A Natural History of the Dead essays

A Natural History of the Dead essays As one begins to dissect Ernest Hemingways short story A Natural History of the Dead, a great deal of meaning can be found through the situations he conveys. Through his commentary and the experiences of Mungo Park, much can be learned about Hemingways views and ideas. Upon quick read, one might think this is a simple-minded story about death and its place in history. However, it actually has a much deeper idea hidden in it. Hemingway is revealing to the reader how trivial death actually is. In fact, A Natural History of the Dead is completely irrelevant except to provide the reader with examples of how death is only a small part in the tremendously large scope of nature and the rest of the world. In his short story, Hemingway provides examples as to why death is just one facet in the big picture of life. Early in his story, Hemingway jump-starts the theme that is to be stressed through the rest of the short story by depicting many smaller experiences and cases. One such story is his description of dead bodies on the battlefield. He explains that one of the most surprising things seen on a battlefield is the paperwork scattered among the bodies. One does not remember the smell of the battlefield as much as the incredible amount of paper strewn about. By way of this example, Hemingway shows that even though a person might die, the rest of life, and everything that person has touched, goes on. After reading this particular part of the story, a real life example immediately came to mind. Throughout the September 11th disaster, it was common knowledge that many of the bodies of the deceased were never found, and most likely never will be. Yet, hundreds of thousands of documents proving these people had lived remain. Financial statements, tax returns, employment records, and so on were e verywhere to be found, but the body of the person often was not. Once again, it shows that death pales in comparison ...

Affirmative Action Essays - Social Inequality, Affirmative Action

Affirmative Action Essays - Social Inequality, Affirmative Action Affirmative Action Affirmative Action: Reverse Discrimination? Affirmative Action is a hot issue in the United States, with wide differences of opinion over the correct way to expand opportunity for people who have historically been discriminated against. With the philosophical difference behind the legal and political tensions is deep. One side wants a total rollback of affirmative action programs, making individual merit the only criterion for hiring and promotional considerations. While the other extreme wants affirmative action to be pushed until the racial makeup of all professions mirrors the racial makeup of US society exactly. While both these sides are to the greatest ends of the argument there needs to be an approach to come up with a medium. This could include laws to force companies to vigorously recruit and develop minorities for professional and managerial jobs. However, there should not be any outright quotas, which reserve a certain number of slots for particular minority groups. This will cause resentments and constitutional obs tacles down the road. The objective here is not to do away with affirmative action in one sweep, rather to seek out strategies to help promising minorities and match them with opportunities they have rightfully earned and deserve. Now, what does the law say? Although Title VII has an affirmative action component part of it, most regulations stem from a requirement imposed by Executive Order 11246. There are a lot of misconceptions about affirmative action and what laws companies actual have to follow. One is that all companies are required to adhere to the laws under affirmative action, this is not the case. Executive Order 11246 states that once a company enters into a contract with a federal governmental agency that exceeds $10,000 it must abide by the affirmative action rules and regulations. These regulations include, but are not limited to, the following: to post in a conspicuous place, available to all applicants, provisions of the nondiscrimination clause; include in contractor's advertisements that all qualified applicants will receive consideration without regard to race, color, religion, gender, or national origin; include statements of these obligations to all subcontractors; and furnish all informa tion and reports to the Secretary of Labor for purposes of investigation to ascertain compliance with the executive order and its regulations. In addition to the above regulations if a corporation enters into a contract of $50,000 or more additional requirements are put in place. A Corporation must develop a written action plan within 120 days of the beginning of a governmental contract. They must also perform a workforce analysis, which must indicate how many women and minorities are in job categories ranging from unskilled workers to managerial employees. These are the basic rules and regulations companies and corporations must follow in order to be within the compliance of the law. There have been several major court decisions that have helped define the application of the statutes and regulations. One of the biggest and earliest cases was that of Regents of the University of California v. Bakke. This case was not against an individual's employer rather against a university. Bakke applied to Davis for two consecutive years but was rejected on both occasions. In both years, applicants with lower scores than Bakke were admitted due to a special admit program. Davis had a program that says applicants who are not of minority status are totally excluded from a specific percentage of the seats in the entering class. When the State's distribution of benefits hinges on the color of a person skin, that individual is entitled to a demonstration that the challenged classification is essential to promote a tangible state interest. For this reason the court's judgment was that Davis' special admission program was invalid under the Fourteenth Amendment. Another case, that di d deal with the employer-employee relationship, was United Steelworkers of America, AFL-CIO v. Weber. In this case a white employee sued because his employer adopted a voluntary affirmative action plan reserving for black employees fifty percent of the openings in a training program. Because the company had put in place a voluntary program to eliminate an apparent racial imbalance the Supreme Court held that the program was permissible and did not unnecessarily trample the rights of white employees. These are just

