Aviation Safety

Aviation Safety Introduction Carelessness can be defined as ignorance or incorrectly assessing a risk. According to NTSB (2003), it is important to carefully follow maintenance and inspection procedures in order to avert aircraft related accidents, safeguard company property, and save life. By and large, most aircraft emergencies and fatal accidents are as a result of mistakes that occur during the process of maintenance and inspection.Advertising We will write a custom research paper sample on Aviation Safety specifically for you for only $16.05 $11/page Learn More Looking at the number of accidents witnessed annually in the sector, it is quite obvious that the training offered to mechanics during their formative stages is not yielding the expected results. Apart from the aviation industry, many other accidents can also be attributed to human error. This paper presents a discussion on mistakes that occur during maintenance and inspection and how they affect the operations of air carriers as well as consumers. Maintenance Related Concerns As can be deduced from past studies, human related errors are to blame for the high number of accidents occurring due negligence, and failure by aviation maintenance technicians to comply with stipulated maintenance standards and procedures (CAA, 2002). Statistically, associated number of accidents has continued to increase and this can be linked to issues such as technical engine failure. Sadly, the repercussions are serious and lead to deaths and severe damage to property and human life (Dillingham, 2010). Similarly, the reputation of the air carriers has been dwindling due to such accidents. Because of the complex nature of the problem, it has been a challenge to come up with concrete solutions. Consequently, the situation has continued unabated. Regardless of whether maintenance related aircraft accidents are new to the aviation industry, the awareness of the need for aviation safety implies that should be thorou ghly investigated. Presently, the increase in the number of accidents due to poor maintenance and inspection is a major concern to many stakeholders (CASA, 2012). It is, therefore, important to shift focus from investigating the performance of flight crews and to concentrate more on establishing where the problem lies within the maintenance and inspection units. Apparently, this has been largely ignored in a number of past investigations. In areas where the possibility of errors is quite high, the task of aircraft maintenance and inspection can be extremely complex and quite varied. One of the greatest concerns is that aviation maintenance technicians often have to work under very strict deadlines. Although these technicians understand the importance of meeting scheduled departure times, it is unhealthy for them to be made to work under pressure.Advertising Looking for research paper on aviation? Let's see if we can help you! Get your first paper with 15% OFF Learn M ore To ease the pressure on aviation maintenance technicians, it is necessary for air carriers to employ additional staff and to designs flexible working plans for the maintenance crew. Among other benefits, this will reduce fatigue and grant them an opportunity to rest and embark on their duties when they are very fresh and feeling energized. Another concern that has been raised is that aircraft maintenance technicians are required to take care of very old aircrafts (Holanda, 2009). In general, this is can be very exhaustive, creates a stressful work environment, wastes so much time, and is quite involving. The demands on aviation maintenance technician increases further as new aircrafts are added to the fleet. The need to take care of old as well new aircraft poses challenges to the maintenance crew and requires familiarity with both technologies. A very highly skilled workforce is thus critical if air carriers are to effectively deal with emerging maintenance issues (CASA , 2012). Besides having a strong educational background, wide experience is a distinct added advantage for any aviation maintenance expert. Fortunately, there is an increased recognition of the significance of human factors in aviation safety. Subsequently, safety and effectiveness of aircrafts is now closely associated with the performance of aircraft of maintenance technicians. Human Error and Aviation safety According to Conquest and Beckett (2003), the effect from technical failures is quite negligible in comparison to that from human error. As such, it is imperative to ensure that the needs of aviation maintenance technicians are fully met. In a recent exercise carried out by Boeing Commercial Airplane Company, three things that lead to accidents include the fact that flight crews fail to adhere to procedures, the existence of maintenance and inspection errors, and design factors. Human Error in Aircraft Maintenance and Inspection Generally, human error in the aviation industry becomes obvious when aircraft failures that are linked to the actions or non actions of aircraft maintenance technicians happen (CAA, 2002). However, the failure experienced may be due to other factors and not necessarily because of the inability of maintenance technicians to deliver effectively. It is also possible that during a maintenance exercise an anomaly may be undetected, leading to aircraft failure and subsequently, an accident. To a large extent, many past accidents have been linked to human errors as major contributors (Conquest Beckett, 2003). While in some cases, accidents can directly be attributed to human error, the same may not be said of certain accidents where poor maintenance is seen to have partially contributed to the occurrence of an accident.Advertising We will write a custom research paper sample on Aviation Safety specifically for you for only $16.05 $11/page Learn More In a list published by the United Kingdom Civil Aviation Aut hority, the major problems resulting from unprofessional practice during maintenance include poor installations of aircraft components, use of unauthorized aircraft parts, poor electrical wiring, unsatisfactory lubrication of movable parts, and fastenings that are left incomplete. According to CASA (2022), there are numerous issues that can lead to maintenance errors. While some are easily noticeable, others may completely be hidden. To address these issues, it is imperative for the air carriers to require all aviation maintenance technicians to strictly follow outlined maintenance procedures while performing maintenance tasks. Aviation maintenance technicians must be made to understand the importance of being extremely vigilant. Any form of negligence must be avoided at all costs and stakeholders must steer away from actions or non actions that can be detrimental to the effective performance of an aircraft. Where an aviation maintenance technician deliberately acts in a manner like ly to create problems for the aircraft and the air carrier company, he or she must be subjected to some form of punishment. In order to effectively deal with problems created by human error, concerned persons must diligently carry out thorough investigations and interpret findings in a way that will benefits the carrier company as well as general public. Contributing human factors or any individual involved must be identified and appropriate measures should be taken to avoid a repeat of the same at a later time. In various past studies, it is evident that while organizations can be a source of accidents due to negligent acts, they can also help to prevent the occurrence of accidents and save human life. However, the ability of organizations to address safety issues in their operations depends so much on the technology available to them. While organizations with improved technology are better placed to effectively deal with identified safety concerns, those without such technology su ffer serious challenges and are unable to address safety problems even after