Posted on

How to write a successful argument

STEPS to a SUCCESSFUL ARGUMENT

THE OVERVIEW

An Argumentative essay takes a position on a debatable issue, such as abortion rights, same-sex marriage, gun control, tax increases, and so forth.

In writing your argumentative essay, you think out the issues and take a position, which is called your thesis. You use the body of your essay to defend and explore your position. The goal is to persuade the reader to agree with your side of the issue.

THE STEPS

  1. Create a Strategy by exploring both sides of the argument and considering who will be your audience. To do this you will LIST the arguments on both sides of the issue and take notes on whom your readers will be.
  2. Consider the Merits and Weaknesses of Both Sides by looking over the lists of arguments and weighing them against how you previously felt about the issue. You also reconsider the audience as you do this.
  3. Take a Position by writing out your thesis. This is your firm stance on the issue.
  4. Create an Outline by using the items in your list that support your side of the issue.
  5. Draft an Introduction that clearly states your thesis, your position, and invites the reader into your argument.
  6. Use the Body of the Essay to Support Each Point in Your Argument with specific evidence. You may want to use statistics, evidence, examples from real life, expert opinions, and other reasonable sources of evidence.
  7. Present and Refute Opposing Arguments by drawing from you original lists. Show the weaknesses and problems in the other side’s position. This will bolster your case.
  8. Build a Link to Your Readers by finding some common ground between the two sides. This is often done by sharing the common values underlying a position on an issue, such as a sense of justice or fairness.
  9. Be Sure to Avoid Common Mistakes in Reasoning by carefully using inductive and deductive reasoning. Inductive reasoning means: you arrive at a conclusion based on several facts. Deductive reasoning means you reach a conclusion based on premises, which may or may not be proven true. Also be sure to avoid logical fallacies, such as making hasty generalizations, using circular language, or employing biased language.
  10. Always provide a thorough bibliography for your well-researched argument essay.

(taken from Rules for Writers, by D. Hacker [pp. 348-361])

Posted on

Vulnerability to Natural Hazards

Vulnerability to Natural Hazards

The topic of the society’s vulnerability to hazards and natural disasters is one that captivated further interest and attention after brief analysis on the issue. Vulnerability in this case refers to the potential of a group of people to be able to cope with a natural hazard (Wisner, Blaikie, Cannon, & Davis, 2003). When a hazard causes a disaster, numerous people get injured and killed. The situations tend to be gruesome to the people affected but it does not affect everybody equally. There are people who are more susceptible to certain natural hazards than another group of people. Vulnerability to natural hazards differs from region to region. For example, people who live in an area that is a plateau and is near a large water body they are most likely to suffer from floods. Regions that are close to tectonic plates are more likely to experience earthquakes than other places. My research would like to involve what factors lie behind the vulnerability, what affects other areas more than others and how can the issue be improved or how can the people protect themselves. My interest in this segment was sparked by various factors that I came across. Most researches and work done on natural hazards do not look at the vulnerability angle of the society but rather concentrate on the triggers (Wisner, Blaikie, Cannon, & Davis). Events that took my keen notice into the research were to specific ones: Haiti’s natural hazard and disasters experience and the Dhaka area in Bangladesh that is populated with squatters within the area. Both these regions have something in common: They have been key witnesses of natural hazards which have led to insurmountable amounts of damage that have set them back. I was curious to the factors that made these areas more vulnerable to the hazards as compared to other places which have fairly similar experiences but are able to maintain their progress. The research topic is well connected with content we are learning in class that is related to natural hazards and its geography. Through the content I have learnt in class I have been able to apply it and to understand how to approach a topic of research. Vulnerability of these regions gives a deeper scope of knowledge that I have learnt about natural hazards and disaster in our class.

For me to be able to learn more about vulnerability and how its related to natural hazards I had to first go through the historical experience of Haiti and disaster. Throughout time, the region has experience a continuous torrent of earthquakes and floods. Based on archived information and newspaper articles, I was able to really dig deep into articles providing the statistics of Haiti’s experience of with hazards (Jones, 2016). In 2008, Haiti was badly devastated by four storms which left almost 75% of its farm land destroyed and cost the life of 800 people (Jones). In 2010, they experienced one of the worst disasters in history. An earthquake left around 90,000 people killed and over 1.5 million people lost their homes. The information was able to really put into perspective the tragedy that the hazard had upon the people and the disaster they experienced. The research was able to provide to me information on the vulnerability that made Haiti vulnerable by the natural hazard. It was more than just their geographical location but factors such as instability in their political circle and high amounts of corruption (Jones). For information on Dhaka and the factors that also made it vulnerable to the disasters I was able to find reliable sources of information from research done on the area (Wisner, Blaikie, Cannon, & Davis).

