Families and Stress - coping skills for living with...

Families and Stress - coping skills for living with stress and anxiety Is stress always bad? No! In fact, a little bit of stress is good. Most of us couldnt push ourselves to do well at things -- sports, music, dance, work, and school -- without feeling the pressure of competition. Without the stress of deadlines, most of us also wouldnt be able to finish projects or get to work on time. If stress is so normal, why do I feel so bad? With all the things that happen on a daily basis in our lives, its easy to feel overwhelmed. Things that you cant control are often the most frustrating. You can also feel bad when you put pressure on yourself -- like to getting good grades or to get promoted at work. A common reaction to stress is to†¦show more content†¦The full recipe involves combining awareness of your physical health, eating habits, rest, exercise, workplace, home environments, and your relationships. In developing your own personal quot;stress recipequot; youll find your family and you to be happier and healthier! Reduction of Burnout In today’s fast paced environment, individuals are more prone to burnout because the stress they have is unrelieved. Constant exposure to stress with no relaxation, leads to a condition that is more serious than stress. This condition is burnout. Burnout is a feeling of total emotional exhaustion, a feeling of not caring for anybody and anything, and a feeling thatShow MoreRelatedCognitive Behavior Therapy ( Cbt ) Is Effective For Treating Depression And Anxiety With Patients With A Mental Health Essay1387 Words   |  6 Pageseffective for treating depression and anxiety with patients with a mental health diagnosis with an intellectual disability. the American Psychiatric Association defines cognitive behavioral therapy as an evidenced based approach for treatment of depression and is recommended as the treatment of choice is proven to reduce anxiety and depression. The purpose for my paper is to research weather or not cognitive behavior therapy is effective for decreasing anxiety and depression in patients with a mentalRead MoreLiving With Anxiety Support Group For Men1476 Words   |  6 PagesLiving with anxiety support group for men. Support groups can play an essential role in coping with stressful events in life. Organising and maintaining an active support group does take time and effort. Support groups can be distinguished from others teams due to the strategies of the primary goals. This kind of group is characterised for emphasises on helping members to share collective experiences. the purpose of our human service organisation is to meet the needs and contribute to the wellbeingRead MoreGroup Counseling Program For Inner City Minority Youth1162 Words   |  5 PagesYouth It is often believed that only adults experience stress and anxiety, however stress is something that does not have an age requirement. Adolescent stress and anxiety are important health issues that often go unnoticed. Early adolescence is defined, as a period between 11 and 14 years of age (Carlozzi, Winterowd, Harrist Thomason, Bratkovich, Worth, 2010, p. 446). These years are usually marked by rapid changes. For most students, stress can stem from puberty, new demands of school, changingRead MoreThe Effects Of Stress On Physical Health1694 Words   |  7 PagesPsychological stress is pressure placed on a person to adapt, cope, or adjust to a situation (Rathus, 2016, p.284). The result of prolonged stress can affect a person’s mood, pleasure experience, and have harmful effects on physical health (Rathus, 2016, p.284). Society in the twenty first century places high demands on people. Technology makes it very difficult to separate work life, school life, and home life. To day, society places a high value on a busy lifestyle for individuals. For exampleRead MoreSocial And Social Support And Spirituality1590 Words   |  7 Pagesreligious. Being close to nature, her family, and her pets gives her life meaning. She prays to God, but feels deviated from a church environment and does not want to belong to a church. She did not want to disclose further information, but summarized her preferences by having a past of traumatic experiences regarding her family’s Catholic following and her education in a Catholic school environment. Economic Status M.L. recently retired from her full time job and is living by a pension. M.L. discussed aRead MoreStress Management (Children) Essays1225 Words   |  5 PagesStress affects each of the five dimensions of health: physical, mental, emotional, social, and spiritual. Examples of distressors (negative stressors) that children and adolescents may confront within these dimensions include: illness, injury, inadequate nutrition, and low levels of physical fitness (physical dimension); pressures to excel in academic and extracurricular activities, depression, and anxiety (mental/emotional dimension); relational issues, peer pressure, and dysfunctional familyRead MoreThe Stress Self Assessment Focused On My Stressors Essay802 Words   |  4 PagesThe Nature of Stress self-assessment focused on my stressors. I learned that most of my stressors were chronic; mainly dealing with school and socializing. The stressors were categorized as mental and spiritual, although I did notice missing family and friends could fall under spiritual and