Patients With Post Stroke Dysphagia Health And Social Care Essay

Patients With Post Stroke Dysphagia Health And Social Care Essay This chapter deals with discussion, summary and conclusions drawn. It clarifies the limitations of the study, the implications and recommendations given for different areas in Nursing practice, Education, administration and research. DISCUSSION The present study was designed to assess the effectiveness of Selected Nursing Interventions among patients with Post Stroke Dysphagia at KMCH, Coimbatore-14. The researcher carried out the study among 30 patients and adopted pre-experimental research design with single group pre test post test design. The researcher used non probability purposive sampling technique to select the 30 subjects. The researcher conducted this study to assess the effectiveness of Shaker Exercise and Hyoid Lift Maneuver on Swallowing and Feeding Performance among patients with Post Stroke Dysphagia. DEMOGRAPHIC DESCRIPTION OF SUBJECTS The demographic variables included in the study were Age, Sex, Education and Habits. The mean Age of the subjects was 60. Half of the subjects were in the Age group 50-70 years. Almost equal numbers of subjects were in the 30-50 and above 70 years Age groups and it was about 23 and 27 percent respectively. Regarding the Sex, nearly equal numbers of subjects were in the male and female Sex group and it showed 53 and 47 percent respectively. On the basis of their Educational Status, 67 percent of the subjects were studied up to secondary Education. About 33.33 percent of the subjects completed any one of the graduate degree course. In accordance with their Personal Habits, 53.33 percent had no bad Habits like Smoking and Alcoholism. Ten percent of subjects had the habit of Tobacco use. Seven percent of subjects were consuming Alcohol. Thirty percent of the subjects had the habit of both Tobacco and Alcohol consumption. CLINICAL DESCRIPTION OF SUBJECTS The clinical variables include Type of Stroke and Co-morbid Illness. In consistent with the Type of Stroke, 10 percent of the subjects had Stroke due to the problem in anterior circulation, 40 percent of the subjects had Stroke due to problem in middle circulation and 50 percent of the subjects had Stroke due to problem in the posterior circulation. With reference to the Co-morbid Illness, 13.33 percent of the subjects had No Co-morbid Illness. About 10 and 40 percent of the subjects had the complaints of Diabetes Mellitus and Hypertension respectively. Remaining 36.67 percent of the subjects had both Hypertension and Diabetes Mellitus. The major findings of the study were discussed according to the objectives: The first objective was to assess the Swallowing and Feeding Performance of patients with Post Stroke Dysphagia. In the pre test assessment of the Swallowing Performance using GUSS Score indicates 23.33% of the subjects had Mild Dysphagia, 40% of the subjects had Moderate Dysphagia and 36.67% of the subjects had Severe Dysphagia. The post-test assessment of Swallowing Performance explains that 16.67% of the subjects were improved to the No Dysphagia stage with good Swallowing and Feeding Performance. About 26.67% of the subjects had Mild Dysphagia and 23.33% of the subjects had Moderate Dysphagia. Remaining 33.33% of the subjects had severe Dysphagia with various improvements in the Swallowing Performance. The pre test and post test Feeding Performance Score using FOIS describes equal number of subjects in the Tube Dependent (36.67%) and Total Oral Intake category (63.33%). Despite the result revealed an equal number of subjects in the pre and post test assessment, the subjects had an improvement in the Feeding Performance during the post test assessment from no oral intake level to tube supplement with consistent oral intake level in the Tube Dependent category. Likewise, subjects showed an improvement from the intake of single consistency to the total intake with no restriction in the Total Oral Intake category. The present study was supported by Trapl et al., who conducted study in 2002 and described that out of 30 patients, 30 to 50% had Severe Dysphagia and showed significantly higher risk of aspiration with liquids compared with semisolid textures (p=0.001). Therefore they confirmed the subsequent sequence of GUSS. The second objective was to determine the effectiveness of Selected Nursing Interventions on Swallowing and Feeding Performance in patients with Post Stroke Dysphagia. With reference to the Swallowing Performance based on the GUSS Score, the mean pre-test SwallowingS among subjects was 12.50 and the mean post-test Swallowing Score was 13.87 based on the GUSS tool. Paired t test was used to compute the mean difference. The t value for this mean difference between pre and post test Swallowing Score was 6.150. The t value obtained at .001 level of significance and at 29 degrees of freedom. Hence there is a significant difference exist between the mean pre and post test Swallowing Scores. It further implies that the Swallowing Score in the post test was higher than the pre test Swallowing Score. This improvement was due to the Selected Nursing Interventions such as Swallowing Exercises and Positioning while Swallowing. So the Swallowing Exercises such as Shaker Exercise and Hyoid Lift Maneuver found to be effective in improving the Swallowing Performance in Stroke