While undergoing this research I was able to find certain important factors that have been given considerable thought. In relation to vulnerability to hazardous natural factors, one key component that determines how much impact the disaster will have upon the region are certain human factors (“Vulnerability to Natural Hazards”). Some of the factors involved are the wealth of the people in the region. Rich people are able to access medical help and have more stable housing as compared to impoverished people which will make them experience the disaster differently. Education is a major component as people who have knowledge on dealing with hazardous situations can be able to protect themselves more adeptly than those who do not. Governance was also shown to be of key importance as they are the ones who develop policies that can reduce the vulnerability of the people to potential natural hazards. Other important factors include age of the people affected and the technological advancement of the area.

To limit my coverage of the topic I have decided to only look at vulnerability and factors that propagate it to make the society less protected to natural hazards. As significant as the hazards and disasters are by themselves, I will not delve into that but concentrate on how the people make themselves vulnerable to the situations. I will dig deeper and uncover more analysis on various areas that have lower vulnerability to hazard compared to those that have a higher amount like Haiti, and compare what the safer areas are doing to protect themselves.

 

References

“Vulnerability to Natural Hazards”. (n.d.). Retrieved May 6, 2017, from https://www.e-education.psu.edu/geog030/node/379

Jones, S. (2016, October 4). Why is Haiti vulnerable to natural hazards and disasters? Retrieved May 6, 2017, from https://www.theguardian.com/world/2016/oct/04/why-is-haiti-vulnerable-to-natural-hazards-and-disasters

Wisner, B., Blaikie, P., Cannon, T., & Davis, I. (2003). t Risk: natural hazards, people’s vulnerability and disasters 2nd Edition.

 

Posted on

Writing your Research Report

Writing your Research Report

Topic: The topic of the research final paper is open to the interests of the students. Students should find a question they would like to answer using the statistical techniques learnt in class.

To find the topic of your final report you need to start from a broad perspective looking at some general idea that you would like to explore. For example, let’s say that you would like to look at the relationship between interest rates and the economy. This is a very broad topic and you need to start doing research looking to specify your main research question. In figure 1 we can see all the different sub-topics, or more specific areas, in which we can divide our broad topic.

Interest Rate and the Economy

Figure 1

 

We could list more sub-topics than the ones we represented in Figure 1. However, we need to pick one so we can have a more focused research topic. Let’s assume that we choose to research the question regarding the impact of interest rates on the growth of construction in the United States. Once that we decided what our topic is going to be, we need to solve three main issues regarding our research project:

  1. Review of literature: we need to research what other people have done previously. Especially, we need to find peer-reviewed publications of researchers that have worked in this specific area and look at their results. To find other research you should go to the website of the UNF Library and search for research papers in this specific area. The following is a guide on how to search the library at UNF:
    1. Enter the Library website and in that website you click on Databases by Subject
    1. Once you click that link a new page will open, which will show you all the different databases of research articles according to the disciplines of study. In our case, we will be interested in the Business (Finance, Investment, International, Management) and the Economics and Geography databases. The specific database will depend on the research topic you choose.
    1. In our specific example, we should click on the Economics and Geography link. There a list of databases will appear. You should select one of them. Let’s say that we pick EconLit.
    1. Once we picked EconLit, a new page will open, where we can start searching for research reports. Then, if we find one that we believe is germane to the selected topic, we can download it and read it and use it in our review of literature and reference sections.

It is important to remember that when we read other people’s work we are looking for the following:

  1. How they addressed the research question
  2. What data they used?
  3. What kind of statistical technique they utilized?
  4. What conclusions they reached?

This will allow us to move further in our research project and to be able to understand how to perform our task.

  1. Data Availability: once we do a review of literature we should be able to tell what kind of data we need to do our research project. At this time, it is very important to be able to find out if the data is available and where we can find them. Many times a research project cannot continue because of the lack of datasets or because the information does not exist yet. It is very important that you can find the data. Useful sites to check out:
    1. Census Bureau: www.census.gov
    2. Bureau of Labor Statistics: www.bls.gov
    3. Bureau of Economic Analysis: www.bea.gov
    4. Federal Reserve Database: http://www.research.stlouisfed.org/fred2/
    5. U.S. Government Open Data: www.data.gov
    6. International Data (World Bank): http://data.worldbank.org/
  1. Statistical Methodology: finally, after the review of literature is done and the dataset is located we need to determine what the methodology that we are going to use is. That means we need to decide which technique that we learnt in class is appropriated to answer the research question. Accordingly, you can use your review of literature to inform this decision, the textbook, class notes, etc.

