Theories of European Integration free essay sample

For some mature ages, the scholastic study of the European Communities ( EC ) , as they were alleged, was essentially interchangeable with the overview of European coordinating. The abdominal muscle initio unobtrusive and generally technocratic achievements of the EC appeared to be less significant than the conceivable that they spoke to for the steady incorporating of the conditions of western Europe into something different: a supranational common request. At the point when the coordinating strategy was voyaging acceptable, as during the 1950s and mid 1960s, neo-functionalists and different theoreticians tried to elucidate the method whereby European incorporating continued from unassuming sectoral beginnings to something more extensive and progressively driven. At the point when things appeared to travel harshly, as from the 1960s until the mid 1980s, intergovernmentalists and others tried to explain why the coordinating methodology had non continued each piece wonderfully as its laminitiss had trusted. Despite the distinctions among these natural structures of hypothesis, we can state unmistakably that the early writing on the EC looked to elucidate the method of European incorporating (rather than, state, strategy making ) , and that in making so it drew for the most part ( yet non altogether ) on speculations of universal dealingss. We will compose a custom paper test on Speculations of European Integration or on the other hand any comparative point explicitly for you Don't WasteYour Time Recruit WRITER Just 13.90/page In the primary version of this volume, Carole Webb ( 1977 ) reviewed the contention among the so prevailing schools of European coordinating, neo-functionalism, and intergovernmentalism, pulling from each assault a lot of findings and theories about the idea of the EC strategy method. So also, here we survey neo-functionalism and its situations about the EU strategy method, thus the intergovernmentalist reaction, each piece great as the refreshing of # 8216 ; expansive intergovernmentalism # 8217 ; by Andrew Moravcsik during the 1990s. In add-on, we inspect later natural structures of incorporating hypothesis institutionalism and constructivism-which offer extremely various places of the coordinating methodology and extremely various derivations for EU strategy making. Neo-functionalism Neo-functionalism In 1958, on the Eve of the constitution of the EEC and Euratom, Ernst Haas distributed his original work, The Uniting of Europe, puting out a # 8216 ; neo-functionalist # 8217 ; hypothesis of provincial incorporating. As explained in ensuing writings by Haas and different bookmans ( e. g. Haas 1961 ; Lindberg 1963 ; Lindberg and Scheingold 1970 ) , neo-functionalism placed a system of # 8216 ; practical overflow # 8217 ; , in which the underlying assurance by authoritiess to put a specific segment, for example, coal and steel, under the approval of cardinal foundations makes power per unit zones to augment the approval of the foundations into neighboring nations of strategy, for example, money trade rates, income improvement, and prizes. Along these lines, neo-functionalists anticipated, sectoral incorporating would deliver the unintended and unforeseen impact of progressing farther coordinating in additional issue nations. George ( 1991 ) recognizes a second strand of the overflow m ethod, which he calls # 8216 ; political # 8217 ; overflow, in which both supranational histrions (, for example, the Commission ) and subnational histrions ( contribution gatherings or others inside the part regions ) make additional power per unit regions for farther coordinating. At the subnational degree, Haas recommended that association bunches runing in a fuse division would hold to cooperate with the universal association accused of the course of their segment. Over clasp, these gatherings would come to welcome the advantages from incorporating, and would in this manner reassign their requests, standpoints, and even their truenesss from national authoritiess to another Center, subsequently going an of import power for farther coordinating. At the supranational degree, besides, natural structures, for example, the Commission would advance such a transportation of truenesss, propelling European strategies and facilitating bargains among the part regions to # 8216 ; overhaul the normal inclusion # 8217 ; . As an outcome of such sectoral and political overflow, neo-functionalists