emotional. Another thing I learned was most of my stressors were caused from my move to Bismarck. For example, living far from home, new job, and not having close friendships. This form of assessment didn’t workRead MoreSexual Abuse Issues And Marital Problems1243 Words   |  5 Pagesappears to have a well-established sense of personal identity in relation to her family role, but is insecure about her role outside of her family system. She is the youngest of 2 and the only girl, and assumes the role as â€Å"baby sister† with her sibling. Mrs. Santiago has no local family, 2 friends, and limited resources in the town she lives. She reports that her husband is the eldest of four and known for being the â€Å"family provider† after his father passed. Mrs. Santiago migrated to the United StatesRead MoreNr 305 Health Assessment Essay1326 Words   |  6 Pagesidentified as abnormal and those that place the person at a health risk. Support your observations with data from the textbook. JAW has anxiety and depression concerns. Her failed two marriages and raising her three children as a single mom are causing her some undue stress in her life and it could possibly lead to some bad decisions about her life choices. Stress can sometimes motivate or enhance a person performance and JAW chooses to run to help her escape what she is experiencing in her lifeRead MoreNR305 Milestone1303 Words   |  6 Pagesidentified as abnormal and those that place the person at a health risk. Support your observations with data from the textbook. JAW has anxiety and depression concerns. Her failed two marriages and raising her three children as a single mom are causing her some undue stress in her life and it could possibly lead to some bad decisions about her life choices. Stress can sometimes motivate or enhance a person performance and JAW chooses to run to help her escape what she is experiencing in her life

Arguments for and Against the Minimum Wage in the Uk

Arguments for and against the National Minimum Wage (NMW) in the UK: stop employees being taken advantage of by being paid unfair wages by their employers. set a standard of the minimum worth of a worker. This benchmark was set so that employers would be unable to hire any staff for less than the suggested hourly rate. reduce pay differentials between genders. What is the new minimum wage?: In October 2009, the NMW for workers increased from:  £5.73 to  £5.80 per hour - aged 22 years and older  £4.77 to  £4.83 per hour - aged 18 to 21 years  £3.53 to  £3.57 an hour - aged 16 and 17 years As of October 2010, the adult minimum rate will start from 21 years. Who qualifies for the†¦show more content†¦This drop in demand then results in an oversupply of goods from the producer, who is then forced to reduce his supply to the new demand level, or goods may sit on the shelf. E2 represents the new Equilibrium level between supply and demand. If the good was perisha ble and the supplier did not adjust his supply, there would be a lot of wastage. Not everybody qualifies: Those who are exempt from receiving the NMW include; Apprentices under 19 years of age, and apprentices 19 years or older in their first year of their apprenticeship. Students on a work placement, forming part of a higher- or further education course, where the placement is for less than one year. The self-employed Those on a Department for Workers and Pensions back-to-work scheme The Recession: A recession is characterised by a period of at least two consecutive quarters of negative growth. During a recession, demand and supply of goods and services in the economy contracts. The UK economy contracted by 1.5% in the last quarter of 2008 and the Gross Domestic Product experienced its biggest fall since the second quarter of 1980 (Kowelle 2009). This is the first time since the inception of the NMW that employment has fallen. Unemployment is rapidly on the increase. A redu ction in output means that the need for labour is reduced. In the early stages of a recession, companies tend to cut back on employee hours, rather than making workers redundant. IfShow MoreRelatedDemand Supply , Examine the Argument in Favour Against Minimum Wage Law in Uk1415 Words   |  6 PagesAssignment: A * (Using Demand Supply: examine the arguments in favour against minimum wage law in UK*) * *Total words: 1,402 Demand It refers to the willingness and ability of buyers to purchase goods and services at different prices. Supply It refers to the willingness and ability of sellers to provide goods and services for sale at different prices What* *is minimum wage? A minimum wage is the lowest monthly, daily or hourly that employersRead MoreThe Argument Against the National Minimum Wage Essay883 Words   |  4 Pages The national minimum wage was introduced in the UK in April 1999 by the Labour government. Essentially it formed a major part of their manifesto as it convinced the average population that Labour were beneficial for everybody. However, they would argue against classical economics and suggest there are wide spread benefits to be gained. The main argument is that the NMW would alleviate poverty across the country. This is an equity issue that has constantly concerned society Read MoreThe Impact Of National Minimum Wage On South Africa s Income Inequality Essay1525 Words   |  7 PagesThe impact national minimum wage would have on South Africa’s income