Essay on Shelby Footes Shiloh - 1669 Words

Shelby Footes Shiloh In the novel Shiloh, historian and Civil War expert Shelby Foote delivers a spare, unflinching account of the battle of Shiloh, which was fought over the course of two days in April 1862. By mirroring the troops movements through the woods of Tennessee with the activity of each soldiers mind, Foote offers the reader a broad perspective of the battle and a detailed view of the issues behind it. The battle becomes tangible as Foote interweaves the observations of Union and Confederate officers, simple foot soldiers, brave men, and cowards and describes the roar of the muskets and the haze of the gun smoke. The authors vivid storytelling creates a rich chronicle of a pivotal battle in American history. This†¦show more content†¦This is a really small book (just over 200 pages) and while the images are graphic and the characters accessable, the author just doesnt have the space to spread out and let the reader develop a real emotional response to these characters and their actions. Nor is he able to provide any perspective on the battle and what it means - even for the individual characters he has presented. I think it helps to have read the section in his narrative history of the Civil War that deals with Shiloh. But this means that the novel doesnt really stand on its own. The reader must come equiped with prior knowledge or be left with questions that will require some research. Perhaps not bad, but I would have preferred a more comprehensive treatment - something more like Tom Wickers Unto This Hour. Thats just personal taste. Foote did what he intended and did it well. I cant help it if I just want more. Fans of Shelby Footes massive three volume Narrative History of the Civil War, (and I am the works biggest fan), will surely find something they like in Footes earlier novel about the battle of Shiloh. I couldnt help thinking, however, that Footes real calling is as historian and commentator, and his effort to write a novel here seems to be a bit off the mark. Perhaps unfairly, novels of the Civil War tend to get compared to Michael Shaaras brilliant Killer Angels, a comparison that does not bode

The Topic of Defiance of Societal Rules in The Stranger...

All societies have societal norms and rules that citizens are expected to follow. Those who don’t, are either labeled as defiant or as a non conformist. One who defies societal rules doesn’t necessarily disobey deliberately, but rather because one’s own beliefs dont parallel. In the novel The Stranger by Albert Camus there is a prevalence of characters breaking societal rules, but as a result these characters face the consequences. Albert Camus connects these actions to the overarching themes of the books in order to convey his message more effectively. To what extent does the topic of defiance of societal rules in The Stranger convey the theme of Absurdism in the novel? The sub-themes of femininity, individuality, and isolation connect†¦show more content†¦Meursault isolates himself from the lifestyle that the society attempts to condition him, but this pressure from society isn’t understood by him. One will not realize that they are breaking s ocietal rules if they are entrapped into a world of their own and believe that that world is perfectly fine the way it is. The sub-theme of femininity is prevalent throughout the novel, however it is much more minor compared to the larger ideas Albert Camus shares. Femininity is a theme that goes hand in hand with Absurdism throughout the novel. It is through Meursaults indifference to love and women that this theme becomes present. It is not a directly expressed much like the others. Not only Meursault expresses this, but also Raymond. At the point in the novel after Raymond finds that his â€Å"girlfriend† cheated on him and used Meursault to write the letter, Raymond shares with Meursault the actions he took upon his â€Å"girlfriend† as if it were a righteous act. Raymond had â€Å"smacked her around. And then I told her exactly what I thought of her. I told her that all she was interested in was getting into the sack.’... He’d beaten her till she bled†¦.What bothered him was that he ‘still had sexual feelings for her.’† (Camus 34) And the m ere fact that Raymond only had sexual feelings shows the lack in value of women. Meursault also shares this attitude towards women, specificallyShow MoreRelatedMeursault Is An Absurdism1499 Words   |  6 Pagesan explanation, whether justified through social, scientific, or religious means. This notion creates expectations for how people should emotionally respond to events around them. However, when one does not conform to these expectations, a complex conflict arises between that individual and the surrounding society. The Stranger, a translated novella by Albert Camus, takes place in the early 1940s and revolves around Meursault, a French Algerian. Developed through a presentation of his own thoughts

Wgu Nut1 Free Essays