anticipated, sectoral coordinating would go independent, taking to the imaginative action of another political element with its Center in Brussels. The greater part of import piece of neo-functionalists to the study of EU strategy making was their conceptualisation of a # 8216 ; Community technique # 8217 ; of strategy making. As Webb called attention to, this perfect sort Community strategy depended for the most part on the perception of a couple of explicit divisions ( the regular agrarian arrangement ( CAP ) , and the imposts fellowship, see Chapters 4 and 15 ) during the developmental mature ages of the Community, and introduced a recognizable picture of EC strategy making as a method driven by a pioneering Commission and having supranational pondering among part state delegates in the Council. The Community strategy in this position was non only a legitimate arrangement of strategy making foundations yet a # 8216 ; procedural codification # 8217 ; molding the viewpoints and the conduct of the members in the methodology. The cardinal components of this unique Community strategy, Webb ( 1977: 13-14 ) proceeded, were fourfold: 1.governments acknowledge the Commission as a legitimate dealing life partner and envision it to play a functioning capacity in developing an arrangement accord. 2.governments exchange with one another with a committedness to critical thinking, and haggle over how to achieve corporate conclusions, and non whether these are alluring or non. 3.governments, the Commission, and different members in the method are antiphonal to one another, do non do unsatisfactory requests, and are eager to do transient relinquishes in viewpoint of longer term increases. 4. Unanimity is the guideline, asking that exchanges proceed until all dissuasions are survived or losingss in one nation are made up for by augmentations in another. Issues are non seen as independent yet related in a continuous strategy of assurance with the end goal that # 8216 ; log-moving # 8217 ; and # 8216 ; side installments # 8217 ; are conceivable. This Community technique, Webb proposed, described EEC dynamic during the period from 1958 to 1963, as the first six part regions met nearby the Commission to set in topographic point the basic components of the EEC imposts fellowship and the CAP. By 1965, by the by, Charles de Gaulle, the Gallic President, had accelerated the asserted # 8216 ; Luxembourg emergency # 8217 ; , take a firm remaining on the significance of territory sway and seemingly go againsting the inexplicit procedural codification of the Community technique. The EEC, which had been booked to make a trip to broad qualified mass vote ( QMV ) in 1966, kept on taking most conclusions de factoby unanimity, the Commission rose debilitated from its encounter with de Gaulle, and the country state seemed to hold reasserted itself. These tendencies were fortified, moreover, by improvements in the seventiess, when financial downturn prompted the ascent of new non-levy hindrances to stock among EC part regions and when the in tergovernmental features of the Community were reinforced by the inventive movement in 1974 of the European Council, a customary summit meeting of EU caputs of territory and specialists. In add-on, the Committee of Permanent Representatives ( Coreper ) , an intergovernmental natural structure of part state delegates, rose as a significant dynamic natural structure fixing rule law for acknowledgment by the Council of Ministers. Essentially, observational surveies indicated the significance of national gatekeeping foundations ( H. Wallace 1973 ) . Indeed, even a portion of the major progresss of this period, for example, the innovative movement of the European financial framework ( EMS ) in 1978 were taken outside the development of the EEC Treaty, and with no proper capacity for the Commission or other supranational EC foundations. Intergovernmentalism Mirroring these turns of events, another # 8216 ; intergovernmentalist # 8217 ; school of coordinating hypothesis developed, get bringing down with Stanley Hoffmann # 8217 ; s ( 1966 ) guarantee that the country state, a long way from being neglected, had demonstrated # 8216 ; resolved # 8217 ; . Most obviously with de Gaulle, however in this manner with the promotion of new part areas, for example, the UK, Ireland, and Denmark in 1973, part authoritiess clarified that they would oppose the continuous transportation of sway to the Community, and that EC dynamic would mirror the go oning supremacy of