Symbolism In Sir Gawain And The Green free essay sample

Knight Essay, Research Paper From the first clip I read Sir Gawain and the Green Knight I have been troubled by the inquiry of whether or non Sir Gawain was right or incorrect in lying in order to maintain the girdle and salvage his life. He was torn between honestness and his ain life. The inquiry he was forced to inquire himself was # 8220 ; what did he value more: his honestness or his life? Many bookmans have struggled with this inquiry for centuries, every bit good as the inquiries of why Gawain made the determination that he did, how guilty he # 8220 ; truly # 8221 ; felt for his actions, and what the poet is seeking to state the reader through Gawain # 8217 ; s ordeal. When I was turning up I was told to ever be honest. I was merely # 8220 ; grounded # 8221 ; twice in my life-time: one time for non stating my ma where I went one afternoon and one time for stating her a prevarication. We will write a custom essay sample on Symbolism In Sir Gawain And The Green or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page I was in Kindergarten and broke a taper ( wear # 8217 ; t inquire me why or how ) . I blamed it on the cat. I couldn # 8217 ; t stand the force per unit area of my female parent # 8217 ; s intense question that consisted of merely inquiring me how the cat could perchance brake the taper which was surrounded by a hurricane lamp. My guilt was so overpowering that I broke down and told her the truth. Thus, I was introduced to the construct of # 8220 ; anchoring # 8221 ; and the importance of honestness. I was taught at a immature age that the foundation of any relationship is honesty and without it, a friendly relationship can merely last so long and its roots travel go merely so deep. But honestness is non everything. My female parent would likely anchor me once more if I did non lie to person to salvage my cervix. There is another side to the inquiry about Sir Gawain # 8217 ; s determination to non give Bertilac the green girdle. While honestness should be extremely valued, it may be unwise to undervalue life itself. In about every civilization decease, every bit good as Gawains # 8217 ; civilization, decease is recognized # 8220 ; as a terrorizing thing which work forces and animate beings likewise try to get away by every device in their power, irrespective of self-respect or responsibility # 8221 ; ( Burrow, # 8221 ; The Third Fit # 8221 ; 37 ) . It may be even more hard to put an overruling significance on the value of honestness in visible radiation of life # 8217 ; s option: decease. # 8220 ; # 8230 ; images of decease permeate the medieval universe # 8221 ; ( Clien. 55 ) . A modern reader of Sir Gawain and the Green Knight should derive an apprehension of what decease means within the # 8220 ; cultural surroundings # 8221 ; which surrounded the Gawain author. Wendy Clein in her book # 8220 ; Concepts of Chivalry in Sir Gawain and the Green Knight # 8221 ; describes the knightly attack to decease as an uncomfortable and awkward matrimony between the warrior # 8217 ; s code on one side and Christianity of the the antithetical side. The warrior codification calls for the knight to # 8220 ; defy decease in Acts of the Apostless of gallantry and thereby derive worldly fame # 8221 ; ( 55 ) . However, the Christian philosophy demands that the knight resignation worldly fame and accept decease as a # 8220 ; transition from this imperfect universe to infinity # 8221 ; ( 55 ) . If knight is to derive celebrity and carry through the warrior codification that is so profoundly engrained into the mind of a warrior, he must play with decease. This is what war and tourneies are all about. It is about looking decease in the oculus and non squinching. Once a knight can make this he has fulfilled the warrior codification of a knight, at least for the minute. The Christian attack to decease is much different from the warrior attack to decease. While some parts of the verse form may look be merely # 8220 ; Christian in harmoniousness with pre-Christian nature belief and ritual # 8221 ; , the issue of infinity and how to populate life can be rather cacophonic ( Speirs. 85 ) . The Christian is called to reject the secular glorification that is offered by the universe of the knight. However the knight who gives up worldly glorification is non left without any awards or glorification. These temporal glorifications are replaced by the # 8220 ; religious wagess # 8221 ; that are enjoyed by the saints. While it might look that the two universes of Christianity and the warrior are reciprocally sole, they can truly congratulate each other when human logic is applied. If warriors are supposed to crush up people, and Christians are supposed to populate their lives for God so logic Tells us that we can unify these two life styles by crushing up people for Jesus. The Crusades were great for these particular sort of persons who desired to keep their committedness to the Church while prosecuting in the bang of violent