they have been detected.Advertising Looking for research paper on aviation? Let's see if we can help you! Get your first paper with 15% OFF Learn More Apparently, the promotion of safety as well as prevention of accidents in the aviation sector is rarely looked at as a human problem that must be dealt with by ensuring that aviation maintenance technicians are well prepared. Better results can, however, be realized when the training offered is accompanied with strict follow ups to ensure that trainees effectively utilize the skills learnt. Obviously, the rising number of accidents point to the fact that aviation maintenance technicians are not putting skills learnt to good use as it is widely expected. Because of carelessness, technicians have ended up causing serious irreversible damage to humanity and air carrier companies. It is also very important for top management in organizations to ensure that staff members are serious about their work. Without some form of reinforcement from senior personnel in the organization, the problem will continue uncontrollably. Strong support from the top is, therefore, a key requirement. Ordinari ly, errors do not happen in isolation. They occur within the context of organizations which can either resist or promote them. Ideally, this implies that organizations have the liberty to decide how to deal with safety concerns that affect their day to day business operations. On the one hand, they can choose to let things get worse, and hence cause more problems for themselves and the general public while on the other hand, they can decide to implement strict measures that will see an end to laxity and alleviate any problems in future. It is, therefore imperative for the organization to have very strong and reliable leadership at the top to avoid the promotion of mediocre standards. Departures from approved procedures must be avoided at all costs and senior managers must see to it that all aviation maintenance technicians perform their functions as expected. Refusal to follow outlined guidelines as well as logging requirements to perform maintenance tasks is unacceptable and must n ot be entertained by anyone in the organization. Human Error in the Maintenance Environment Typically, unique characteristics are bound to shape human error within the maintenance environment (Huang, 2009). To a great extent, this is thought to be completely different when compared to other operational departments of an organization. One of the biggest challenges faced by aviation maintenance technician is that unlike problems seen in other departments, maintenance related errors cannot be identified at the time of occurrence. In some cases, the aviation maintenance technician who makes an error may fail to realize it as it may happen long after the maintenance has taken place. Ordinarily, detected human errors associated with maintenance only become obvious when an aircraft malfunctions and it is generally not easy to identify the real cause of the error. Errors are thus discussed with regard to failures encountered with aircrafts. According to Goldman et al. (2002), communication is a very important factor to consider in aircraft maintenance. In most cases, communication breakdown among stakeholders leads to unexpected repercussions. The huge amount of information created must be properly disseminate to the right recipients and where possible properly stored for future reference. Besides, it is important to ensure that any information sent out is in a form that can be effectively understood by whoever receives it. Ineffective communication to the maintenance crew, for example, can have a very damaging outcome. Communication must be put in the simplest possible form and the use of technical jargon must be avoided so as to ensure that the recipient understands the communication relayed. When maintenance problems are encountered, communication must be sent to the manufacturer before it is late, to get the correct remedy. If ignored, this could lower the performance level of an aircraft and in some cases lead to unnecessary expenses. Although communication betwe en airlines is never easy to do, it is necessary and the maintenance crew must be encouraged to get involved. Lack of or poor communication within the organization’s maintenance unit can also be very dangerous (Goldman et al, 2002). For there to be unity, and for everyone to move towards the same direction, there must be smooth communication. It is, therefore, the responsibility of the unit head to keep the communication fire burning within the organization. Whenever issues are encountered, these must be dealt with immediately so that people can move on. Any complicated issues can, however, be escalated to senior managers in the organization for further attention and advice. In a worse case scenario, a breakdown in communication can easily lead to delays in delivery of critical services and this can in turn affect the general operation of the airline. In the event that such misunderstandings affect the customer, the biggest loser will be the company. Conclusion Given the tigh t link that exists between human error and aviation safety, it is certainly not easy to effectively deal with the resultant problems. Although well structured training programs and strong leadership can be of great help, good will from the aviation maintenance technicians is vital. Without whole hearted support from these technicians, any efforts to deal with aviation safety will bear very little or no fruit at all. As has been explained in this paper, detecting human errors in the aviation industry is not easy. Errors tend to be detected long after they have happened and usually, they tend to occur in the absence of the aviation maintenance technicians. Analysis is thus based mostly on assumptions rather than on concrete evidence. This notwithstanding, organizations must take all the necessary precautions to guarantee the safety of their staff members, customers, and aircrafts. Proper guidelines and procedures must be put in place and the maintenance crew should be equipped with cr itical skills to help them carry out their tasks. Dissatisfaction among staff and lack of concern will lead to serious damage and must be addressed fully. Aviation maintenance technicians and by extension, all other employees, must be treated with respect. They must all form an opinion that the organization has their interests well catered for. When all is said and done, it is the organization’s reputation that is at stake. Other important considerations are effective communication at all levels and well organized of trainings for aviation maintenance technicians. However, as noted earlier, it is imperative to devise follow up programs that will make it possible to reinforce the skills learnt during the training. It is of no use for people to receive world class training but fail to utilize it effectively. References Civil Aviation Authority (CAA). (2002). Human Factors in Aircraft Maintenance and Inspection. Web. Civil Aviation Safety Authority (CASA). (2012). SMS for Aviati on – A Practical Guide. Web. Conquest, T. Beckett, B. A. (2003). Aviation Safety: Better Guidance and Training Needed on Providing Files on Pilots Background Information. Collingdale, PA: DIANE Publishing. Dillingham, G. L. (2010). Aviation Safety: Improved Data Quality and Analysis Capabilities are needed as FAA Plans a Risk-Based Approach to Safety Oversight. Collingdale, PA: DIANE Publishing. Goldman, S. M., Fiedler, E. R. King, R. E. (2002). General Aviation Maintenance Related Accidents: A Review of Ten Years of NTSB Data. Web. National Transport Safety Board (NTSB). (2013). Mechanics: Managing Risks to Ensure Safety. Web. Holanda, R. (2009). A History of Aviation Safety: Featuring the U. S. Airline System. Bloomington, IN: AuthorHouse Publishing. Huang, J. (2009). Aviation Safety through the Rule of Law: ICAOs Mechanisms and Practices. Frederick, MD: Kluwer Law International.