string(46) " is like a finger print of the assigned user\." Introduction to the Electronic Medical Record (EMR) Introduction to the Electronic Medical Record (EMR) Gary L Williams Western Governors University Introduction to the Electronic Medical Record (EMR) The new millennium has produced many changes in the world as we know it. Our national security which seemed to be impermeable has revealed its vulnerability to being breached. Remember September 11, 2001 when the hi-jacking of planes lead to the destruction of the Twin Towers in New York City, and severe damage the Pentagon in Washington DC. We will write a custom essay sample on Wgu Nut1 or any similar topic only for you Order Now Now our Healthcare System has now moved into the information highway. How you may ask, through the introduction of the EMR. So will the EMR be safe and secure? Let us investigate. So just what is the EMR? There are many formal definitions but the one that stands out and will be used today is from the Healthcare Information and Management Systems Society (HIMSS). It states: The Electronic Health Record (EHR) is a longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data and radiology reports. The EHR automates and streamlines the clinician’s workflow. The EHR has the ability to generate a complete record of a clinical patient encounter – as well as supporting other care-related activities directly or indirectly via interface – including evidence-based decision support, quality management, and outcomes reporting. (HIMSS) Within this definition there is a multitude of system components. Think of it like the multiple Introduction to the Electronic Medical Record (EMR) dividers that were found in the paper medical record. For instance, you may see headers like, medication record, order entry, nursing assessments, the plan of care, education, radiology, cardiology, etc. Under the medication tab lays the eMAR, medication history, and reconciliation. Each band with the click of the mouse will open a new file within this record. The design is formatted to follow a systematic flow with check boxes, drop down lists, or free text space to document the patient findings, activities, and assessments. The EMR will have many benefits for the entire healthcare team and the patient. By development and design with the assistance of key personnel, the EMR should flow and make documentation easier. By having a standardized flow and options to document the standards of care, documenting should become easier and provide more consistency. Take for example a urine description. You may see for color description amber, yellow, red, clear, or tea. Then cloudy, turbid, clots, or mucous followed by malodorous, sweet, or pungent. This will provide a means of potential measurement for Evidence-Based Medicine (EBM). How many patients with UTI receiving Bactrim DS have amber mucous pungent urine on a GU unit? Can you see the pattern? The EMR will assist in critical thinking as well. Your physical assessment for instance may be by body system or a complete head to toe assessment. These screens will assist the nurse in reminders of required documentation. The nurse may receive a task list for a certain procedure or required documentation of a high risk factor, such as fall precautions, to alert the bedside nurse or technician that the document is due or past due. Introduction to the Electronic Medical Record (EMR) The EMR will provide real time data and reports from various disciplines within the healthcare facility. For instance, a Vancomycin trough was ordered at 0700 and its 0900 and the IV medication is due. By selecting the laboratory tab your result will be there in front of you before the dose is administered. The same can be expected of radiology imagining results, EKG, stress test reports, a bedside capillary glucose test done by the technician. No more searching through multiple computer systems or piles of lab results to find the data you need. The information is there and readily available. Healthcare providers have the penmanship of a deranged mad scientist. How often do you have multiple nurses trying to determine what Dr. Hyde just wrote? What if you guess wrong? Now you place that call to Dr. Hyde for clarification when you have a multitude of things to be doing. With Computerized Provider Order Entry (CPOE), no longer will guessing what was written be an issue. Standard order sets will be available with the opportunity to be individualized or modified from a pre-determined list of ommon orders for routine admission or for specific disease processes like the Acute Myocardial Infarction. Included may be diet, activity, vital signs, IV fluids, labs, EKG, PCXR, or consults. As touched upon earlier with the urine sample report, there is a myriad of potential data that can be extrapolated to form reports for research and to assist with the EBM. What is the average number of days for patients on the ventilator for June, 2011 ? How many patients in the rehabilitation unit have pressure ulcers? Maybe a nurse says to the unit manager that it seems like a large number of the patients on the unit have C- Difficile? A report can be run to show Introduction to the Electronic Medical Record (EMR) trends of the patients with this condition. Maybe it’s a hand washing issue or cross contamination from multi-use bathroom facilities. There are many opportunities that would at best have been difficult to track from the old paper medical record. Identity theft is rampant in this world of technology. How will the EMR be secured? How can the nurse access the EMR? Today home computers are almost essential. The same virus and malware that affect your home computer can infect the EMR if security is lacking. The Information Technology team will provide the overall security for the system by continuous upgrades to software like antivirus and