patients. The final result concluded that 22 subjects (73.3%) expressed improvement after the treatment. Remaining 8 subjects (26.7%) had no changes in their Swallowing Performance after the therapy. The median of pre-test Feeding Score among subjects was 5 and the median of post-test Feeding Score was 6.5. Sign test was computed to find out the difference between the pre and post test median Scores of Feeding. The sign test Score showed the p value 0.000 which was significant at .001 level. It showed that, a significant difference present between the pre and post test Feeding Scores. It further implies that the Feeding Score in post test was higher than the pre test Feeding Score. This improvement in the Feeding Performance was due to the Selected Nursing Interventions. So the Swallowing Exercises were effective in improving the Feeding Performance in Stroke patients having Dysphagia. Median test was used to compare the effect between the pre test and post test group instead of mean as because the FOIS was a 7 point likert scale. As the variables did not follow the normality and the highest Score was 7, parametric test was not applicable. Hence non parametric sign test was adopt ed which is equivalent to paired t test to find out the effectiveness. The result of the present study was substantiated with a study conducted by Mepani et al., in 2005 on augmentation of deglutitive thyrohyoid muscle shortening by the Shaker Exercise. The study involved the effect of 6 weeks shaker exercise in 11 dysphagic patients; six patients were randomized to control group and 5 patients to the Shaker Exercise group. After the therapy the change in thyrohyoid distance among Shaker Exercise group was significantly greater compared to the control group (p=0.034), this subsequently improve the swallowing function of the patients. Association of the Swallowing and Feeding Performance with selected Demographic and Clinical variables among patients with Post Stroke Dysphagia The Fisher exact test was used to associate the selected Demographic and Clinical variables with the Swallowing and Feeding Performance of the patients with Post Stroke Dysphagia. The calculated p values for the association between the Swallowing Performance of Post Stroke patients with the selected Demographic and Clinical variables such as Sex, Habits, Type of Stroke and Co-morbid Illness were not significant and hence there exist no association between them. The calculated p values for the association between the Feeding Performance of Post Stroke patients with selected Demographic and Clinical variables such as Sex, Habits, Type of Stroke and history of Co-morbid Illness were not significant and hence there is no association between them. SUMMARY The aim of the present study was to assess the effectiveness of Selected Nursing Interventions on Swallowing and Feeding Performance among patients with Post Stroke Dysphagia, for which the following objectives were formulated; To assess the Swallowing and Feeding Performance of patients with Post Stroke Dysphagia. To determine the effectiveness of Selected Nursing Interventions on Swallowing and Feeding Performance in patients with Post Stroke Dysphagia. To associate the Swallowing and Feeding Performance with selected Demographic and Clinical variables. The study was based on Ernesteine Wiedenbachs helping art of clinical nursing theory (1970). The research design applied for the study was pre experimental single group pre test-post test design. Study was conducted in KMCH. 30 samples were selected by non probability purposive sampling technique. The tool used for data collection consists of Demographic and Clinical variables, Gugging Swallowing Screen (GUSS) and Functional Oral Intake Scale (FOIS) to assess the Swallowing and Feeding Performance in Post Stroke Dysphagic patients. The data were collected for a period of 6 weeks. Descriptive and inferential statistics were used in statistical analysis, to assess the effectiveness of Selected Nursing Interventions among patients with Post Stroke Dysphagia. Fisher exact test was used to find out the association between the selected Demographic and Clinical variables with the Swallowing and Feeding Performance in patients with Post Stroke Dysphagia. Major findings of the study On the basis of Gugging Swallowing Screening (GUSS), the investigator observed the degrees of improvement in Swallowing difficulty after the therapy among patients with Post Stroke Dysphagia. About 16.67% of the subjects had No Dysphagia, 26.67% had Mild Dysphagia, 23.33% had Moderate Dysphagia, and 33.33% had Severe Dysphagia. In accordance with the Functional Oral Intake Scale (FOIS), 36.67% of the subjects were in Tube Dependent category and 63.33% were in Total Oral Intake category with sustained improvement in the Feeding Performance. The mean pre test score of the Swallowing Performance using Gugging Swallowing Screening (GUSS) tool was 12.50. The mean post test Score of the Swallowing Performance using GUSS evaluation tool was 13.87. There was a significant difference between the mean pre-test and post-test Swallowing Performance Score. The t value obtained was 6.150 which is significant at 0.001 level and at 29 degrees of freedom. The final result explained that, 22 subjects (73.3%) expressed Swallowing improvement after the treatment. Remaining eight subjects (26.7%) had no changes in their