the country state. Under these fortunes, Haas himself ( 1976 ) articulated the # 8216 ; outdated nature of territorial coordinating hypothesis # 8217 ; , while different bookmans, for example, Paul Taylor ( 1983 ) , and William Wallace ( 1982 ) contended that neo-functionalists had thought little of the strength of the country state. At a similar clasp, authentic grant by Alan Milward and others ( Milward 2000 ; Milward and Lynch 1993 ) bolstered the position that EU part authoritiess, rather than supranational associations, played the cardinal capacity in the recorded improvement of the EU and were fortified, rather than debilitated, as an outcome of the coordinating methodology. By diverge from neo-functionalists, the intergovernmentalist picture recommended that # 8216 ; the bartering and accord building procedures which have risen in the Communities are minor polishs of intergovernmental discretionary dealings # 8217 ; ( Webb 1977: 18 ) . Thus, the early versions of Policy-Making in the European Communitiesfound significant grounds of intergovernmental bartering as the predominant way of strategy making in numerous

Legal Issues Case Study For Nursing Essay -- essays research papers

Lawful Issues Case Study for Nursing Case 2 Nursing Situation: Cindy Black (invented name), a four-year-old youngster with wheezing, was brought into the crisis room by her mom for treatment at XYZ (invented name) medical clinic at 9:12 p.m. on Friday, May 13. Starting triage appraisal uncovered that Cindy was experiencing a sore throat, wheezing respectively all through all lung fields, seal-like hack, brevity of breath (SOB), respective ear torment. Crucial signs on affirmation were beat rate 160, respiratory rate 28, and a temperature of 101.6 Â °Fahrenheit (F) (rectal). Cindy Black was admitted to the crisis office for treatment. Notes composed by the crisis office doctor on starting assessment peruse, "Croupy female; course breath sounds with wheezing; gentle two-sided tympanic film hyperemia. Chest X-beam uncovers respective infiltrates." Drug recommended included Tylenol (acetaminophen) 325 mg orally for raised temperature, Bronkephrine (ethylnorepinephrine hydrochloride) 0.1 millimeter subcutaneous, and screen results. Attendant Slighta Hand, RN (imaginary name) regulated the medicine as requested and the kid was watched for thirty minutes. Miss Hand's diagramming was brief, practically indecipherable, and read, "Medicines given as endorsed. Cindy seen without positive outcomes. Doctor notified." The doctor analyzed the kid; notes read that the youngster had "minimal clearing" because of the bronchodilator. The accompanying prescriptions were at that point endorsed: Elixir of turpenhydrate with codeine one milliliter by mouth, Gantrinsin (sulfisoxazole) 10 Case 3 milliliters, and Quibron (theophylline-glycerol guaiacolate) 10 milliliters. Attendant Slighta Hand, RN graphed the drugs were given as endorsed. Her note at 11:08 p.m. peruse, "Vomiting; incapable to hold medication. Breath expanded (54), temperature 101.4Â °F (rectal); wheezing with expanded trouble breathing." No further notes were made with respect to Cindy's condition on the crisis division record by the attendant, but to express that at 12:04 am, "child discharged from crisis department." Thirty minutes after release from the crisis division, Cindy Black was taken back to the emergency clinic. This time her indispensable signs were missing, her skin was warm without mottling, and the understudies of the eye were expanded however responded slowl... ...30 minutes) Â · Pulse rate, mood, quality (at regular intervals) Â · Respiratory rate, mood, character (at regular intervals) Â · Patency of the aviation route (somewhere around at regular intervals, more if in trouble) Â · Blood pressure (each 30 to an hour) Â · Skin shading and temperature (like clockwork) Â · Level of cognizance (at regular intervals) Â · Emesis sum, character, and recurrence Rundown: Correspondence all through the nursing procedure is pivotal for the arrangement of safe patient consideration reliable with the common expert norm. Spoken correspondence among all individuals from the human services group, and particularly among attendant and doctor for explaining orders, arranging understanding consideration, and detailing critical patient perceptions is imperative to the nursing procedure. Similarly significant is composed correspondence by the medical attendant as brief also, exact sections in the clinical record. References Bernzweig, E. (1996). The medical attendant's obligation for negligence. (sixth ed.). St. Louis: Mosby Creasia, J. also, Parker, B. (1991). Reasonable establishments of expert nursing practice. St. Louis: Mosby Sincere, V. (1993). Clinical abilities in nursing practice. (second ed.). Philadelphia: J. B. Lippincott