Paul Berg and the Asilomar Conference Essay Example | Topics and Well Written Essays - 1000 words

Paul Berg and the Asilomar Conference - Essay Example "Many scientists worried that hybrid molecules from recombinant DNA experiments could result in dangerous new organisms that could pose a threat to public health. Others were deeply concerned about ethical issues related to genetic engineering, especially as it might be applied to humans." (Photographs from Asilomar). This chaotic situation led the National Academy of Sciences to ask Paul Berg to head a committee that "in July 1974 took the unusual move of calling for a voluntary moratorium on certain types of recombinant DNA experiments until the hazards could be evaluated." (Barinaga). Seven months later, Berg organized the International Congress on Recombinant DNA Molecules, which was held in February 1975 at the Asilomar Conference Center in Pacific Grove, California. In an essay posted by Paul Berg at the Nobel Prize Organization website in 2004, he revisits the recombinant DNA controversies of the 1970's, the 1975 Asilomar Conference and 30 years later. Looking back, Berg explains and justifies the voluntary moratorium which scientists universally imposed on themselves regarding certain recombinant DNA experiments. ... rg became the 1975 Asilomar Conference on Recombinant DNA Molecules and one of its aims "was to consider whether to lift the voluntary moratorium and, if so, under what conditions the research could proceed safely", according to Berg. At the conclusion of the conference, consensus was for recombinant DNA research to proceed but under strict guidelines. Berg supports this conclusion. He mentions that hundreds of millions of experiments have been conducted since 1975 with "no documented hazard to public health attributable to the applications of recombinant DNA technology. Moreover, the concern of some that moving DNA among species would breach customary breeding barriers and have profound effects on natural evolutionary processes has substantially disappeared as the science revealed that such exchanges occur in nature." He also mentions, that in support of the resolutions of the conference, immediately after, in 1976, the Guidelines for Research Involving Recombinant DNA Molecules wer e promulgated by the National Institutes of Health and by comparable bodies in other countries. Despite Paul Berg's support of both the moratorium and the successful conclusion of the Asilomar Conference, he has strong reservations regarding resurrecting the Asilomar model for the resolution of "hot button issues confronting scientists and the public today". He compares the environment of 30 years ago, which worked for the success of the 1975 Asilomar Conference versus the present scenario. He believes, "an Asilomar type conference trying to contend with contentious views is doomed to acrimony and policy stagnation." Although I agree with the points Berg raised against convening an Asilomar type conference in the present day, I believe that communication, dialogue, exhaustive discussion

Dirct and eMarketing Essay Example | Topics and Well Written Essays - 1000 words

Dirct and eMarketing - Essay Example This connection between good levels of customer service and good levels of customer satisfaction and retention underpins the common association of customer service with keeping, rather than winning, customers. Customer service therefore plays a pivotal role in relationship marketing. Getting this role right, and to a standard of expertise that is superior to that of competitors and sustainable in the longer term, requires an in-depth understanding of the nature and nuance of customer service. Knowing customers means closing the loop between the messages sent to them and the messages they send back. Developments in IT have led to interactive communication tools such as the mobile phones being used to complement less interactive mechanisms such as mail or media advertisements. Growing use of carefully targeted direct mail has characterized this as the age of addressability. "Mobile commerce refers to transactions using a wireless device and data connection that result in the transfer of value in exchange for information, services, or goods. Mobile commerce, facilitated generally by mobile phones, includes services such as banking, payment, and ticketing" (Mobile commerce, 2005). "Some organisations view m-Commerce as merely another e-Commerce channel, those organisations that exploit the m-Commerce channel properly by developing alternative and complementary propositions will be more successful in m-Commerce" (E-Commerce, 2001). For suppliers, building longer-term customer relationships with the help of m-commerce means maintaining a dynamic knowledge of customers' requirements, preferences and expectations. While corner shop managers may be able to retain customer likes and dislikes in their heads, larger organizations need customer relationship management systems which manage data throughout the customer life-cycle, from initial contact, through information exchange and sales, to delivery and post-sales service. "Elsewhere in Asia, subscribers to Hong Kong mobile service Sunday can receive offers from shops as they pass them in the mall"(May, 2001). This interaction is as important with the mobile as with any other communication medium, and outsource its development and operations with minimal provision for information transfer - hence repeating the mistakes often made in the early days of the call centre. As surveys continue to show, advertising products and services with the help of m-commerce is relatively easy; more difficult, but absolutely crucial, is to gather vital customer information, obtain customer feedback, utilize existing knowledge about the customer and exploit the interactive nature to add value though product configuration (Evans, O'Malley, 2004). For instance, "a European-based mobile operator recently had some tickets for a pop concert for sale. Having identified a target audience, specials offers were sent to mobile customers by SMS allowing them to buy tickets at a discounted rate. Within an hour, all the tickets had been sold for approximately $100 each, customer details had been captured, and most customers had given permission for further follow up offers" (E-commerce, 2001). It is apparent that some industries are being restructured as organizations redefine themselves to take advantage of IT-enabled marketing, or are replaced by newcomers which operate

Bad Sugar Essay Example for Free

Bad Sugar Essay Unnatural Causes In this video Bad Sugar the Pima and Tohono Oodham Indians of southern Arizona have the highest diabetes rate in the world. This affects more then half the adults in this Indian group, but a century ago diabetes wasnt even heard of. What has happened to the health of the Pima Indians? During the 20th century the river water was used by white settlers and Pimas local Indians went into poverty and became dependent on the U. S. government. This resulted in the Indians eating tepary beans, cholla buds and wild life these everyday ood items changed to white flour, lard, processed cheese and canned foods. Needless to say this had a big impact on the Pima Indians. This exclusive documentary shows crucial evidence on how we pour more money into drugs, fad diets, medical technologies, but is it deeper then that? Evidence shows therere more to bad habits and unlucky genes. If we can find a solution to poverty we can solve many of the problems that individuals deal with on a day-to-day bases. As a future educator I will teach them strategies and help improve their daily exercise. Teaching hem strategies will help them to become independent with their exercise as well as quality nutrition and realize how truly Important It Is, which should lower the diabetic rate. Goals: 1 . Promote healthy lifestyles to prevent risk factors for pre-dlabetes, diabetes, heart disease, and stroke 2. Improve the detection, control and treatment of risk factors and pre-diabetes for the prevention of diabetes, heart disease, and stroke 3. Improve the detection, control and treatment of diabetes and cardiovascular disease to prevent complications and disabilities and reduce the severity and progression of disease

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Æ’Â ´Ã†â€™Ãƒâ€¢Ã†â€™Ãƒâ€"ƒÙƒÞƒÙƒÃ ¤Ã†â€™Ãƒâ„¢Ã†â€™ÃƒÅ¸Ã†â€™ÃƒÅ¾Ã†â€™nƒßƒÃâ€"Æ’nÆ’Â ½Ã†â€™Ãƒ ©Ã†â€™Ãƒ £Ã†â€™Ãƒâ€¢Ã†â€™ÃƒÅ"Æ’Ãâ€"   Ã‚  Ã‚  Ã‚  Ã‚  The definition I would place upon myself would consist of what I look like on the outside and what I feel and believe on the inside. In my opinion they way you look and how you dress and present yourself is hyped up a lot in the world today. What you wear has such an impact on how someone thinks about you.  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  I personally don ¡Ã‚ ¦t wear the GAP, Abercrombie & Fitch, or Old Navy clothes not because of the people who wear them, or because I don ¡Ã‚ ¦t want to be considered  ¡Ã‚ §trendy ¡Ã‚ ¨, I just don ¡Ã‚ ¦t wear them. I will go into the stores to look for something to buy, and I just never seem to find anything that I like. Stores I most often shop at are Pacific Sunwear, DEB, and Aeropostle. The style I guess you could categorize me into would probably be skater/ glam, at least that ¡Ã‚ ¦s what my dad would call it. My personal style does represent me in a lot of ways it ¡Ã‚ ¦s clean cut, yet edgy, and it ¡Ã‚ ¦s full of color, not a lot of black and white in my wardrobe.   Ã‚  Ã‚  Ã‚  Ã‚  Appearance wise I ¡Ã‚ ¦m pretty much the same way as I am with my wardrobe. I love to play with make up. I like a lot of color. I love to play up my eyes; on occasion I will load up the eyeliner. My role model for clothing and make up is Gwen Stefani, the lead singer of No Doubt. She has such an awesome style; she just seems to be so together and knows what she wants. I love that! Sometimes I feel that way about myself, but it ¡Ã‚ ¦s just not as often probably.   Ã‚  Ã‚  Ã‚  Ã‚  The location of which I live isn ¡Ã‚ ¦t what you would expect the inside of my house to look like. At least that is what I think personally, only because my family lives in an apartment in downtown Auburn, Maine. From the outside it isn ¡Ã‚ ¦t anything fancy, and then once you step in through the front door, you ¡Ã‚ ¦ll be amazed how a little decorating can go a long way. Having my parents divorce in 2000 meant downsizing our house so it was hard on me. No matter where I live it ¡Ã‚ ¦s always home, and that I am very thankful for.   Ã‚  Ã‚  Ã‚  Ã‚  My family is something I cherish dearly. My father is a very close friend of mine he is somebody I can talk to about anything with, even things most kids usually get all nervous about when it comes to telling their parents mostly my dad just lets me know his opinion, (which sometimes I may not like) and that ¡Ã‚ ¦s about it.

