How and Why Starbucks Is Affected By both Internal and External Essay

How and Why Starbucks Is Affected By both Internal and External Challenges - Essay Example This paper illustrates that increased globalization and trade liberalization of markets has resulted in the facilitated growth of international business. However, together with opportunities for increased revenues and new markets’ potential, many firms have faced with a challenge of managing organizational behavior in different environments. Organizations, especially those that operate in multiple regions or continents are continuously exposed to divergent legal, political and socio-cultural environments. One of the great examples of such organizations is Starbucks Corporation. Starbucks is a leading multinational corporation operating in the specialist coffee retailing sector. Its values share in the world coffee shops category has reached 0.7% in 2013. While the company’s largest business unity is in the US (63% of sales), it has managed to establish a substantial international presence. The company pursues a strategy of global business expansion. As the company opera tes in numerous international markets it faces with various external factors that influence the company’s strategy and operations. In order to overcome all these challenges and other difficulties, it is vital for a business organization to have efficient and appropriate organizational structure. The company has implemented a functional organizational structure and combined it with a divisional approach, whereas organizational structure is comprised of various departments and divisions that are responsible for performing different functions. After Howard Shultz, the founder of the Starbucks returned to the organization as the CEO in 2008, he has introduced some transformational changes to the organizational structure. The company has decreased the number of partners and the number of existing positions, and also reduced its workforce. Furthermore, in 2012, the company has redefined its organizational structure of retail business focusing on geographic principle and identifying three-region structures: Americas (US, Latin America, and Canada), China/Asia Pacific, and Europe, Middle East and Africa. Thus, the company has supplemented its structure with geographically based divisional structure design.

Killing Custer Book Review Essay Example for Free

Killing Custer Book Review Essay From time to time, a book of true historical significance is written on a subject that has been written on almost endlessly. The Battle of the Little Big Horn is one of the most written about, speculated on, celebrated, talked about, and glorified events in American History. Popularly known as Custers Last Stand, it has been the subject of many films, documentaries, novels, and was even re-enacted at every Wild West Show put on by Buffalo Bill Cody. In the work Killing Custer: The Battle of Little Bighorn and the Fate of the Plains Indians, Welch and Stekler do an excellent job in the subject matter at hand, and come to the correct conclusion that this battle, which was a huge military disaster for the United States, directly resulted in an even greater disaster for the Indian victors who won it: that is, total defeat and total subjugation. The first chapter sets up the massacre of the Blackfeet on the Marias River, James Welch and Paul Stekler have done a magnificent job in researching and putting forth, a new book on this subject that has been so written about. Citing much of the new discoveries, that is archeology, and the Indian accounts, Welch was originally contacted by Stekler to do a script for a documentary for PBS’s â€Å"American Experience: Last Stand at Little Bighorn†. They worked on it together, and that particular one hour documentary was excellent. Feeling that he hadn’t exhausted the subject, Welch delved more deeply into it, and wished to write a book on the subject. â€Å"Killing Custer† was the result, and it is quite excellent indeed. It is a stunning and thrilling read from cover to cover. The information is not wholly new, but Welch and Stekler combine all of the newest discoveries into one stirring volume, and they stress the narratives, which in the past were largely discarded and disclaimed, of the Indian accounts of the battle, after all, they were the ones who survived it! The authors rightly put the battle into its historical perspective, pointing out that this huge defeat of the United States Military led directly to the total subjugation and defeat of the Plains Indians, putting them on reservations once and for all, with the final defeat and insult at Wounded Knee, the massacre that was so unnecessary and so tragic.

Anthrax :: essays research papers

Anthrax is the preferred biological warfare agent because: It is highly lethal. 100 million lethal doses per gram of anthrax material (100,000 times deadlier than the deadliest chemical warfare agent). Silent, invisible killer. Inhalational anthrax is virtually always fatal. There are low barriers to production. Low cost of producing the anthrax material. Not high-technology. Knowledge is widely available. Easy to produce in large quantities. It is easy to weaponize. It is extremely stable. It can be stored almost indefinitely as a dry powder. It can be loaded, in a freeze-dried condition, in munitions or disseminated as an aerosol with crude sprayers. Currently, we have a limited detection capability. What is Anthrax? Anthrax is a naturally occurring disease of plant eating animals (goats, sheep, cattle, wine, etc.) caused by the bacterium Bacillus anthracis. It is an illness which has been recognized since antiquity. Anthrax was common in essentially all areas where livestock are raised. Intensive livestock immunization programs have greatly reduced the occurrence of the disease among both animals and humans in much of the world, an most outbreaks occur in areas where immunization programs have not been implemented or have become compromised (primarily Africa and Asia; however, outbreaks occurred during the mid- I 990's in Haiti and the former Soviet Union). Anthrax spores can remain viable for several decades under suitable environmental conditions; thus, absence of cases does not equate to absence of risk. Humans can contract anthrax in three ways: Through cuts or breaks in the skin resulting from contact with an infected animal (cutaneous anthrax), resulting in local and possibly systemic (bloodstream) infection. From breathing anthrax spores (termed "woolsorters" disease) resulting in an infection of the lungs (inhalational anthrax). From eating infected meat, resulting in gastrointestinal infection (gastrointestinal anthrax). Gastrointestinal anthrax is generally not considered a threat to U.S. forces. What are the symptoms? Symptoms of anthrax begin after a 1 to 6 day incubation period following exposure. For contact or cutaneous anthrax, itching will occur at the site of exposure followed by the formation of a lesion. Untreated contact anthrax has a fatality rate of 5-20 percent, but with effective antibiotic treatment, few deaths occur. Initial symptoms for inhalational anthrax are generally non-specific: low grade fever, a dry hacking cough, and weakness. The person may briefly improve after 2 to 4 days; however within 24 hours after this brief improvement, respiratory distress occurs with shock and death following shortly thereafter.

