is following local and national policy and it could also bring to light other problems such as rushed transfers, doctor shortage and lack of support. RIDDOR coordinates its work with the NPSA. The National Patient Safety Agency (NPSA) was formed in 2001 following two publications of patient safety in the NHS. These incorporated research conducted by Vincent et al (2001) which showed that 10% of patients admitted to hospital suffered some kind of patient safety incident. The NPSA has produced a guide to good practice called Seven Steps to Patient Safety (NPSA, 2003) Steps include; building a safer culture, leading and supporting your practice team, integrating your risk management activity, promoting reporting, involving and communicating with patients and the public, learning and sharing safety lessons and implementing solutions to prevent harm. Dimond (2002) explains how the NPSA aims to ensure that adverse events will be identified, reported, analyzed and recorded to make a change to local and national policies and procedures. Jo could refer to this guide and also make others aware of it and improve the patient safety of not only Daniel but every patient on the ward. Inter-professional Working There are several benefits of inter-professional working, the senior nurse and Jo should be aware of these in order to work together and provide effective care. Benefits of inter-professional working which were identified in a report by Cook et al (2001) showed that the team members had more confidence in their decision making as they had encouragement and support from their colleagues. This allowed team members to make better contributions to the overall service in which they were a part of, consequently providing a more effective service to the patients in their care. Jo would have increased her confidence in dealing with similar situations in the future if the senior nurse had spoke to her and answered her questions. There is a great deal of literature which discusses the barriers and difficulties associated with inter-professional collaboration. It should not be assumed that simply instructing professionals to work together will be sufficient to result in effective teams which provide improved services to their patients. A variety of barriers to interdisciplinary working exist that delay the developments of close collaborative working relationships. Hudson (2002) outlines some barriers to effective inter-professional working in terms of relationships between members of different professions such as nurse and doctors. One barrier that he notes is that the character of professional identity is such that where members of a certain profession have similar or shared values, perceptions and experiences, there will be more agreement between members of a profession than between members of different professions. This disagreement shapes inter-professional relationships, and is likely to cause problems wi thin multi-disciplinary team working. In Jos case, she could have bleeped the doctor herself and asked him about the prescription, but as mentioned if he was busy he may have been reluctant to take the call. The senior nurses reaction to Jo demonstrated the hierarchical struggle between a more senior nurse and a very junior member of staff. Although inter-professional working has much potential to enhance care, it can also produce tensions and concerns within the health care team (Peate 2006). It is also important to note that some barriers are organisational or structural such as merging or Trusts, relocation and withdrawal of services. In this scenario, the main barrier is that there are two different skill mixes with conflicting ideas. Irvine et al (2002) also consider some organisational difficulties and barriers to the effectiveness of inter-professional practice. They identify that differences in working hours may hinder the development of close working relationships between professionals. Also the time different professionals take to carry out particular work may cause difficulties. For example doctors may be making decisions regarding clients on a day-to-day basis whereas social workers need to undertake longer term casework to meet their clients needs. Also, financial constraints can influence the ability of a team to practice effective collaborative working. McCray notes that when budgets and resources are limited, the issue of who will pay for the intervention can also create tension within teams. Even if practitioners wish to work collaboratively, their managers may be less able to facilitate this due to budgeting constraints, and may therefore place restrictions on the amount of collaboration that can tak e place. Irvine et al (2002) considers that differing value systems between professions may also contribute to problems with the determining of priority of certain cases. The senior nurse may have decided that she would prioritise Daniels well-being over the values of Jo. Different professions or grades will see patients needs as being at different levels of importance as their aims and goals for the patient will be dissimilar. This can create problems and sources of conflict between different grades of nurses and some, such as the senior nurse may feel as though their patients needs are being ignored or devalued mainly in this situation by Jo or the doctor who is looking after Daniel. Hudson (2002) also explains that issues relating to professional status also have implications for inter-professional relationships. Health and social care professions in particular have very different levels of training, education and legal restriction. In this case, it seems that the senior nurse is devaluing Jos opinions and knowledge and sticking to her own. All the barriers discussed can create stress and tension between team members. Irvine et al (2002) state that professional structures are differentiated by demographics; the size of the occupations membership; gender composition; the class of origin of its members; educational attainment; status and the relative size and source of primary income. These differences are all quoted as barriers to inter-professional working. What have I learnt? By analysing this scenario I have learnt many attributes which contribute to effective patient care and working in a team.