Cultural Diversity By Thomas Sowell Summary - 877 Words

Throughout the entirety of Cultural Diversity: A World View, Thomas Sowell clearly establishes the distinction between the modern interpretation of diversity and that which he accepts as truth. Sowell uses this separation from the accepted definition of diversity as a foundation upon which he builds his argument. In disentangling both himself and his statements from the convoluted explanations of diversity, he is able to view this concept through a historical and global lens which gives a solid basis for his argument. This approach can be observed through the first major point presented which highlights the inevitable impact which all cultures have on other groups. Whether it is an exchange of natural resources, such as†¦show more content†¦To conclude his article, Sowell explicitly condemns those who attempt to promote diversity by rigidly preserving cultural aspects which are ineffective. He claims that in this approach to diversity, enormous harm is inflicted upon th ose groups whose culture is supposedly being preserved. Sowell states that No culture has grown great in isolation, and in this the overarching, basic argument that humans need other humans presents itself. In Cultural Diversity: A World VIew, Thomas Sowell continually supports his claims with logical and historical information which validates his argument and allows for the reader to easily understand the basis to the statements being made. As someone who enjoys studying history, these sources used effectively drew me into the points being made and gave obvious examples which I could then use to solidify my personal understanding of the text. While I agree that the use of history is definitely necessary throughout Sowells argument, I thought that if the psychology behind humanitys struggle between diversification and preservation was addressed during the analysis of modern diversity it would enrich the explanation of why we face the perception of diversity that we do. Personally, I agreed with many of Sowells points. One ofShow MoreRelated Affirmative Action Essay4528 Words   |  19 Pageseducation, jobs, income, class, and social mobility. Another concern, therefore, is what inequalities are acceptable? These material inequalities of income, education, housing, etc. are necessary to a multi-class capitalist society, but the unacceptable cultural inequalities of race, gender, discrimination, and prejudice must be ameliorated. Current trend in the United States, and in fact the world, is to try to remedy this link between race/gender and measurable inequalities by affecting opportunity. AffirmativeRead MoreWorkforce Diversity in Indian Organization3598 Words   |  15 PagesBEHAVIOUR | Work Force Diversity in Indian Organization | | Submitted by: Vaibhav Gupta Executive Summary: We’ve looked at the challenges that Indian companies face because of diversity, both at the workplace and the marketplace. We’ve also seen the ways companies can use, to not only manage existing diversity but also to promote it and gain a competitive advantage in the market. Probably, the most important aspect that comes out from the study is that diversity is finally all about

Essay Analysis of George Orwells A Hanging

This assignment offers guidelines on how to compose  a  critical analysis of A Hanging, a classic narrative essay by George Orwell. Preparation Carefully read George Orwells narrative essay A Hanging. Then, to test your understanding of the essay, take our multiple-choice reading quiz. (When youre done, be sure to compare your answers with those that follow the quiz.) Finally, reread Orwells essay, jotting down any thoughts or questions that come to mind. Composition Following the guidelines below, compose a soundly supported critical essay of about 500 to 600 words on George Orwells essay A Hanging. First, consider this brief commentary on the purpose of Orwells essay: A Hanging is not a polemical work. Orwells essay is intended to express by example what it means to destroy a healthy, conscious man. The reader never finds out what crime was committed by the condemned man, and the narrative isnt primarily concerned with providing an abstract argument regarding the death penalty. Instead, through action, description, and dialogue, Orwell focuses on a single event that illustrates the mystery, the unspeakable wrongness, of cutting a life short when it is in full tide. Now, with this observation in mind (an observation that you should feel free to either agree with or disagree with), identify, illustrate, and discuss the key elements in Orwells essay that contribute to its dominant theme. Tips Keep in mind that youre composing your critical analysis for someone who has already read A Hanging. That means you dont need to summarize the essay. Be sure, however, to support all your observations with specific references to Orwells text. As a general rule, keep quotations brief. Never drop a quotation into your paper without commenting on the significance of that quotation. To develop material for your body paragraphs, draw on your reading notes and on points suggested by the multiple-choice quiz questions. Consider, in particular, the importance of point of view, setting, and the roles served by particular characters (or character types). Revision and Editing After completing a first or second draft, rewrite your composition. Be sure to read your work aloud when you revise, edit, and proofread. You may hear problems in your writing that you cant see.