escapade. This is one of the alone times when the values of mediaeval Christianity and the medieval warrior truly compliment each other: when it is clip to crush up aliens for Jesus. There are a figure of advantages to the religious life that Wendy Clein explores. One advantage that the religious universe has over the warrior universe is that it is non of an sole nature. In a conflict to the decease, merely one warrior can win, while the other warrior must decease. Whereas in the religious universe, redemption is unfastened to all and accomplishable by all who embrace the Christian manner of life, because it is non of an sole nature. Rich and hapless, every bit good as the strong and the weak, can accomplish the wealths of the religious universe. Harmonizing to Clein the 14th century civilization points out to that another benefit of fall ining the Christian nine is that it does non offer one of those miserable life-time ranks. By fall ining this nine, all members automatically receive an ageless guarantee on the human psyche at no excess cost. A life-time guarantee expires manner to early: Moralists turned assorted occasions into chances to reflect on decease. John Mirk # 8217 ; s discourse for the Feast of the Circumcision moves from sing Christ # 8217 ; s mortality to cheering hearers to believe on their ain # 8230 ; . Images of disintegrating flesh provide the most dramatic illustrations of earthly transiency. The cadaver as souvenir mori appears early in a Christian context, transforming the Egyptian and Roman image from a carpe diem exhortation to an admonition non to give ageless felicity for the fugitive pleasances of the organic structure. The image pervades the ulterior Middle Ages. ( 60-61 ) In visible radiation of this kind of imagination it is apprehensible how Gawain might hold felt the guilt that appears to be utmost to most modern readers of the verse form. Gawain # 8217 ; s guilt is utmost when he at the terminal of the verse form he discusses why he wears the set: This set symbolizes the incrimination I bear on my cervix ; It signifies the sorrowful loss that I have suffered, Caught by cowardliness and covetousness at that place ; It is a item of the untruthfulness that trapped me, And I wear it for every bit long as I may populate ; For a adult male can conceal his injury, but neer hurl it off, Since one time it is attached, it will neer vanish. ( ln 2506-2512 ) It was believed that the pleasances of the tribunal threaten work forces by deflecting them from the # 8220 ; truth # 8221 ; that the cadavers can now understand. In the civilization of the Gawain poet, merely as in our modern civilization and every civilization in between, there was lip service and handily timed alterations of bosom. After the knights went out into the universe to prosecute in their varied and unhallowed pleasances of the universe, they would reprobate knighthood. There is a certain rhythm to the human status that brings relevancy to the narrative of Gawain. Just as the babe boomer parents didn # 8217 ; Ts like all that stone and axial rotation music their kids adored so much, the knights did non desire their kids to hold excessively much merriment. The # 8220 ; Black Prince # 8221 ; becomes low and rejects the secular pleasances in composing his epitaph: # 8230 ; /now I am hapless and lowly, laid deep in the Earth, / My great beauty is all gone, my flesh is all dissolved. / My house is really narrow and I have nil but truth. ( John Nichols. A Collection of All the Wills of the Kings and Queens of England. Clein p.62 ) While his epitaph is quaint and marked by humbleness, the prince still ordered a expansive funeral that was far call from the humbleness he professes: And we wish that at that clip our organic structure be led through the town of Canterbury to the priory, that two war Equus caballuss decked in our weaponries and two work forces armed in our weaponries and our helms attend our said organic structure, viz. , one for war in our whole weaponries quartered, and the other for peace in our badges of ostrich plumes with four streamers of the same suit, and that each of those who carry the said streamers have on his caput a chapeau of our weaponries. And that he who is armed for war has an armed adult male transporting after him a black pennant with ostrich plumes ( nichols. p88 CLein p70 ) . The # 8220 ; truth # 8221 ; of which the Black Prince writes in reasoning his epitaph was improbably of import to 14th century moralss. The importance of truth is manifested in Gawain # 8217 ; s guilt trip at the terminal of the verse form. He wears the green sash to remind him of his # 8220 ; untruthfulness # 8221 ; ( ln. 2509 ) Not merely was I taken aback by Gawain # 8217 ; s extreme guilt which seems absurd, but I was thrown off by the wickednesss with which he chooses to reprobate himself, peculiarly the Cardinal or capital wickedness of # 8220 ; covetousness # 8221 ; ( ln 2508 ) . J. A. Burrow dismisses Gawain # 8217 ; s self-conviction of covetousness. The observer argues that Gawain # 8220 ; is non conceited or envious: he does non have on the lady # 8217 ; s gift # 8216 ; for wele # 8217 ; ( lns. 2037,2432 ) . It seems clear # 8230 ; that the ring episode is designed to do the same point-to brand sure in progress that the reader does non misconstrue the hero # 8217 ; s motivations # 8230 ; .It clears the land. Anyone who refuses such a ring is immune from covetousness at least # 8221 ; ( Burrow. 