Nursing Essay Example | Topics and Well Written Essays - 3000 words

Nursing - Essay Example These changes coupled with the escalating complexities of the ever evolving healthcare delivery system and the changing socio-political market has further heightened the pressure on nurses to be more responsible and accountable for delivery of quality patient care (Lenburg, 1999; Savage & Lucy, 2004:9). As the healthcare environment becomes more demanding with the increasing complexity and changing patterns of healthcare delivery, and the development and evolution of the nursing practice in response to the increasing health needs of clients, nurses are faced with the increasing pressures of decision making (Accountability in Nursing and Midwifery, 1997). In all these changes, what stands the same is that the nurse must exercise discretion and judgment in the management and supervision of patient care, in accepting or rejecting responsibilities, seeking consultation and even in assigning responsibilities to others who may carry out nursing care. With this increasing level of responsibility in patient management and care, the demand for nurses to be accountable for their decisions, judgment of discretion becomes more crucial for evaluating and improving quality of care. The Nursing and Midwifery Council (NMC) A-Z Advise sheet on Accountability states that "registered nurses have a responsibility to deliver safe and effective care based on current evidence, best practice, and where applicable, validated research." (NMC, 2006:1). While the NMC code of ethics also states that as a registered nurse, "you are personally accountable for your practice. This means that you are answerable for your actions and omissions, regardless of advice or directions from another professional." (NMC 2002) These policies hold grave implication for the nursing management of patient care. This paper therefore aims to look at the subject of accountability, in the light of the related concepts such as responsibility, autonomy and authority and how it affects the nurse delivery, supervision and management of patient care in the adult branch of nursing. For a start, let us take a look at what the term 'accountability' entails. According to Savage & Lucy (2004), although accountability is not a recent concept, it has however evolved over the last couple of decades from "a matter of regular reporting to an explanation of actions and outcomes and, more recently, a justification of the values informing actions and outcomes"(pg13). They argue that despite the fact that the use of the term is increasing in frequency in management and policy making circles, the term is becoming more vague as it now appears to refer to an increasing number of phenomena. However, within the nursing context, accountability has been described in different lights, by different authors. For instance, while the American association of Nurses (ANA) described nurse accountability as being Answerable to someone for something one has done. It means providing an explanation or rationale to oneself, to clients, to peers, to the nursing profession, and to society. In order to be accountable, nurses act under a code of ethical conduct that is grounded in the moral principles of fidelity and respect for the dignity, worth and self-determination of clients (Accountability in Nursing and Midwifery, 1997). The NMC considers accountability as being "fundamentally concerned with weighing up the interests of patients and clients in complex

The Financial Analysis of The Royal Bank of Scotland Group Research Paper

The Financial Analysis of The Royal Bank of Scotland Group - Research Paper Example   The Royal Bank of Scotland (RBS Group) carries out its business activities in the United Kingdom, Asia, Europe, the Americas, and the Middle East, with more than thirty mullion customers. Large corporations, institutions, and individuals are among the customers, that the group provides its products to (RBS Group, 2013). Despite the adverse effects of the financial and economic crises that faced the world and the United Kingdom, banks and the economy of the United Kingdom began this year with a stronger position, compared to last year (Accenture, 2012). The last five years have been characterized by poor performance among many companies. In the United Kingdom, the banking industry is unique. This is because it is large and diversified, accommodating a large international industry (Accenture, 2012). As a result, competition is great, and individual banks have to analyze their strategies to ensure superior performance in the financial markets, given the volatile, current and future economic conditions. Income Statement Analysis From the common size income statement of the Royal Bank of Scotland, it is evident that revenue has been decreasing each subsequent year, for the last three years. For instance, the bank’s revenue for 2012 was 17, 941 Million, compared to revenue of ?24,651Million earned in 2011 and 31, 798 Million earned in 2010 (RBS Group, 2013, p, 45). This trend shows that revenue has been decreasing significantly. Subsequently, the Bank’s operating loss increased significantly, over the three years. In 2010, the Royal Bank of Scotland had an operating loss of 469 Million. In 2011 the operating loss increased to   1,190 Million, while it further increased to 5,165 Million in 2012. The same trend was recorded in loss after tax of the Royal Bank of Scotland for the three years of analysis. For instance, the Royal Bank of Scotland recorded a loss after tax of 1,033 Million in 2010, while the figure increased to 2,317 Million and 5,806 M illion for 2011 and 2012 respectively (RBS Group, 2013). This resulted in a loss for the period of 1,666 Million in 2010, which increased to 1,969 Million in 2011 and 5,806 Million in 2012 (RBS Group, 2013, p, 45). The Royal Bank of Scotland has never made any dividend payment for the last three years, probably because it has been making losses from its business. Given that the Royal Bank of Scotland has been making losses for the last three years, the earnings per share portray a negative value. For example in 2010, the earnings per share for the Royal Bank of Scotland were -5.00p, while in 2011 and 2012 recorded earnings per share of -2.13p and -53.70p, respectively (Hargreaves Lansdown, 2013).  Ã‚