Poaching in Zimbabwea, causes and attempts to stop sense the 1990s Annotated Bibliography - 1

Poaching in Zimbabwea, causes and attempts to stop sense the 1990s - Annotated Bibliography Example help me to identify the causes of poaching in Zimbabwe and the general overview of the steps taken by the South African governments to fight poaching. Consequently, I will use this source to show how the South African countries have suffered from poaching and the strategies they have employed to curb cases of poaching. Gabriel, Hua, and Wang have explored the market dynamics of ivory. They have pointed out that China is the leading market for ivory that is smuggled from Zimbabwe and other African countries. They have raised concerns that despite the ban of ivory trade, this was only short-lived because poaching still continues. Additionally, they have pointed out that the research conducted by IFAW implicates China as the leading market for ivory that is smuggled from Africa. In this scenario, there are a big number of industries of ivory processing industries in China thus affecting Zimbabwe and other African countries negatively. I will use the source to point out the China’s influence on poaching in Zimbabwe. Gulland and Williams explores the steps taken by the African countries following the1989 ban of the ivory trade. They have pointed out how the African member countries enacted laws that could stop and control poaching. In Zambia, they have pointed out the government was out to fight poaching that was rampant in the Luangwa valley. Research shows that poverty is one of the factors contributing to poaching amongst the locals. Additionally, the Zambian government passed stern penalty to poachers found poaching in Luangwa valley between a periods of 1970s-1985. Consequently, the gang members who were caught poaching could be sentenced in groups and sent to jail. I will use this source to argue the steps taken by various African member countries affected by poaching to stop poaching within their territories. The article explores on how the demand for ivory has gone up in the Asian markets more especially in China. The reason given is that these goods are

Setting and Theme of these stories Essay Example | Topics and Well Written Essays - 1000 words

Setting and Theme of these stories - Essay Example The plot type is tragedy, and the novel is about depressed, hopeless and saddened characters, which endure hardships and loss. The novel focuses over the wanted success of different characters, and it describes their dreams. The needed relationships in life, friendship and loneliness of characters are the elements contained in this novel that makes it worth reading. The themes of the novel include pain of loneliness and tragedy of mental retardation. Locations discussed in this novel are the California farm, Salinas River and villages. Author is sympathetic to the characters, yet he does not give them a happy ending. Even till now, it is argued that the novel is emphasizing over hope, happiness and joys of life or it takes its reader into depression. The style of this novel is naturalist, which relates to the depressing literary style. The tone of the author throughout the novel is gloomy and dismal. Steinbeck is a naturalist writer and for the naturalist writers the human characters are more like a human-beast as they seem to be the victim of others around them. In the novel, the author has referred Lennie as a â€Å"bear† and â€Å"horse†. The author does not describe his characters as evil or good as he believes that they are controlled by their environment, chances or heredity. The author does not represent its characters by enforced judgment about their actions; he just presents the characters as they are. He mirrors his characters through the writing style. The language used is simple but compelling. Author keeps the language simple, straightforward and descriptive. A famous novel A Tale of Two Cities is written by Charles Dickens, the novel portrays the scene and circumstances in London and Paris during French Revolution. This novel consists on three books named Recalled to Life, the Golden Thread and the Track of a Storm. The