42 ) The job with this reading is that the author defines covetousness excessively narrowly and more narrowly than the writer intended. While it might be easy to state that Gawain merely went brainsick at the terminal of the verse form this merely opens up a whole new set of inquiries. Why would he desire Gawain to travel brainsick when he has been a symbol of the closest a homo can acquire to perfection? Why would the writer make the tribunal which has appeared foolish and weak in the right while Gawain was in the incorrect? D. F. Hills explores why Gawain was right to impeach himself of covetousness, why Gawains # 8217 ; response was proper, and how the poet # 8217 ; s usage of # 8220 ; covetousness # 8221 ; maps to clear up and stress instead than confuse. It is obvious why Gawain accuses himself of # 8220 ; cowardness # 8221 ; ( ln 2508 ) and # 8220 ; untruthfulness # 8221 ; ( ln.2509 ) , but why would he bear down himself with # 8220 ; covetousness # 8221 ; ( 2508 ) ? Hills recognizes that in order to understand why Gawain every bit good as what the poet is seeking to state us we # 8220 ; must analyze the medieval construct of covetousness # 8221 ; ( 313 ) . Hills quotes St. Thomas Aquinas from Summa Theologiae: # 8230 ; covetousness can be diversely understood. In one sense, it is an inordinate desire for wealths # 8230 ; . In another sense, it means an inordinate desire for any temporal goods whatsoever # 8230 ; . In still another sense, it can intend some disposition of a corrupt nature to overly want bribable goods. And therefore they say that covetousness is the root of all wickednesss, by analogy with the root of a tree, which draws its nutriment from the Earth, for in the same manner all wickedness grows from the love of temporal things. ( 314-315 ) Gawain reacts as he should if life in the universe of Aquinas, because he has tapped into the root of all wickedness. Gawain senses that his being has been usurped by his wickedness, and he will get down decomposing from the interior out. Along this same way of medieval idea, covetousness is the # 8220 ; antithesis of charity # 8221 ; ( 315 ) . It is a love of the universe which is non a love directed toward God, but instead covetousness is love directed towards the ego: Covetousness is the component in all wickedness which is due to loving oneself more than God and seeking # 8230 ; a solace which has no solace # 8230 ; . So no affair how much the human psyche contains, it is neer full unless it can keep God, whom it can ever keep. O envious adult male, if you wish to be satisfied, discontinue being envious, because every bit long as you are envious you can non be satisfied. ( 318 ) Hills states that # 8220 ; It is basically a religious disease # 8221 ; ( 319 ) and Gawain monsters out when he accepts that he has contracted the disease. By specifying covetousness in this manner we open up a whole new manner of looking at the significance of Gawain # 8217 ; s mistake. Hills takes the Aquinas definition of covetousness and brings it to fruition by using it to Sir Gawain # 8217 ; s self-proclaimed wickedness of covetousness: Clearly a rigorous regard for the truth # 8230 ; would necessitate that Gawain should manus over the green girdle to Bertilak or possibly decline to accept it in the first topographic point. In non making so because he loved his life excessively much he was puting his love for himself above his love for truth and hence God. ( 321 ) By the poet explicitly calling Gawain # 8217 ; s mistake # 8220 ; covetousness # 8221 ; he is clear uping his subject of the H2O and oil nature of the religious universe and the the secular universe. He is calling the root of wickedness. Man valuing this universe over the following. Why does it count if you get your caput violently cut off? You are traveling to decease shortly anyhow, so you should be free of any wickedness, even the small 1s, in order to acquire on God # 8217 ; s good side. Eternity is a long clip. While Gawain sees himself as this dark evil individual the reader joins Arthur, Bertilac, and the Court of Arthur in thining the significance of Gawain # 8217 ; s discourtesy. Bertilak sees it as # 8220 ; a little defect, my friend: you lack some faithfulness./ It didn # 8217 ; t originate for an disingenuous object or amative fling-/ No! You merely loved your life! And I blame you the less for it # 8221 ; ( ln. 2366-8 ) . This did non function to soothe him, because it merely precipitated a # 8220 ; Shivering inside himself with a black fury # 8221 ; ( ln. 2370 ) . John Burrow argues that covetousness is non so of import