inequality should it be implemented. South Africa is still considered one of the countries which still consist of high income inequality. Economists argue that inequality is the most unavoidable part of the economic development and that it continues to increase in developing countries due to economic growth (Keeton, 2014). Inequality is a problem in countries such as South Africa, because it shifts the attention from bigger andRead MoreMinimum Wage Is The Price Floor For Jobs Essay1239 Words   |  5 Pages Minimum wage is the price floor for jobs. Many people are either for it or against it, however not denying the fact that it is very important to employees. Because, minimum wage creates a pathway for workers to sell their labour though getting paid less, businesses willingly hire them and workers gain experiences. Yes, in many ways it can benefit both the employers and the employees but there is always a down side to it. When it comes to revenue businesses can only spend so much and it doesRead MoreThe Challenge s of Implement a Minimum Wages Policy1077 Words   |  5 PagesCreating a so called â€Å"culture of compliance† among employers (Skidmore 1999: 435) is a low-cost strategy for facilitating the self-enforcement of minimum wage. This strategy implies the construction of persuasive arguments in favor of the minimum wage and the appeal to common values and beliefs such as, for instance, the principle of â€Å"fair pay – fair play†. Here, two main strategies for building commitment among employers can be identified. First, persuasive processes at the interpersonal levelRead MoreImpact Of Minimum Wage On Unemployment1305 Words   |  6 PagesImpact of minimum wage on unemployment The supply and demand factors show significance towards growth of unemployment. It has been observed that the price floor above equilibrium wage should cause unemployment. There are many people who have provided their arguments against the fact. However, it has been observed that whenever there has been a rise in the minimum wage of workers, unemployment rate goes very high. For example, an organization has to maintain its expenses as well as its incomes.Read MoreIncome Guarantee Schemes And The Developed Countries3248 Words   |  13 PagesThe first half part of this paper tells that income guarantee schemes in these three countries have both similarities and differences because they have really different histories in development. The second half part discusses the significance of minimum wage policy and some its influences on several issues. At the last of the paper, I present my own opinions on issues of income guarantee schemes. I. Introduction Employment is a popular topic in global economy. After the economic crisis of 2008, theRead Morewage differentials essay2027 Words   |  9 Pagesis the smallest for UK employment at 10%. Manufacturing is the lowest in terms of employment for migrant workers at 12% and is the second largest with 10% of UK employment. Distribution, hotels and restaurants is the represents the highest amount of UK employment in industrial sectors with 18% and is the second highest for migrant workers with just over 50%. construction is the third largest in terms of migrant employment sector with 30% and the third largest sector of UK employment with 9%. Read MorePurchasing Goods Produces Winners And Losers1208 Words   |  5 Pagesan interesting argument and the two defined groups are clearly identifiable in everyday life from a social science point of view. You can argue in this case that the seduced are winners in society and the repressed are losers in society. However there has been an emergence of shops that are aimed at those in the repressed group that offer brands at a much lower cost to their supermarket or department store counterparts. There are plenty of winners in a consumer society. In the UK, the supermarketsRead MoreConsumer Society And The Social Society1244 Words   |  5 Pagesthis. It will briefly introduce conspicuous consumption in relation to the seduced. Secondly supermarket power and monopolies are discussed. Finally it will introduce the concepts of positive and zero sum games in relation to supermarkets. Bauman’s argument is that â€Å"society remains unequal and divided today on the basis of whether or not you are in a position to consume effectively† (Allen, 2014, p.275) although he also argues that â€Å"the forms of inequality and freedom in a consumer society differ from

Event Study on Ma Deals in Singapore free essay sample

Efficient-markethypothesisMergers and acquisitions (MA) are one of the most important events in corporate finance, both for the firms involved, as well as the economy. Empirical research on these events has revealed a great deal about their trends and characteristics over the last century. Many researchers have addressed the question of gains from acquisitions. Typically, target shareholders earn significantly positive abnormal returns from all acquisitions while acquiring shareholders earn none or negative abnormal returns from mergers. The evidence is usually based on returns computed over a pre-acquisition period starting immediately before the announcement date and ending on or before the effective date. This assumes that prices fully adjust to the likely efficiency gains from acquisitions. Our study attempts to examine the effects of MA announcements on acquiring firms listed on the SGX through the event study methodology. At the same time, we will also to draw insights on the efficiency of the Singapore stock market with relation to MA announcements. This paper starts with a review of past literature, followed by description of our methodology and data, motivations for MA, empirical results of study, and ends with an interpretation of results. 