What Does Running A Technology Practice A Modern Agency...

What does running a technology practice in a modern agency look like? 1. Opportunities and Goals a. Strategic Alliances There is a ton of tiny gems in New York—nuclear teams of a handful of developers able to crank out code of superb quality at rates below market. Using a honeypot of smaller and larger projects we can quickly find and build relationships with multiple teams and groom them for acqu-hire. Using small teams, Brand Connections can build an improved mobile platform to replace race to retail. b. Incubation Building mobile, 3D/VR, and other capabilities in-house would be a great asset to the company. By building a small incubator we can attract talent for pennies, as long as we supply the facilities and exposure. Some tech to explore would be: i. Emerging Technologies 1. Microsoft HoloLens (dev kits ship in the spring) 2. Oculus Rift (DK2 available now, Consumer Version expected this year) 3. Samsung Gear VR (already out) ii. Interactive Advertising and Measurement 1. Reactive ad displays 2. Brand ambassador interaction tracking with facial recognition 3. In-store navigation solutions 2. Technical Debt Working with vendors, partners, and internal dev teams is always difficult when it comes to code quality. Since technical debt is the most straightforward way to measure software quality, this section attempts to explain what technical debt is, and propose a way to quantify and manage it at Brand Connections. What is technical debt? From the perspective of aShow MoreRelatedMalware And Protecting Assets From Malware Essay1657 Words   |  7 Pageslarger, more threats are posed to innocent people that put them and their information at serious risk. To properly analyze what malware is and how to protect personal computers and information from threats , it is seems fit that this paper will begin with a very brief look into the history of malware and viruses. Then, it will take an in-depth look into the concepts of malware and what is being implemented to prevent unwanted access of computers and networks. On top of that, insight will be given intoRead MoreDesigning A User Interface Design1468 Words   |  6 PagesIntroduction User Interface design focuses on anticipating what users might need to do and ensuring that the interface has elements that are easy to access, understand and use. Universal user interface design is aimed to develop products that can be used by all people in different environments to the greatest extent possible, without having the need to adapt or having a specialized design (Chubb, 2014). The computing environment is growing rapidly, and this has made it possible for the designersRead MoreNursing Concepts of Virginia Henderson1298 Words   |  6 PagesRunning Head: VIRGINIA AVENEL HENDERSON Nursing Concepts of Virginia Avenel Henderson Barbara Sullivan Submitted in partial fulfillment of the requirements for NSG 316: Introduction to Professional Nursing Practice University of Southern Mississippi Fall Mini-Session, 2009 Abstract This paper provides a biographical look at the life and work of Virginia Avenel Henderson. Her definition of nursing focused on the function of nursing as assisting the individual, sick or wellRead MoreBook Report on Anthropology of Globalization by Lewellen1571 Words   |  7 Pagestechnical-term-loaded text, but immensely enjoyed! So much more to be said, but I stop here. I look forward to your lively, insightful interactions and discussions. Major Learnings Chapters 1-2 o Contemporary globalization is an on-going process of not just economic flows, but also cultural flows—the increasing flow of trade, finance, culture, ideas, and people brought about by the technology of communication and travel and by the worldwide spread of neoliberal capitalism†¦ (7). o GlobalizationRead MoreInnovation, Design, Creativity, and the United States Postal Service3532 Words   |  15 Pagesnature, in business it is survival of the fittest. The key to success and longevity for businesses in the modern world is to be innovative and creative. To be innovative, it is imperative that a company develop a culture that encourages new ideas, welcomes the latest technology, and implements pioneering processes. 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If people across the country were to have enough food, these programs would not exist. It goes to show that just because one has something (i.e food) does not mean a different person does. Another preconceived notion that has been changed is that of dietary supplements and their safety. At the beginning it was thought that all dietary supplements were healthy and safe for human consumption. This has all come to a haltingRead MoreThe Invention Of The World Wide Web1938 Words   |  8 Pagesoccurs—when a novel technology is introduced to build upon or succeed an older one—the entire society (and the individuals that comprise it) changes. However, as Marshall McLuhan suggested within the printed pages of Understanding Media: The Extensions of Man, â€Å"the medium is the message† (McLuhan 1964). In other words, these shifts are not as much the direct result of the invention’s content or it’s use, as they are the outcomes of effects that are intrinsic within the technology itself. AlthoughRead MoreMy Time At The Law