to understanding the poets purposes. Rather that cowardliness is the root of Gawain # 8217 ; s failure. Burrow provinces that # 8220 ; cowardliness led him to perpetrate one of the traditional # 8216 ; Acts of the Apostless of covetise # 8217 ; # 8221 ; It was merely because Gawain was a coward foremost that he subsequently became covetousness harmonizing to Burrows reading. I will fall down on Hills # 8217 ; side and suggest that the poet is utilizing the fact that Arthur # 8217 ; s tribunal doesn # 8217 ; t reprobate Sir Gawain, but in fact laugh at him for doing such a large trade out of his wickedness, to foster his motive of the cyclical stupidity of the multitudes. To add sarcasm to diss the writer has the Round Table where the sash as a grade of award when it is truly intended to be a grade of shame. The writer is shouting to the reader that the Court with all of their energies focused on this universe merely do non grok what is traveling on. When Gawain accepts the lacing, he does non understand the nature of the trial ( Benson. 224 ) . For Gawain # 8217 ; s trial is non a trial of temporal endurance as with what we see with the fox, it is a religious trial. It is a trial of which universe Gawain will take to populate in, and he can non populate in both. It is either/or with nil in between. For Gawain recognizes that in the 14th century universe that he took the first measure, which is non undistinguished in theological footings, on that long way to hell. Bibliography Benson, Larry. Art and Tradition in # 8220 ; Sir Gawain and the Green Knight # 8221 ; . New Brunswick: Rutgers Universty Press, 1965. Burrow, John. # 8220 ; # 8216 ; Cupiditas # 8217 ; in Sir Gawain and the Green Knight # 8221 ; . Oxford: Clarendon Press, 1964. Critical Surveies of Sir Gawain and the Green Knight. Notre Dame: University of Notre Dame Press, 1968. # 8212 ; # 8221 ; The Third Fit. # 8221 ; A Reading of Sir Gawain and the Green Knight. London: Routledge and Kegan Paul, Ltd. , 1965. Twentieth Century Interpretations of Sir Gawain and the Green Knight. Clein, Wendy. Concepts of Chivalry in Sir Gawain and the Green Knight. Norman, Oklahoma: Pilgrim Books, 1987. Hills, David Farley. # 8220 ; Gawain # 8217 ; s Fault in Sir Gawain and the Green Knight # 8221 ; . Review of English Studies. Oxford: Clarendon Press, 1963. Spiers, John. # 8220 ; Sir Gawain and the Green Knight # 8221 ; . Scrutiny. Cambridge: Cambridge University Press, 1949. 35f

How to Write a Sample Linguistics Title

How to Write a Sample Linguistics TitleA sample title is the first thing a reader looks at when they are attempting to understand the content of an essay. Sample titles are not difficult to find, but they do take some time and thought to ensure they are appropriate for the topic. The first step to writing your sample title is to think about what you want to say in your essay. This will require time, preparation and research on your part.Think about who is going to read your sample title and decide how it will fit into the overall essay. In a sample essay, it is important to understand that a reader might have very different ideas about the topic than you. Writing a good title is the first step in making sure that the reader gets the information that they are looking for.Before writing the sample titles, you should already know the topic of the essay. When you know the topic, you will be able to figure out what topics will be covered and which samples you will need to include. Then yo u can start thinking about how you are going to create your sample titles.While you are researching the topic, the example title is the second step to writing a great essay. Most writers use the example title as their reference when they are working on their essay. It's important to remember that examples are meant to serve as a guide.Your examples should be able to explain the main point of the sample title, and this should also be the primary reason that your examples are included in your essay. A primary reason that the examples are included is to help your reader understand your title. Your samples will be easier to understand if you include clear examples.You should consider the main point of the title as well. The main point of the title will be the best way to focus the essay. The main point of the title should be the main point of the entire essay. If the main point is not clear, you may need to modify the main point to make it clearer.Another aspect of the main point of the title is to make sure that it makes sense. If you are unsure about what you want to say, you can include another example to help you with your main point. Try not to write too much, because the sample titles should be a way to get your reader excited about the topic.So when you are writing your title, be sure to add your examples as well as your main points. When you add examples, you are teaching your reader about your main points, your examples, and the main point. This is the best way to help the reader understand what you are trying to say.