A stressful life is an inevitable consequence

A stressful life is an inevitable consequence In our career-driven society, work can be a pervasive source of stress. According to a report cited in an edition of the Financial Times, stress at work is one of the biggest problems in European companies. It is evident that the prevalence of stress at work majorly influences job satisfaction, work performance and productivity (Mullins, 2002). The Health and Safety Executive (HSE) define stress as the adverse reaction people have to excessive pressures or other types of demand placed on them (ISMA, 2004). Stress can be accumulated through constant tension and frustration, and can arise from a number of issues including individual, group, organizational and environmental factors. In this essay, I am going to discuss the implications that stress incurs on the individual, and on the organization as a whole by looking at some of the most important issues such as cost, stress-related illnesses, and how to tackle stress in the workplace for a better and healthier workforce. With the changing lifestyles of people today (25-year mortgages, easier credit arrangements, etc.) most people are looking for permanent, full-time employment. Nevertheless, with the current economic crisis, many businesses are cutting back on staff and many jobs are being lost. This has lead to an increase in stress levels. An article published by the Daily Mail on 5 November 2008 (National Stress Awareness day) stated that almost 2/3 of 2700 workers polled said that they felt more run down, stressed and prone to illness than they did three years ago. This has resulted in many of them putting in seven hours of unpaid overtime a week. The article urged employers to tackle this problem as the research shows the credit crunch is having serious implications on the nations workforce, with people working and worrying more (Daily Mail, 2008). As these findings demonstrate, the stress caused by the current economic situation will lead to grave consequences for both individuals and organizat ions; if the individual suffers, the organization is inevitably going to suffer, and vice-versa. Certainly, a healthy workforce gives a larger contribution to a business. Working in a stressful environment means that not only performance is decreased, but productivity is also reduced. So what causes stress? Some would say that being under a lot of pressure causes one to be stressed. However, there is a difference between working under pressure and working under stressful conditions. It is said that a certain level of pressure is needed in our daily life to motivate us and enable us to perform at our best (ISMA, 2004). Cooper et al. (1988) have identified six major sources of stress at work: intrinsic to the job, role in the organization, relationships at work, career development, organizational structure and climate and home-work interface. He also added that conflicts, such as bullying and harassment, at work are another cause of stress. However, stress is said to be a very personal experience as individuals respond and cope differently with the causes and effects of stress. One major source of work stress develops from role incongruence and role conflict. When workers are not clear about their roles in the company, it creates difficulties in communication and interpersonal relationships. In addition, it can have an emotional impact on morale, performance and effectiveness at work, and health. In order to improve business, many organizations restructure and reduce staff, leading to more pressure on the remaining staff. This often results in an increase of work-related health problems, work stress and a less efficient workforce (Mullins, 2002). Handy (1993) has suggested five organizational situations that are likely to produce role problems, and thus stress for the individual: having responsibility for the work of others such as reconciling conflicting objectives of groups and organizations; conflict between the routine aspects of the job and the creative side; being the outside contact is particularly stressful due to the lack of control over demands or resources; relationship difficulties in the company, such as problems with a boss or colleagues; and last but not least, having career doubts if future career prospects are uncertain. Role ambiguity has greater effects on the physiological and psychological well-being of the individual, among them being low self-confidence, low motivation, higher job-related tension, and even depression (Handy, 1993). Karasek and Theorell (1990) have predicted that the most unpleasant reactions of psychological strain such as fatigue, anxiety, depression and physical illness, occur when the psychological demands of the job are high and the workers have low freedom in deciding the task. This model of the high strain situation suggest that arousal energy is transformed into damaging, unused residual strain because of an environmental constraint on the persons optimal response (e.g. trying to get lunch and queues are very long, travelling distance involves a crowded, heavy traffic road; this results o n the residual strain which lasts longer than a normal arousal reaction). Basically, this model implies that environmental stressors that we are presented with in our everyday life can leave us aroused for hours, thus leading to psychological strain and therefore stress. This has great implications for individuals that tend to be more affected by these environmental factors than others. The burden of strain that workers experience on a daily basis has therefore an indirect implication for the organization as performance is affected by the unpleasant, unproductive, and in the long term, unhealthy state of workers. In respect to the unhealthy state of workers and psychological strain, extended exposure to stress has been linked to almost every illness imaginable: heart disease, high-blood pressure, metabolism problems, colds, depression, obesity, memory problems and migraines (Jaffe-Gill et al. 2007). It all comes down to the biological response to stress, Fight or Flight mechanism, which prepares us for emergency. When in danger, the hypothalamus in the brain sets off a chemical alarm. The sympathetic nervous system responds by releasing a flow of stress hormones, including adrenaline, nor epinephrine, and cortisol, which