2. REVIEW OF LITERATURE Several studies indicate the presence of large abnormal returns accruing to shareholders of merged firms in the period immediately before the merger. However, evidence suggests that shareholders of acquiring firms earn, on average, no abnormal returns at the acquisitions announcement, though there is tremendous variation in these returns. Researchers have been unable to successfully explain much of this variation, partially because the announcement of a takeover reveals information about numerous things. For example, Grinblatt and Titman (2002) state that the stock return at the time of the bid cannot be completely attributed to the expected effect of the acquisition on profitability, arguing that, the stock returns of the bidder at the time of the announcement of the bid may tell us more about how the market is reassessing the bidders business than it does about the value of the acquisition. Hietala, Kaplan, and Robinson (2001) note that the announcement of a takeover reveals information about the potential synergies in the combination, the stand-alone values of the bidder and target, and the bidder overpayment. They argue that it is often impossible to isolate these effects and, thus, know the meaning of the markets reactions to a takeover announcement. Empirical studies by Keown and Pinkerton (1981), Malatesta and Thompson (1985), and Mikkelson and Ruback (1985) provide some support for the notion of mergers being partially anticipated events. Keown and Pinkerton find that market reactions to mergers occur before the first public announcement of the event, and conclude that â€Å"merger announcements are poorly held secrets and trading on this non-public information abounds†. These earlier studies are of a much larger scale and are generally more descriptive of the American and European equity markets during the merger booms. Our study attempts to supplement research in this area by concentrating on the Singapore market. . METHODOLOGY DATA 3. 1. Event studies methodology The event date is taken to be the first day when publicly available information indicative of the acquirers’ intentions to acquire the companies was released. In most instances, the event date is the day of announcement made by the company. Daily data is used as the market is typically responsive to news on business combinations. For this study, we establish an event period of -30 to +30 trading days. As mentioned, the stock prices of the acquirers and targets typically shift before any publicly information is made available to justify the price changes, and therefore prices of trading days before the announcement date are included in the study to examine these effects. We also establish an estimation period of 90 trading days before the event period (t = -120 to -31) to allow us to capture the relationship between the companies’ stock returns and the market returns prior to the announcement. To measure the abnormal returns, we must first calculate the estimated normal returns of the stocks. This is calculated from using the risk-adjusted return model given by the following formula: Rit = ? + ? Rmt (where Rit = estimated returns during the event period, Rmt = market returns). The estimated returns for each day of the event period are predicted using regression between the return on stock against the return on the market. The abnormal returns for each company are calculated by taking the difference between the actual returns and estimated returns. The abnormal returns are calculated for all trading days during the estimation period and event period. The average abnormal returns (A. A. R. ) are calculated by taking the average of abnormal returns of all companies for each day in the event period and the cumulative average abnormal returns (C. A. A. R. ) by summing up the A. A. R. during the relevant period of study (i. e. the C. A. A. R. of the event period is calculated by summing the A. A. R. from -30 to +30 trading days). Hypothesis testing is run to determine whether the A. A. R. or C. A. A. R. are statistically different from zero. It reveals whether there is statistical evidence that stock returns are affected by the MA announcements. The standard deviation of abnormal returns is calculated from the A. A. R. during the estimation period. As it is estimated from the samples, abnormal returns are assumed to follow a Student t-distribution, with nine degrees of freedom, given the sample size of ten. The t-values are calculated as follows: td = ;tab = 3. 1. 1. Key Assumptions of studies For the purpose of our research, we assume the betas of the companies remain largely constant during the event window, and changes in abnormal returns of the stock are mainly affected by the announcements given the selection criteria used for the samples. 3. 