Free Essays on Mythic Tragedy

Hydra was an excellent island†¦and then the plague came. The ranchers of Hydra invested wholeheartedly in their harvests and animals. Their large animals trouble were respected all through the land on account of the highest caliber of wellbeing they had. So normally, it came as a stun when the principal bulls were found dead lying in the fields. Doubts emerged regarding the reason for their abrupt passings. Numerous doctors examined the dead bodies, yet found no variations from the norm in the killed creatures. At that point gradually, more ranchers started to lose their dairy cattle to a similar unreasonable illness. It was felt that by isolating the animals from everybody, the development contamination could be controlled, seeing as how the farmer’s centurion populace had been not recognizably been tainted. Be that as it may, the individuals who had been doled out as overseers of the rest of the groups, which had dwindled to a bunch, started to display certain social ch anges. Their tempers were immediately touched off, and they were inclined to vicious sessions. However, with the keeping mixing of the overseers among everyone, the whole centurion cooperation started to disintegrate. Battles were begun, family structure started to separate, yet the reason for such inconsistent savagery and cultural corruption was as yet ambivalent. Numerous who had seen the impacts of the pollution fled the purported wellbeing of the group of centurions, just to be pursued somewhere around the mentally changed centurions. One was blessed enough to make it to the sure after catch and extreme torture...beaten nearly to the point of death he battled toward the coast, liberating a vessel from the docks utilized for different exchanges farming. With an end goal to get away from the wanton carnage and dispirited culture currently getting uncontrolled in his once cherished country the lost centurion destroyed his vessel on the shores of Anelis. Discovering the rough preci pices, the waves pulverizing his debilitated body, he hears the hints of lifeï ¿ ½... Free Essays on Mythic Tragedy Free Essays on Mythic Tragedy Hydra was a wonderful island†¦and then the plague came. The ranchers of Hydra invested heavily in their harvests and animals. Their helpful animals trouble were appreciated all through the land due to the highest caliber of wellbeing they had. So normally, it came as a stun when the primary bulls were found dead lying in the fields. Doubts emerged with regards to the reason for their abrupt passings. Numerous doctors examined the dead bodies, yet found no irregularities in the killed creatures. At that point gradually, more ranchers started to lose their steers to a similar silly ailment. It was imagined that by isolating the animals from everyone, the development contamination could be controlled, seeing as how the farmer’s centurion populace had been not discernibly been tainted. Be that as it may, the individuals who had been alloted as overseers of the rest of the herds, which had dwindled to a bunch, started to display certain conduct changes. Their tempers were imme diately touched off, and they were inclined to vicious sessions. In any case, with the keeping mixing of the overseers among everybody, the whole centurion partnership started to disintegrate. Battles were begun, family structure started to separate, yet the reason for such inconsistent savagery and cultural debasement was as yet ambivalent. Numerous who had seen the impacts of the pollution fled the purported security of the family of centurions, just to be pursued somewhere around the mentally changed centurions. One was blessed enough to make it to the sure after catch and extreme torture...beaten nearly to the point of death he battled toward the coast, liberating a vessel from the docks utilized for different exchanges farming. With an end goal to get away from the wanton slaughter and dampened culture presently getting widespread in his once cherished country the lost centurion destroyed his pontoon on the shores of Anelis. Discovering the rough precipices, the waves walloping his debilitated body, he hears the hints of lifeï ¿ ½...