Aflac

Table of Contents I. Executive Summary†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 3 II. Company History†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦3-4 III. Company Financials†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 5 IV. Internal Factors & External Industry Analysis. 6-11 V. House of Quality & DMAIC†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 11-19 VI. Tree Diagram & PDPC†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦. 19-22 VII. Flowchart & Check Sheet†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦22-26 VIII. Consultants Conclusion†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. 26 IX. Works Cited†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ 27 ? I. Executive Summary AFLAC, incorporated offers all different types of insurance including life, health, and accident insurance as being their top sellers. The insurance industry can often be a competitive one. There are many insurance companies, in the past few years, that have been greatly effected by the current recession in the United States. Some insurance companies needed government intervention to help them through this. AFLAC, just like other big companies out there, have gone through many problems. Building the House of Quality and using Deming’s five points will help this company succeed and train their employees better. Using flow charts, check sheets, and tree diagrams will show the employees the right way to do their work and can continuously improve at their work. Consultants will be overall most satisfied with these types of practices. II. Company History Aflac, also known as American Family Life Assurance Company, was founded in Columbus, Georgia in the year 1955. It was discovered by brothers John, Paul, and William Amos to sell life, health, and accident insurance (â€Å"Aflac Incorporated History). † Competition was very fierce back then and the little company did poorly. In the 1940s and 1950s, there were many cases of polio scares and had spawned insurance coverage written specifically for this disease. It was then that Aflac decided to sell cancer insurance (â€Å"Aflac Incorporated History). † In the year 1958, they introduced the world’s first cancer insurance policy. This wound up being a big hit for this company and had written over a million dollars in premiums and had expanded over state lines. This company grew very quickly. It grew very quickly in the decade of the 1960s. They developed a selling approach that was much clustered. This approach worked as employees were willing to make payroll deduction for premiums (â€Å"Aflac Incorporated History). † By the year 1971, this company was booming in over 42 states. In the 1970s, John Amos then decided to expand his company outside the United States. This started by Amos visiting the World Fair in Osaka and he then decided to market this idea to the Japanese (â€Å"Aflac Incorporated History). † The Japanese healthcare plan left them exposed to considerable expense from cancer treatments. After four years, the company finally got approved to sell health insurance overseas to the Japanese (â€Å"Aflac Incorporated History). † It was basically approved because after research, it would have not threatened existing markets and the Amos’s found notable backers in the insurance and medical industries. Aflac became one of the first insurance companies to enter the Japanese market, and it had an eight year monopoly with the Japanese (â€Å"Aflac Incorporated History). † Aflac has sought to supplement its cancer insurance by introducing new products and improving old ones to encourage the policyholders to add on or trade up (â€Å"Aflac Incorporated History). † The company boosted its name recognition in the United States from two percent to fifty six percent primarily through advertising, including the slots throughout the 1998 Winter Olympic Games and NASCAR races (â€Å"Aflac Incorporated History). Accident and disability premiums surpassed cancer premiums in the United States for the first time in the company’s history in the year 2000. The popular Aflac duck made its first appearance on television in the year 2001 for a commercial for accident insurance (â€Å"Aflac Incorporated History). † III. Company Financials With every company, the financial po rtion of the company will vary from year to year. AFLAC, which is one of the most trusted insurance companies and has the most popular commercials, has been doing very well over the years as an insurance company. This company has annual sales presently at over eighteen million dollars (â€Å"Aflac Financial Reports†). Ten million dollars of the eighteen million dollars in revenues were solely from the sales of the employees that worked for this company. This company is a publicly traded company located on the New York Stock Exchange (NYSE). Over the years, this stock price has gone up and up every single year. It is now priced at fifty five dollars per share, which shows how successful this company has been over the years. Below, is a chart that shows Aflac’s stock price from June of 2009 to April of 2010 (Business Source Complete). It shows that in June of 2009, it was price at thirty three dollars per share. It had a significant setback right before September where it dropped under thirty dollars per share (Aflac’s Financial Reports. )† It has since resurged in the past ten months to be up to fifty five dollars per share. It shows that Aflac has not been affected by the recession, which is ongoing in the United States. IV. Internal Factors & External Industry Analysis The insurance industry is a very competitive industry. AFLAC’s main concern is the customer service problems and that the agents are not trained enough to help out the various customers the company deals with. AFLAC specializes in accident and health insurance mostly, with the option of life insurance as well (Business Wire). The industry as a whole is very successful. The most popular aspect that most people will recognize about this company is their memorable commercials featuring the AFLAC duck (Price 1). The duck’s familiar quack and voiceover by Gilbert Godfrey immediately shows that it provides worker’s compensation to its employees (Price 1). There are definitely way more strengths than weaknesses in this particular company. The strengths of this advertisement are its catchiness and cleverness of the advertisements design rather than its theme. The main theme of the advertisement should have gone in a more interesting way of the necessity of the worker’s compensation as part of one’s health insurance package (Price 1). However, the nature of the duck in AFLAC’s commercials makes the surface theme of the duck recognizable and that’s why AFLAC’s commercials with the duck are so popular and has been a big reason why AFLAC has been a solid company over the years. Moreover, in the strengths of this company, it also has to do with