Importance of Initial Consultation and Ethical Issues Facing the Therapist

Introduction This paper discusses why the initial consultation is so important and what factors an ethical therapist will cover in this aspect of the therapy process. It also tackles the ethical issues besetting a therapist in the conduct of his profession dealing with psychotherapeutic counseling and hypnotherapy and counseling skills. The role of a therapist in the behaviour alteration of his or her client is so vital that it is necessary to observe some ethical considerations in the practice of his profession. Importance of initial consultation An initial consultation is the first of the stages of psychotherapy and generally includes a discussion of the reasons as to why the client is seeking psychotherapy help and what he is hoping to obtain from the experience. Why it is important is because it provides an opportunity to find out whether the needs, interests, and goals of the client fit with the skills of the therapist. This stage also provides the initial clarification about the limits of confidentiality, therapeutic approach, and other terms of professional services. Moreover, the initial consultation helps both the client and the therapist to gauge whether each is likely to be able to work with the other successfully (Plante, 2011). The importance of initial consultation is also found in making a formal determination of the client’s fit for a psychotherapeutic relationship and potential for meaningful change (Klonoff, 2010). Whilst informed consent is shown as important in the therapy process, with a clear descr iption of the limits of confidentiality, full informed consent to treatment has been mandated by ethical guidelines. If for example, a client approaches a therapist for initial consultation, informed consent to treatment may involve information on behavioural therapies demonstrating effectiveness and rapid changes in the treatment of the behavioral problem that the client is complaining about (e.g. panic) (Weiner and Hess, 2006). Further, initial consultation is important because it is where a range of decisions are in terms of whether to schedule a second session. For example, the client may evaluate whether it is adequate to have his or her needs be met by working with the therapist, as well as whether the practical terms of the therapy are acceptable to the client. In addition, considering the information thus provided during the consultation session, the therapist may ascertain whether he or she possesses the needed expertise to work effectively and successfully with the client (Klonoff, 2010). Another importance of initial consultation is that it allows initiating a collaborative relationship between the client and the therapist and evaluating initial consultation efforts. If the therapist happens to assess a need for consultation services, then the entry stage would then initiate a consulting relationship. The value of initial consultation is seen in the establishment of a voluntary and collaborative consulting relationship between the counselor and the client. Different role expectations can lead to resistance on the part of the client, which thus necessitates a vital importance of agreement relating to role expectations to reduce such potential resistance. An initial step in evaluating a client’s condition is establishing an accurate diagnosis, which is done during the initial consultation (Boylan et al., 2011). Much as the above are important for conducting an initial consultation, it is also because such consultation may potentially lead the client not to continue further services. The client may come to a decision that the therapist, for some reason, cannot adequately meet his or her needs. For example, he or she may find the therapist as being too direct, aloof, expensive, inexperienced, young, old, etc., and thus may conclude that the therapist’s qualities are not fit to his or her needs. The client may also feel better after the initial consultation and may no longer feel compelled to continue further sessions. Similarly, the therapist may decline from providing continued services for a variety of reasons, such as the client’s revelation of an alcohol problem, about which the therapist might decide to refer him or her instead to a specialist in the treatment of problems relating to substance abuse (Plante, 2011). Alternatively, there are times that patients are referred by their physician right after discharge from an inpatient rehabilitation setting. Of note, the one seeking therapy for the patient is in fact not the patient himself but the patient’s family. Perceptive health care professionals are the ones who usually recognise a need for psychotherapy by the patient, with an emphasis on coping, psychoeducation, and deficit adjustment. Therefore, it must not always be assumed that it is the client who is motivated to seek psychotherapy (Klonoff, 2010). In cases of patients being considered for psychotherapy, a physician’s referral is needed, in which relevant medical records must be acquired to determine whether the patient is appropriate for therapy as well as whether he or she anticipates potential psychotherapeutic needs and challenges. It is during the initial consultation in which records are presented after being obtained and reviewed in advance in order for the therapis t to thoroughly understand what the client has gone through or is going through (Klonoff, 2010). Therefore, without the initial consultation, psychotherapeutic intervention might not be sufficient and effective enough. Ethical issues faced by therapists The psychotherapist is guided by ethical standards and codes that provide professional standards aimed at guiding their ethical conduct (Kohlenberg and Tsai, 2007). One ethical issue faced by a therapist in terms of initial consultation is whether to provide the consultation free of charge to the client, as some clients who have taken up this offer tended to decide to continue in counseling because of being obliged to do so. This would prompt a concern whether the therapist has violated any portion of the code of ethics (Welfel, 2013). There are some who do not charge for initial consultations, and it is important that the client is informed whether the therapist does or does not charge for the first session (Wheeler, 2014). A potential problem may ensue with the use of a free initial consultation. This is because clients may feel committed after the initial consultation and may have difficulty declining further treatment because the initial consultation was free of charge. Some mig ht even regard this practice as taking advantage of clients and may perhaps be seen as undue influence mentioned in the code of ethics (Welfel, 2013). Another ethical issue that may ensue during initial consultation is sexual attraction between the client and the therapist, which is identified as a boundary ethical issue (Houser et al., 2006). The client may have emotional or sex-related problems that he/she initially presents to the therapist, which the therapist must approach objectively. Albeit discussion of these feelings can foster therapeutic progress, it is still unethical and counter-therapeutic to act on them. Even when it may seem sound to become sexual with a client with sexual problems as an intervention, engaging in such unethical activity is definitely against established ethical standards and codes. Rather, the best intervention that the therapist may adopt for his/her client with sexual problems is sex therapy with the client and a significant other.The several malpractice suits filed against therapists relating to sexual relationships with their client only confirm the unethical and counter-therapeutic stance of se xual relationship between the therapist and client (Kohlenberg and Tsai, 2007). Even at the onset of the initial consultation, sexual attraction may already spark, which the therapist, being the more responsible person, must put a wall against. Emotional tyranny is also a common ethical issue that may occur even during an initial consultation. It is a term describing abuse of power by psychotherapists to the disadvantage of their clients, caused by the power