2. Data and Data Source The data analyzed in this study consist of acquisitions and mergers in which the acquiring companies have stocks listed on the Singapore Exchange , and that their stocks continued to be listed in the exchange after the acquisition. A list of business combinations based in Singapore is derived from Thomson One Banker’s database. Market returns are computed from the Morgan Stanley Capital International (MSCI) Singapore (Free) Index . Appendix A shows the component stocks of the index. The index which includes several small and medium-sized firms provides a more diversified selection than the STI index, which consists of only blue-chip stocks. It has a greater fit with the diversified portfolio of samples selected for the event studies. Share prices of the selected samples and MSCI Singapore Free Index are subsequently derived from Thomson One Banker. For this study, ten acquirers are selected from the list of acquisitions. Details of the ten acquisitions are elaborated in Appendix B. For each sample event, we source for news and announcements related to the acquisitions, extracting them from the SGX website, companies’ webpage and archived newspaper reports from Factiva’s database. 3. 3. Selection Criteria for Samples For companies to be qualified in our sample, the acquirers must acquire at least 75% stake of the acquired companies, at one go, in the selected acquisition transactions. A high ownership share grants the acquirers control over the acquired companies, and provides strong support that substantial effort will be undertaken to integrate the operations for the long term such that synergistic benefits can be realized. The acquirers must not own any equity in the acquired companies prior to the acquisitions. This is to avoid potential bias in the results when the market has already incorporated the value of the acquisition into the share price; even a minority stake held in the acquired company may signal future intentions to incorporate the companies. As a result, the market may have already responded accordingly. We avoid acquisition deals with companies that involve government linked companies, due to the fact that government linked companies have less default risk and are thus less reflective of the market volatility. During the event window, there must also be no other announcements or market event, such as the stock market crash of August 1998, as it could have a material impact on the results. The samples are selected from different years, across a wide range of industries. The diversified portfolio of companies will allow us to reduce effects of time-specific and industry-specific bias. Of the cited reasons, one which the market recognizes most significantly is the substantial monopoly gains that the companies stand to gain from the merger and acquisition. The increase in market share and reduction in competition in the market proves to be pertinent in mergers especially the ones involving OCBC – Keppel, UOB – OUB, and UMS Holdings Ltd. To illustrate, the phenomenon of market consolidation in the local banking industry was driven by the need of the banks to expand its markets locally and abroad. Beyond a certain capacity, the banks will need to consolidate to be able to compete within the industry. With the monopoly gains from the acquisitions of OCBC and UOB, they would be able to weed out foreign competition and maintain its market position as the top 3 local banks as today. The gains would also enhance their ability to expand into foreign markets of Malaysia and Greater China. 4. 2. Economies of Scale and Scope The substantial reduction of cost realized from the Economies of Scale and Scope are also one of the main reasons why companies go into mergers. Super Coffeemix – Owl acquisition would enable them to produce their products in larger amounts in the different overseas markets and thus derive substantial cost savings.

Nurse Staffing Essay Example

Nurse Staffing Essay Abstract Two major forms of staffing guidelines will be discussed, nurse-to-patient ratio and staffing by acuity. This paper will discuss the history of each staffing form. It will point out the benefits and negative features of both practices, describe how hospitals deal with staffing and discuss the states that have laws requiring certain guidelines be followed. Nurse Staffing: Does One Size Fit All? What is the one conversation that usually gets heated when talking to nurses? Bring up the subject of staffing levels on their unit. As a nurse assistant, staff nurse, charge nurse or nursing administrator, inadequate staffing creates tension and stress. When staffing is inadequate patient safety, infection rates, patient satisfaction and staff satisfaction are only a few of the areas affected. Many hospital administrators and lawmakers want to make patient care a numbers game. The Joint Commission on Accreditation of Healthcare Organizations requires hospitals to create a staffing plan that defines staffing effectiveness as the skill mix, competence, and effectiveness related to the services needed. (Morgan, 2004) When it comes to staffing, one size does not always fit all. Patients are individuals with individual needs and one patient with a certain diagnosis can take much less attention and time from the nurse than a patient of the same age with the same diagnosis. For good nurses the main goals during their shift is giving exception patient care and providing a safe environment. â€Å"The notion of high-quality care in hospitals is essential to public safety isn’t new. In 1751 Benjamin