Once you performed these three tasks you are ready to use excel to calculate your model and show your results. Accordingly, we are ready to write our research report.

Format Research Report

The following are the main sections of your research report and a short explanation of what the contents of each section should be:

  1. Cover Page: contains the title, authors and class section.
  2. Introduction: this is a short section of your paper, no more than one page. However, this is a very important part of your report, as this is the section that most people are going to read first. As a result, you need to make sure that people are convinced of the worthiness of your research. You should emphasize the following:
    1. Why is this research topic important? Why the reader should keep reading? Why should the reader care about this paper?
    2. What are the main findings of your research?
    3. Why these findings are important?
  3. Review of literature: Explains the previous work on this topic, if any, and how the topic of this paper fits that body of work. You need to explain, very shortly what other people have found with regards to this research question and how their findings compare to your findings. By mentioning other people’s work you discuss the problem at hand and how other people have addressed this problem. If your research topic is about your company you need to discuss the nature of the problem and the different solutions that were offered and why you think that your empirical analysis could improve those proposed solutions. This section should have 2-3 pages.
  4. Data: in this section you need to describe the data you found, show a table with the main statistics, like the mean and the standard deviation for each variable. Explain what the sources of your data are. This sections should be 2 pages at the most.
  5. Methodology and results: In this section you need to proceed as follows: first, explain the statistical techniques that you are going to use to answer your research question. For example, if you are using a regression model you need to show the theoretical equation with the independent variables and why are you using the variables that you are using. Second, you need to show your results and do the tests to show that your model, if it is a regression model, satisfies the assumptions. If you introduced some modifications to satisfy the assumptions, then you need to explain those changes. Finally, you need to explain your results main results and conclusions. This section should be 4-5 pages long.
  6. Conclusions: Explains what the results are and why they are important. This sections should be 1 page long.
  7. References should be listed at the back of the paper.
  8. Appendixes after the references (if needed)

Length and Format: The length of the paper is 12-15 pages (12 pages minimum), including title page, references and figures, but excluding appendixes.

The format of the page should be 1.5 spacing, font size 12 Times New Roman. The margins should be Right:1.25”, Left:1.25”, Top:1” and Bottom:1”

Format Standard: you can use any style: APA, MLA, Chicago, etc. The library has a great guide for citation styles at http://libguides.unf.edu/citationguide

Still stuck with your research report, get more help here:

Posted on

How does Bitcoin works

Essay on How Bitcoin works

ABSTRACT

Bitcoin is the simplest way to exchange money.

Bitcoinis a software-based online payment systemdescribed bySatoshi Nakamotoin 2008 and introduced asopen-source softwarein 2009.Payments are recorded in a publicledgerusing its ownunit of account,which is also calledbitcoin.Payments workpeer-to-peerwithout a central repository or single administrator, which has led theUS Treasuryto call bitcoin a decentralizedcurrency. Although its status as a currency is disputed, media reports often refer to bitcoin as acryptocurrencyordigital currency.

INTRODUCTION

Bitcoin uses peer-to-peer technology to operate with no central authority or banks; managing transactions and the issuing of bitcoins is carried out collectively by the network.Bitcoin is open-source; its design is public, nobody owns or controls Bitcoin andeveryone can take part. Through many of its unique properties, Bitcoin allows exciting uses that could not be covered by any previous payment system.

How does Bitcoin work?

As a new user, you canget startedwith Bitcoin without understanding the technical details. Once you have installed a Bitcoin wallet on your computer or mobile phone, it will generate your first Bitcoin address and you can create more whenever you need one. You can disclose your addresses to your friends so that they can pay you or vice versa. In fact, this is pretty similar to how email works, except that Bitcoin addresses should only be used once

Balances- block chain

The block chain is ashared public ledgeron which the entire Bitcoin network relies. All confirmed transactions are included in the block chain. This way, Bitcoin wallets can calculate their spendable balance and new transactions can be verified to be spending bitcoins that are actually owned by the spender. The integrity and the chronological order of the block chain are enforced with cryptography

Transactions- private keys

A transaction isa transfer of value between Bitcoin walletsthat gets included in the block chain. Bitcoin wallets keep a secret piece of data called aprivate keyor seed, which is used to sign transactions, providing a mathematical proof that they have come from the owner of the wallet. Thesignaturealso prevents the transaction from being altered by anybody once it has been issued. All transactions are broadcast between users and usually begin to be confirmed by the network in the following 10 minutes, through a process calledmining.