the sole person that the customer is dealing with (Wiki wealth). The main strength of this company is the agents that are hired to work with the various customers. If a customer has a great representative, it has come apparent that they would recommend the company to all their friends and family. Personally, having a good representative will keep the customer more calm and know that their insurance claims will be paid in a more efficient time period. In addition, having an agent that can answer all of the customer’s questions and concerns is a big thing as well. If the agent is intelligent enough to answer all of the inquiries the customer may have, the customer will overall have a great experience and would feel that dealing with a company like this would be overall a great experience for that individual. Many believe that the insurance industry can be a profitable one. The industry in itself can be a very successful one, but also can be risky at times. As many might already know, insurance involves pooling different funds from many uninsured entities in order to pay for relatively uncommon, but severely devastating losses which can occur to these entities (â€Å"Industry Handbook). In the United States, the Gramm-Leach-Bliley Act of 1999 was put into legislation. It stated that banks, brokerages, and insurance firms can come together to offer the customers a range of services (â€Å"Industry Handbook. )† In the insurance industry, this had led to an outrage of â€Å"Merger and Acquisition† activity. In addition, a majority o f liability insurance companies underwritten in the United States has been through big firms, which has been scooping up all different insurance industries (â€Å"Industry Handbook†). Insurance can also have some positive and negative effects on society and the economy as well. These are effects that are important and have to be monitored closely (â€Å"Insurance†). One negative about it is that it can increase fraudulent acts by individuals (â€Å"Insurance†). People will try to use insurance companies to try to get money out of them even if nothing extraordinary happens when they need money. On the other hand, it can help many families and individuals prepare for catastrophes and the effects of this on households and societies (â€Å"Insurance†). As one can see, the risk of insurance companies is that there can be access to fraud by individuals trying to exploit these companies for money. On the other end, this is a great way just in case a catastrophe happens in a family such as a deadly car accident, untimely death, or anything of that circumstance. Other factors need to be considered as well when talking about the internal and external aspects of this industry. Demographics is an important factor that needs to be considered. It can affect the sales for insurance, particularly the life insurance aspect (â€Å"Industry Handbook†). As people become older, they tend to rely more on life insurance products for their retirement. In more recent years, the insurance industry has made great headway in offering investments and savings type insurance products for their benefit (â€Å"Industry Handbook†). The Global Insurance Industry is also an important factor when it comes to insurance companies. The industry has to deal with the many fluctuations of the interest rates established. Global insurance premiums grew by 3. 4% to reach 4. 3 trillion dollars (â€Å"Reuters†). Insurance companies do invest in much of the collected premiums, so the income generated through these premiums is highly dependent on these interest rates (â€Å"Reuters†). For the first time in the past three decades, premium income has declined in inflation adjusted terms, with non life premiums falling by 0. 8% and life premiums falling near 3. 5% (â€Å"Reuters†). It has become apparent that this industry (insurance) is exposed to the global economic turndown on the assets side by the decline in return on investments and on the liabilities side by a rise in insurance claims (â€Å"Insurance†). It shows that AIG, a similar insurance company just likes AFLAC, was bailed out in September of 2008 and has had an enormous effect on AFLAC’s business and the insurance industry as a whole. The recession and the financial crisis that has gone on throughout the United States the past few years have shown that the insurance industry is sufficiently capitalized (â€Å"Insurance†). The vast majority of the insurance companies have had enough capital to survive, with only a few insurance companies asking the government for help. AFLAC was one of the companies that did not to have the government intervene into their company. The Five Forces Model, which originated from Michael E. Porter’s book, â€Å"Competitive Strategy: Techniques for Analyzing Industries and Competitors,† has become a frequently used tool for analyzing a company industry structure and corporate strategy (â€Å"Porter’s Five Forces Analysis†). These five aspects include Threat of New Entrants, Power of Suppliers, Power of Buyers, Availability of Substitutes, and Competitive Rivalry. First, the threat of new entrants is the first aspect in Porter’s Five Forces Model. In explaining this, it most nearly means that the easier it is for new companies to enter the industry, the more cutthroat the competition will be (â€Å"Porter’s Five Forces Analysis†). Barriers to entry can limit the threat of new entrants. When it comes to the insurance industry, it is not like any type of person or entrepreneur cannot come along and start an insurance company. The threat of new entrants lies within the insurance industry itself. AFLAC has been fearful in the past of being squeezed out by the big players (â€Å"Industry Handbook†). Another threat for AFLAC may be the other financial services companies entering the market (â€Å"Industry Handbook†). This might cause a direct threat to AFLAC and often hurt them in the long run. If a bank or investment company offered insurance products, it would directly hurt the success of AFLAC. The second aspect of this model is the Power of Suppliers. This most nearly means how much pressure suppliers can place on a business (â€Å"Porters Five Forces Analysis†). In the insurance industry, there can be an immense amount of pressure. The suppliers of capital might not pose a big threat initially, but the threat of suppliers luring away human capital does pose a big threat (â€Å"Industry Handbook†). In AFLAC’s case, they do not want suppliers luring away their human capital because they would lose a lot of business. Also, if this had happened, government intervention might have to happen if they were not doing well financially. For example, if a talented insurance agent is working for a smaller insurance company, there is a legitimate chance that they will be enticed away from the smaller company moving to a larger one. In AFLAC’s case, there have been a few individuals that have gone from smaller insurance