imbalance between them. For example, during the initial consultation, the therapist’s power is seen in how he establishes the therapy session, how long the session should last, how often he and the client should meet, how much the session costs, and what the permissible and impermissible behaviour must be within the session (Kohlenberg and Tsai, 2007). The realm of ethical decision-making involves the aspects of ethical dilemma, the client and the therapist’s values, race, gender, personal history, etc.; local and national laws; professional knowledge; and codes of ethics (Houser et al., 2006). The therapist may also face violations relating to dual relationships. Such relationships are nonsexual that may involve counseling a friend, relative, or neighbour, as well as receiving referrals from people who know the client and the counseling process. An ethical dilemma of dual relationships may potentially occur when the therapist has several roles with a client; in that apart from being a client, the person is also a friend, a neighbor, a relative, etc. to the therapist. It has been suggested that accepting referrals from existing clients may constitute a boundary violation (Houser et al., 2006). Indeed, even at the initial consultation, the therapist is already face-to-face with the issue of whether to continue with the professional relationship, or terminate it right away upon seeing his or her friend across the table as a client seeking therapy. Self-disclosure is another ethical issue besetting the therapist. Even during the initial consultation, the issue of self-disclosure may occur. Relating to this issue, it is important to determine the extent of information a therapist should share with the client and the types of self-disclosure to be made as well. Another example of ethical issue involving boundary is socialising with a client outside the counseling session and negotiating for fees (Houser et al., 2006). One possible ethical dilemma facing the therapist during is confidentiality, which deals with maintaining privacy and non-disclosure of information to others outside the counseling relationship, unless the client expresses consent to do so (Jenkins, 2007; Houser et al., 2006). Whenever the client enters the counseling room for the first time, he or she already expects that anything being discussed with the therapist would be kept confidential. It has been found that violations of confidentiality were a common complaint made against therapists and counselors. The client, even in the initial consultation, already begins disclosing some personal matters to the therapist, which the therapist is expected to keep confidential as his legal duty. Of important note however is the fact that confidentiality is not absolute and that there are times in which the therapist may divulge certain information a necessary (Corey, 2013; Houser et al., 2006). Examples of these are those surrounding harm that may involve the client who is contemplating about suicide or is expressing thoughts about inflicting harm to others; court-involved clients; child abuse reports; and clients with medical conditions who express engaging in precarious acts relating to their condition (e.g. HIV) (Houser et al., 2006). Further, it was found that successful outcomes ensue when clients change their personal values and take a close resemblance of that of the therapist/counselor. A relevant ethical dilemma with regard to this is in order for the counseling to be successful, how similar the client’s values must be to the counselor. Moreover, another dilemma is whether fostering such similarity is ethical and helpful enough to the client. A question for the profession is whether therapists utilise moral and ethical frameworks reflecting society’s norms as the only basis of their ethical decision-making, or whether therapists come to an ethical decision whilst taking into account the values, morality, and ethical stances of their diverse client population (O’Donohue and Fisher, 2009; Houser et al., 2006). These issues are being dealt with even upon an initial consultation. Conclusion This paper dealt with the importance of initial consultation and the ethical issues facing the therapist in the performance of his profession. An initial consultation is important because it forms the basis of the client’s diagnosis. It generally covers finding out the reasons as to why the client seeks help and what he or she aims to obtain as a result of the psychotherapy experience. The ethical issues faced by the therapist in the conduct of his profession during the initial consultation are those involving a decision to charge the client for a specific fee or not for the initial consultation; potential sexual attraction between them; the issue of confidentiality and client consent; emotional tyranny; violations relating to dual relationships; and self-disclosure. Having laid down these ethical factors besetting a therapist, the conclusion being arrived at is that the therapist is bound by set standards and ethical codes through which the expected functions of his performance must be based, and that he/she should conduct the initial consultation and further sessions objectively. References Boylan, J. C., Malley, P. B/, and Reilly, E. P. (2011) Practicum Internship: Textbook and Resource Guide for Counseling and Psychotherapy. Third Edition. NY: Brunner-Routledge. Corey, G. (2013) Theory and Practice of Counseling and Psychotherapy. Ninth Edition. Mason, OH: Cengage Learning. Houser, R., Wilczenski, F. L., and Ham, M. (2006) Culturally Relevant Ethical Decision-Making in Counseling. London: Sage Publications, Inc. Jenkins, P. (2007) Counseling, Psychotherapy and the Law. London: Sage Publications, Inc. Klonoff, P. S. (2010) Psychotherapy After Brain Injury: Principles and Techniques. NY: The Guilford Press. Kohlenberg, R. J. and Tsai, M. (2007) Functional Analytic Psychotherapy: Creating Intense and Curative Therapeutic Relationships. NY: Springer. O’Donohue, W. T. and Fisher, J. E. (2009) General Principles and Empirically Supported Techniques of Cognitive Behavior Therapy. NJ: John Wiley & Sons. Plante, T. G. (2011) Contemporary Clinical Psychology. NJ: John Wiley & Sons. Weiner, I. B. and Hess, A. K. (2006) The Handbook of Forensic Psychology. NJ: John Wiley & Sons. Welfel, E. (2013) Ethics in Counseling and Psychotherapy. Mason, OH: Cengage Learning. Wheeler, K. (2014) Psychotherapy for the Advanced Practice Psychiatric Nurse: A How-to Guide for Evidence-Based Practice. NY: Springer Publishing Company, LLC. Bibliography Boylan, J. C., Malley, P. B/, and Reilly, E. P. (2011) Practicum Internship: Textbook and Resource Guide for Counseling and Psychotherapy. Third Edition. NY: Brunner-Routledge. Clarkson, P. (2005) Transactional Analysis Psychotherapy: An Integrated Approach. NY: Routledge. Cooper, J. and Alfille, H. (2011) A Guide to Assessment for Psychoanalytic Psychotherapists. London: Karnac Books Ltd. Corey, G. (2013) Theory and Practice of Counseling and Psychotherapy. Ninth Edition. Mason, OH: Cengage Learning. Forrest, G. G. (2010) Self-disclosure in Psychotherapy and Recovery. Plymouth: Jason Aronson. Houser, R., Wilczenski, F. L., and Ham, M. (2006) Culturally Relevant Ethical Decision-Making in Counseling. London: Sage Publications, Inc. Jenkins, P. (2007) Counseling, Psychotherapy and the Law. London: Sage Publications, Inc. Klonoff, P. S. (2010) Psychotherapy After Brain Injury: Principles and Techniques. NY: The Guilford Press. Kohlenberg, R. J. and Tsai, M. (2007) Functional Analytic Psychotherapy: Creating Intense and Curative Therapeutic Relationships. NY: Springer. O’Donohue, W. T. and Fisher, J. E. (2009) General Principles and Empirically Supported Techniques of Cognitive Behavior Therapy. NJ: John Wiley & Sons. Plante, T. G. (2011) Contemporary Clinical Psychology. NJ: John Wiley & Sons. Weiner, I. B. and Hess, A. K. (2006) The Handbook of Forensic Psychology. NJ: John Wiley & Sons. Welfel, E. (2013) Ethics in Counseling and Psychotherapy. Mason, OH: Cengage Learning. Wheeler, K. (2014) Psychotherapy for the Advanced Practice Psychiatric Nurse: A How-to Guide for Evidence-Based Practice. NY: Springer Publishing Company, LLC.