Processing- mining

Mining is adistributed consensus systemthat is used toconfirmwaiting transactions by including them in the block chain. It enforces a chronological order in the block chain, protects the neutrality of the network, and allows different computers to agree on the state of the system. To be confirmed, transactions must be packed in ablockthat fits very strict cryptographic rules that will be verified by the network. These rules prevent previous blocks from being modified because doing so would invalidate all following blocks. Mining also creates the equivalent of a competitive lottery that prevents any individual from easily adding new blocks consecutively in the block chain. This way, no individuals can control what is included in the block chain or replace parts of the block chain to roll back their own spends.

Bitcoin for Individuals

Mobile payments

Bitcoin on mobiles allows you to pay with a simple two step scan-and-pay. No need to sign up, swipe your card, type a PIN, or sign anything. All you need to receive Bitcoin payments is to display the QR code in your Bitcoin wallet app and let your friend scan your mobile, or touch the two phones together (using NFC radio technology).

Security and control over money

Bitcoin transactions are secured by military grade cryptography. Nobody can charge you money or make a payment on your behalf. So long as you take the required steps toprotect your wallet, Bitcoin can give you control over your money and a strong level of protection against many types of fraud.

Works everywhere, anytime

Just like with email, you don’t need to ask your family to use the same software or the same service providers. Just let them stick to their own favourites. No problem there; they are all compatible as they use the same open technology.

Fast international payments

Bitcoins can be transferred from Africa to Canada in 10 minutes. There is no bank to slow down the process, level outrageous fees, or freeze the transfer. You can pay your neighbours the same way as you can pay a member of your family in another country.

Zero or low fees

Bitcoin allows you to send and receive payments at very low cost. Except for special cases like very small payments, there is no enforced fee. It is however recommended to pay a higher voluntary fee for faster confirmation of your transaction and to remunerate the people who operate the Bitcoin network.

Protect your identity

With Bitcoin, there is no credit card number that some malicious actor can collect in order to impersonate you. In fact, it is even possible to send a payment without revealing your identity, almost just like with physical money. You should however take note that some effort can be required toprotect your privacy.

Bitcoin for Businesses

The lowest fees out there

Bitcoin’s high cryptographic security allows it to process transactions in a very efficient and inexpensive way. You can make and receive payments using the Bitcoin network with almost no fees. In most cases, fees are not strictly required but they are recommended for faster confirmation of your transaction.

Protection against fraud

Any business that accepts credit cards or PayPal knows the problem of payments that are later reversed. Chargeback frauds result in limited market reach and increased prices, which in turn penalizes customers. Bitcoin payments are irreversible and secure, meaning that the cost of fraud is no longer pushed onto the shoulders of the merchants.

Fast international payments

Bitcoins can be transferred from Africa to Canada in 10 minutes. In fact, bitcoins never have any real physical location, so it is possible to transfer as many of them anywhere with no limits, delays, or excessive fees. There are no intermediate banks to make you wait three business days.

No PCI compliance required

Accepting credit cards online typically requires extensive security checks in order to comply with the PCI standard. Bitcoin still requires you tosecure your walletand your payment requests. However, you do not carry the costs and responsibilities that come with processing sensitive information from your customers like credit card numbers.

Get some free visibility

Bitcoin is an emerging market of new customers who are searching for ways to spend their bitcoins. Accepting them is a good way to get new customers and give your business some new visibility. Accepting a new payment method has often shown to be a clever practice for online businesses.

Conclusion

We can Sendbitcoinfrom your computer, tablet, smart phone or other device, to anyone, anywhere in the world, day or night. Bitcoinis an innovative payment network and a new kind of money. Every informed person needs to know about Bitcoin because it might be one of the world’s most important developments.