firewall protection. Each team member will be issued a unique log-in and password to access the EMR. This must be kept strictly confidential for the nurse’s protection. This secure log-in is like a finger print of the assigned user. You read "Wgu Nut1" in category "Essay examples" When the EMR is accessed, there is a time stamp of what records were accessed, for what length of time, and by whom. A secure trail of entry into the EMR can be traced. What is the Personal Health Record (PHR) and how does it differ from the EMR? The PHR is essentially the same document that you would produce in the Physician’s Office. The PHR can be completed online either through a Physician’s Office or through an outside resource. Things that would be included in the PHR might be your name, address, telephone number, date of birth, and possibly the social security number. This record could also contain your Physicians name and phone number, the list of your current medications and dosages, a list of current and Introduction to the Electronic Medical Record (EMR) past medical conditions, and passed surgical history. This type of a record is usually maintained by the patient themselves. The PHR will differ from the Electronic Medical Record in that the Electronic Medical Record is property of the Health Care facility and not the consumer. The personal health record becomes more vulnerable to breaches in security since it is maintained by the consumer. For example, I might give my sign on and password to my family or friend to input data for me. This obviously breaches ones security. This allows access to these individuals to alter ones personal health record at will. The website that maintains the personal health record may not be as secure as that of the Health Care facility. The Electronic Medical record is usually maintained by the healthcare facility, outpatient clinic, or Physician’s Office. These healthcare facilities must maintain high security to protect the information within that medical record. In 1996, Congress passed a law entitled The Health Insurance Portability Accountability Act (HIPAA). This law was designed: -To improve portability and continuity of health insurance coverage in the group and individual markets. To combat waste, fraud, and abuse in health insurance and health care delivery. -To reduce costs and the administrative burdens of health care by improving efficiency and effectiveness of the health care system by standardizing the interchange of Introduction to the Electronic Medical Record (EMR) electronic data for specified administrative and financial transactions. -To ensure protecting the privacy of America ns’ personal health records by protecting the security and confidentiality of health care information. (James) The security and confidentiality are paramount. Fines are levied as a result of a breech to the HPPA law. There must be alerts to vulnerabilities, safeguards to help protect the EMR and the Information Technology team must be able to identify possible threats. Using an EMR (electronic medical record) has no absolute right and wrongs in either computer equipment or software for HIPAA compliance. Usually there are four areas to examine: -Physical Security – can your computers with patient data be stolen? -User Security – can anybody log on to the patient database? -System Security – what happens on a hard drive crash? -Network Security – can unauthorized persons outside your facility access patient data? Milne, 2006) Security is never easy to maintain; it requires continuous safeguarding. As a team we are all responsible to assist in the security of the EMR. Always log on and off when you are no longer Introduction to the Electronic Medical Record (EMR) using the bedside computer. Always check before charting that it is indeed you that is longed into the system and that only one patient record at a time is open for use. The EMR can be a valuable tool for Quality Improvement (QI). Through the design phase, a number of measurable data can be built into the EMR for report generation. If the team wanted to look at the number of times vital signs were not documented as dictated per Policy Procedure. This data can be built into the system and reports run daily, weekly, or monthly. The same thing can be built to monitor for overdue or omitted medications. This can be further expanded to identify which team member is involved and to check for trends. Data may also be collected to support EBM. For example, tracking the effectiveness of two different antibiotic treatment regimens of a selected disease process may be used to support a change in the disease treatment (e. . antibiotic A showed improvement in five days where as antibiotic B showed improvement in ten days. ) Here again the possibilities seem endless. Think of the time savings for all the key people that would be required to look through endless paper medical records for this type of data collection in the paper medical record. So how does the EMR come to fruition? It takes a large team of various specialtie s and specialists to develop the EMR. It starts with the Healthcare system researching and then purchasing the best system to fit the company’s needs and requirements. Once purchased, the owner of the software will deploy a team of specialists that will assist the Healthcare systems team to design and develop the contents and flow of the EMR. The team includes senior management