Swallowing Performance after the therapy. Median test was used to compare the Feeding Performance Score of the pre and post test groups. The median pre test Feeding Performance of the patients with Post Stroke Dysphagia was 5 with a range of 1 to 6 and that of post median test was 6.5 with a range of 1 to 7. The non parametric sign test was used to find out the effectiveness of the therapy on Feeding Performance. The obtained p value was 0.000 at 0.01 level of significance. This revealed a significant improvement in the Feeding Performance of Post Stroke Dysphagic patients. The final result revealed that 24 respondents (80%) showed an improvement in their Feeding Performance after the therapy and was assessed by FOIS scoring. But remaining six respondents (20%) showed no changes in the Feeding Performance when assessed by FOIS. There was no significant association exist between the Swallowing and Feeding Performance of the Post Stroke Dysphagic patients with the selected Demographic and Clinical variables. CONCLUSION The study was tested and accepted the hypothesis that there is a significant difference in Swallowing and Feeding Performance before and after the implementation of Selected Nursing Interventions in Post Stroke patients with Dysphagia. The result concluded that the study group had better outcome than the others. There was a significant improvement in the Swallowing and Feeding Performance of the Post Stroke Dysphagic patients after the Exercise and Positioning therapy. The participants had reduced the risk of aspiration and aspiration related complications after the therapy. Hence, Selected Nursing Interventions such as Swallowing Exercises like Shaker exercise and Hyoid Lift Maneuver and positioning during Swallowing can be recommended for the patients with Post Stroke Dysphagia. IMPLICATIONS The present study has its own implications in nursing practice, nursing education, nursing administration and nursing research. Nursing practice: Dysphagia is one of the major complications among Post Stroke patients. This study implies the effectiveness of Selected Nursing Interventions in the improvement of Swallowing and Feeding Performance among the Post Stroke Dysphagic patients. This study creates awareness among the nursing personnel about the importance of the various complications after the Stroke and its various evidence based management. The present study shows that the exercise intervention for the Post Stroke Dysphagic patients can prevent the risk of aspiration and aspiration pneumonia. The result shows that, Selected Nursing Intervention for the Post Stroke patients can reduce the risk of malnourishment. Nurses can gain skill for providing Swallowing Exercises in the Post Stroke Dysphagic patients to improve their quality of life. Nursing Education: The nurse educator can create awareness among the health care professionals about the complicated effects of Stroke and its various evidence based management. The nurse educator can arrange in-service Education programs to update their knowledge regarding the new techniques and modalities to manage the Post Stroke Dysphagia. The nurse educator can teach the students about the present study findings and its implication in patients with Post Stroke Dysphagia. This will help to improve the knowledge of the students on Swallowing Exercises. The nurse educator can motivate the nursing personnel and students to use this Swallowing Exercises and positioning in the improvement of Swallowing and Feeding Performance and in the reduction of aspiration risk in Post Stroke Dysphagic patients. Nursing administration: Nurse administrator should aware of the problem experienced by the clients after the Stroke. Nurse administrator can provide continuing education or short term courses in the clinical area for preparing the nurses with competence in managing the after effects of Stroke especially Dysphagia. Nurse administrator can plan and organize seminars, workshops and conferences about Selected Nursing Interventions for the improvements of Swallowing and Feeding Performance among patients with Post Stroke Dysphagia. Nurse administrator can formulate protocol to incorporate the study findings in nursing intervention. Nursing research: This study provides a basis for further studies. The findings of the study can be a foundation for conducting the study on large sample to strongly support the efficacy. The implications of the study can be used as a motivation for nurses to conduct research in India, where the health care system is advancing. This study helps to update the knowledge and proper utilization of resources in the field of nursing practice. LIMITATIONS OF THE STUDY The study was limited to small sample size of 30 subjects. The study was limited to a single setting. The study was conducted using a single group. RECOMMENDATIONS A similar study can be conducted with large number of subjects to generalize the research findings. A study can be conducted at different settings. Similar study can be undertaken using different Swallowing and lingual exercises. This study can be conducted with experimental and quasi experimental design. A comparative study can be conducted between different types of Swallowing Exercises in Post Stroke Dysphagic patients. A similar study can be done to assess the effectiveness of Swallowing Exercises among patients with Dysphagia who are receiving head and neck radiation for cancer. ABSTRACT The present study entitled Effectiveness of Selected Nursing Interventions on Swallowing and Feeding Performance among patients with Post Stroke Dysphagia at KMCH, Coimbatore-14. This study was undertaken during the year 2012-2013, in partial fulfillment of requirement for the degree of Master of Science in Nursing at KMCH College of Nursing, Coimbatore, which is affiliated to the Tamilnadu Dr. M.G.R. Medical University, Chennai. Objectives: 1.To assess the Swallowing and Feeding Performance of patients with Post Stroke Dysphagia. 