Firm2532 Words   |  11 PagesMy time at the law firm was full of ups and downs a lot like any other job may offer. T hroughout the internship as the semester was ending I began to see a difference in the way I was treated by the workers and I began to notice a difference in the attitudes of my co-workers. Maybe it was just because the end of the year was coming and stress from outside the work area was entering the office. Anyhow the drama created by the stress levels of the co-workers personal and work life created many flawsRead MoreOrganizational Diagnosis4870 Words   |  20 PagesRunning head: UNIT 10 PROJECT: ORGANIZATIONAL DIAGNOSIS Unit 10 Project: Organizational Diagnosis Owen Robinson Capella University 11/26/2009 Professor: Dr. Linda Terry Abstract An organizational analysis and diagnosis was conducted on Giga-Net Solutions (GNS) from the symbolic-interpretive and modernist organization theory perspectives. GNS structure, technology, and organization environment has a major impact on the organization success and management. This paper strives to outline the

Emotional Intelligence A Part Of Organizational Setting

Introduction In this era of technological advancement and highly competitive workplace, emotional intelligence , though the word sounded familiar, enough amount of researchers such as the Goleman.D(2012) suggested that this concept is a subject matter of high importance. In order to prove that ‘ Emotional intelligence has no part in the organization setting as emotions play no part in business’ is a misconception statement, this essay will focus on its background, its importance and significance with a conclusion that emotional intelligence is a part of organisational setting and why the organisations should adopt this concept for reaping better benefits in achieving their business goals. Emotional Intelligence: A Recap Given the†¦show more content†¦A concept that benefits both the employee and the employer/the organisation. Unfortunately, one cannot check these kind of emotions at the working space, so being aware of individual potential and the relating to others is important says Momeni,J (2007). It is a well known concept or a general practice by the human resource professionals that they would prefer to bring on board a candidate who possess a high emotional intelligence in contrast to the one having low intelligent quotient (Dziechciarz,J.,2003). The reason behind this decision is simply because that it helps a person in assessing people’s behaviors, management styles , attitudes, interpersonal skills in making the formal communications with an organisation more effective (Goleman,D.,1997). It is important now to understand the model of Emotional Intelligence. Emotional Intelligence Model: Emotional intelligence(EI) and organisational effectiveness model by Cherniss et al.(2001) lights upon the concepts of Emotional intelligence for organizational improvement. The elements of his models provide a sufficient understanding on how emotional intelligence can create a significance in an organizational setting. Figure 1.0: Adapted from Cary Cherniss and Daniel Goleman (2001) The model has a specific approach where it’s been classified into two different sections. One that contains leadership, human resource

Unauthorized Outside Channels In Abundance †Myassignmenthelp.Com

Question: Discuss About The Unauthorized Outside Channels In Abundance? Answer: Introducation Unwanted pregnancies are one of the rising public health concerns in the current age and with the advancements in the health care industry progressing a little every day, there are a lot of choices in the market for the mothers who do want to pursue with the pregnancy, and medical abortion is one such choice for the unwilling mothers. Medical abortion can be described as the phenomenon of using medical drugs or pills to terminate a pregnancy in the early stage (Trussell et al., 2014). It is also known as non surgical abortion or medication abortion as abortifacient drugs are used to terminate a pregnancy, early and easy. The concept of early medical abortion was introduced in the 1970s when the prostaglandin analogue drugs were introduced, and the very first abortifacient drug introduced in the market had been mifepristone, followed by misoprostol in the 1980s (Sanhueza Smith et al., 2014). According to a report by the World health organization, the safe abortion policy describes the main purpose behind the medical abortion being used in the health care is to provide the women the access to a safe and home- based option who do not have access to surgical interventions. However, the exploitation of the medical abortion pills has raised a concern for the entire health care industry (Baird 2015). Taking the Australian context under consideration, the abortion pills like mifepristone is a widely used medical abortion pill, utilized abundantly in both the clinical settings and in home based care scenario. The more abortion techniques like the surgical dilation and curettage are considered to be potentially risky for the health and safety of the women who undergo it, medical abortion pills on the other hand had been a lesser evil, as it providers a much safer abortion experience to the women. However, taking the Australian context into consideration, the restrictive