The walam olum

Phenomena: is a fact, occurrence, or circumstance observed or observable Sentence: â€Å"Myths attempt to explain natural phenomena† (The Walam Olum) Sentence: The Walam Olum is explained in natural phenomena, based on the humans' origin, the customs, and the religion rites. 2. Pictographs: is a picture or symbol standing for a word or group of words Sentence: â€Å"Originally it consisted of a long series of pictographs explaining the origin of the Delaware people such as a result of the actions of a manito, or spirit. † (The Walam Olum) Sentence: The Walam Olum is represented by pictographs which explain how the Great Manito createdEarth. 3. Leisure: freedom from the demands of work or duty Sentence: â€Å"All had cheerful knowledge, all had leisure, all thought in gladness† (The Walam Olum) Sentence: The Great Manito fetched them food and many other things which left them to leisure. 4. Quarrel: an angry dispute or altercation; a disagreement marked by a tempo rary or permanent break in friendly relations Sentence: â€Å"And with him brought badness, quarreling, unhappiness. † (The Walam Olum) Sentence: Later, the Great Magician came to earth and brought quarreling. He brought many bad things like bad weather, sickness and also brought death. Ablution: a cleansing with water or other liquid, especially as a religious ritual. Sentence: â€Å"Soon after the ablutions were completed they heard the distant call of the approaching gods. † (The Navaho Origin Legend) Sentence: The people heard a call of the gods after they were done ablutions. 6. Protrude: to thrust forward , cause to project Sentence: â€Å"While the wind was blowing, eight of the Mirage People came and walked around the objects on the ground four times, and as they walked the eagle feathers, whose tips protruded from between the buckskins, were seen to move. † (The NavahoOrigin Legend) Sentence: After the eagle's feathers were protruded they walked up to t he buckskin, and saw that the corn had diapered and found a men and woman laying down there. 7. Constitution: the way in which a thing is composed; physical make-up; structure Sentence: â€Å"The Iroquois constitution outlines a system of laws and principles. † (The Iroquois Constitution) Sentence: The Iroquois constitution was spoken and not written; the constitution had to be presented in way that would catch the listener's attention. 8. Disposition: An inclination or tendency Sentence: â€Å"If any man or any nation the Five Nations shall obey the laws of the GreatPeace and make known their disposition to the lords of the confederacy, they made trace the roots to the tree and if their minds are clean and they are obedient and promise to obey the wishes of the confederate council, they shall be welcomed to take shelter beneath the Tree of the Long Leaves. † (The Iroquois Constitution) Sentence: 9. Confederacy: an alliance between persons, parties, states, etc. , for some purpose. Sentence: If any man or any nation the Five Nations shall obey the laws of the Great 10. Trivial: of very little importance or value; insignificant Sentence: â€Å"It shall be a rong for anyone to lead a lord into trivial affairs†¦ (The Iroquois Constitution) Sentence: Leading the lord into trivial affairs is considered to be wrong; they should respect their honorable position. 1 1 . Emblem: a sign, design, or figure that identifies or represents something Sentence: â€Å"We now do crown you with the sacred emblem of the deer's antlers, the emblem of your lordship† (The Iroquois Constitution) Sentence: He was crowned with emblem of the deer's antlers. He then, became the mentor of the Five Nations. 12. Deliberations : thoughtful, careful, or lengthy considerationSentence: â€Å"In all of your deliberations in the confederate council, in your efforts at law making, in all your official acts, self-interest shall be cast into your oblivion. â€Å"(The Iroqu ois Constitution) Sentence: All of his action will be deliberate carefully. 13. Oblivion: the condition of being forgotten or disregarded Sentence: â€Å"In all of your deliberations in the confederate council, in your efforts at law making, in all your official acts, self-interest shall be cast into your oblivion. † (The Iroquois Constitution) Sentence: All of his wrong act will be oblivion will be not only cast on him but also in his family.

Transcultural Nursing in relation to Holistic Nursing Practice The WritePass Journal

Transcultural Nursing in relation to Holistic Nursing Practice Introduction Transcultural Nursing in relation to Holistic Nursing Practice IntroductionTranscultural NursingThe Culture Care Diversity and Universality Theory by Madeleine LeiningerThe Sunrise EnablerThe Ethno-nursing MethodHolistic Nursing PracticeThe Theory of Environmental Adaptation by Florence NightingaleTranscultural Nursing vs. Holistic Nursing PracticeConclusionReferencesRelated Introduction Diversity of the world’s population has reached a point where it is vital to address and more importantly to understand, the ever growing challenge that transcultural nursing poses to the nursing profession. Addressing this issue avoids discrimination and promotes equality within holistic nursing practice in order to meet patients’ needs. Health care professionals should be qualified to deliver, on a daily basis, proficient care and sensitive skilled communication to culturally different individuals (Maier-Lorentz, 2008). To exercise professional nursing in a conceptual way holistic nursing care focuses on physical, emotional, social, environmental and spiritual aspects as well as on the idea that any individual involved in treatment care should be treated as a whole and with dignity (Dossey Guzzetta, 2005). One of the areas to be discussed is Transcultural Nursing and Leininger’s Transcultural Theory of Culture Care Diversity and Universality and its research enablers: the Sunrise Enabler and the Ethnonursing Method. Another area will be Holistic Nursing Practice and Nightingale’s Nursing Theory of Environmental Adaptation as well as the liaison between Transcultural Nursing and Holistic Nursing Practice. Nightingale’s theory has been chosen over others because she was the first to acknowledge nurses’ work in a theoretical framework and also because she was considered to be the mother of nursing practices (Ellis, 2008). The development of culture care theory introduced health care professionals into a new nursing dimension formed by issues such as culture background, spirituality, environment and others that demonstrated how culture and health care are linked (Leininger, 2002a). Holistic Nursing Practice encourages active communication and reciprocal understanding, underlines the exercise of physiological and psychosocial awareness, it is based on logical thinking and supports values such as autonomy and patient wishes and tendencies (MacKinnon, 2010). Transcultural Nursing Transcultural nursing may be defined as a method to contrast and observe how individuals view health care, biased by their culture background. The principles of practising transcultural nursing are to provide complete nursing care to individuals or groups by treating them with respect and taking into account their cultural factors. It is all about nursing practice applied to cultural values and limitations (Leininger, 1991). Definitions of transcultural nursing incorporate many factors that shape the individual’s cultural orientation. These include are age, sexual orientation and financial aspects. It has been suggested that by ignoring these culture background factors, health care professionals do not achieve enough cultural experience to be incorporated in holistic nursing practice (Barnes et al. 2000). This absence might lead to unsafe nursing care and both dissatisfied patients and professionals (Curren, 2006 cited in Leininger McFarland, 2006, pp.159-160). To promote transcultural nursing care, Narayan (2001) felt that there are four crucial attitudes to assume caring, empathy, openness and flexibility. This shows the patients a cultural understanding, appreciation, consideration and willingness from health care professionals that are based on individual care. Cultural education and the creation of culturally competent care professionals are one of the biggest challenges yet to tackle worldwide. For instance, in America, as the migrant population increases notably so it does the need for reducing inequalities and barriers such as language. Maier-Lorentz (2008) firmly understood that such a need could be met by the targeting of bilingual health care professionals coming from different backgrounds. Moreover, she suggested that in order to provide culturally competent nursing care, some knowledge of non-vocal communication signs could be of great value, as it is in eye contact, touch, silence, space and distance, and health care habits. Green-Hernandez (2004) recommended that as a step towards multicultural competency, professionals that need to deal with farmers should familiarize themselves with their specific customs such as using animal medication for their own conditions as a consequence of living far away from the care institutions. With the purpose of understanding culture, Andrews Boyle (1997) gave out diverse illustrations. For example, they suggested that by understanding a people’s proverbs, professionals may grasp knowledge of the cultural values shared by that population. The authors also stressed the importance of culture knowledge when coming across two different ways to view stealing. For one culture it may not be acceptable whereas for another one, e.g. gipsy people, it may be ok, as long as it is coming from a better-off person. Furthermore, they also found, through researchers, that different cultures may think that by being a demanding patient, the treatment they receive may improve. Riley (2004) reported that a foremost test for nurses in an ethnically different society is communication. Not just words but also tone and volume form spoken communication which in diverse cultures differs greatly. For example, Thai people are regarded as not talking too much as they believe it is a sign of idiocy whereas Cuban people are happy with talking vociferously. He also pointed out that Europeans are not afraid of talking about emotions whereas Asians are hesitant to do so. With regards to communication without words Riley (2004) explained that eye contact is not always expected. For instances, in Native America and Asian cultures it is offensive and among Muslim Arab women it is allowed only to their husbands. Therefore, he identified the importance for healthcare professionals to be culturally aware. Phillimore (2011) explored the challenge of provision of diversity needs in the UK based on studies done on health care service provision to new migrants, during 2007/08 in Birmingham. She stated that with political forces wanting to reduce welfare support for new migrants, such provision becomes quite a challenge. She also believed that, in the long run, this disregarding of health care needs will lead to further issues for the health care system that otherwise could be avoided by just providing what is needed now: cultural and language services and health support. It was also suggested that in today’s political climate offering of ethnically specific provision by the community and for the community, results in the local needs not being met, as the existing GP systems are already overstretched. She concluded that a number of migrants are condemned to an unwelcoming future since UK seems to embrace a tendency of anti-migrant sentiment and a move to community institution instead of multicultural provision (Phillimore, 2011). The Culture Care Diversity and Universality Theory by Madeleine Leininger In the 1950’s Madeleine Leininger, a nurse-anthropologist, realised that nursing practice was requiring a theory to allow people to transform nursing into a more advanced and beneficial discipline that challenges nurses to open up to cultural variety and universality (Leininger, 2006). This was developed as a response to the demand for multicultural care which was immense and yet incomplete as many healthcare systems did not consider the need for bringing together culture and nursing care (Giger Davidhizar, 2008). The culture care diversity and universality theory developed by Leininger in 1991 (Leininger, 2002a) is unique in that it focuses on competent care, can be used upon any culture and is based not only on individuals but groups and families too. The theory addresses the importance of a consistent cultural competence instrument to acquire cultural awareness through a constant learning attitude and approval towards human differences and rights by health care professionals (Burford, 2001, cited in Baxter, 2001, pp. 202-203). Leininger (2002a) insisted on the importance of transcultural knowledge as a tool to avoid human acts such as the event of September 11, 2001. She then proposed the culture care theory as the most holistic approach to gradually transform the health system. This much needed transformation requires understanding of individuals in ways that identify and respect their cultural background and will lead us to understand such transcultural dismay. The theory was used in a study among Hispanic home care patients in the US, 2007, in order to identify cultural needs. As a result, care delivery improved in some areas and there was a suggestion describing the use of the model as a tool to reduce costs in the health care system (Woerner et al. 2009). Leininger’s theory applies not only to races from different backgrounds but also to today’s controversial groups such as transgendered people, disabled people , the youth, poverty and the homeless that may pose a certain degree of difficulty of understanding to healthcare professionals. There is also an agreement that, thanks to Leininger’s culture care theory, the nursing profession today knows how to allow for culture when looking after individuals and has a widely spread   caring philosophy in hospitals (Clarke et al. 2009). For this model to assist the health care professional to understand factors as important as management and policies, as well as being able to reflect on their decisions and actions, Leininger designed two tool assessments, The Sunrise Enabler and the Ethno Nursing research method, which are based on monitoring treatment care on a daily basis (Hubbert, 2006, cited in Leininger McFarland, 2006, pp. 354-356). The sunrise enabler focuses mainly on total life ways and caring factors influencing health and well-being, disabilities and death. It also identifies features influenced by the patient’s cultural background whereas ethnonursing finds ways in which multicultural care could be better. In doing so, the reflected culture becomes part of the holistic nursing practice (Leininger, 2006). The Sunrise Enabler The Sunrise Enabler is used as an assessment tool to enable multidisciplinary teams to deliver suitable and competent cultural assessments that impede intolerance and stereotype behaviour. This is to supply the healthcare system with a guide to cultural vicinities ranging from religious beliefs to economic factors (Giger Davidhizar, 2008). Wherever a healthcare professional starts the model either from the top or from the bottom, the most important feature is to listen to the individuals, trying to grasp ideas and concepts rather than enforcing them (Leininger, 2002a). Healthcare professionals struggled to understand the meaning of factors influencing the care practice so crucial when applying the culture care theory. Such factors as culture beliefs, environment and religion were to be included in the nursing care, therefore Leininger (1997) built the Sunrise Enabler to illustrate such aspects. The Ethno-nursing Method This