5 Cases of Awkward Appositives

5 Cases of Awkward Appositives 5 Cases of Awkward Appositives 5 Cases of Awkward Appositives By Mark Nichol In each of the sentences below, a writer has referenced a person, place, or thing with an appositive, a word or phrase equivalent to another word or phrase, but erroneous punctuation or syntax introduces a flaw in sentence construction. The discussion following each example explains the problem, and a revision illustrates its resolution. 1. A dome-shaped structure made of ice or snow, or igloo, is a form of temporary shelter. When a term is defined, the definition should follow the term- the focus of the sentence- rather than serve as an introduction to the concept followed by the term: â€Å"An igloo, or dome-shaped structure made of ice or snow, is a form of temporary shelter.† 2. The first of two main strategies when building application security is the top-down or proactive approach. The strategy is not called â€Å"the top-down or proactive approach†; it is called â€Å"the top-down approach† or â€Å"the proactive approach.† To clarify that these names are alternatives to each other, rather than elements of a compound name, the second adjective should be treated as a parenthetical: â€Å"The first of two main strategies when building application security is the proactive, or top-down, approach.† 3. FBI Criminal Investigation Division Deputy Assistant Director John Smith discussed the report.   Technically, this sentence begins with a job title- a cumbersome one, at that- rather than an appositive, which is similar in function but not in form. With some reconstruction of elements, the title is easily converted to an appositive, but note that when a title is treated this way, it is no longer capitalized (though the associated proper nouns are): â€Å"John Smith, deputy assistant director of the FBI’s Criminal Investigation Division, discussed the report.†Ã‚   4. The group, OurMine, took responsibility for the hacks after the tweets were deleted. Assuming that no previous reference has been made to the organization in question (whether identified by the word group or a synonym), its name is an essential component of the sentence and should not be set off as a discretionary parenthetical: â€Å"The group OurMine took responsibility for the hacks after the tweets were deleted.† (If it had been previously mentioned, then group would be an appositive of â€Å"OurMine,† and the original sentence would be correct.) 5. The outcome depends on the quality of the plans developed during the previous, inspection phase. Here, two aspects are being ascribed to the phase- it is previous to another phase, and it involves inspection. However, the two aspects are not equivalent, so they should not be treated as coordinate adjectives: â€Å"The outcome depends on the quality of the plans developed during the previous phase, inspection.† (Or â€Å"The outcome depends on the quality of the plans developed during inspection, the previous phase.†) Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Style category, check our popular posts, or choose a related post below:36 Adjectives Describing Light30 Baseball IdiomsRunning Errands and Doing Chores

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Management Work and Society People, Management and Business Essay

Management Work and Society People, Management and Business - Essay Example The structure of this paper is as follows. In the next section, the main arguments on the gendered nature of the organization are presented. This section is further divided into a number of subsections. The first subsection discusses the ways in which occupational mobility is important for women, and how it influences the organizations. Issues of the way in which lack of mobility can lead to gender pay differences are also discussed. In the next subsection, the aspects of gender and ethnic makeup of the senior management are discussed. It is noted that the type of senior management present in an organization will influence the kind of people who are hired. The third subsection discusses the ways in which pay differential is a key determinant in the gendering of the organizational environment. The next subsection discusses the implications of education on the nature of the organization. It is established that the organization is highly influenced the type of education which is availab le to the employees, and that women are generally less educated which decreases their chances at getting to the higher levels of management in the organization. The final subsection takes all these issues into account, and is a philosophical discussion on the ways in which a gendered policy is suitable for an organization working in a competitive market environment. This paper concludes that although there is some evidence that the gendered nature of organization is changing, however significant further progress needs to be made before organizations can call them self gender neutral. 2 Discussion & Review of Literature A great deal has been written about the organizational careers and the ways in which gender influences it (Barry et al., 2006, Belfield, 2005, Charles and Harris, 2007, Deem, 2003). Many of the studies on gender and women in management have established that satisfaction level of women working in organizations in UK and elsewhere is lower (Smith, 2009) because of j ob discrimination, difficulties in work-life balance (Charles and Harris, 2007), and poor attitude of management (MarTins and Parsons, 2007). The issues of gender in women, especially within the UK context has been debated in the literature for a long time, and has been a subject of controversy and debate (McDowell, 2005, Metcalfe, 2008). 2.1 Occupational Mobility One of the key issues facing women working in professional environment is occupational mobility. The circumstances under which women can choose or refuse promotions, new work environments and other key changes in the nature of the job are the key turning points in the career of women (Berg and Einspruch, 2007, Guillaume and Pochic, 2009, Tomlinson, 2006). A number of authors are of the view that careers of women are conceived as a set of adjustments to their family lives, which negatively affects their working relationships (Charles and Har