obstructions by the Federal Goods Administration legislation have been restricting the availability of the medical abortion until 2006 (Baird 2015). And the medical abortion drugs have been allowed commercial import only in 2012 in Australia, and mifepristone had become a government subsidized medication only in the year of 2013. Elaborating more on the development of the concept of medical abortion in Australia, the initiation of the use of mifepristone occurred in the late 1990s around in The New South Wales and Victoria, and the medication was tested as both emergency contraceptive and abortifacient in the early phase. H owever, the availability of the medical abortion was obstructed in the 1996, by the conservative government of PM John Howard, creating a new legislation mandating special condition or the use of mifepristone, effectively banning the use of the drug commercially (Costa et al., 2015). The movements of the Abortions Providers Federation of Australia had been a slow but steady work in progress in facilitating the entry of the medication as any other normal drug in Australia. The cumulative work of both the federation and female federal parliamentarians was successful in the lifting the ban on mifepristone around 2006, however the import allowance for the medication took a few years to be materialized; although time gap served to facilitate the time consuming process of physicians becoming authorized prescribers of the drug (Doran and Nancarrow 2015). Within the 2012, 200 doctors practising in Australia become authorized prescribers of abortifacient pills, and the process of ensuring av ailability of abortifacient drugs in Australia was escalated a few more steps. In August, 2012, a subsidiary company in the name of Marie stopes was established which could extract the authorized registration for the two abortifacient pills from the Therapeutic Goods Administration, for mifepristone Linepharma and misoprostol GyMiso. Since the entry of the medical abortion pills in the year 2012, it has been abundantly used in the market and the alarming use of this drug in the present day scenario is one of the emerging public health priorities (Grossman and Goldstone 2015). Even during the prolonged wait period for the authorized access for the drug, the perception of the Australian women about the abortifacient drugs have been growing, and the restrictions for the drug in Australia only fed the raging demand for the pills in the women. As soon as medication was available in the Australian market in the 2013, the outrage for early medical abortion began in Australia (Newton et al., 2016). Even before the drug was legitimately available in the Australian markets, women in Australia were reported to obtain it from outside channels. Many of the underage women had also been reported being arrested in the Australian market due to unauthorized usage of abortion pills in Australia. After it was made available in Australian market legitimately, mifepristone was the most exploited drug accessed through unauthorized outside channels in abundance (ORourke, Belton and Mulligan 2016). With the demand for early medical abortion extremely high in the Australian women, the drug soon became enlisted under the pharmaceutical benefits scheme. However, with the extreme demand and availability, there have been a number of serious adverse effects of this development of early medical abortion in Australia. First and foremost, there have been serious concerns regarding the cost effectiveness of the medication abortion, while some regions reported it to be cheaper than the surgical alternative, where as in some regions it was reported to cost more than the surgical alternative altogether (Baird 2015). Along with that post abortive care for the poorer women with limited access to better health care and lifestyle standards suffered the consequences of unwarranted use of abortion pills by the means of over the counter unauthorized purchase. The complete absence of coordinated action by public health departments in Australia can one of the most vital contributing factors behind the chaos in context of medical abortion pills and its availability (Oppegaard et al., 2017). On a concluding note, the legitimate introduction of medical abortion pills in the Australian market has undoubtedly been a blessing for the women to successfully and safely undergo abortion without having to resort to surgical interventions. However, the need for regulatory precaution and post operative management is crucial, which in case of unauthorized outside channel access of the medication will not provide. The extreme cost for authorized usage of these pills can be the reason propelling the Australian women belonging to low economic standards to resort to over the counter usage. Hence, there is need for interference from the public health authorities so that the pain staking process of medical development or medication abortion does not eventually lead to adverse consequences for the women. References: Baird, B., 2015. Medical abortion in Australia: a short history. Reproductive health matters, 23(46), pp.169-176. Costa, C., Douglas, H., Hamblin, J., Ramsay, P. and Shircore, M., 2015. Abortion law across Australiaa review of nine jurisdictions. Australian and New Zealand Journal of