REFERENCES

http://en.wikipedia.org/wiki/Bitcoin

https://bitcoin.org/en/

https://www.weusecoins.com/en/

Posted on

Work related stress in healthcare Setting

Work related stress in healthcare Setting

Work related stress in healthcare Setting

Stress may be defined as the physical and emotional response to excessive levels of mental or emotional pressure, which may arise from issues in both the working and personal life. Stress may cause emotional symptoms such as anxiety, depression, irritability or low self-esteem, or even manifest as physical symptoms including insomnia, headaches, loss of appetite and difficulties concentrating. Individuals experiencing high levels of stress may experience difficulty in controlling emotions such as anger, and may be more likely to experience illness or consume increased quantities of alcohol (NHS Choices, 2015). In the UK a survey undertaken by the Health and Safety Executive (HSE) has estimated that in the year 2013-2014, 487,000 of work related illnesses (39%) could be attributed to work-related stress, anxiety or depression (HSE, 2014). Additionally the survey found that as many as 11.3 million working days were lost in the year 2013-2014 as the direct result of work-related stress (HSE, 2014).

Work related stress in healthcare SettingStudies have shown that healthcare professionals, particularly nurses and paramedics, are at an increased risk of work-related stress compared with other professionals (Sharma et al., 2014). This is likely to be due to the innate long hours and high pressure of maintaining quality care standards in the job, as well as pressures caused by staff shortages, high levels of patient demand, a lack of adequate managerial support as well as the risk of aggression or violence towards nurses from patients, relatives or even other staff (Royal College of Nursing (RCN), 2009). Indeed, a 2014 survey of nursing staff by the RCN showed that up to 71% of staff surveyed worked up to 4 hours more than their contracted hours a week, 80% felt that work-related stress lowered morale, and that 72% reported that understaffing occurred frequently in their workplace. As a result of these issues, 66% of respondents in the survey considered leaving the NHS or the nursing profession altogether (RCN, 2014b). A separate report by the RCN suggested that over 30% of absence due to illness was due to stress, which was estimated to cost the NHS up to £400 million every year (RCN, 2014a).

In addition to the physical and emotional symptoms of stress previously discussed, studies in this area have shown that nurses experiencing high levels of work-related stress were more likely to be obese and have low levels of physical exercise, factors which increased the likelihood of non-communicable diseases and co-morbidities such as hypertension and type 2 diabetes (Phiri et al., 2014).

Stress and staff absence

Chronic stress has been linked to “burnout”(Khamisa et al., 2015; Dalmolin et al., 2014), or a state of emotional exhaustion under extreme stress related to reduced professional fulfilment (Dalmolin et al., 2014) and “compassion fatigue”, where staff have experienced so many upsetting situations that they find it difficult to continue empathising with their patients (Wilkinson, 2014). As previously discussed, reducing staffing levels contribute to stress in nursing staff, and in this way chronic stress within the workplace launches a self-perpetuating cycle of understaffing; increased stress leads to increased illness, more staff absence and increased understaffing. In turn, these negative emotions also reduce job satisfaction and prompt many staff to consider leaving the nursing profession, further reducing staffing availability for services (Fitzpatrick and Wallace, 2011).

Studies amongst nursing staff have also reported stress occurring as the result of poor and unsupportive management, poor communication skills amongst team members, institutional and organisational issues (e.g. outdated or restrictive hospital policies) or bullying and harassment (RCN, 2009). Even seemingly minor issues have been reported as exacerbating stress amongst nursing staff, for example a lack of common areas to take breaks in, changing shift patterns, and even difficulty and expense of car parking (Happell et al., 2013).

Work related stress can particularly affect student or newly qualified nurses, who often report higher expectations of job satisfaction from working in the profession, they have worked hard and aspired to join, and are therefore particularly prone to experiencing disappointment on discovering that they do not experience the job satisfaction that they presumed they would do whilst training. Student and newly qualified nurses may also have clear ideas from their recent training on how healthcare organisations should be run and how teams should be managed, and may then be disillusioned when they discover that the reality is that many departments could in fact benefit from improvements and further training for more experienced staff in these areas (Wojtowicz et al., 2014; Stanley and Matchett, 2014). Nursing staff are also likely to, on occasion, find themselves in a clinical situation that they feel unprepared for, or do not have the necessary knowledge to provide the best possible care for patients, and this may cause stress and anxiety (RCN, 2009). They may also be exposed to upsetting and traumatic situations, particularly in fields such as emergency or intensive care medicine (Wilkinson, 2014).