race through the bloodstream, preparing us to either escape the scene or battle it out. However, the more the stress response its activated, the harder it is to shut off which causes the stress hormones, heart rate, and blood pressure to remain elevated even after the crisis has passed. In addition, continuous activation of the stress response causes havoc on the body. This i mplies that workers who are continuously responding to stress are damaging their body; the stress response system will eventually become exhausted causing the immune system to break down, thus making it easier for various illnesses to attack the body. Consequently, this will have enormous effect on the individual, leading to reduced performance in every domain of their life, in particular work. Not to mention the number of increased absence from work that will affect the organization, financially as well as performance wise. In the December 2008 issue of Glamour Magazine, there was a very interesting article about the consequences of stressful life situations. Research shows that women are more prone to negative effects of stress as they tend to be more emotionally tuned in than guys. Women seem to stress more over a problem, they keep thinking about it over and over in their head. The stress caused by a bad day at work is an example of what experts call acute stress, which triggers the fight-or-flight response, but it is temporary and therefore it is harmful as such. It only leads to a tiring day as it burns up a lot of energy. However, when every day at work is a bad day, the acute stress turns into chronic stress, which could cause a lot of damage to your body. As mentioned before, this leads to the fight-or flight response being constantly activated and thus causing strain on the body which in turn can lead to stress-related illnesses. All body systems are affected by this. Recent British research fo und that while stress doesnt necessarily cause cancer, women that have high-pressure jobs had at least a 20% higher risk of breast cancer than those with less job strain. Research also shows that we are getting more stressed with each decade. In a report that looked at the incidence of work-related stress and mental ill-health in the United Kingdom (1996-2001), an estimated annual average of 3624 new cases were reported by psychiatrists (reported higher rates for men), and 2718 by occupational physicians (reported higher rates for women). Anxiety/depression or work-related stress were mainly diagnosed, and post-traumatic stress accounted for ~10% of cases reported by psychiatrists. Inherent to the job factors (for instance work overload) and interpersonal relations problems were generally the most common causes. Nevertheless, those in personal and protective services and professional workers also showed high rates of ill-health (Cherry et al. 2006). Managing mental ill-health requires the adaptation of the workplace to meet legitimate expectations and capacities of the worker, as well as the adaptation of the worker to increase his/her capacity to cope with work demands, through training and cognitive therapy. Therefore t o be able to do this, workers and managers need to collaborate together in order to ensure that both parties know what is expected, thus stress levels reduced. In collaboration with stress management professionals, the Health and Safety Executive has developed the Management Standards approach to reduce levels of work-related stress. This approach displays good practice through risk assessment, allows for the current situation to be measured using various data-collection techniques, and encourages active discussion with employees to help decide upon the practical improvements that can be made (HSE, 2005). This was developed after figures of stress have risen to 1 in 5 people finding work very or extremely stressful. The Management Standards include six key areas of work, which if not properly managed, can cause poor health, lower productivity and increased sickness absence. These primary sources of stress at work are: demands, control, support, relationships, role and change. As the main causes of stress are now well-known, managers can work with employees to find solutions in order to reduce stress at work, unlike in the past that modest a ttempts were made to deal with them. This approach will be excellent news for organizations if followed and applied in the right manner, as well as good news for the worker as hopefully, stress levels will be reduced. One huge factor that has lead to the development of such an approach is the financial cost that work-related stress incurs on the organisation and the society. Stress is the single largest cause of occupational ill-health in the public sector, accounting for around half of all days lost to work-related ill health. In financial terms the estimated cost of sickness absence to the UK as a whole is around  £12 billion a year, and around  £4 billion of this has been attributed to the Public Sector (HSE, 2006). Each case of stress-related ill health leads to an average of 29 working days lost. A total of 13.4 million working days were lost to stress, depression and anxiety in 2001. Work-related stress cost society  £3.7 billion a year in 1995, a figure which has undoubtedly risen in 2008, as stress levels have undeniably soared considering the sharp fall of house prices, cut of interest rates and the loss of numerous job posts due to the current economic climate (HSE, 2005). The cost factor has great implications for organisations as they are spending unnecessary money which could instead be spent effectively to develop their business and create a less stressful work environment, rather than covering the costs of stress-related illnesses that workers seem to endure from working in a stressful work environment. Stress is upsetting to the individual and detrimental to the business at a time when the need to control business costs and ensure an effective and healthy workforce is greater than ever (Mullins, 2002). Much of ill-health is associated with the discrepancy that is caused when changes in job demands exceed the worker capacities. Mental-ill health which arises from traumatic events at work can be avoided by employing good managerial techniques to tackle stress, and in the event of the occurrence, it should be dealt with promptly and effectively.