method was developed to fit the purposes of qualitative research methods. It is a systematic method for studying multiple cultures and care factors within a familiar environment of people and to focus on the interrelationships of care and culture to arrive at the goal of culturally congruent care. Ethnonursing is a particular research method developed by Leininger to inspect the theory. It was developed to allow health care professionals to discover new ways of helping different cultural groups distinguish features of nursing care (Leininger, 2006). Leininger (2006, p.6) stated that the ethnonursing method â€Å"†¦was new and unknown in nursing and was different from other qualitative methods including ethnography†. Holistic Nursing Practice The exercise of modern nursing is based on the view of holism that underlines the individual’s wholeness. Healing viewed as an indication of nursing practice that treats people as whole, developed in the late 20th and early 21st century into a popular subject in nursing in order to clarify the meaning of wholeness and holism. As a result, alternative therapies surfaced as approaches of practice in holistic nursing (Locsin, 2002). The definition of holistic came into effect in the 20th century. Then the word holism included the physical, emotional, mental, social, cultural, and spiritual view. This view of holism was envisioned by Florence Nightingale who is seen today as an example to follow, although many of her studies are not used in today’s nursing practice (Beck, 2010). â€Å"Holistic nursing care embraces the mind, body and spirit of the patient, in a culture that supports a therapeutic nurse/patient relationship, resulting in wholeness, harmony and healing. Holistic care is patient led and patient focused in order to provide individualised care, thereby, caring for the patient as a whole person rather than in fragmented parts† (McEvoy Duffy, 2008, Vol.8, p. 418). Furthermore, it addressed the expansion of multidisciplinary and collaborative teams as a way to applying holistic care into practice and asserted that the practice of holistic care by health professionals should avoid intrusion and, when really needed, as it is the case of unconscious patients, should use skills that include aspects such as consideration, disciplined criticism and liability in order to exercise nursing in a holistic approach (McEvoy Duffy, 2008). Since individuals from different culture backgrounds may appreciate holistic nursing practice and care choices in different ways so is the healthcare provided in different ways (Locsin, 2001). It may also be the case that some individuals may feel embarrassed to mention alternative remedies used in the past, therefore the assessment should be supportive rather than disapproving (Maddalena, 2009). Pearcey (2007) ran a study on clinical practices amongst student nurses to draw on a few key points related to holistic nursing practice. It was found that the notion of holistic care was not clear within nursing practice. Some students claimed not to know the right meaning of holistic nursing practice and also claimed that tasks and routines are what nursing is all about. The study showed an evident lack of professionalism and knowledge amongst care professionals as well as a huge gap between what is taught and what is really applied at work. The author concluded that there is a real risk of inconsistency within the profession. Within the practice of holistic care there has been lately a huge influence of alternative or complementary medicine which care experts have tried to professionalise by setting certain values to be met. A study amongst nurses and midwives accomplished in England, 2008, revealed this but also the lack of initiative from the NHS to incorporate such practices, even though it was demonstrated that a huge variety of them were successfully applied on patients where biomedicine seemed not to work. Such practices included reflexology, aromatherapy, acupuncture and massage that actually underlined biomedicine rather than substituted (Cant et al. 2011). Whilst carrying out an interview on medical students in the UK, a student suggested that it is actually a catch-22-situation when looking after patients from diverse races as they have diverse predominance of whatever conditions that eventually will require different treatment, a world apart from what is being taught in medical schools with regards to treating everyone in the same way (Roberts et al. 2008). A quick look to Harrison (2008) for a concluding comment on multicultural nursing in relation to holistic care, offers us this brief view: a Western health care organism that has not managed to treat minority communities in a holistic manner is a system that claims to care for one and all identically. The Theory of Environmental Adaptation by Florence Nightingale According to Nightingale’s Theory of Environmental Adaptation, an individual’s health is improved by looking after the surrounding environment. It goes further than this and asks for the environment to be operated by the health care professionals as an approach to healing (Howett et al.   2010). Florence Nightingale defined nursing as â€Å"†¦the act of utilising the environment of the patient to assist him in his recovery† (Funnell et al. 2009). She determined that the deficiency of factors such as uncontaminated air, clean water, sanitation, hygiene and sunlight is unhealthy to the human being. Furthermore, she reasoned that temperature, environment and nutrition affect the patient (Kozier, et al. 2008). This theory of nursing includes inspection, recognition of environment changes and their execution and supporting the patient health care by allowing the environment to benefit the patient (Neils, 2010). Selanders (2010) reviewed and compared this theory’s aspects with modern day practice and reported that Nightingale’s concept, such as air, light, noise and cleanliness is equal to today’s concept of physical environment; health recommendations to psychological environment; food to nutritional status and observation to nursing management. The author also estimated that the theory has been used in several qualitative works and some studies on the childbirth process. Transcultural Nursing vs. Holistic Nursing Practice According to Leininger (2002b) patients are not provided full holistic care by health professionals. Factors such as kinship, religion, environment and culture are largely missing. For that reason, care professionals should avoid being judgmental when delivering holistic care and rather provide an all-inclusive care that respects the individual’s cultural background (Maddalena, 2009). As a student nurse, it is vital to value the development of cultural awareness and competency within the profession in order to encourage and address all stages of holistic nursing practice as it is meaningful to today’s multicultural society. Leininger (1997) also claimed that essential practice is needed to create a regulation of multicultural nursing that could be of use to much ignored cultures. For example, acute medical treatment, medication, and patient fulfilment can be improved by understanding care beliefs when bringing in nursing care which, in turn, could save the health care system financially and also have a desired positive outcome on patients (Woerner et al. 2009). Individuals or groups may clash with health professionals if they are not showing respect for each other’s cultural beliefs resulting in poor treatment and patients losing hope in the health care system. Hogg (2010a) also underpinned this understanding as crucial to delivering accurate holistic nursing practice. However, not only patients may lose faith in the system. Hogg (2010b) also affirmed that nurses from black and minority ethnic have suffered, at some point, racial harassment as well as lack of opportunities according to their numbers in the