2. To determine the effectiveness of Selected Nursing Interventions on Swallowing and Feeding Performance in patients with Post Stroke Dysphagia. 3. To associate the Swallowing and Feeding Performance with selected Demographic and Clinical variables. Research Design: Pre experimental design with single group pre test-post test design. Setting: Neuro inpatient and outpatient department of Kovai Medical Center and Hospital, Coimbatore. Samples: All Post Stroke Dysphagic patients. Sample Size: The sample size was 30. Sampling Technique: Non probability purposive sampling. Conceptual framework: Ernestine Widenbachs Helping Art of Clinical Nursing Theory (1970) was adopted. Intervention: Selected Nursing Interventions such as Swallowing Exercises and Positioning during the swallowing were incorporated. The clients were instructed to do the Shaker Exercise and Hyoid Lift Manoeuvre 3 to 6 times a day for a period of 6 weeks. The subjects were instructed to elevate or down the chin and tilt the head towards stronger side while Swallowing. Outcome Measures: Swallowing and Feeding Performance was assessed by Gugging Swallowing Screen (GUSS) and Functional Oral Intake Scale (FOIS) respectively. Results: The mean difference between pre and post test Swallowing Score was 6.150 and which was significant at 0.001 level. The p value obtained for Feeding Score was 0.000 at 0.001 level of significance. The result showed a significant improvement in the Swallowing and Feeding Performance. Conclusion: This study proved that the implementation of Selected Nursing Interventions rather than the other conventional treatment will improve Swallowing and Feeding Performance among Post Stroke patients with Dysphagia. Hence the Swallowing Exercises and Positioning can be recommended in clinical practice to improve the Swallowing and Feeding Performance in Post Stroke Dysphagic patients.

His Panic: Why Americans Fear Hispanics in the US Essay

Review by Howard Jordan, The City University of New York – Hostos Community College of book His Panic: Why Americans Fear Hispanics in the U. S. written by Emmy-award-winning journalist Geraldo Rivera. Rivera has truly emerged as a true warrior in defense of the Latino community and immigrant rights by dissecting and clarifying several myths that feed the anti-immigrant prejudice against the growing number of United States-born and foreign-born Latinos in our nation. One of the most obvious untrue assumptions surrounding immigrants is that Latinos are more prone to crime than their American counterparts. Rivera confronts the question of whether immigrants are committing crimes at higher rates than U. S. citizens. The debate started with a story about a drunk driver in Virginia Beach who killed two teenage girls in a terrible accident. The driver was an â€Å"illegal† Mexican. Rivera accusing Bill O’Reilly of making this same â€Å"cheap political point,† Rivera said, â€Å"[He] could have been a Jewish drunk, an Italian drunk, or an Irish drunk, would you still care? (p. 5). I believe this is the perfect example to showcase the constant double standard that exists when it comes to use Latinos as ‘scapegoats’ to take the blame for high rates of crimes or other issues. Statistics show that immigrants are no more prone to committing crimes than are the native-born. Another false rumor that causes anti-immigrant hostility is that Latino immigrants come here to take jobs from U. S. citizens. This statement cannot be further from the truth. With agreements like NAFTA, immigrants are not the ones to blame for stealing the jobs of American citizens. Conversely, the ones truly affected before any U. S. citizen is deprived of any opportunity are Mexicans because the jobs that NAFTA secures in the U. S. were jobs previously held by Mexican workers across the border. So, let’s take a moment to rethink who’s taking what from whom? In addition, Rivera cites several studies that show â€Å"Latino immigrants are not displacing American workers†¦ and rarely over-utilize social services†. Those criticizing must know that illegal immigrants are not entitled to receive any governmental assistance, because of their immigrant status. Going further Rivera has evidence in his book about â€Å"nonpartisan, non-ideological, scientific data [that] proves that immigrants contribute greatly to the America economy† (p. 169). Again this corrects the misinformation that immigrants are not a burdensome to the U. S. if not a huge contributing force of this nation whose rights are often violated. A further huge inaccurate detail Rivera addresses in his book is the assumption that immigrants use ‘anchor babies’ presumably to further the parents’ quest for citizenship. Anchor babies are children born of illegal immigrants to help their parents acquire