which will assist in the purchase and be the governing authority of the proposed Introduction to the Electronic Medical Record (EMR) work flow before implementation. There are many subdivided teams. Nursing will have Subject Material Experts (SME) that will be the voice to assist in the flow, wordage, and design of the nursing components of the EMR. The SME’s will be from every department of nursing. From this group will be the Super User. The Super User will act as the cheerleader for the project development and will be the main source for assisting with the Go Live of the EMR. The Information Technology (IT) will be a multi-tiered group ranging from System Support Analyst or the front line of communication, the Computer Programmers and System Analyst or the builders and troubleshooters, to the Project Managers or the supervisors of the IT team. Nursing will also have the Clinical Informatics Application Analyst who will be the voice between nursing and the technical side of issues, concerns, and development. The End User which is the front lines of nursing and everyone that will be using the system for documentation. And last but not least will be the Educators that will teach the system to the entire team. This is a rather large of individuals working as the voice of the EMR development and implementation. In conclusion, change will be rough at times but change is necessary for progression. Be positive and listen to the teams and the tips that are offered. Assist each other as support with the continued learning and development of the EMR. The Technology age is here and we should all reap the benefits of this endeavor. Remember how Florence Nightingale was the frontier to nursing as we know it. Well each of you deserves a pat on the back as you are the pioneers that have lead nursing into the technology phase of the Electronic Medical Record. You too are a part of nursing history. References HIMSS. (n. d. ) EHR Electronic Health Record. Retrieved from http://www. himss. org/asp/topics_ehr. asp James, R. (n. d. ) What is HIPPA? Retrieved from http://www. dhmh. state. md. us/hipaa/whatishipaa. html Milne, M. (2006, March 6). HIPAA in a â€Å"Nutshell† – Guidelines for EMR and Paper Medical Records Compliance. Retrieved from http://ezinearticles. com/? HIPAA-in-a-Nutshell—Guidelines-for-EMR-and-Paper- Medical-Records-Complianceid=156737 Ten open ended questions. 1. When the EMR is first implemented on your unit, how can you assure the patient that you are competent in your profession? You will explain that you are a seasoned nurse and an expert in the nursing field. Today our facility is introducing the new EMR which will benefit you in the future. This will take a little more time for me to learn and I do not want you to feel like you are being ignored. I may have to ask you a lot of questions as I go through each section. Please feel free to ask me any questions or concerns that you may have. Our goal is your comfort and safety though the high quality of care. 2. On the day of Go-Live, how can your unit best assist you in providing support as you learn this new technology? My unit manager should over staff initially as we learn the new system. I can foresee the nurse being so buried in the computer that the delivery of care might be too slow initially. Having the extra staff will decrease the patient load and allow extra hands to assist with the delivery of care. 3. As you learn the new system there will be some anticipated frustration. How can you divert this frustration so that your patient doesn’t sense that something is wrong? We will need to have the Super-User and Analyst available to assist us as problems or concerns occur. It is imperative that the bed side nurse remain positive an up beat as we learn. I suggest maybe huddles through out the day away from the bed side to discuss our concerns. We don’t want the patient to feel uncomfortable. 4. Your patient asks you why it is important to have the computer charting. Briefly tell me what you might say and why? The EMR is being implemented throughout the area as well as world wide. As you record develops, we will only need to verify some of your past medical history, allergies, medications, etc. These types of data will flow from one visit to another making you care easier as the data is readily available. No more waiting for old charts to arrive and thumbing through page after page of data to look for pertinent information. 5. How do you perceive future benefits of an interoperable EMR? It will be possible in the future as the EMR progresses, that your hospital record, physician office record, out patient records, and pharmacy to communicate with each other. By doing so, some potential errors may be thwarted. For instance, maybe you are not able to recall all of your home medications and your consulting physician decides you need a new blood pressure medication. If the records could speak to each other then this physician would be able to see that you were already prescribed an antihypertensive medication or the pharmacy might catch the possible error. 6. Futuristically, let’s say you take a dream vacation to a foreign country. While on your visit you become ill and collapse unconsciously. How can the interoperable EMR potentially be a benefit in this case? If the system develops into a world wide communication link, then with limited data perhaps the hospital in the foreign country would be able to access and utilize my EMR to provide answers in how to deliver the best possible care for me. So if I went in with a suspected ruptured appendix, by accessing my EMR surgical history it would be noted that I have had an appendectomy ten years prior so the focus could be directed at another possible cause. 