Obstetrics and Gynaecology, 55(2), pp.105-111. Doran, F. and Nancarrow, S., 2015. Barriers and facilitators of access to first-trimester abortion services for women in the developed world: a systematic review. J Fam Plann Reprod Health Care, 41(3), pp.170-180. Grossman, D. and Goldstone, P., 2015. Mifepristone by prescription: a dream in the United States but reality in Australia. Contraception, 92(3), pp.186-189. Newton, D., Bayly, C., McNamee, K., Hardiman, A., Bismark, M., Webster, A. and Keogh, L., 2016. How do women seeking abortion choose between surgical and medical abortion? Perspectives from abortion service providers. Australian and New Zealand Journal of Obstetrics and Gynaecology, 56(5), pp.523-529. ORourke, A., Belton, S. and Mulligan, E., 2016. Medical abortion in Australia: What are the legal and clinical risks? Is medical abortion over-regulated?. Journal of Law and Medicine, 221. Oppegaard, K.S., Sparrow, M., Hyland, P., Garca, F., Villarreal, C., Fandes, A., Miranda, L. and Berer, M., 2017. What if medical abortion becomes the main or only method of first trimester abortion? A roundtable of views. Contraception. Sanhueza Smith, P., Pea, M., Dzuba, I.G., Martinez, M.L.G., Peraza, A.G.A., Bousiguez, M., Shochet, T. and Winikoff, B., 2014. Safety, efficacy and acceptability of outpatient mifepristone-misoprostol medical abortion through 70 days since last menstrual period in public sector facilities in Mexico City. Reproductive health matters, 22(sup44), pp.75-82. Trussell, J., Nucatola, D., Fjerstad, M. and Lichtenberg, E.S., 2014. Reduction in infection-related mortality since modifications in the regimen of medical abortion. Contraception, 89(3), pp.193-196.

Nursing Case Study- How to improve the monitoring of fluid balance

Question: Describe about the Nursing Case Study (Improving the Monitoring of Fluid Balance in Clinical Settings)? Answer: Introduction: Water is the most important part of life and maintenance of proper water balance is of utmost important in order to lead a healthy life. Imbalance in water leads to a number of health consequences. Again, in case of the critically ill patients and post-operative patients, maintaining fluid balance is very important in order to improve their health condition. One of the main roles of the nurses assigned in the ICU department of a health care organization is to monitor the fluid balance of the patients. Adverse health condition may arise if there is a fluctuation of 5-10% in the fluid balance of a patient (Glade, 2010). Various procedures are followed to monitor the fluid balance of the critically ill patients all over the world. According to a study carried out by Bontant et al. (2014), in a critical care unit, the frequency of incorrect calculation of the balance of fluid in patients is 70%. The study also showed that the nurses who work in the critical care units do not perform the monitoring of the fluid balance accurately or correctly. So, in this assignment we are going to discuss the monitoring of the fluid balance of the patients who are admitted to the ICU department of a hospital and also look for the ways by which, the monitoring techniques can be improved in order to decrease the inaccuracy that occurs while monitoring the fluid balance. Are You Daunted by the Thought of due Case Study ? Avail Our Services and Receive Case study Help from experts. Discussion: As defined by Elliot et al. (2007), the ICU is that department of the hospital in which patients suffering from life threatening diseases or illness are treated. According to the World Federation of Critical Care Nurses or WFCCN, a nurse who works in the ICU and offers services to the critically ill patients should have proper understanding of the situation of the patients, should be capable of making necessary decisions for the patients and should be able to provide advanced and quality care in order to restore the health of the patient (WFCCN, 2007). The term fluid balance is used to state the input and output balance of fluid in the body that is essential for the proper functioning of the metabolic processes of the body (Welch, 2010). In case of women, around 52% of the body weight is fluid and in case of men the percentage of body fluid is 60% of the weight and the body fluid consist mainly of water and electrolytes (Louden, 2015). In case of healthy people, the maintenance of the balance of fluid is a dynamic process that is controlled by the body with the coordination of the renal and the hormonal system (Scales and Pilsworth, 2008). An increase in the fluid in human body leads to overloading of fluid which in turn may cause pulmonary oedema. On the other hand, a decrease in the fluid volume in the body can lead to dehydration related complications including hypotension. A fluid volume deficit is termed as negative fluid balance, whereas excess fluid in the body is termed as positive fluid balance (Scales and Pilsworth, 2008) . According to Pikwer et al. (2012), the fluid balance of a patient is the indicator of the clinical status of the patient. In case of critically ill patients admitted to the ICU department, the normal fluid balance is disrupted. So, restoring the fluid balance is the major concern for the nurses caring for the patient. In these kinds of patients, optimal tissue perfusion