citizenship status in the U. S. That cannot be further from the truth because under current law, an illegal immigrant parent seeking citizenship cannot use the fact that their child is a citizen, until that child reaches the age of twenty-one. However, immigrants are being wrongfully and constantly criminalized for intending to build and raise a family. In conclusion I believe that the United States has to stop using fear mongering to influence, manipulate the opinions and actions of its citizens with the goal of fueling anti-immigrant sentiment. This country was built by immigrants’ sweat and hard labor not just from Latin America, but from Europe and Africa. How can the U. S. carryon with not only taking their land, but also taking their pride, belittle them by inviting immigrants into this country and then deporting them as they conveniently desire when ‘those second class citizens are no longer useful’. I genuinely believe that American are in fear of Latinos. And they act they way they do to keep them at a margin, contain at a place where they are in need to settle and at often times take the poor jobs they get. It is embarrassing as a U. S. citizen that my own country carries this behavior. How can anyone be the cause of such horrible acts, of separating families due to technical issues and then praise to be the most powerful country in the world. The United States is the most powerful country in the world because our predecessors have gone out of their way to steal anything of value, not other communities’ ideas like Iroquois, or from the other developing countries of the world. The U. S must stop this way of politics and reach an agreement. An agreement where immigrants and workers are rewarded for their efforts, where we pay the price they are worth and earned for their hard work, that we restore what has been stolen, where the rich upper class get taxed according to the gross income they are earning. Where the jobs stolen are restored to Mexicans and Africans, restored for everything they have lost as a result of being brought here to build this country. This should be the land of opportunity, where everyone is equal at all levels and topics, not the land of exploiting the weak and enslaving them. Where is all this nonsense going to stop? I know is not that simple, to reverse the damage that has been done after so many years but we must start somewhere, perhaps by acknowledging the truth and not hiding the real facts behind the Latino scapegoat. People must be educated before taking a stand on what spot on the spectrum to be in. It is a very sensible topic that involves the lives of actual people, actual families. Thank you Geraldo Rivera for not forgetting about your roots, and using your position as a media figure to be an activist against the Latino immigrants.

Why Do People Resist Change At Work - Free Essay Example

Sample details Pages: 8 Words: 2349 Downloads: 10 Date added: 2017/06/26 Category Statistics Essay Level High school Did you like this example? Why do people resist change at work and how can this resistance be overcome from an HR perspective? 1. Introduction Change is a common feature of the workplace. This paper examines why people resist change at work. It then explores how this resistance can be surmounted from an HR viewpoint. 2. Resistance to change at work From research into individual and organisational behaviour, it is well established that people at work can sometimes resist change (Robbins, 1992). The Chartered Institute of Personnel and Development (CIPD) define resistance to change at work as an individual or group engaging in acts to block or disrupt an attempt to introduce change (CIPD, 2014, p.2) and argue that, in general, resistance to change in the workplace occurs in two ways: resistance to the content of change and resistance to the process of change (CIPD, 2014, p.2). The reasons for resistance to change at work are numerous. Resisting change enables stability and for the status quo at work to be maintained (Robbins, 1992). Change jeopardises the comfort zones and security of employees who are risk averse and who like familiarity (Holbeche, 2001). The fear of the unknown may result in resistance to change (Robbins, 1992). There may be resistance when change appears to threaten someones income (Robbins, 1992). Change can appear threatening to the individual worker when it is foisted on them top down without their input as they do not feel in control (Holbeche 2001). Gifford et al (2012), in their review of change programmes in NHS South of England, found that many people do embrace change, but it is easy to feel undermined or threatened by it, even if one accepts at a broad level that change is needed. As well as the challenge of embracing new ways of working, it can be hard to let go of the old ways. Not only do people have ingrained habits and ways of thinking; they also become skilled in familiar work and may feel that their credibility is based upon it. For example, if someone spends years honing skills in a specific procedure and is then told they should be using a completely different technique, this may cut at their sense of self worth (Gifford et al, 2012, p. 15). Thus, there may be resistance if a persons perception of how the world of work should be is threatened. Robbins (1992) explains that individuals shape their world through their perceptions. Once they