7. Your patient states to you that she hates the computer and that it is the devils advocate. She is tearful and appears anxious. How might you handle this as you are in the middle of documenting in the EMR? You should stop what you are doing and maybe sit beside the patient and gently hold her hand and ask what seems to be troubling her? She might say she feels the nurses spend more time touching the computer and no time touching her, as you just did, and that we come across as cold and not caring. We need to realize that patient interaction is still paramount to the overall delivery of care. Take time to interact with the patient. Then step back and document; perhaps explaining what you are documenting and why it is important to her care. 8. What do you anticipate will be your plan of action when the computer system is down? What will be your back up plan? If the computer is down for a set amount of time, as determined by the hospitals administration, then the paper chart will be utilized. If the downtime is for an extended period of time, then this data would be scanned into the EMR as soon as possible after the computer system is back on line. If the duration was short, say an hour or so, then this data should be manually documented back into the EMR with the assessment time documented. 9. How do you anticipate computer physician order entry being a benefit? For one legibility! No more trying to decode what you think may have been written. It will be clear and concise. Also the physician may be able to look at documentation form somewhere other than the patients unit and decide orders need to be given. He can simply do computer order entry and a task will appear for new orders. If the order is anything other than routine, a call should be placed to alert the nurse of the priority. 10. What do see as a benefit to Quality Improvement by the institution of the EMR on a unit basis? We will be able to track data at a faster and higher accuracy a opposed to thumbing through paper record after record searching for data collection. The data collected can be as concise as to a particular nurse or a specific health issue. The data collected helps to support EBM change. How to cite Wgu Nut1, Essay examples

Develop Your Marketing Skills

Questions: 1. What type of new product do you think Hololens is is it an innovative product, a replacement product, or an imitative product? Explain your reasoning with respect to the definitions of these three types of new products in Richardson and Gosnay (2011) and the potential features of Hololens. 2. What stage of the product life cycle do you think virtual reality technology is in general right now? Also, what stage of the product life cycle do you think Microsofts Hololens augmented reality technology is in?3. Based on the most research you have been able to find on Hololens, what steps in the new product development has Microsoft already completed? Which of the remaining steps that they have not completed do you think will be the most challenging or most crucial? Refer to either the eight stages of the new product development process in Richardson and Gosnay (2010) or the six phases discussed on pages 158-161 of Paley (2007). Answers: 1. The change in the desired previous technology is mainly to add new features to it or is for bringing innovation to the product. HoloLens is basically a type of virtual reality technology which helps in providing the desired and unmatched 3D experience to the respective users. The technology of providing the virtual reality experience to the customers was launched in the 1990s via the video games to the consumers ("Googles latest accomplishment: refining marketing practice", 2012). In this HoloLens, the level of emersion is a bit on the higher side it is enabled with latest and newest forms of computing in which the computer system could be seen as the desired living room of the concerned person. The innovativeness of a product is determined by the creativity and the desired change in it as per the new trends throughout the market segment in order to enhance the experience of users. Moreover, the innovation refers to the desired creation of the original products in a new form as to enhance the reliability and satisfaction of customers or one can say the improved version of the original products. the replacement product refers to the replacement of some of the parts as to improve the product and imitative products define those products which are new for the firm but already exist in the desired market segments (Hult, Pride, Ferrell, 2014). Therefore, the compact of the HoloLens is newer for the firm but it has already been launched in the 1990s as the virtual reality and was used especially for the video games. The potential features of HoloLens reveal the 3D experience to the users and it provides a unique visual experience like the dining room of the concerned user. The hardware consists of several features as it offers 3D specialized sound. Wide angle camera which can provide a view of 120 degrees and moreover it offers the connection through Wi-Fi connectivity. Besides CPU and GPU it consists of a holographic processing unit (HPU) which mainly integrates as well as processes the real data revealing the holographic data to provide an unmatched experience to the concerned users. 