nursing profession. As holistic nursing practice centres on recognition of patients’ rights and choices (Potter, 2005 cited in Dossey et al. 2005, p.347), it is subsequently supporting the meaning behind multicultural care. The association of both precepts confirms an ongoing engagement to pursue equality and diversity as promoted by the Nursing Midwifery Council (2008). â€Å"Inherent in nursing is respect for human rights, including cultural rights, the right to life and choice, to dignity and to be treated with respect. Nursing care is respectful of and unrestricted by considerations of age, colour, creed, culture, disability or illness, gender, sexual orientation, nationality, politics, race or social status† (The International Council for Nurses, 2005). When assessing, planning, implementing and evaluating a patient’s needs as to medication, health professionals should take into account culture’s physiologic traits, as it can seriously impact the treatment. For instances, due to genetics, for one patient a normal given dose may develop a reaction whereas for another it may not work at all (Anon, 2005). Conclusion It is obvious that cultural competency is a must when performing holistic nursing practice, in order to deliver a responsive and high quality care system. It is therefore recommended that specific cultural training should be given to all health care professionals so as to not overlook the great multi-cultural society we all are in. As society becomes more diverse, health care professionals should expand guiding principles that sponsor cultural skills as a way to deliver enhanced holistic healthcare. By carrying out this essay, the author realises the significance of treating people in a holistic way and not making assumptions just because they are from different cultures. This is something that seems yet not to be well implemented in my workplace (NHS since 2007). The author will, from now on, be more aware of his practice when caring for individuals from different culture backgrounds. It can be considered that nursing as a profession is also an example of human culture so indispensable for a in peak condition community, as seen looking through the theories of nursing and its tools presented in this paper, which if not recognized may affect the execution of holistic practice and its results, i.e. it is a profession whose culture needs to be elastic if it is to fulfil its function. References Andrews, M., M., Boyle, J., S., (1997) Competence in Transcultural Nursing Care. American Journal of Nursing. [Online]. 97 (8), pp.16AAA-16DDD. Available from: http://ovidsp.tx.ovid.com/sp-3.3.1a/ovidweb.cgi?S=EHLPFPCDPPDDHHPPNCCLKEDCHEEBAA00Link+Set=S.sh.15|1|sl_10 [accessed 20th March 2011]. Anonymous, (2005). Understanding transcultural nursing. Nursing 2005. [Online]. 35 (1) p. 21. Available from: http://ovidsp.tx.ovid.com/sp-3.3.1a/ovidweb.cgi?WebLinkFrameset=1S=IEMKFPLPLODDGHLBNCCLCBIBLGGDAA00returnUrl=ovidweb.cgi%3f%26Titles%3dS.sh.15%257c1%257c10%26FORMAT [accessed 20th March 2011]. Barnes, D., M., Craig, K., K., Chambers, K., B., (2000). A review of the concept of culture in holistic nursing literature. Journal of holistic nursing. [Online]. 18 (3), p. 209, Available from: http://jhn.sagepub.com/content/18/3/207 [accessed 11th February 2011]. Beck, D., (2010) Remembering Florence Nightingales Panorama: 21st-Century Nursing−At a Critical Crossroads. Journal of Holistic Nursing. [Online]. 28 (4), pp. 293-295. Available from: http://ezproxy.napier.ac.uk:2823/content/28/4/291.full.pdf+html [accessed 21st March 2011]. Burford, B., (2001). The cultural competence model. In: Baxter, C., (2001) Managing Diversity Inequality in Health Care. Edinburgh: Harcourt Publishers, pp. 202-203. Cant, S., Watts, P., Ruston, A., (2011).   Negotiating competency, professionalism and risk:  The integration of complementary and alternative medicine by nurses and midwives in NHS hospitals. Social and Science Medicine. [Online]. 72 (4), pp. 529-533. Available from: http://ezproxy.napier.ac.uk:2152/science?_ob=MImg_imagekey=B6VBF-51PRYF2-3-1_cdi=5925_user=132448_pii=S0277953610008294_origin=gateway_coverDate=02%2F28%2F2011_sk=999279995view=cwchp=dGLbVzb-zSkzSmd5=5ba01dbfd0bec164153cdcfb3c576b78ie=/sdarticle.pdf [accessed 31st March 2011]. Clarke, P., N., McFarland, M., R., Andrews, M., M., Leininger, M., (2009).   Caring: Some Reflections on the Impact of the Culture Care Theory by McFarland Andrews and Conversation with Leininger. Nursing Science Quarterly. [Online]. 22 (3), pp.234-237. Available from: http://ezproxy.napier.ac.uk:3158/content/22/3/233.full.pdf+html [accessed 2nd April 2011]. Curren, D., A., (2006). Culture Care Needs in the Clinical Setting. In: Leininger, M., McFarland, M.,R., (2006) Culture Care Diversity and Universality: A worldwide nursing theory (2nd ed.). Sudbury, MA: Jones Bartlett, pp. 159-160. Dossey, B. M., Guzzetta, C., E., (2005) Holistic Nursing Practice. In: Dossey, B. M., Keegan, L., Guzzetta, C., E., (2005) Holistic Nursing: A handbook for practice. (4th ed). Sudbury, MA: Jones Bartlett Publishers, pp. 32-33. Ellis, H. (2008) Florence Nightingale: creator of modern nursing and public health pioneer. Journal of Perioperative Practice. [Online] 18 (9), pp. 404-406. Available from: http://ezproxy.napier.ac.uk:2083/ehost/pdfviewer/pdfviewer?sid=965b1f56-f54c-4a4c-a8bd-1905cb576d1b%40sessionmgr10vid=1hid=18     [accessed 18th February 2011]. Funnell, R., Koutoukidis, G., Lawrence, K., (2009). Tabbners Nursing Care: Theory and Practice. (5th ed). Chatswood, N.S.W.:  Elsevier Australia. Giger, J., N., Davidhizar, R., E., (2008). Transcultural Nursing: Assessment and Intervention. (5th ed). Missouri: Mosby Elsevier. Green-Hernandez, C., Quinn, A., A., Denman-Vitale, S., Falkenstern, S., Judge-Ellis, T., (2004). Making Primary Care Culturally Competent. The Nurse Practitioner. [Online].   29 (6), p. 51. Available from: http://ezproxy.napier.ac.uk:2083/ehost/pdfviewer/pdfviewer?vid=19hid=8sid=6f3fcd96-903f-4ca3-9709-39e0b3d63d3e%40sessionmgr113 [accessed 30th March 2011]. Harrison, P., (2008). Thinking holistic, thinking integrated? Journal of Integrated Care. [Online]. 16 (2) p.44. Available from: http://ezproxy.napier.ac.uk:2083/ehost/pdfviewer/pdfviewer?vid=20hid=24sid=67bf3a85-e548-475a-ac5f-a761877ae0a5%40sessionmgr11 [accessed 31st March 2011]. Hogg, C., (2010a). Understanding the theory of health and illness beliefs. In: Holland, K., Hogg, C., (2010). Cultural awareness in nursing and health care. London: Hodder Arnold, p.16. Hogg, C., (2010b). Cultural Diversity and Professional Practice. In: Holland, K., Hogg, C., (2010). Cultural awareness in nursing and health care. London: Hodder Arnold, pp. 203-205. Howett, M., Connor, A.,      Downes, E., (2010).Nightingale Theory and Intentional Comfort Touch in Management of Tinea Pedis in Vulnerable Populations. Journal of Holistic Nursing. [Online]. 28 (4) p. 244. Available from: http://ezproxy.napier.ac.uk:2823/content/28/4/244.full.pdf+html [accessed 15the March 2011]. Hubbert, A., O., (2006) Application of the Culture Care Theory for Clinical Nurse Administrators and Managers. In: Leininger, M., McFarland, M., R., (2006) Culture Care Diversity and Universality: A worldwide nursing theory (2nd ed.). Sudbury, MA: Jones Bartlett, pp. 354-356. Kozier, B., Erb, G., Berman, A., Snyder, S., Lake, R., Harvey, S., (2008). Fundamentals of nursing. Concepts, process and practice. Harlow: Pearson Education Limited. Leininger, M., (1991). Culture care diversity and universality: a theory of nursing. New York: National League for Nursing Press. In: Leininger, M., (1997). Transcultural Nursing Research to Transform Nursing Education and Practice: 40 Years. Journal of Nursing Scholarship. [Online]. 