Franklin founded America’s first hospital-Pennsylvania Hospital-and commented that patients ultimately suffer and die without sound nursing care. We will write a custom essay sample on Nurse Staffing specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Nurse Staffing specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Nurse Staffing specifically for you FOR ONLY $16.38 $13.9/page Hire Writer † (Clarke, 2003) Nursing leaders are under tremendous pressure to lower costs while improving quality. (Carter, 2004) It is often found that hospitals during low census times or times of budget cuts will try to let ancillary staff go and assign their duties to the nurse caring for the patient. Nurses can replace several other positions in a healthcare setting but no other position can replace the nurse. Nursing is not only a highly trained individual but someone who is called to be compassionate, caring and dedicated individual. There are many reasons why staffing by acuity or nurse-to-patient ratios should not be mandated by lawmakers. Direct care nurses should be involved in staffing decision. Outcomes are better when nurses have control of their workload. (Anonymous, 2005) Adequate staffing must be priority for anyone involved in healthcare and there are pros and cons to both staffing by acuity and nurse-to-patient ratios. With our aging population and the increased age of the baby boomer generation nurses are going to increase in demand. Healthcare is changing so quickly and this also affects the shortage. The average acuity of patients has increased over the last decade while the nursing shortage continues. Nurse-to-patient ratios are supposed to draw people into the filed but there is a shortage of educators at present time as well. Many colleges have long waiting list for nursing programs, yet many nurses only stay in the field for a short time after graduating. Many universities turn away good candidates to nursing programs due to insufficient number of faculty, clinical sites, classroom space, clinical preceptors, and budget constraints. (Allen, 2008) We as a nation must come to a conclusion to deal with the nursing shortage. Too many lawmakers are paying attention to the staffing formats suggested above and not doing anything to fix the nursing shortage. Whether by acuity or ratios, for each nurse to take fewer patients we will definitely need more nurses. Staffing by acuity is a format used to decide how many nursing hours are needed for certain diagnosis or types of patients. Typically areas within a healthcare facility where patients are less ill such as rehabilitation and medical-surgical units, nurses can care for as many as seven patients at a time. Their acuity score is much lower than a patient in the intensive care unit or a step-down unit. Healthcare systems that utilize staffing by acuity are looking at the safe number of certain levels of patients that one nurse can care for. The down side to staffing by acuity is that many feel administration will influence numbers to maintain a high number of patients per nurse. If all patients on a unit were a level eight then most acuity systems would call for three patients to one nurse but if all patients on a unit were all level ones then a nurse could be caring for as many as eight to ten patients. Acuity does not take every patient encounter into consideration. For instance a dementia patient may have a low acuity based on the nursing care since they usually do not have indwelling lines or invasive procedures. Although the same patient may require a high amount help with activities of daily living, decision making and education. (Walsh, 2003) Thus staffing by acuity can be a subjective form of nurse staffing. When done accurately, acuity based staffing can be very beneficial for the nursing staff. Illinois is one of many states that have implemented laws requiring hospitals to base staffing on acuity systems and then report compliance on a quarterly basis. Illinois Hospital Association supports acuity based staffing over nurse-to-patient ratios. (Anonymous. 2008) SB867 is a law in Illinois that requires hospitals to base staffing on a model that has been developed by a nursing care committee made up of at least 50% direct care nurses. (Anonymous. 2008) This assures the bedside nurse a significant voice in the staffing process. It allows nurses to base their staffing on the work they perform. The model should include levels of care and examples that fit you patient population. At times, nurses will under staff themselves by simply not giving their patients credit for their true acuity level. This law and practice demonstrates hospital’s commitment to their direct nurse staff. Acuity based staffing is believed to take all facts into the picture. Nurses should be trained to develop and use their acuity tool to best describe the patients they are caring for, thus supporting the need for additional staff. Nurse-to-patient ratios are a concept that mandates a certain number of patients for each nurse to care for. Depending on the types of patients being cared for this number can differ. California has a law requiring nurse-to-patient ratios be following in hospitals. This law was signed in 1999 but was unable to be implemented for another four years. California state guidelines say that medical-surgical patients are one to five and in the intensive