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Coca cola - Essay Example The waste reduction strategies do not reduce current production’s quality level. Initially, the lean production strategy was crafted to cater to the production line of one of Japan’s top selling car models, Toyota. Toyota’s lean production cropped up after World War II. Japan was just recovering from the war loss. Lean production is a continually innovative process. Daily, the production line and staff personnel as well as production management team continue to find ways to reduce production wastes. Lean production reduces the avoidable costs, expenses, and costs associated with typical production processes. The typical production process includes employees accidentally generating avoidable wastes, expenses, and costs to delay the production process and delaying (reducing) revenue generation. Further, the lean production strategy can cover all the business entities’ activities. The activities may include the design of the product as well as the production process. The activities include the production of the company’s saleable or finished products. The activities include the marketing department’s product delivery and selling processes (Jones, 2013). Coke implements several lean production strategies. The strategy significantly reduces production expenses. Initially, coke marketed its quality coke products as having the same taste around the world. To do this, coke used only one water source. The singular source came from only one place. The company exported the coke products to different countries around the world. However, the cost of shipping the coke products increased as the distance between the original home production facilities to the country of destination (Marcotte et al., 2012). Consequently, the higher shipping and production costs of products sold in very far away countries generated a lower net profit than coke products sold in places nearer the production facilities. As the distance between

Quality and Risk Scenario Essay Example for Free

Quality and Risk Scenario Essay The HIM professional can have a direct impact on the quality or compliance of specific operations or employees within a healthcare institution. Healthcare institutions, such as hospitals, can be huge institutions made up of hundreds or even thousands of treatment or operation specific areas operation. This can include anything from the surgeon who performs coronary artery bypass to the neonatal intensive care nurse who directly cares for struggling newborns to the physical plant worker who makes sure all the lights in the building stay on and the operating room is maintained at a certain temperature. As an overall institution the thought of identifying risk and liability within the organization can be quite overwhelming and daunting. The best way to approach this is to break things down into specific issues or areas and focus on one thing at a time, with the overall goal to be improving quality and reducing risk to the institution. 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A study by the University Healthcare Consortium analyzed over 29,000 blood transfusions over a 7 year period from 2003-2009 (Williams, 2011). These transfusions ranged anywhere from scheduled routine outpatient surgeries to unexpected traumatic injuries brought in through the emergency room. The analysis identified many risks associated with blood transfusions, including poorly trained staff, lack of trained staff, minor hemolytic allergic reactions all the way up to severe anaphylactic reactions. The study was even able to identify that the time of day that the transfusion was performed could positively or negatively affect the patient outcome. So, while this can be a lifesaving procedure a blood transfusion should not be taken lightly. Another study published in the April, 2012 issue of the professional journal Anesthesiology was conducted by Johns Hopkins Hospital analyzing the outcomes of over 3000 patients who received blood transfusions. 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The blood is then separated into red blood cells, platelets and plasma, to be distributed specifically where needed. Include the storage and transportation costs and you can start to understand why blood is so expensive. Only giving blood when truly indicated has been shown to reduce the use of blood by up to 66% per institution with no change in outcomes to the patient including â€Å"length of stay, heart attack, stroke, death, and even the ability to walk† (Clark, 2012). This is where the HIM professional can come into play. The HIM can take research articles like this or even acquire their own research and then do training to educate the hospital staff. The Hopkins tudy indicated that when the HIM spoke directly with the surgeons and showed them the research there was a tendency to accept the new mindset and start delaying blood transfusions until the patient hemoglobin dropped below 7. This resulted in extra blood