29 (4), p. 344. Available from: http://ezproxy.napier.ac.uk:2899/doi/10.1111/j.1547-5069.1997.tb01053.x/pdf [accessed 30th March 2011]. Leininger, M., (1997) Overview of the Theory of Culture Care with the Ethnonursing Research Method. Journal of Transcultural Nursing. [Online] 8 (2), p. 32-51. Available from: http://tcn.sagepub.com/content/8/2/32.extract   [accessed 16th February 2011]. Leininger, M., (2002a). Culture Care Theory: A Major Contribution to Advance Transcultural Nursing Knowledge and Practices. Journal of Transcultural Nursing. [Online]. 13 (3), pp.189-190. Available from: http://tcn.sagepub.com/content/13/3/189 [accessed 25th February 2011]. Leininger, M., (2002b) Founder’s Focus: Linguistic Clichà ©s and Buzzwords in the Culture of Nursing. Journal of Transcultural Nursing. [Online]. 13 (4), p. 334, Available from: http://tcn.sagepub.com/content/13/4/334 [accessed 25th February 2001]. Leininger, M.,  (2006)  Culture care diversity  and universality theory and evolution of the ethnonursing method. In: Leininger, M., McFarland M., R. (2006). Culture  care diversity and universality. A worldwide nursing theory. (2nd ed). Sudbury, MA: Jones Bartlett Publishers. p. 20-22. Locsin, R., C., (2002). Culture Perspectives. Holistic Healing: A Practice of Nursing. Holistic Nursing Practice. {Online]. 16 (5), pp. ix-x. Available from: http://ezproxy.napier.ac.uk:2083/ehost/pdfviewer/pdfviewer?vid=6hid=127sid=0ac34b19-9151-40a3-aa73-db1c67bfcd63%40sessionmgr115 [accessed 30th March 2011]. MacKinnon, F., (2010). Holistic Nursing Practice. Available from: http://vista.napier.ac.uk/webct/urw/lc2614698887011.tp2614698927011/displayContentPage.dowebct?updateBreadcrumb=falsepageID=3565742930031 [accessed 30th March 2011]. Maddalena, V., (2009). Cultural Competence and Holistic Practice: implications for nursing education, practice, and research. . Holistic Nursing Practice. 23 (3) pp.156-157. Available from: http://ezproxy.napier.ac.uk:2099/sp-3.3.1a/ovidweb.cgi?S=AGEGFPPEJIDDKGKDNCCLNEIBICCAAA00Link+Set=S.sh.15|1|sl_10 [accesed 30th March 2011]. Maier-Lorentz, M., M., (2008). Transcultural nursing: its importance in nursing practice. Journal of Cultural Diversity. [Online]. 15 (1), pp.37-43. Available from: http://ezproxy.napier.ac.uk:2083/ehost/pdfviewer/pdfviewer?vid=7hid=123sid=6f3fcd96-903f-4ca3-9709-39e0b3d63d3e%40sessionmgr113 [accessed 30th March 2011]. McEvoy, L., Duffy, A., (2008). Holistic practice- A concept analysis. Nursing Education in Practice. [Online]. 8 (6), pp. 416-418. Available from: http://download.journals.elsevierhealth.com/pdfs/journals/1471-5953/PIIS147159530800019X.pdf [accessed 30th March 2011]. Narayan, M., C., (2001). Six steps toward cultural competency: a clinician’s guide. Home Health Care Management and Practice. [Online]. 14 (1), p. 41. Available from: http://hhc.sagepub.com/content/14/1/40.full.pdf [accessed 30th March 2011]. Neils, P., E., (2010). The influence of nightingale rounding by the liaison nurse on surgical patient families with attention to differing cultural needs. Journal of Holistic Nursing. 28 (4) p. 242. Available from: http://jhn.sagepub.com/content/28/4/235 [accessed 26th March 2011]. Nursing Midwifery Council (2008) The code: Standards of conduct, performance and ethics for nurses and midwives. Available from: nmc-uk.org/Documents/Standards/The-code-A4-20100406.pdf   [accessed 14th February 2011]. Pearcey, P., (2007). Tasks and routines in 21ST century nursing: student nurse’s perceptions. British Journal of Nursing. [Online]. 16 (5), pp. 296-300. Available from:   http://ezproxy.napier.ac.uk:2083/ehost/pdfviewer/pdfviewer?vid=6hid=17sid=67bf3a85-e548-475a-ac5f-a761877ae0a5%40sessionmgr11   [accessed 31st March 2011]. Phillimore, J., (2011). Approaches to health provision in the age of super-diversity: accessing the NHS in Britain’s most diverse city. Critical Social Policy. [Online]. 31 (1), pp. 5-25. Available from: http://csp.sagepub.com/content/31/1/5 [accessed 30th March 2011]. Potter, P., J., (2005) The holistic caring process. In: Dossey, B. M., Keegan, L., Guzzetta, C., E., (2005) Holistic Nursing: A handbook for practice. (4th ed). Sudbury, MA: Jones Bartlett, p. 347. Riley, J., B., (2004). Communication in Nursing. (5th ed). St Louis: Mosby. Roberts, J., H., Sanders, T., Wass, V., (2008) Students perceptions of race, ethnicity and culture at two UK medical schools: a qualitative study. Medical Education. [Online]. 42 (1), p.50. Available from: http://ezproxy.napier.ac.uk:2083/ehost/pdfviewer/pdfviewer?vid=21hid=24sid=67bf3a85-e548-475a-ac5f-a761877ae0a5%40sessionmgr11 [accessed 31st March 2011]. Selanders, L., C., (2010). The Power of Environmental Adaptation: Florence Nightingales Original Theory for Nursing Practice. Journal of Holistic Nursing. [Online]. 28 (1), p. 84. Available from: http://ezproxy.napier.ac.uk:2823/content/28/1/81.full.pdf+html [accessed 2nd April 2010]. The International Council for Nurses, (2005). The ICN Code of Ethics for Nurses. Available from:icn.ch/images/stories/documents/about/icncode_english.pdf [accessed 20th March 2011]. Woerner, L., Espinosa, J., Bourne, S., O’toole, M., Ingerson, G., L., (2009). Project Exito!: Success through diversity and universality for outcomes improvement among Hispanic home care patients. [Online]. Nursing Outlook. 57 (5), p.271. Available from: http://ezproxy.napier.ac.uk:2152/science?_ob=MImg_imagekey=B6WNY-4XB1JCX-B-1_cdi=6975_user=132448_pii=S0029655409000177_origin=gateway_coverDate=10%2F31%2F2009_sk=999429994view=cwchp=dGLzVlz-zSkzkmd5=04d1ebfb99f4824da35541a0a368b5a6ie=/sdarticle.pdf [accessed 30th March 2011].

Narrative essay Essays (457 words) - Free Essays, Term Papers

Narrative essay Essays (457 words) - Free Essays, Term Papers Narrative essay People say that what happens in movies do not always happen in real life. That those funny moments you see in television do not really happen to people. Well, with what I go through everyday, those funny and excruciatingly embarrassing moments really do happen. But there is one day in particular I would describe as the most unpredictable day. And it all started one fateful morning. As always i woke up late on a monday morning. As quickly as I could, I jumped in the shower and started clenching myself. I was in such a hurry that I accidentally inhaled my liquid shampoo, as soon as that happened; I instantly felt one of the worst pains I have ever dealt with my entire life. That kind of pain was unbearable to say the least; it made me cringe and whimper in pain. To relieve myself from the pain I inhaled some water and blew it out where a lot of bubbles came out. As I step out of the shower, I slipped on my soap and fell on my butt. Showering in a hurry really does have its advantages. I brushed off the pain I felt and washed myself again. I stepped out the shower more carefully, dried myself off; put on my colthes and went on with my day. As the day went on, more unfortunate events have happened to me. During lunch I almost tripped on a grade school student. It was a good thing that I caught myself on time or else nothing would have broken my fall except for the student I almost fell on top of. After lunch, as I was coming upstairs, a teacher caught up with me and told me that drinks were not allowed in the classroom. As if my daw wasnt bad enough already I had to drink my beverage outside the classroom. Alone. Dismissal finally came and I steel feel lika karma was chaseing me. As I was walking out of the main building, I almost got hit by a huge car. Thinking I was going to die that day, I saw my bad day flashed before my eyes and I was thinking of what I have done to deserve this way of dying. After that incident, I was scared of what more karma has in store for me today. When I got home, I finally found a time to relax after doing all my school works, I was randomly texting people until one of them texted me back, It was my happy crush and his reply to me made me forget about my very bad day. It really is true that every day may not be good but there is something good in every day.