Lisa Sherman Case Analysis

Lisa Sherman worked for Verizon for many years. While there she never revealed her sexual orientation . Then one fated day, there was a diversification workshop with her fellow managers. The outcome of this was that her coworkers were bigoted towards homosexuality. Lisa Sherman had a tough decision to make, whether to stay or to leave. The following analysis shows a suggested solution. Lisa Sherman Case Analysis: Lisa Sherman spent many years not being true to who she was. She never told her coworkers that she was gay during her 15 years at Verizon Communications. Then, the company decided they wanted to hold diversity training. This is what led Lisa Sherman to the tough decision of whether to stay working at Verizon or put in her notice. The diversity training displayed general statements about different types of people, with statements such as â€Å"gay people are†¦Ã¢â‚¬  written on poster boards. The corporate leaders then formed groups and wrote on the poster boards what their first concept of a particular group of people was. Their statements of groups such as Blacks and Jews involved only positive messages. However when they got to the board regarding homosexual people, it was nothing at all positive, with comments such as â€Å"immoral, pathetic, perverse, and spreading disease. † (Audenaert and George, 2008). How could Lisa now open up and tell these people that she herself was Gay, when they thought such horrid things? Not only were negative derogatory statements bad for Lisa Sherman they were also bad for the company. The CEO Ray Smith wanted to enact a policy of diversification, to take Verizon into a more flexible and creative company. He planned to establish policies that barred not hiring someone because of their ethnic background, religion, race, sex, and sexual orientation. However if his highest level managers felt this way about Gay people what did the rest of the company feel? Lisa Sherman was with Verizon for 15 years, working her way up the chain. She had always hid her sexuality and the existence of her partner Sophie, using pronouns such as â€Å"him† and â€Å"we† for â€Å"her† and â€Å"she† (Alboher, 2008). She felt that if she were to tell anyone it would affect her career, which allegedly proved to be a correct assumption, from the comments that her co-workers made. One of the most homophobic individuals turned out to be one of Lisa’s mentors. In essence, the people Lisa had been closest to turned out to be bigoted individuals. When deciding what to do, Lisa needs to be sure it is in the best interest of her needs. Since she has been with the same company for 15 years, and quickly worked her way up, she probably has a myriad of opportunities waiting for her. She can inform the CEO Ray Smith of her sexual orientation, as he wants the company to become more progressive and would (allegedly) not be bothered by her sexuality. However, the rest of her coworkers still feel that Gay people are immoral, disgusting people. Even if the CEO did not mind her sexuality, her coworkers would still see her in a different light. I feel the best decision that Lisa can make is to look for different work, with a more open, progressive company, then resign from Verizon. This decision would allow her time to get her finances in order. However, if she had a large savings, then the best decision would be to resign immediately, because being around such bigoted individuals would cause her undue stress, and her performance may be affected. If Lisa Sherman chooses to resign, since the CEO Ray Smith is so open to becoming a more diversified workforce, perhaps he can use her and her experience, when she informs him of her sexuality, as a consultant for future policies. Lisa could be a great asset to the company, as she has experienced the bigotry and discrimination about her sexuality her whole adult life, since she first came out. She understands what it means to not admit to others your true self, for fear of losing a job, or not gaining a job. Policies can be changed but unfortunately it takes much more work to change people’s opinions. People are afraid of the unknown, they fear change (Pratt, 2005). To help change people’s opinions training would need to be done, to show that Gay individuals are no different than anyone else. They do not choose their sexuality anymore than someone chooses their skin color. Someone should not be judged by something that they cannot choose. If Lisa Sherman chooses to resign, Verizon Communications and the CEO need to reeducate their employees on what a diversified workplace should be like. There are currently no federal laws that prohibit workplace discrimination based on sexual orientation (Smith, 2010). However many states and companies have laws and regulations that prohibit discrimination based on sexual orientation. The company should respond by offering condolences to Lisa Sherman, then start by making policies to make all workers comfortable. Lisa Sherman was a good employee and a hard worker for many years, yet she had to hide who she really was. No employee should have to hide their family life; it affects their stress levels and their mood. Lisa stated that while others had pictures of their wives and kids on their desks, she had a picture of her dog. Lisa should have been comfortable with having her partner’s photo on her desk, as she was her family. Unfortunately, as the office was not a comfortable place for a lesbian woman to state that she was a lesbian, she was unable to. Whatever the actual outcome was in this case, Lisa Sherman should leave the company for her own peace of mind, and sense of self worth. Verizon Communications and Ray Smith need to take the company to a modern, progressive state, by hiring openly gay people, and enacting policies to prevent discrimination in hiring, and the harassment of workers. Such a progressive policy is not only good for the workforce but for the company. As a company that is so open to diversification, they are bound to increase their customer base. Works Cited http://www.life-with-confidence.com/life-change.html http://www.hrhero.com/topics/sexual_orientation_discrimination.html