supply for those patients who truly need it and a significant reduced operating cost to the institution. It’s the HIM’s job to establish or change procedures that reflect changing and beneficial modalities and to get the information out to the hospital physicians and staff so they can help reduce institutional costs and ultimately benefit their own livelihood. This process can be done for hundreds or even thousands of processes currently in place within a hospital institution. Now we move on from our blood transfusion scenario to one involving the infrastructure of the hospital. The specific example to be used here is the hospital power supply. Hurricane Sandy revealed for many healthcare institutions in the north eastern United States that they were not as prepared as they thought. Some of these hospitals did have emergency generators in place, but they did no good for providing electricity when they were located in the basement of the building submerged in water from the flood. Sometimes it takes a real catastrophe for us to truly see how prepared we really are and how to improve. It’s crucial that a hospital be able to maintain electricity at all times. Almost every part of the building depends on electricity for staff to function and take care of their patients. Without electricity the lights won’t work, the furnace and air conditioners won’t work, the pumps won’t pump water through the pipes, ventilators will stop working and elevators won’t even be able to transfer sick patients between floors. These are some examples, but surely you can find many more failures if you look hard enough. For this reason, it is important that a hospital evaluate and have a plan in place to reduce the possibility of losing electricity and also have a plan in place if all safe guards fail. The concerns can truly be specific to a geographic area. For example, a hospital in the Midwest may not have to worry much about being hit by a hurricane, but it could be hit by a tornado. I spoke with hospital administrator Robyn Mazzolini at Advocate Lutheran General Hospital in Park Ridge, Illinois regarding how their hospital has addressed the issue of maintaining electricity to the facility. Robyn indicated that there were three specific issues of highest concern. They included the loss of power from the local utility company, flooding of the existing generators in the basement of the main hospital and damage from tornados. Robyn indicated that about ten years ago the hospital installed a generator in the basement of the main building that is capable of providing power to the entire ten story hospital, including all lights and HVAC. The problem was that the unit was very large and heavy and, as a result, had to be installed in the basement. A second generator was installed right next to the first to act as a backup generator should they lose power from the power company. These generators are also designed to operate on both natural gas or stored gasoline in the event the gas lines become compromised. This seemed to solve 90% of the scenarios that could come up. Then the neighboring community experienced a flood that shut down utilities for days and a few weeks in some areas. The hospital was concerned that they would be shut down in the event of a flood in their generator rooms in the basement. So, they added a third generator inside a remote area on the south perimeter of the hospital. This generator is located inside a concrete structure three floors above ground level. This is a smaller generator that will run specific areas in order for the hospital to stay functional. For example, this generator only supplies certain lights so that there is always enough visibility to operate. It also is designed to operate all electronics in the operating rooms, emergency room and critical care areas so there is no compromise to patient care. On the remaining medical floors there is one or two red colored electric outlets that operate off this third generator. In addition, this generator is not connected in any way to the basement level so that it can power the upper floors of the hospital even if the ground level is buried under 20 feet of water. The third generator is also enclosed in walls of reinforced concrete with the thought that it could withstand a tornado. It was the HIM and the HIT who were involved in the process to help determine the essential power needs of the hospital. The HIM evaluated the staff and the various facilities to determine that they could function treating most patients as long as there was one dedicated outlet within each patient room. The HIT also identified that the operating rooms, critical care areas and emergency room pretty much needed full power capabilities no matter what. The HIM and facilities managers both have a critical role in communicating the needs of the patients, staff and hospital to the engineers, administrators and building designers. And while Lutheran General Hospital was able to spend millions to prepare for a power disruption and pretty much covered every scenario, they still need to be ready to operate should all power to the facility cease. It is the HIM who can evaluate the various areas of the hospital based on resources, staffing and needs to determine the most critical issues to address first in the event of a total power failure. This takes a lot of time and energy and is probably an evolving process as conditions and resources change. But, in the end, it is the HIM professional who is able to connect all the dots to help bring the best solution for the organization. The third and final scenario presented here is related to staffing and how the