have created this world, it resists change. So individuals are guilty of selectively processing information in order to keep their perceptions intact (Robbins, 1992, p.281). Psychologists have studied resistance to change and it has been recognised that change may involve a significant shift for the individual, like a bereavement, where what was once certain is no longer so and they have to relinquish the familiar in order to be able to embed change (Holbeche, 2001). The psychological contract is an important consideration when looking at resistance to change at work. Guest and Conway (2002) defined the psychological contract as the perceptions of both parties to the employment relationship, organisation and individual, of the reciprocal promises and obligations implied in that relationship (Guest and Conway, 2002, p.22). The CIPD (2005) argue that the psychological contract is now best seen as a tool that can help employers negotiate the inevitable process of change so as to achieve their business objective without sacrificing the support and co-operation of employees along the way (CIPD, 2005, p.4). CIPD (2005) commented that people expected commitments made to them by management to be honoured and that management should make the effort to do so. Where management is not able to honour a commitment, attempts should be made, however difficult, to explain why and its impact on the employee. A breach of the psychological contract is likely to result in employees having a negative attitude to their employer which would include resistance to change. A case study at a Scottish manufacturing plant, where employees believed that the psychological contract had been breached by the employer, noted that the regular imposition of change programmes had resulted in a high level of cynicism amongst supervisors and shop floor staff (Pate, Martins and Staines 2000). If there is a lot of organisational change in a workplace, it is likely to be negatively received by its staff (CIPD, 2005;Guest and Conway 2001). Furthermore, where there is frequent change, it is likely to result in staff believing that management do not know what they are doing and their trust in them declines (CIPD 2005) (Guest and Conway 2001). In spite of all the above, research into change management reveals that there are things that can be done to alleviate resistance to change. Don’t waste time! Our writers will create an original "Why Do People Resist Change At Work" essay for you Create order 3. Overcoming resistance to change: the HR viewpoint 3.1 Adopt a positive approach to resistance at work Resistance to change can be a cue for stakeholders in an organisation to have a meaningful debate about the merits of the proposed change. This may lead to amendments and improvements to the change (Robbins 1992). 3.2 The need to understand why change is happening Research has shown that it is important for staff to understand why change is happening in terms how it will benefit the business and ideally how will it benefit them. In the Gifford et al (2012) review of change programmes across the NHS South of England, it concluded that leaders need to sell the benefits of the change. To do this they need to express their vision in a way that makes it easy for stakeholders to relate it to the purpose and values of the NHS and to their own principles and motivations (Gifford et al., 2012, p.5). Gifford et al (2012) added that purpose and vision [of the change programme] are crucial factors (Gifford et al., 2012, p. 51) that should be communicated in many ways to make sure the message connects with the stakeholders. In redundancy situations, Holbeche (2001) discovered that there was a link between the perceived reason for the delayering and the effect on employees. If people thought that the reason for the delayering was simply cost cutting , their morale and motivation tended to be more adversely affected than where there appeared to be a more strategic reason for the change (Holbeche, 2001, 367). 3.3 Communication Communication plays a critical part in helping staff understand why change is happening and in feeling engaged in the change process. Internal communication mechanisms which enable staff to feel empowered and involved are key to minimising resistance. Two way communication mechanisms like attitude surveys can be effective, but only if visible changes arise as a result (Holbeche, 2001). Other forms of communication that can help are senior management presentations (where questions can be asked and answered), road shows, team briefings and management cascades, question and answer mechanisms (for example by email) and internal newsletters (Holbeche, 2001). Communication should ideally involve an element of being two way and should include all stakeholders. The CIPD (2005) found that top down communiques by senior managers were perhaps the most ineffectual way of delivering important messages to staff. Mission statements were slightly more effectual, but the most successful way of r eaching staff with messages that they are likely to believe is through line managers (CIPD, 2005). In recent times, storytelling, narratives and theatre have been used in change situations as innovative ways of communicating with staff in order to get them engaged and involved. These methods allow for a move away from top down senior management communication (Daley and Browning, 2014, Dennis, 2010, Thomas and Northcote, 2012). Formal communication, in times of change, should: Inform à ¢Ã¢â€š ¬Ã¢â‚¬Å" about the organizational/ personal implications Clarify à ¢Ã¢â€š ¬Ã¢â‚¬Å" the reason for the change, the strategy and benefits Provide direction à ¢Ã¢â€š ¬Ã¢â‚¬Å" about the emerging vision, values and desired behaviours Focus à ¢Ã¢â€š ¬Ã¢â‚¬Å" on immediate work priorities and actions, together with medium term goals Reassure à ¢Ã¢â€š ¬Ã¢â‚¬Å" that the organisation will treat them [staff] with respect and dignity (Holbeche, 2001, p.368). 