Ventilator Associated Pneumonia in the Icu

Ventilator associated pneumonia (VAP) is a nosocomial infection occurring in hospitalized patients who are mechanically ventilated. These infections are common in ICU settings, difficult to diagnose early, and unfortunately have a high rate of mortality and morbidity. VAP accounts for almost half of infections in ICU settings, up to 28% of mechanically ventilated patients will develop VAP and of these patients the mortality rate is between 20% and 70% (Craven & Steger, 1998). A patient that develops VAP while mechanically ventilated adds days to his recovery as well as thousands of dollars to the care costs. Numerous studies have been conducted across the county in an effort to understand VAP, however very few of those studies focus on the nursing interventions that can prevent this deadly and costly nosocomial infection. Many of these studies focus on the â€Å"bundling† of certain interventions, so the question is does the implementation of a VAP bundle compared with the use of non-bundled interventions decrease the incidence of VAP in ventilated patients. The research that was found in nursing journals along with a related study from a medical journal follows. Cason, Tyner, Saunders and Broome (2007) conducted a study of 1200 critical care nurses and the results demonstrate the variability in the recommended and reported care of the ventilated patient. Their study aims to identify the areas of needed improvement to comply with the CDC recommendations for prevention of VAP. The study consisted of a questionnaire distributed to nurses who attended the 2005 American Association of Critical Care Nurses National Teaching Institute, with the findings demonstrating a need for more education and research in the area of preventing ventilator associated pneumonia. Ferrer and Artigas (2001) also noted the lack of compliance in even the most basic of preventative measures. The study focuses on non-antibiotic preventative strategies for VAP; they suggest the use of antimicrobial hand soap, clorahexidine oral rinses, stress ulcer prophylaxis, prevention of gastric over distension, providing adequate nutritional support as well as frequent position changes. The research also suggests that endotracheal tubes with an extra lumen designed to continuously suction secretions pooled above the endotracheal tube cuff would lower the incidence of VAP by reventing these secretions from being aspirated into the lower airway. The authors also suggest more research be done to further limit the number of patients who develop VAP. Siempos, Vardakas and Falagas (2008) found that after meta-analysis of nine published randomized controlled trials that a closed tracheal suction system has no benefit in reducing the incidence of VAP compared with an open tracheal suct ion system. The preliminary data suggests that a closed circuit would reduce the incidence of VAP, however the data and trials that were reviewed showed that there was no decrease in the rate of infection. Due to the fact that a closed system can be used more than once, and only needs to be changed every 24 hours, it does tend to be more cost effective. Also of note, in two separate trials, a closed system was found to increase colonization of both the respiratory tract and the ventilator tubing. Obviously more research is needed to determine the best intervention when endotracheal suctioning is necessary. Ventilator associated pneumonia is both common and unfamiliar to nurses in the critical care setting, according to Labeau, Vandijck, Claes, Van Acken & Blot (2007). They note that while nurses deal with VAP frequently their knowledge of the infection and preventative measures may be a reason that VAP is still so prevalent in the intubated patient. The research points to the idea that because many nurses are not responsible for the ventilator circuit; they rely on the respiratory therapist to manage the ventilator, they may be less informed than if they had more control and training in the interventions necessary to prevent VAP. The research suggests more training and education for nurses who work with ventilated