Work related stressMoral distress can also cause strong feelings of stress amongst healthcare professionals. This psychological state occurs when a discrepancy occurs between the action that an individual takes, and the action that an individual feels they should have taken (Fitzpatrick and Wallace, 2011). This may occur if a nurse feels that a patient should receive an intervention in order to experience best possible care, but is unable to deliver it, for example due to organisational policy constraints, or a lack of support from other members of staff (Wojtowicz et al., 2014). For example, a nurse may be providing end of life care to a patient who has recently had an unplanned admission onto a general ward but is expected to die shortly. The nurse may feel that this patient would benefit from having a member of staff sitting with them until they died. However, due to a lack of available staffing this does not happen as the nurse must attend to other patients in urgent need of care. If the patient dies without someone with them, the nurse may experiences stress, anger, guilt and unhappiness over the situation as they made the moral judgement that the dying patient “should” have had a member of staff with them, but were unable to provide this without risking compromising the safety of other patients on the ward (Stanley and Matchett, 2014). One large scale questionnaire based study in the USA on moral distress amongst healthcare professionals has shown that moral distress is more common amongst nurses than other staff such as physicians or healthcare assistants. The authors suggested that this may be due to a discrepancy between the level of autonomy that a nurse has in making care decisions, (especially following disagreement with a doctor, who has a high level of autonomy), while experiencing a higher sense of responsibility for patient wellbeing than healthcare assistants, who were more likely to consider themselves to be following the instructions of the nurses than personally responsible for patient outcomes (Whitehead et al., 2015).

It is acknowledged that many individuals find that being asked to perform tasks that they have not been adequately trained or prepared for can be very stressful. As such management teams should also try to ensure as far as possible that individuals are only assigned roles for which they have adequate training and abilities, and support employees with training to improve skills where necessary (RCN, 2009).

Surveys have frequently reported that organisational issues such as a lack of intuitive work patterns, overloading of workloads and an unpleasant working environment can all contribute to work related stress. Organisations can reduce the impact of these by developing programmes of working hours with working staff and adhering to them, making any necessary improvements to the environment (e.g. ensuring that malfunctioning air conditioning is fixed), and that incidents of understaffing are reduced as much as possible (RCN, 2009). Issues such as insomnia and difficulty in adapting to changing shift patterns can also be assisted by occupational health, for example by encouraging healthy eating and exercise (Blau, 2011; RCN, 2005). For example, in 2005 the RCN published an information booklet for nursing staff explaining the symptoms of stress, ways in which it can be managed e.g. relaxation through exercise or alternative therapies, and when help for dealing with stress should be sought (RCN, 2005). More recently, internet based resources are available from the NHS to help staff identify if they need assistance, and how and why it is important to access it (NHS Employers, 2015).

Witnessing or experiencing traumatic or upsetting events is an unavoidable aspect of nursing, and can even result in post-traumatic stress disorder (PTSD). However, there are ways in which staff can be encouraged by their management teams and organisations to deal with the emotions that these circumstances produce, limiting the negative and stressful consequences of these events. This may include measures such as counselling or even peer support programmes through the occupational health departments (Wilkinson, 2014). Staff should also be encouraged to use personal support networks e.g. family, as this can be an important and effective source of support, however studies have shown that support within the work place is most beneficial, particularly if this can be combined with a culture where healthcare professionals are encouraged to express their feelings (Lowery and Stokes, 2005).

One commonly cited reason for work related stress amongst nurses is the incompetence or unethical behaviours of colleagues, and a lack of opportunity to report dangerous or unethical practice without fear of reprisal. Therefore it is important that institutions and management teams ensure that there is an adequate care quality monitoring programme in place, and a culture where concerns can be reported for further investigation without fear of reprisal, particularly with respect to senior staff or doctors (Stanley and Matchett, 2014).

It has been reported that in the year 2012-2013, 1,458 assaults were reported against NHS staff (NHS Business Service Authority, 2013). Violence and abusive behaviour towards nursing staff is an acknowledged cause of stress and even PTSD, and staff have a right to provide care without fear (Nursing Standard News, 2015; Itzhaki et al., 2015). Institutions therefore have a responsibility towards their staff to provide security measures such as security staff, workplace design (e.g. locations of automatically locking doors) and policies for the treatment of potentially violent patients e.g. those with a history of violence or substance abuse issues (Gillespie et al., 2013).