requires proper fluid balance and a disruption in the tissue perfusion may result in the failure of multiple organs causing the death of the patients (Khwannimit, 2008). Any inaccuracy in the fluid balance measurement may result in inaccurate data regarding the fluid status of the patient which in turn lead to improper treatment of the patient (Koonrangsesomboon and Khwannimit, 2014). In the body, the maintenance of fluid balance is the function of hormones and renal system (Scales and Pilsworth, 2008). The three hormones that are associated with the function include ADH or anti- diuretic hormone, the other name of which is the vasopressin and is secreted from the pituitary gland; ANP or the atrial natriuretic peptide and aldosterone, secreted from the adrenal gland present in the kidney (Payen et al., 2008). The ADH is associated with the re-absorption of fluid from the kidney and returns it to the blood stream. This hormone is also associated with the decrease in the volume of urine and increase in the concentration of urine (Thornton, 2010). The ANP hormone causes the kidney to eliminate of the sodium and water. Aldosteron on the other hand is associated with the re- absorption of sodium in exchange of potassium ion (Queisser, 2010). The renal system maintains the electrolyte balance through filtration, secretion and re-absorption (Lumbers, Boyce and Gibson, 20 07). There are various studies that are focused on the importance of monitoring of fluid balance in critically ill patients. According to Vincent et al. (2006), the monitoring of fluid balance influences the recovery of a patient in the ICU. The basis of monitoring the fluid balance is the assessing, recording and calculating the input and output of fluid of a patient (Garrett, 2003). As per the study carried out by Chapelhow and Crouch (2007), fluid balance chart is very important to monitor the fluid balance of the patients. These charts include the recording of all measurable excreted as well as ingested fluids. According to the chart, the intake of fluid includes orally taken fluid, orally taken medications, application of intravenous fluid and any other types of fluid that are administered through any tube. On the other hand, the output fluid includes drainage, urine, vomit, secretion through nasogastric tube and measurable stools, collected in colostomy bag. According to Lobo, Macafee and Allison (2006), recognizing the excretion of fluid via respiration, perspiration, bowel activity and fever etc. is important while determining the fluid output. These types of outputs account for up to 600- 900 ml of fluid per day and these are not included in the fluid chart. Again, as per Godin, Bouchard and Mehta (2013), sometimes it is difficult to accurately measure the fluid balance in patients, such as in case of diarrhea where the amount of fluid is large and immeasurable. Again, according to Silversides et al. (2013), it is important to assess the clinical condition of the patient and the blood chemistry value along with the fluid chart in order to determine the fluid status of the patient. Accuracy in the assessment and interpretation of the fluid status of the critically ill patients are very important for effective management of the health of the patient (Hindahl and Wilson, 2011). So, it is very important to carry out continuous monitoring of the fluid balance of the critically ill patients (Culleiton and Simko, 2011). According to Foley (2008), one of the earliest indications of the disruption of the fluid balance is the urine production. As per the studies by Foley, a volume of urine that is less than 0.5 ml/ kg body weight/ hour should be considered as the indication of fluid imbalance and the nurse should respond to the condition of the patient. According to Knowles (2008), the vital signs of the patients are the important indicators of the fluid status of the patients. The vital signs include pulse rate, blood pressure, and rhythm of the heart, central venous pressure, breathing rate and body weight (Weissman and Landesberg, 2005). According to Dnser et al. (2013), a decrease in the blood pressure level may result in the decrease in the perfusion of the organs that may cause organ failure in the critically ill patients. Again according to Stevens (2007), tissue hypoperfusion may also results in the damage of organs. So, maintenance of proper tissue perfusion is very important to maintain the fluid balance of the patients. Another indicator that is used for checking the fluid balance in patient is the level and frequency of thirst of the patient (Garrett, 2003). Again, according to Armstrong et al. (2014), the laboratory report of blood cell count and the electrolyte count are able to provide additional information regarding the fluid status of the patient. According to Besen (2015), the overload of fluid in patients can be indicated by high blood pressure, increased weight of the body, swollen neck veins, trachycardia, shortness of breath, cyanosis, increased rate of breathing, increase in the pulmonary arterial pressure and peripheral oedema. In case of severe overload of fluid, pulmonary oedema can result, which is a critical condition that needs immediate addressing and ventilations service (Hindahl and Wilson, 2011). According to Scales and Pilsworth (2008), generally