2. Virtual reality The virtual reality technology can be considered to have the growth of the concerned product life cycle which can be modified in several ways as to enhance the customer satisfaction. The growing stage refers to the certain modification which can be done as to enhance the reality of the desired product and to enhance the user experience in order to increase the selling of the respective product (Kahn, Kay, Slotegraaf, Uban, 2013). Therefore the virtual reality technology was launched in the 1990s in order to enhance the visual and gaming experience of the gamers and therefore there it currently requires certain latest modification to increase the satisfaction of the customers. It provides the only visual gaming experience to the gamers and it has been also used by any industries to provide training to their respective employees (Chakrabarti, 2013). The growth stage of this product highlights the desired measurement of the expansion of the concerned awareness for the product and attra cted a large number of users by the technology used in the product. HoloLens It has the extraordinary feature than virtual reality and offers a unique exceptional experience to the users. It can be considered on the maturity stage of the development of the product lifecycle. It fulfills the desired modification and the implementation of the new and latest feature which lacked in the virtual reality and is able to draw the attention of the users for the purchase of the product. Microsoft has fulfilled all the needs that the customers can ask for having a true and real experience related to the visual and the sound technology (Garg, 2010). The firm is expecting that the product will be helpful in analyzing the desired data required for the medical purposes and for standardized computing and gaming experience (Ritchie, 2009). The Wi-Fi connectivity along with the unique 3D sound system enhances the reliability of the users and therefore it can be categorized in the maturity stage of the product lifecycle. 3. Yes, Microsoft has successfully brought up a new enhanced product in order to fulfill all the demands of the users. There are some of the crucial stages in the development of the new product for any of the firm, which is mentioned below: Generating Using the desired strengths and the weakness of the SWOT analysis is considered to be very important for the development of the product which is going to be launched in the concerned market segments. Lean, Scalable and mean are some of the vital points that need top analyzed before the development of the product (Richardson Gosnay, 2011). For some of the firm, the development of the multiple versions is required in order to enhance the reliability of the concerned users. Screening of the idea Integration of the new and innovative ideas is crucial as it reflects in improving the product as per the satisfaction of the customers. Moreover, the product needs to attract the users by providing the latest technology which can be beyond the expectation of some percentage of the users within the concerned market segments. Testing of the concept The concept needs to be tested by the experts and it is the fundamental stage of the product development (Richardson Gosnay, 2011). HoloLens has been tested by Microsoft in order to make it free from errors and to provide complete and unmatched experience to the users. Analysis of the business It reflects the need for the capital investment required to manufacture the product. Marketability tests Private test groups and launching of the different user versions improve the overall reliability of the product in front of the customers (Richardson, Gosnay, Carroll, 2010). Development of the product It reflects the strategic stage for the product development and it follows the diversified procedure in meeting the expectations of the clients. Commercializing It helps in revealing that the product has gone throughout mainstream, the clients are purchasing the good and moreover the technical support needs to provide and monitored. Launching of the product This is the final stage and the product is launched with effective communication technique as to increase the selling of the product. Microsoft needs to complete one more stage in the above-mentioned stages which is commercializing of the product as revealing the customer's response and providing them the desired technical support may be required. References Chakrabarti, A. (2013).CIRP design 2012. London: Springer. Garg, K. (2010).Mobile computing. Delhi: Dorling Kindersley (India). Googles latest accomplishment: refining marketing practice. (2012).Journal Of Consumer Marketing,29(3). https://dx.doi.org/10.1108/jcm.2012.07729caa.002 Hult, G., Pride, W., Ferrell, O. (2014).Marketing. South Melbourne, Victoria: South-Western Cengage Learning. Kahn, K., Kay, S., Slotegraaf, R., Uban, S. (2013).The PDMA handbook of new product development. Hoboken, N.J.: Wiley. Richardson, N. Gosnay, R. (2011).Develop your marketing skills. London: Kogan Page. Richardson, N., Gosnay, R., Carroll, A. (2010).A quick start guides to social media marketing. London, UK: Kogan Page. Ritchie, C. (2009).Marketing. Harlow: Financial Times Prentice Hall.