patients. Research done at the University of Toledo College of Medicine has shown a decrease in the incidence of VAP in its ten bed surgical ICU by implementing a â€Å"FASTHUG† protocol. Papadimos, et al, (2008) explained the interventions that the college used as a tool to educate the critical care team. â€Å"FASTHUG† stands for daily evaluation of feeding, analgesia, sedation, thromboembolic prevention, head of bed elevation, ulcer prophylaxis, and glucose control in critically ill intubated patients. The â€Å"FASTHUG† protocol was emphasized at morning and afternoon rounds and after a 2 year esearch period the incidence of VAP declined to 7. 3 VAPs/1000 ventilator days down from a historical rate of 19. 3 VAPs/1000 ventilator days. Of note, in 2007 the surgical ICU that implemented this program actually had no incidence of VAP from January to May. The research suggests that the use of bundled care processes for ventilated patients may reduce the rate of VAP. The nurs e’s knowledge of the use of the ventilator bundle is crucial to the success of the protocol according to research done at the University of Texas. Education sessions were held with pre and posttests administered as well as observation to evaluate the nurse’s understanding of the bundles. The VAP bundle focused on the elevation of the head of the bed, continuous removal of subglottic secretions, change of the ventilator circuit no more often than every 48 hours, and washing of hands before and after contact with each patient. The research done by Tolentino-DelosReyes, Ruppert and Shiao (2007) suggests that a lack of understanding and knowledge of VAP leads to a higher rates of infection. Observation of the nurses in the study revealed that after the education sessions nurses demonstrated an increase in compliance with the established standards of care. Given the high mortality and morbidity of ventilator-associated pneumonia, compliance in the critical care unit is crucial to reducing the rate of VAP. The critical care nurse is vital to the prevention of VAP, and nurses need to initiate further research concentrating on education and prevention. References Cason, C. L. , Tyner, T. , Saunders, S. Broome, L. (2007) Nurses’ implementation of guidelines for ventilator-associated pneumonia from the Center for Disease Control and Prevention. American Journal of Critical Care, 16, 28-37. Craven, D. E. , Steger, K. A. (1998) Ventilator-associated bacterial pneumonias: Challenges in diagnosis, treatment, and prevention. New Horizons, 6(2). Ferrer, R. & Artigas, A. (2001) Clinical Review: Non-antibiotic strategies for preventing ventilator-associated pneumonia. Critical Care 2002, 6, 45-51. Hunter, J. D. (2006) Ventilator associated pneumonia. Postgraduate Medical Journal, 82, 172-178. doi:10. 1136/pgmj. 2005. 036905. Labeau, S. , Vandijck, D. M. , Claes, B. , Van Aken, P. , Blot, S. I. & on behalf of the executive board of the Flemish Society for Critical Care Nurses (2007) Critical care nurses’ knowledge of evidence-based guidelines for preventing ventilator- associated pneumonia: An evaluation questionnaire. American Journal of Critical Care, 16, 371-377. Morrow, L. E. Shorr, A. F. (2008) The seven deadly sins of ventilator-associated pneumonia. Chest, 134, 225-226. doi:10. 1378/chest. 08-0860. Papadimos, T. J. , Hensley, S. J. , Duggan, J. M. , Khuder, S. A. , Borst, M. J. , Fath, J. J. , Oakes, L. R. , & Buchman, D. (2008, February) Implementation of the â€Å"FASTHUG† concept decreases the incidence of ventilator-associated pneumonia in the surgical intensive care unit. Patient Safety in Surgery 2(3). doi:10. 1186/1754-9493-2-3. Siempos, I. I. , Vard akas, K. Z. & Falagas, M. E. (2008) Closed tracheal suction system for prevention of ventilator-associated pneumonia. British Journal of Anasthesia 100(3), 299-306. doi:10. 1093/bja/aem403. Tolentino-DelosReyes, A. F. , Ruppert, S. D. , Shiao, S. P. K. (2007) Evidence-based practice: Use of the ventilator bundle to prevent ventilator-associated pneumonia. American Journal of Critical Care, 16, 20-27. Ventilator-associated pneumonia. (2008). Critical Care Nurse. Retrieved from http://ccn. aacnjournals. org