a patient who shows the sign of fluid overload, generally have a history of liver, cardiac or kidney diseases. On the other hand, the dehydration in critically ill patients is clinically indicated by low blood pressure, loss of body weight, increase in the pulse rate, thirst, arrhythmia, and decrease in urination, skin dryness, weakness and drowsiness (Simmons, 2010). It is duty of the nurse to monitor the fluid balance of the patients accurately. As per the opinion of Culleiton and Simko (2011), monitoring the balance of fluid in critically ill patients is a challenging but important component of the health care sector, which is described by the authors as the critical care shuffle, as the critical medical condition of the patient often complicate the status of fluid in those patients. According to the authors the nurses in charge of the critical care unit should be able to recognize as well as react quickly to the fluid balance disturbance. A study carried out by Carlsen and Perner (2011), also showed the importance of proper fluid monitoring by the nurses or proper treatment of the patients. Arguments: There are various studies that have discussed the role and the accuracy of the nurses to monitor the fluid balance of the patients. There are practice guide lines regarding the education and training of the critical care nurses, proposed by the World Federation of Critical Care Nurses. According to Williams, Schmollgruber and Alberto (2006), only registered and trained nurses should be provided with the duty of care for the critically ill persons. A study carried out by Chari et al. (2011), showed that the main reason behind the inaccuracy in the monitoring of fluid balance is the unavailability of qualified nurses. Again, Whiteley et al. (2009), emphasized on the fact that though several technologies are used for monitoring the fluid imbalance in patients such as alarms and other security features, it is still necessary that the critical care nurses are actively involved in the monitoring of fluid balance in order to provide quality services to the patients. In a study carried out by Markmann (2011) on 147 patients who were under intensive care, the authors were concerned regarding the incorrect calculation of fluid balance and found that in about 33% of the cases, there was inaccuracy in the calculation of fluid balance of critically ill patients. The authors also suggested that more accurate measures should be developed in order to monitor the fluid balance properly. again the same result was shown by Kashiouris et al. (2013), who found that the cumulative fluid balance calculated by the registered nurses were not accurate. Recommendations: There are various recommendations provided by various researchers to improve the accuracy of the monitoring of the fluid balance in the critically ill patients. In order to improve the monitoring of fluid balance, Rassam and Counsell (2005) suggested that there is a requirement of information notes that will be present on the bedside of the patients, nursing training that is focused on the fluid balance monitoring in order to increase the accuracy and there should be a balance sheet that is user friendly. The authors also suggested that, the signature of the nurse who has recorded the fluid balance data should be there in the balance sheet. According to Scales and Pilsworth (2008), as the nurses are the main persons associated with the monitoring of the fluid balance of the critically ill patients, improvement of knowledge in the nurses regarding the monitoring of fluid is very important. Again, Soutter-Green (2013) suggested that the recording charts should be simple in order to decrease the workload of the nurses and increase the accuracy of recording the data. They showed that increase in documentation in turn increases the workload on the nurses which in turn decreases the time for calculation leading to decreased accuracy in the calculation of fluid balance. Their study also showed that if there is regular auditing regarding the practice of monitoring of fluid balance, then the efficiency of the nurses increases considerably. Bennett (2015) suggested that the fluid balance chart should be designed for individual patients in the ICU separately and reviewing of the chart should be done on a regular basis in order to use the chart accurately and efficiently. According to Dewitte et al., (2015), measuring the total body water (TBW) can provide accurate data regarding the fluid balance of the critically ill patients. They suggested the use of bioimpedance techniques for measuring the TBW of the patients. They carried out their studies on 25 patients who were under mechanical ventilation. Their study showed that as a non-invasive way to measure the fluid balance of the critically ill patients, use of bioimpedance technique is reliable and provide accurate calculations, but for using the technique, the body weight of the patients should be known. There are various automated devices available in the market for the accurate calculation of fluid balance. One of such devices is the digistat, offered by United Medical. The company assures that the uses of the device for measuring the fluid balance will significantly decreases the human errors and increase the patient outcome. This device is