Approaches to the Study of Religion Essay -- Theology Religion Sociolo

The sociological methodology takes a gander at strict conviction and practice according to the general public. Sociologists are keen on two topics, the centrality of religion in the public arena and the decent variety of structures it possesses (Hamilton 1995/2001:1). It sees religion as a social actuality subject to experimental perception, which produces observational proof (Dillon 2003:7). The human science of religion is a result of the illumination, from which it acquired an inclination to excuse religion as incongruent with judiciousness (Dillon 2003:6). This excusal has had huge effect on the mentality towards religion and it is the reason for the most persuasive worldview throughout the entire existence of the field; secularization. The secularization hypothesis guarantees that religion is or will be on the diminishing in the public eye. So significant was its effect that advanced human science regularly intends to represent the proceeded with nearness of religion in the publ ic arena and has commonly held a somewhat negative perspective on religion just like a shameful subject of study(Davies 2007:2). The explanation behind the secuarlisation can be found in the way that humanism is a hypothesis both guided by and expects to manufacture speculations (Wuthnow/Dillon 2003:21). Hypotheses require examination and speculation. It is difficult to break down a subject without first characterizing the subject (Robertson 1970:34). Definition is an argumentative issue on the grounds that various definitions involve various rules which lead to various examples being indentified in information. Speculations are made by the distinguishing proof of examples in information which are then generalised.(Davies 2007:5). In this manner a definition will endlessly influence the substance and idea of a hypothesis. Meanings of religion in human science fall into two classes, useful and considerable. This exposition will evaluate... ...in the appropriate responses yet in the inquiry. Works Cited Davie, Grace (2007) The Sociology of Religion. London. Sage Publications Dillon, Michele (2003) Handbook of the Sociology of Religion. Cambridge. Cambridge college press Hamilton, Malcom (1995/2001) The Sociology of Religion: Theoretical and Comparative Perspectives. second version. Routledge. London Chase, Stephen J (2002) Religion in Western Society. London. Palgrave McGuire, Meredith B. (1997) Religion: The Social Context fourth version. Wadsworth Pickering, W.S.F. (1984) Durkheim’s Sociology of Religion: Themes and Theories. Routledge. London Robertson, Ronald (1970) The Sociological Interpretation of Religion. Blackwell Sociology Series. London Steinsaltz, Adin (2000) A Guide to Jewish Prayer . New York Wuthnow, Robert (2003) ‘Studying Religion, Making it Sociological’ in Dillon (2003) pp.16-30

Drexler’s World Famous Bar-B-Que

Drexler’s BBQ is a family eatery that is situated on the Third Ward Houston, TX. This café is being open for a long time, and it’s turning into a family custom. A great many ages the business stay at administration, considerably in the wake of being rename, or close for extension and revamp another cutting edge café individuals on the local despite everything discussing it. The café is particular with the privileged insights of the old family plans however just on the food arrangement yet the most significant on the insider facts of the family esteems. The manner in which the family picture the business isn't what number of they sell depends on how the sell, underlined quality including fondness and gratefulness for the client and companions. Here and there apparently are not entirely adaptable with the tasks hours, however is on the grounds that they need to make a point to provide for the network what the network provides for them. They are exceptionally agile to in any case have a business standing and they care about the network that makes it conceivable. At the point when it ‘s to business choice we need to recollect that costumer allow us our notoriety and to stay in business, so at certain point we depend of them. This is exceptionally urgent in this family required on a privately-run company with good and qualities. What job do values play in how Drexler’s Bar-B-Que communicates with its neighbors and clients? Qualities assume a huge job with its neighbors and clients. Purchasers will in general gander at the all out worth and on account of Drexler’s the clients get fantastic consideration. Mrs. Scott continually is checking with clients to ensure they are accepting wonderful assistance. Clients need associations to be receptive to their necessities, give the best cost and item and be expeditious with administrations. Drexler’s likewise offers back to the network, which is a significant piece to being a powerful association. You should offer back to your condition. The café puts stock in supporting the network in offering back to the encompassing African American people group I accept that since this eatery is extremely a family arranged business situated close to the Third Ward, which is a financially burdened neighborhood they need to elevate to residents that there is trust, you simply need to buckle down for it. Is Drexler’s a successful association? Why? I surmise you would state the café proprietors remembered where they originated from and needs to help other people who are destitution blasted get an opportunity to encounter things/occasions that couldn't be experienced without the assistance of sponsorship. Drexler’s is a compelling association. They esteem their clients; offer predominant assistance and an extraordinary item. Drexler’s additionally adjusts to the outside condition. They extended their café so as to suit the developing customer base. Apply the frameworks model to delineate how Drexler’s Bar-B-Que works with its condition. As indicated by the reading material, frameworks hypothesis is the point at which an association takes assets (contributions) from the bigger framework (nature), forms the assets and returns them in a changed structure (yield) Beginning with the information sources the association will enter their qualities and supplies, which they at that point procedure so as to produce an effective. Yield †their brilliant food. Their item is a consequence of the qualities the association and its representatives hold. The yield brings about producing income, which at that point returns into nature through drawing in shoppers to the zone, support a nearby softball crew and a Boy Scout troop.