As previously discussed, nurses are more likely than other healthcare professionals to experience moral distress as the result of a discrepancy between the actions they believe are correct and the actions they are able to perform (Whitehead et al., 2015). However there are policies that can be introduced into healthcare organisations to reduce its occurrence, and the severity with which it can affect nursing staff. Studies have shown that nurses who were encouraged to acknowledge and explore feelings of moral distress were able to process and overcome these in a less damaging manner than those who did not (Matzo and Sherman, 2009; Deady and McCarthy, 2010). Additionally, it is thought that moral distress is less frequent in institutions and teams that encourage staff to discuss ethical issues with a positive attitude (Whitehead et al., 2015). For example, institutions could employ a designated contact person for staff to discuss stressful ethical issues with, or set up the facility for informal and anonymous group discussion, for example on a restricted access internet-based discussion board (Matzo and Sherman, 2009)

Conclusion

Work related stress is responsible for significant costs to the NHS in terms of staffing availability and financial loss from staff absence from stress itself or co-morbidities that can be exacerbated by stress (RCN, 2009), for example hypertension and diabetes (Phiri et al., 2014; RCN, 2009, 2014a). The loss of valuable and qualified staff from the profession is also a significant cost to health services, and of course exacerbates the situation by increasing understaffing further, which in turn increases stress for the remaining staff (Hyrkas and Morton, 2013). It can also exert a significant cost to healthcare professionals who experience it, in terms of their ability to work, their personal health, effects on personal relationships (Augusto Landa et al., 2008) and job satisfaction (Fitzpatrick and Wallace, 2011). However, organisations can implement recommendations to reduce work related stress, for example by encouraging a positive and supportive culture for staff by offering interventions such as counselling (Wilkinson, 2014; RCN, 2005). Furthermore, interventions such as encouraging the reporting of unsafe or unethical practice – a commonly cited source of stress amongst nurses (RCN, 2009; Stanley and Matchett, 2014) – may also contribute to improving the quality of patient care.

References

Augusto Landa, J. M., López-Zafra, E., Berrios Martos, M. P. and Aguilar-Luzón, M. D. C. (2008). The relationship between emotional intelligence, occupational stress and health in nurses: a questionnaire survey. International Journal of Nursing Studies, 45 (6), p.888–901. [Online]. Available at: http://www.ncbi.nlm.nih.gov/pubmed/17509597

Blau, G. (2011). Exploring the impact of sleep‐related impairments on the perceived general health and retention intent of an Emergency Medical Services (EMS) sample. Career Development International, 16 (3), p.238–253. [Online]. Available at: http://www.emeraldinsight.com/doi/abs/10.1108/13620431111140147

Dalmolin, G. de L., Lunardi, V. L., Lunardi, G. L., Barlem, E. L. D. and da Silveira, R. S. (2014). Moral distress and Burnout syndrome: are there relationships between these phenomena in nursing workers? Revista Latino-Americana de Enfermagem, 22 (1), p.35–42. [Online]. Available at: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-11692014000100035

Deady, R. and McCarthy, J. (2010). A Study of the Situations, Features, and Coping Mechanisms Experienced by Irish Psychiatric Nurses Experiencing Moral Distress. Perspectives in Psychiatric Care, 46 (3), p.209–220. [Online]. Available at: http://www.ncbi.nlm.nih.gov/pubmed/20591128

Fitzpatrick, J. J. and Wallace, M. (2011). Encyclopedia of Nursing Research. 3rd ed. New York: Springer Publishing Company.

Gillespie, G., Gates, D. M. and Berry, P. (2013). Stressful Incidents of Physical Violence Against Emergency Nurses. OJIN: The Online Journal of Issues in Nursing, 18 (1). [Online]. Available at: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-18-2013/No1-Jan-2013/Stressful-Incidents-of-Physical-Violence-against-Emergency-Nurses.html

Happell, B., Dwyer, T., Reid-Searl, K., Burke, K. J., Caperchione, C. M. and Gaskin, C. J. (2013). Nurses and stress: recognizing causes and seeking solutions. Journal of Nursing Management, 21 (4), p.638–647. [Online]. Available at: http://www.ncbi.nlm.nih.gov/pubmed/23700980

HSE. (2014). Statistics – Stress-related and psychological disorders in Great Britain. Health and Safety Executive. [Online]. Available at: http://www.hse.gov.uk/statistics/causdis/stress/index.htm

Hyrkas, K. and Morton, J. L. (2013). International perspectives on retention, stress and burnout. Journal of Nursing Management, 21 (4), p.603–604. [Online]. Available at:

Itzhaki, M., Peles-Bortz, A., Kostistky, H., Barnoy, D., Filshtinsky, V. and Bluvstein, I. (2015). Exposure of mental health nurses to violence associated with job stress, life satisfaction, staff resilience, and post-traumatic growth. International Journal of Mental Health Nursing, 24 (5), p.403–412. [Online]. Available at: http://www.ncbi.nlm.nih.gov/pubmed/26257307

Khamisa, N., Oldenburg, B., Peltzer, K. and Ilic, D. (2015). Work Related Stress, Burnout, Job Satisfaction and General Health of Nurses. International Journal of Environmental Research and Public Health, 12 (1), p.652–666. [Online]. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4306884/

Lowery, K. and Stokes, M. A. (2005). Role of peer support and emotional expression on posttraumatic stress disorder in student paramedics. Journal of Traumatic Stress, 18 (2), p.171–179. [Online]. Available at: doi:10.1002/jts.20016

Matzo, M. L. and Sherman, D. W. (2009). Palliative Care Nursing: Quality Care to the End of Life. 3rd ed. New York: Springer Publishing Company.

NHS Business Service Authority. (2013). 2012-13 figures released for reported physical assaults against NHS staff. NHS Business Service Authority. [Online]. Available at: http://www.nhsbsa.nhs.uk/4380.aspx

NHS Choices. (2015). Stress, anxiety and depression. NHS Choices. [Online]. Available at: http://www.nhs.uk/conditions/stress-anxiety-depression/pages/understanding-stress.aspx

NHS Employers. (2015). Health work and wellbeing. NHS Employers. Available at: http://www.nhsemployers.org/your-workforce/retain-and-improve/staff-experience/health-work-and-wellbeing

Nursing Standard News. (2015). Stress at work affecting nurses’ health, survey finds. Nursing Standard, 29 (27), p.8–8. [Online]. Available at: http://journals.rcni.com/doi/10.7748/ns.29.27.8.s6

Phiri, L. P., Draper, C. E., Lambert, E. V. and Kolbe-Alexander, T. L. (2014). Nurses’ lifestyle behaviours, health priorities and barriers to living a healthy lifestyle: a qualitative descriptive study. BMC Nursing, 13. [Online]. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4264254/

RCN. (2005). Working well initiative: Managing your stress. A guide for nurses. Royal College of Nursing. [Online]. Available at: http://www.rcn.org.uk/__data/assets/pdf_file/0008/78515/001484.pdf

RCN. (2009). Work-related stress. Royal College of Nursing. [Online]. Available at: https://www.rcn.org.uk/__data/assets/pdf_file/0009/274473/003531.pdf

RCN. (2014a). Importance of stress awareness. [Online]. Available at: http://www.rcn.org.uk/newsevents/news/article/uk/importance_of_stress_awareness

RCN. (2014b). Two thirds of staff have considered leaving the NHS. [Online]. Available at: http://www.rcn.org.uk/newsevents/news/article/uk/two_thirds_of_staff_have_considered_leaving_the_nhs

Sharma, P., Davey, A., Davey, S., Shukla, A., Shrivastava, K. and Bansal, R. (2014). Occupational stress among staff nurses: Controlling the risk to health. Indian Journal of Occupational and Environmental Medicine, 18 (2), p.52–56. [Online]. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4280777/

Stanley, M. J. C. and Matchett, N. J. (2014). Understanding how student nurses experience morally distressing situations: Caring for patients with different values and beliefs in the clinical environment. Journal of Nursing Education and Practice, 4 (10), p.p133. [Online]. Available at: doi:10.5430/jnep.v4n10p133

Whitehead, P. B., Herbertson, R. K., Hamric, A. B., Epstein, E. G. and Fisher, J. M. (2015). Moral Distress Among Healthcare Professionals: Report of an Institution-Wide Survey. Journal of Nursing Scholarship, 47 (2), p.117–125. [Online]. Available at: http://www.ncbi.nlm.nih.gov/pubmed/25440758

Wilkinson, S. (2014). How nurses can cope with stress and avoid burnout: Stephanie Wilkinson offers a literature review on the workplace stressors experienced by emergency and trauma nurses. Emergency Nurse, 22 (7), p.27–31. [Online]. Available at: http://rcnpublishing.com/doi/abs/10.7748/en.22.7.27.e1354

Wojtowicz, B., Hagen, B. and Van Daalen-Smith, C. (2014). No place to turn: Nursing students’ experiences of moral distress in mental health settings. International Journal of Mental Health Nursing, 23 (3), p.257–264. [Online]. Available at: http://www.ncbi.nlm.nih.gov/pubmed/23980930