developed to overcome the shortcomings of the fluid balance chart. Another such device is the volumetric pump. This device is used for measuring the fluid input in an hourly basis and is also attached with a warning device (Lopot, 2011). Another device that is used by the nurses in order to measure the volume of output fluid includes an urimeter. This device is used for measuring the urine volume and remains attatched with the indwelling urinary catheter (Lee et al., 2011). According to Scales and Pilsworth (2008), blood chemistry analysis is good method to determine the fluid status of the patients. Again Wolfson and Harwood-Nuss (2005) stated that in the blood chemistry analysis, the measure of blood electrolytes such as blood urea nitrogen, potassium, sodium, bicarbonate and chloride etc. provides a clear view of the fluid status of a person. According to the author, if there any change in these electrolytes compared to the normal level, then it is the indication of the change of fluid status of the patient and the data should be used in order to prescribe any intravenous fluid administration in order to restore the balance of fluid in critically ill patients. On the other hand, Vivanti, Harvey and Ash (2010) suggested that the blood chemistry analysis does not provide accurate information in case of minor dehydration in case of older people. So, the authors suggested that analysis of the physical signs will be a more effective measure in order to detect fluid imbalance. Changes nursing management and implementing them in nursing practice: With the advent of various methods for accurate detection of fluid balance of a patient, the nursing duty and responsibility for measuring the balance has changed over time. The implementation of newer methods has reduced the responsibilities to a great extent. Still, the nurses play a major role. According to the NHS, the roles and responsibilities of a nurse include- On admission, the patients are examined for their fluid balance, which includes measuring the weight, checking the vital signs, checking the thirst level etc. The baseline electrolytes and urea are also measured. The nurse should then assess the urine passed by the patient for the first time. The urine is tested using urimeter and also the color and smell of the urine are also checked. The nurse should document the results in details. The nurses should properly fulfil the fluid balance chart. The nurses should be well aware of the instruments and the procedures that are used for measuring the fluid balance. The laboratory results also play a very important role in detecting the fluid balance in recent times. Theory about fluid balance: The body fluid balance theory was proposed by the ancient Greeks. According to the theory, in order to obtain a good health, one should maintain the balance of humor. The ways to balance humor was the removal of excessive body fluids by means of sweating, bleeding, purging and with the help of specific foods and medications (Britton, 2002). This theory was called humorism. The four humors are blood, black bile, yellow bile and phlegm. As per the theory, the deficiency of each humor leads to the disturbance of health and temperament of a person. The humor is also called cambium. Developing own idea: As a nurse in the ICU department, I feel that the patients in the ICU departments demand specialized care and services. Their conditions are critical and need proper and careful attention and monitoring (Lopot, 2011). According to the NHS guidelines, the fluid management of the patients should be done frequently and by the registered nurses. The guidelines also state that it is the responsibility of the nurses to monitor and calculate the fluid balance of the patients accurately and properly. Monitoring of fluid balance is one of the major duties of the nurses working in the ICU department of a health care organization. In our ICU departments, the nurses have to maintain the fluid chart of each and every patient. Again there are emergency alarm and warning devices in order to detect any fluid disturbance of any patient. While working in the department I have felt that the fluid chart that we have to maintain for the patients should be simplified in order to ease the process of record and increase the accuracy (Soutter-Green, 2013). To my opinion, use of advanced devices is very helpful as they automated the monitoring procedure, but still the nurses should be aware of the fluid condition of the patients (Scales and Pilsworth, 2008). Through the discussion, arguments, and recommendations and also from my experience, I feel that, the nurses in the ICU department need specialized training and education regarding the proper and accurate ways of monitoring and calculating the fluid balance of the patients (Rassam and Counsell, 2005). According to the NHS guidelines, the fluid management of the patients should be done frequently and by the registered nurses. The guidelines also state that it is the responsibility of the nurses to monitor and calculate the fluid balance of the patients accurately and properly. Conclusion: Maintenance of fluid balance is of utmost important for maintain the homeostasis of the patients and avoiding any negative health consequences. 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