HIM can help reduce risk and liability when it comes to the behavior of hospital staff. Hospital employees by their human nature are susceptible to making mistakes or forgetting to do certain things in the course of their patient care. Every health care institution, and any other business for that matter, strives to find ways to provide the best service possible to its customers. The challenge in improving service and reducing liability is finding a process that actually works. Ohio State University Medical Center found a way to improve the quality and consistency of patient care from its medical professionals. Ohio State did created a system of check lists to be used by hospital staff in their particular department and area of responsibility. So, there were many different checklists, but each employee only had one checklist that they were specifically responsible for. The University compared the outcome of over 3000 patients both before the check lists were used and then an additional 3000 plus patients after the checklists were used. The results were staggering. The study showed, for example, that the surgical death rate of patients decreased 47% when check lists were used compared to none used. Surgical infection rates were found to have decreased by 45%. These are dramatic results that clearly show a huge improvement in patient care and reduction of risk and liability. A possible cause for such improvement is that using checklists prevented medical staff from skipping a stop that could have caused a serious complication or infection. The aviation industry has proven that checklists work. When a pilot has a sudden engine failure there is plenty of room for panic and impulsive missed steps. This is why pilots are trained to immediately pull out their check lists, even if they have them memorized, and go systematically down the list to make sure that all steps are completed as indicated. This following of check lists has proven to significantly improve survivability of the aircraft during an emergency. The use of check lists seems to hold true for the health care industry, too, as the data clearly shows. The HIM plays a critical role in the development and rollout of these check lists to the various departments. The HIM must involve the hospital staff, managers and physicians in the process of developing a check list that easily and safely covers the needs of both the patient and the hospital. Once developed the HIM must develop and take the time to train the staff so that they understand the intent of the check lists as well as the individual steps and why they are to be completed. This training will ensure that the employees buy into the use of the check lists and choose to use them consistently with every patient. Theoretically, this should provide the same process and the same desired outcomes each time. Besides implementing the checklist program through training the HIM also plays an important role in developing a policy that says how the plan is to be implemented. Employees appreciate it when everything is clearly spelled out of what is expected of them. The HIM is in a position to deal with both the hospital administrator and the front line nurse who is physically caring for patients. This allows the HIM to obtain feedback and recommendations from all involved in the process and create or modify the plan as it is determined that changes need to take place. The HIM is possibly also in the best position to analyze the data to present the findings of the continued analysis to administrators to determine if the check list process is working or not. An example of a checklist that Ohio State University Medical Center used was the Pre-Op holding RN checklist that ends with transfer to the operating room RN checklist. Each nurse has specific duties to complete with their patient as they prepare them for their surgical procedure. The Pre-Op nurse can follow the check list to ensure that all required actions have indeed taken place. When transferring care to the operating room nurse the pre-op nurse passes on her check list to verify to the next nurse that everything has been completed properly. Each nurse is also required to ask the next receiving nurse if they have any questions. As you can see, this process really does maintain a high quality of continuity of care for the patients as they move throughout the various areas in the hospital during their stay. Cutting corners and skipping steps in the patient care process is significantly reduced if not completely eliminated and the HIM or HIT professional is involved all along in helping to create and improve the process within that hospital. This paper only discussed three scenarios in the process of seeking to maintain quality while reducing financial liability within a hospital environment. These processes can be used and applied towards the thousands of specific areas of responsibility that exist within a large health care facility like a hospital. The HIM professional really does play a crucial role in connecting the various departments and providers within a small or large healthcare institution. The HIM is in a position to know the pulse of the front line operations as well as the upper office administration’s intended direction going forward. The HIM professional can pull everyone together to compile data and make recommendations or changes that benefit the patient, the physicians and nurses, the facilities operators and even the top level administrators. There are few other individuals who are in such a good position to create such positive change. Quality HIM professionals will be in demand for many years to come.