Whats In Your Backpack

Whats In Your Backpack Its not unusual to overpack for college move-in day. Any Pinterest photo or BuzzFeed article will provide you with an extensive (and quite honestly, exaggerated) list of things, from TVs to cars.  And while these may (or may not) be helpful, there was one area I failed to find expertise on: what to bring in my backpack. First off, it is important to get a high-quality backpack that can carry a heavy load as well as last an entire school year. While a stylish backpack may seem like the priority, quality beats appearance on this one. Recommended backpack brands include Northface, Herschel, Amazon, and Swissgear. Second, and most importantly in my opinion, get a backpack with AT LEAST one cupholder. Carrying a reusable water bottle around campus is not only great for the environment but is necessary for student health. In any given day, a college schedule can fit in 3 miles of walking, and not drinking water can lead to serious dehydration. Third, invest in a backpack with a laptop sleeve. Unlike high school, laptops are generally allowed in classes for note taking and are much lighter than carrying a notebook for each class, not to mention that laptops save tons of paper. A backpack without a laptop sleeve will result in a heavier feel and less protection for the laptop. Last but not least, test your backpack out BEFORE you leave for home. Try walking around the block with a water bottle, a laptop, and a yearbook to check your chosen backpack for optimal comfort. Backpacks without proper comfort and support can lead to back pain, poor posture, and a very grumpy mood. Rachel Class of 2020 I am studying Middle Grades Education with concentrations in Social Sciences and Literacy in the College of Education. Although I now reside in Champaign, I am originally from Vernon Hills, a Northwest suburb of Chicago.

Create a Reflective Piece Using The Gibbs Reflective Model - Free Essay Example

Create a reflective piece using the Gibbs Reflective Model which identifies an incident in the workplace where there was a lack of leadership. Use critical analysis of a reflective cycle to explore how this incident has increased your knowledge and understanding of professional practice with respect to the values and behaviour s in the field of nursing, and how future your behaviours will change. Definition of Gibbs Reflective Cycle Gibbs reflective cycle (1988) is a tool used by numerous professionals, including (but not limited to) health professionals, education workers and those in leadership positions: its purpose is to assist practitioners in reflection, which contributes to continuous personal development (CPD) and helps to ensure that a person is continually learning and improving in their role. The idea is to systematically reflect on a particular situation to ensure that all aspects have been considered and evaluated, as this will assist the reflector in understanding what to do next time they are in a similar situation. The process consists of the following steps: Click to Expand Description: What happened? Feelings: What were you thinking/feeling? Evaluation: What was good about the experience? What was bad about it? Analysis: What sense can be made of the situation? What was really going on, as opposed to what you may have perceived? Conclusion: What was the end result à ¢Ã¢â€š ¬Ã¢â‚¬Å" how well did you think you managed the situation overall? What else could you have done in the situation? Action plan: If the situation occurred again, what would you do? Would you act differently? Is there a skill you can develop or something you can learn to help you to be better equipped next time? Introduction The incident I will be reflecting on occurred whilst I was placed with the vascular team. We had received a request for a duplex carotid scan for a patient on ITU who had been admitted due to a large stroke. Upon arrival we read her notes which highlighted significant aphasia and difficulties with communication. The nurse also informed us that the patient had a long standing memory problem and as a result of this, she did not remember why she had been admitted and would become very distressed when her stroke was discussed. When we approached her to perform the scan we found that she was under minimal sedation and was having assistance from a ventilator. The scan was completed without difficulty and we began to document our findings in the notes. A nurse came onto the ward with two members of the public in order to show them around ITU before the mans surgery. This has been a long-standing protocol which strives to decrease worry before a planned stay in ITU. The members of the p ublic were brought to the bedside where the nurse began to explain what the equipment was and what it was used for. The nurse made no effort to introduce the members of the public or herself to the patient. She also glanced at the patients notes and then informed the members of the public that she