care units ratios are one to one. Illinois also has a law up for approval, HB0485 that would mandate ratios. â€Å"Establishing a minimum,  specific and numerical ratio implies that there is a scientific basis for determining the number of nurses to patients above which good outcomes patients can be guaranteed. † ( Flowers, 2009) This law would put even more stringent regulations on hospitals. California has seen many issues related to the ratios law. Ratios can cause longer transfer times for patients, increased ER bypass and postponed elective surgeries. California has experienced 12 hospital closures and downsizing of services since ratios was implemented. Patients are not all alike, their needs are individually different. Nursing units are different and ratios do not take into account the nurse’s level of experience or the physical layout of the facility. Many times hospitals will attempt to meet ratio laws by terminating such positions as nurse assistants and environmental services workers. So in reality nurses may only have four patients to care for but they are responsible for total care of those patients. The other strategy hospitals have used to meet ratio guidelines is to replace registered nurses with licensed practical nurses and have only one register nurse on each shift as a charge nurse. Under California law, nurses are considered registered or licensed practical nurses. HB0485 prohibits this by stating the nurse ratio can only be made up from registered nurses. Supporters of nurse-to-patient ratios believe that these types of laws will recruit more individuals into the field and retain our current nurses. According to CNA President Deborah Burger, the ratio law is a mafor reason why more nurses are coming into California and why RN’s are staying at the bedside. (Anonymous, 2005) The working conditions are believed to be better when a nurse has fewer patients. The environment is considered safer when more nurses are available to care for the patients. Nurses feel they will have more time for direct patient care and fully evaluate the patient’s needs. Individuals, who support both staffing by acuity and ratios, believe that research is needed to support both ideas. I feel that acuity is the most accurate way to determine safe ratios. At Union County Hospital, where I work, we use our acuity tool to establish a level for each patient. This is nursing staff’s first indicator of needed staffing levels. We also use ratios to staff. Once the acuity is finished the charge nurses takes the acuity of the patients, level of experience of the oncoming shift and also our staffing matrix into consideration and staffs the next shift appropriately. I did a simple study recently and based on our staffing matrix that the charge nurse can take up to three patients and each additional staff nurse should not routinely take over six patients, we met the staffing matrix 84% of the time. Of that 84%, only 12% of the time did the acuity call for different staffing levels and most of that was that the acuity actually called for less staff. We are a for-profit hospital and as a manager I have to validate our staffing to the CFO on a weekly basis. I asked the nurses to accurately and honestly complete the acuity, keep our matrix in their mind, and make the best decision for the patients. I also ask that if there are any circumstances that influenced their decision they should leave note of this on the daily staffing sheet. I think that acuity and ratios complement each other when used together, but one size does not fit all in nurse staffing models. Lawmakers and hospital administrators should not be making these decisions for nurses, the bedside nurse should be able to make an individualized staffing plan for each shift based on the patients on the unit. References Allen, L. (2008). The Nursing Shortage Continues As Faculty Shortage Grows. Nursing Economics, 26(1), 35-41. Retrieved March 1, 2009, from ProQuest Education Journals database. Anonymous (2005). Schwarenegger flexes muscles on nurses. Australian Nursing Journal, 12(7), 29. Retrieved March 1, 2009, from ProQuest Education Journals database. Anonymous (2005). Ratios: Savior or villain? Australian Nursing Journal, 13(1), 15. Retrieved March 1, 2009, from ProQuest Education Journals database. Anonymous (2008). Keep Contacting You State Representative To Oppose Nurse Staffing Ratio. Illinois Hospital Associations Position Paper. Retreived Febuary 24, 2009, from http://www. ihatoday. com/issues/workforce/hb392. html Carter, M. (2004). The ABC’s of staffing decisions. Nursing Management, 35(6), 16. Retrieved March 1, 2009, from ProQuest Education Journals database. Clarke, S. (2003). Patient safety series, part 2 of 2: Balancing staffing and safety. Nursing Management, 34(6), 44-48. Retrieved March 1, 2009, from ProQuest Education Journals database. Flowers, M. (2009). Nursing Care and Quality Improvement Act HB0485. 96th Illinois General Assembly. Retreived Febuary 24, 2009, from http://www. ilga. gov/legislation/96/HB/09600HB0485. htm. Morgan, S Tobin, P. (2004). Managing the Nursing Workforce. Nursing Management. Chicago, 35, 4-6. Retrieved March 1, 2009, from ProQuest Education Journals database. Walsh, E. (2003). Get Real With Workload Measurement. Nursing Management. Chicago, 34(2), 38-42. Retrieved March 1, 2009, from ProQuest Education Journals database.