companies to the more, popular large ones to move into a particular market that they are comfortable in. The power of suppliers has a huge effect on AFLAC and needs to be monitored closely. The third aspect of this model is the Power of Buyers. This is just the opposite of the Power of Suppliers. In this case, this most nearly means how much pressure customers place on a business (â€Å"Porter’s Five Forces Analysis†). The customer can hold substantial power when it comes to insurance companies such as AFLAC. A regular individual does not pose a threat to AFLAC when it comes to the power of customers. But, what do pose a threat to AFLAC, is the large corporate clients that have more bargaining power than AFLAC (â€Å"Industry Handbook†). Just like airlines and pharmaceutical companies pay lots of money in premiums every year and insurance companies try hard to get high corporate clients (â€Å"Industry Handbook†). AFLAC tries this approach so they can get more for their dollar and be successful in different ways of the insurance industry. The fourth aspect of this model is the availability of substitutes. If someone who uses AFLAC as an insurance possibility and the cost of switching is low, this could cause a potential serious threat to AFLAC (â€Å"Industry Handbook†). This aspect is a pretty straightforward one as there are various substitutes in the insurance industry. Most large insurance companies, such as AFLAC being one of them, offer similar services. Whether it be automobile, life, home, and health insurance, chances are that the competitors can offer similar services. Companies focusing on niche areas usually have a competitive advantage, but this advantage depends on the size and whether there are barriers of entry available (â€Å"Industry Handbook†). AFLAC is one of these companies that do focus on the niche areas of the industry and have the competitive advantage. It seems that they are going to be fine when it comes to other companies offering substitutes. The fifth and final aspect of this model is the competitive rivalry. This is the most important part of the model. This describes the intensity of the various companies in the insurance industry (â€Å"Porter’s Five Forces Analysis†). It is becoming a very highly competitive industry. The difference between one insurance company and another is not all that different (â€Å"Industry Handbook†). As a result, it seems that insurance has become a commodity, which means an area in which the insurance company with a low cost structure, greater efficiency, and good customer service will beat out the competitors (â€Å"Industry Handbook†). AFLAC has the historical characteristics of having a low cost structure and good efficiency, but the customer service is still â€Å"Up in the air. † In the long run, I believe we may see more consolidation in the insurance industry. Other companies may prefer to take over or merge with smaller companies, but AFLAC’s approach is to advertise and market with the AFLAC duck and so far it has been a success over the years these commercials have aired. V. Product or Service for Improvement (House of Quality, DMAIC) There is not one company out there in the world that cannot improve. Even if you are considered a â€Å"perfect company,† there will always be room for some type of improvement on a product or service. In AFLAC’s case, they have been a successful company, but at the same time, they have many concerns within their organization. Within AFLAC, there are multiple changes that could be made to their product or service. The most important thing to fix in their system is that it seems that the company does not pay the customers claims in an efficient amount of time. This can mean a certain wide of things, but more importantly needs to be fixed before this company loses more and more customers. Paying the claims on certain individuals and families have been delayed for as long as two years, which seems to be an unreasonable amount of time. Moreover in this, it seems the customer service is lackluster and needs to be improved as well. Building an improvement plan so this company can get better reviews and even improve financially is important. I believe the first aspect of this is to build what is called a House of Quality. The House of Quality is â€Å"A set of matrices used to relate the voice of the customer to technical features and production planning and control requirements (Evans, 294). The House of Quality relates the attributes of the customer to the technical features. This requires six basic steps needed to be successful. When it comes to AFLAC, building a House of Quality will be reliable in their organization. The first step of this model is to identify the customer attributes. The manager must apply Quality Functional Deployment, which is used to ensure custo mer requirements throughout the product or improvement design process (Evans, 293). It is vastly important to use the notion of â€Å"The voice of the Customer† so it is not misinterpreted by any type of designers or engineers. For AFLAC,I have developed three customer attributes that AFLAC deals with. The first one is the basic attribute, which also can be called the â€Å"Must haves†(â€Å"AFLAC Attributes†). These are expected by the various customers. The second attribute is the â€Å"Linear Satisfiers† (â€Å"AFLAC Attributes†). If this company uses this attribute more effectively, this will increase the customer satisfaction, which at some points, is lacking. The third customer attribute is the â€Å"Energizers† (â€Å"AFLAC Attributes†). This means that it is not expected or required, but creates high customer satisfaction when present and can make the difference in choices for the consumer. For AFLAC, the different type of customers might include single individuals, families, working unions, and government officials (Evans, 295). Therefore, there are many classes that need to be considered. The second step of this model is to identify the technical features that are necessary to meet the requirements of customers (Evans, 295). These technical features expressed the language of the designer and engineer. These are the people that form the basis for design and service activities in an organization. In AFLAC, these must be measurable to track the positive or negative results and the output will be compared to the goals of AFLAC. The roof of the House of Quality (Evans 297) shows the interrelationships between any pair of technical features. These technical features can include the premiums, fees, allocated income, less claims, and less operating expenses. They are classified into either a very strong relationship, strong relationship, and a weak relationship (Evans, 296). The third step of this model is to relate the customer attributes to the technical features. The customer attributes is applied to using Quality Functional Deployment. The customer attributes is to have a better