had been admitted to ITU because of a stroke. Upon hearing this, the patient became overtly distressed and had to be more heavily sedated after the nurse in charge of her care could not calm her by talking in a soothing manner. This event clearly caused undue anxiety to both the patient and members of the public, in addition to the members of staff who bore witness to the incident. The incident was reported using an in-house critical incident report by both myself and staff from ITU as this was a breach of patient confidentiality and poor practice. Interpretation of the incident Before the incident, I was aware that the nurse was showing the members of the public around the ITU in order to familiarise them with the ward. I was very surprised when the nurse did not check the patients notes beforehand, and the distress caused to both the patient and the members of the public was entirely unnecessary. To critically reflect upon this incident I shall use a well-known reflective cycle from Gibbs (1988). This model is cyclical and is unique because it includes emotions, knowledge, and actions and believes that experiences are repeated, which moves away from the model proposed by Kolb (1984). Some scholars, such as Zeichner and Liston (1996), believe that a wider and more flexible approach is needed by examining values in a critical light and how the practice of this can lead to changes in quality. Description The most important factor in this incident was the lack of intervention from myself or the other healthcare professionals. The nurse should have been made aware that this was not a suitable area to bring the members of the public to. I also assumed that there would not be disclosure of specific patient details as this would be a breach of patient confidentiality policies which are covered in numerous guidelines from the Healthcare Professions Council (HCPC, 2012) and the Nursing and Midwifery Council (NMC 2015). Feelings The main emotion that I felt in this situation was anxiety. I had been to ITU many times before and it is an environment in which I feel comfortable. I had not been to ITU to perform a carotid ultrasound before and I felt nervous as I wanted to perform the test well. I believe that, as a result of this, I moved some accountability to my senior colleague. I found the incident upsetting to witness as the distress was caused by a member of staff and their actions were avoidable. Evaluation My role was to complete the scan and establish the presence or absence of carotid disease, which I did. The results of the scan would have been used to determine the best course of management for this patient. It is important to note that acting in the patients best interests was also part of my role, and I feel that I did not fulfil this completely. The duty to protect patients and patient confidentiality at all times lies with all staff, including myself, my vascular colleague, and the ITU staff. Our failure to act as a team could be explained by Rutkowskis (1983) theory of group cohesiveness. This theory proposes that altruistic behaviour is dependent upon the social norm, and is defined as people helping those in need, and who are dependent upon them for help. Rutkowskis (1983) showed that the group is more likely to act in accordance with the perceived social norm if there is a high level of group cohesiveness. In the situation that I have described, neither my colleague nor I were familiar with the healthcare professionals on ITU and there may have been a low level of group cohesiveness as a result of this. Further work (Koocher Keith-Spiegel 2010) has demonstrated that irresponsible professional behaviour can be averted by informal interventions. People were found to be more likely to take action if they were the senior person in a situation, and most felt that a positive outcome was as a result of their intervention (Koocher Keith-Spiegel 2010). It is important to note that the way in which this outcome was measured (taken from data described as feelings after intervention), may have introduced bias as it is likely that participants felt pleased with their courage in acting in an appropriate manner, regardless of the outcome of the intervention. It is possible that their intervention garnered no difference in professional behaviour. It is important to note that cases of major misconduct, such as those which could result in harm to patients or dam age to the reputation of the Trust, should be dealt with by more formal routes. We completed an internal incident report which automatically flags the incident to senior clinicians and managers which would ensure that this incident was not unheeded. If this incident had not been reported, it would be an indicator of declining professionalism and acceptance of inferior standards of care. Tolerance of poor standards was highlighted by the Francis report (2013) as a consequence of poor staffing, policies, recruitment and training, and leadership. Analysis The