3.4 Staff engagement Those affected by the change need to feel engaged so that they believe that they are invested in the change. This can be time consuming and difficult for those leading the change (CIPD 2005, Gifford et al. 2012). Engagement can mean getting staff to buy into change that has already been devised or it can mean getting staff involved in actually designing the change (Gifford et al., 2012). Leaders need to be clear about what level of engagement is being offered as unfulfilled expectations risk demotivating staff and weakening good will. (Gifford et al, 2012). Bearing in mind the psychological contract, the CIPD (2005) argue that managing change well involves getting employees buy-in and making sure that they are not caught unawares. Employees want fair treatment and it is important that they believe that they can trust management. As stated earlier, if employees expectations are not to be met, the reason why should be explained by management (CIPD, 2005). 3.5 Leadership Those in leadership positions in the organisation have to act as role models for change to be successful. If the behaviour of the leaders in an organisation is at odds with their verbal utterances in a change situation, it can result in cynicism in staff and thus resistance to change. Holbeche (2001) reports of a case study where company directors were charged with leading an organisational change involving paying particular attention to the customer. The directors talked to staff about the importance of the organisations values, especially teamwork. However, staff knew that the senior leadership team did not work well as a team and thus, the change message was being met with cynicism. When the Chief Executive took drastic action and threatened to punish the directors financially, that was when the directors became serious about role modelling good team work and effective leadership. As a result, the change message became believable to staff. 3.6 Apply learning from neuroscience Dowling (2014) explored the connection between neuroscience and change management. He found that neuroplasticity, the concept of the adult brain being able to change through specific activity and experiences, was applicable in change situations, if it was self-directed by the individual employee. He advised that employers should give their employees the latitude to have their own insights into the proposed change and that this would allow new neural pathways to be formed in the employees brain, making sustainable change possible. Downing (2014) also explored the impact of threat and reward on employees behaviour. He argued that when a person is faced with a perceived threat, the brain has an inbuilt defence mechanism which is activated. This provides some explanation as to why there is resistance at work when an employee feels threatened. This argument reinforces the need for those leading the change to emphasize the benefits of the proposed change so that the employees brain re ward response is activated as opposed to their threat response. Downing (2014) additionally looked at habit and how the prefrontal cortex of the human brain (the advanced cognition brain area) operates primarily on the basis of habit, otherwise it would be using a huge amount of energy which would not be sustainable. During periods of change, when individuals are being required to adopt new habits, a heavy burden is potentially being placed on the prefrontal cortex. When designing change programmes, there needs to be an awareness of the brains limited capacity for change (Downing, 2014, Scarlett, 2013). 3.7 HR HR has a pivotal role to play in staff communication and engagement as well as in planning change effectively, including taking into account the learnings from neuroscience. There has to be a real partnership between the business and HR for change to be effective. HR plays a role in assisting, developing and supporting those in leadership positions to be effective in their roles so as not to undermine the success of the change programme and engender resistance to change (Holbeche, 2001, CIPD, 2005, Gifford et al., 2012). 4. Conclusion Although resistance to change is something that occurs in the workplace for many understandable reasons, it can be minimised by good communication and staff engagement, explaining the need for change in terms of its benefits to the business and to the individual member of staff, learning from research, effective leadership as well as HR working well with the business and being an integral part of the change. Overcoming resistance at work matters, as while resistance is occurring, it may result in negative consequences such as having a negative impact on performance and productivity, creating an environment for turf wars at work as well as demoralising and demotivating staff (Holbeche, 2001,Robbins 1992, Cannon and McGee 2008, Hughes, 2010). 