patient had a jugular line in place, which I had anticipated would make the scan more difficult and therefore probably contributed to my increased level of anxiety. I feel that if I had not been as anxious I would have been more likely to intervene; however it is clear that both my colleagues and I should have intervened more quickly. I believe that an informal intervention as described by Koocher and Keith-Spiegel (2010) would have been appropriate in this situation. Conclusion Having witnessed the distress caused to both the patient and members of the public, I am now aware of the important of being more assertive if similar situations were to arise in future. Although I believe I should have intervened at the time, the experience I have gained from this has made me more aware of the important of always acting in the best interests of the patient even when this may take courage. I believe that having greater confidence in my ability to scan would have reduced my diffusion of responsibility and allowed me to act in a more autonomous fashion. There should also be a greater emphasis to establish strong working relationships between healthcare professionals to in turn increase levels of group cohesiveness (Rutkowski et al 1983). Action plan My future practice will involve becoming more proactive when I believe that there is a risk to patient confidentiality, and I will not assume that other members of staff will act in a professional manner at all times. I will continue to undertake reflective practice by using the model proposed by Gibbs (1988), and will aim to become confident when protecting patient confidentiality, particularly in situations where I am applying clinical skills which are new to me or that I do not feel completely confident with. As a trainee healthcare scientist, I aim to consistently implement the values and principles as set forth by the HCPC (2012) of a clinical scientist, and although this experience was difficult, I now feel that I have a greater understanding of these principles and values. Changes in norms and behaviours Due to the incident, I have formed a new set of behaviours. The first of these is that I will no longer assume that all members of staff will act in accordance with guidelines about patient confidentiality. Tied to this is a conscious effort on my part to refrain from assuming that I can predict the actions of other healthcare workers and I will always prioritise the welfare of patients in my care. Gibbs (1988) model has allowed me to critically reflect on my behaviours and has allowed me to identify aspects of my behaviour which may be detrimental. Critical reflection of this incident has made it clear that there is a deference to those I deem more senior than myself, perhaps due to a subconscious desire to maintain good working relationships. It is possible that the major obstacles which prevented me from speaking out in this incident were my perception of an authority gradient between myself and my colleague and low group cohesiveness. To prevent future events like this occur ring I will express any concerns about my clinical skills before beginning any procedures in order to both reduce any authority gradient and to also reduce the diffusion of responsibility as much as possible. I now feel more confident in protecting patient confidentiality and will aim to always embody the values and principles of a healthcare scientist. References Dewey, J. (1933). How we think: A restatement of the relation of reflective thinking of the educative process. 2nd edition. New York: Heath and Company. Francis Report (2013), Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, London: The Stationery Office. Gibbs, G. (1988) Learning by doing: a guide to teaching and learning methods. Oxford: Further Education Unit. Hatton, N. and Smith, D. (1995). Reflection in Teacher Education: Towards Definition and Implementation. The University of Sydney: School of Teaching and Curriculum Studies. Healthcare Professionals Council (2012), Confidentiality à ¢Ã¢â€š ¬Ã¢â‚¬Å" guidelines for registrants, London: Park House. Kolb, D. (1984). Experiential learning: experience as the source of learning and development, New Jersey: Prentice Hall. Koocher, G. and Spiegel, K. S. (2010) Peers Nip Misconduct in the Bud, Nature, 466(2), 438-440 National Committee of Inquiry into Higher Education (1997) Dearing Report: Higher Education in the Learning Society. London: The Stationery Office. Nursing and Midwifery Council (2015) The Code for Nurses and Midwives. London: Park House. SchÃÆ' ¶n, D. (1983) The Reflective Practitioner. How professionals think in action, London: Temple Smith. SchÃÆ' ¶n, D. (1987) Educating the Reflective Practitioner, San Francisco: Jossey-Bass. Quality Assurance Agency (2001). Personal development planning: guidance for institutional policy and practice in higher education. Rutkowski, G. K., Gruder, C. L., Romer, D. (1983). 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