5. References CANNON, J. A. and MCGEE, R. (2008) Organisational development and change. CIPD toolkit. London: Chartered Institute of Personnel and Development. CHARTERED INSTITUTE OF PERSONNEL AND DEVELOPMENT (2005) Managing Change: The role of the Psychological Contract. Research report. London: Chartered Institute of Personnel and Development. CHARTERED INSTITUTE OF PERSONNEL AND DEVELOPMENT (2014) Change management. Factsheet. Available: https://www.cipd.co.uk/hr-resources/factsheets/change-management.aspx#link_2 DAILEY, S.L. and BROWNING, L. (2014) Retelling stories in organizations: understanding the functions of narrative repetition. Academy of Management Review. 39(1). p. 22-43. DENNIS, R. (2010) Intimacy at work: playback theatre and corporate cultural change in Mercedes Benz, Brazil. Journal of Organizational Transformation Social Change. 7(3). p. 301-319. DOWLING, N. (2014) Its all in the mind. Training Journal. Aug2014. p.47-51. GIFFORD, J., BOURY, D., FINNEY, L., G ARROW, V., HATCHER, C., MERIDITH, M. AND RANN, R. (2012) What makes change successful in the NHS? A review of change programmes in NHS South of England. Horsham: Roffey Park. GUEST, D. E. AND CONWAY, N, (2002) Communicating the psychological contract: an employer perspective. Human Resources Management Journal. 12(2). p. 22-38. GUEST, D.E. AND CONWAY, N. (2001) Organisational change and the psychological contract: an analysis of the 1999 CIPD survey. Research report. London: Chartered Institute of Personnel and Development HOLBECHE, L. (2001) Aligning Human Resources and Business Strategy. Oxford: Elsvier Butterworth Heinemann. HUGHES, M. (2010) Managing change: a critical perspective. 2nd Ed. London: Chartered Institute of Personnel and Development PATE, J., MARTIN, G. AND STAINES, H. (2000) Exploring the relationship between psychological contracts and organizational change: a process model and case study evidence. Strategic Change. 9 (8). p.481-493. ROBBINS, S. P (1992) Essentials of Organizational Behavior. Third edition. New Jersey: Prentice-Hall International SCARLETT, H. (2013) Neuroscience helping employees through change. Strategic Communication Management. 17 (1). p.32-36. THOMAS, P. and NOTHCOTE, R. (2012) Storytelling in transforming practices and processes: the Bayer case. In TYRONE, S., SIMPSON, A. and DEHLIN, E. (eds.) Handbook of organizational and managerial innovation. Cheltenham: Edward Elgar.

When Daylight Became a Mere Spark - 1424 Words

Anthony Brathwaite February 13, 2014 Narrative Essay When Daylight Became a Mere Spark In some weird way parents always think that first day after the summer vacation is very exciting for their kids. They buy clothes all summer long searching for that right outfit for the first day. You could hear the many conversations between the adults, who is wearing what and how cute their little one are. I came to realize quickly that this event caused more excitement for them than for the kids. I remember my first day like it was yesterday and I can’t relate to the excitement that many parents have today. It was a normal day in Barbados. Sunrise was very beautiful, as it rides just beyond the cliff of the sea. A bright orange just five†¦show more content†¦I knew if anything happened he’d be there to protect me. Just at that moment I was feeling some what comfortable in my skin, there was a startling clanging of the bell in the distance that made my heart want to race back home. Fear rushed into my body as I wrapped my arm s around my brother holding on with all my might. I could just imagine how he must have felt, but he never said a word. As we were making our way to his class line, I heard a loud screeching voice pierce my ears with pain. â€Å"Excuse me boy, you need to get to your class line right now.† Not realizing she was speaking to me, I continued to stay with my brother. Maybe that wasn’t the smartest thing I did. The old, thin, wrinkled skin lady started marching in my direction holding a piece of bamboo in her hands. She glared at me and repeated even louder with more authority. â€Å"Get to your class line at once.† My world began to crumble before my eyes, and darkness quickly overshadowed me, until daylight was a mere spark. I remembered yelling to my brother, â€Å"Selwyn, Selwyn, please help me.† But my plea was in vain. The bright start of the day became the darkest hour of my life. Surrounded by strangers as these foreign eyes stared at me as the tears c ontinued to stream down the cheeks. My heart was thumping in my body like a bass drum in a school band parade. Saliva was absent from my mouth and throat like a hot pot on a stove when the water has boiled out. I wish thisShow MoreRelated The Time Machine Essay2591 Words   |  11 Pagesthings are mere abstractions.’ ‘That is all right,’ said the Psychologist. ‘Nor, having only length, breadth, and thickness, can a cube have a real existence.’ ‘There I object,’ said Filby. ‘Of course a solid body may exist. All real things---’ ‘So most people think. But wait a moment. Can an instantaneous cube exist?’ ‘Don’t follow you.’ said Filby. ‘Can a cube that does not last for anytime at all, have a real existence?’ Filby became pensive. ‘ClearlyRead MoreJourney by Patricia Grace3775 Words   |  16 Pagesthree poems you have studied. 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