â€Å"experience† than they have had in the past with AFLAC. As set up on the House of Quality chart, the customer attributes are listed down the left hand column with the technical features listed across the top (Evans, 296). Using a relationship matrix is the most effective way to show this. AFLAC’s customer attributes must show whether the final technical features adequately address the customer attributes. These technical features can affect several of the customer attributes. â€Å"The lack of a strong relationship between a customer attribute and any of the technical feature suggests that the attributes are not being addressed and that the final service will have difficulty meeting customer needs (Evans, 296). If the technical feature does not match customer attribute, then the designer might have missed something important. † For instance, in AFLAC the â€Å"Voice of the Customer,† all input is appreciated with expert experience, customer surveys or overviews, or any type of controlled experiments (Evans 296). AFLAC should implement customer surveys and overviews to see what the customers have to say about their experience. Within many companies, especially restaurant establishments, they give out survey cards and rate the service of the waiter and restaurant staff. AFLAC should implement this and read over these surveys so at each AFLAC branch, they can see what they are excelling in and what they are struggling in. This would be beneficial to the company as a whole and to the customers as well. The next step of the House of Quality is evaluating the competitive products or services. This evaluation helps highlight the strengths and weaknesses of the problem. In AFLAC’s instance, the strengths of this company is that they have a strong financial strength within the company, the coverage it provides, the portability, the cost, and the direct payment (Hartman 1). The weaknesses include delays on paying customer’s claims, poor customer service, and more concerned about processes than progresses (Hartman 1). This step enables the designers to seek the opportunities for improvement. This links Quality Functional Deployment to a company’s strategic vision and allows priorities to be set in the design process (Evans, 297). † Some customer attributes become key selling points and help establish promotional strategies. The next step is the evaluation of the technical features of competitive aspects and development of targets. This step is usually accomplished through internal testing and translated into measurable results (Evans, 297). With AFLA C, these evaluations are compared with the competitive evaluation of customer attributes to find inconsistencies. The inconsistencies with AFLAC is their customer service. Targets for each technical feature are set on the basis of customer importance ratings and the existing products strengths and weaknesses (Evans, 298). The final step in building the House of Quality is selecting the technical features to be deployed in the remainder of the process. This means â€Å"identifying the characteristics that have strong relationships to customer needs, have poor competitive performance, or are strong selling points (Evans, 297). † The cost and direct payments with AFLAC are the proper actions and controls to maintain the voice of the customer. Also, on the negative side, the poor customer service and the delay of paying customer claims are critical as well and do need the attention. The House of Quality shows the six steps and how they are to be evaluated in sequential order. They will either be a very strong relationship, strong relationship, or weak relationship. We have to focus to make sure AFLAC improves its processes. It is important AFLAC improves as a company as a whole or could face the financial crisis as AIG did in September of 2008. They need to improve on what they have been criticized for in the past. Using a six sigma approach would be beneficial to their improvement plan. This is an approach to measuring product and service quality (Evans, 93). â€Å"The late Bill Smith, a reliability engineer at Motorola, is credited with originating the concept during the mid 1980s and selling it to Motorola’s CEO, Robert Galvin (Evans, 94). † He wanted to improve product and service quality in his organization and wanted to achieve six sigma capability by 1992. The key concepts of this was think, focus, emphasize, ensure, provide, Create highly qualified improvement experts, and set stretch objectives for improvement (Evans, 94). Today, Six sigma is used as a quality framework and in service organizations. As part of the improvement plan, AFLAC needs to implement a six sigma approach called DMAIC methodology. â€Å"This is a standard problem solving approach used in Six Sigma (Evans, 264). The DMAIC stands for define, measure, analyze, improve, and control. AFLAC can use this methodology to help solve their problem of not dealing with the insurance claims in an efficient amount of time and the customer service that goes along with it. It is explained that the six sigma project selected is dealing with the insurance claims in a sufficient amount of time without any delays. Therefore, the first step is to define the process that needs to be solved or needs â€Å"help. † The problem must be described in operational terms. As an example for AFLAC, this company has history of poor customer service and not paying the claims in time. Therefore, this six sigma project is to improve customer service reliability. Along with this problem, shows that the various insurance agents that are employed with AFLAC seem to not be motivated enough to satisfy the customer. In most organizations including this one, the main job is to satisfy the customer and make sure he or she got the experience with the company and is walking away happy with the customer service. This drills down to a more specific process which is called project scoping (Evans, 264). The customers must be identified that have the most impact on this negative performance, errors or the customer complaints. This phase also needs to address project management issues. In a more timely effort, these AFLAC agents may need some motivation whether it be more of an incentive or extensive training practices to make sure every customer walks out happy. The next phase is the measuring phase. This phase main focus is on how to measure the internal practices of the problems (Evans, 265). It does require an understanding of relationships between process performance and the value of the customer. In AFLAC, every customer is important. Once this is understood, collecting good data, observation, and careful listening should be implemented (Evans, 265). With AFLAC, the high managers and CEO should be doing this type of aspect of this cycle. They should be doing the observation part of every AFLAC branch. Hiring a team of auditors would most likely be the smartest idea. The careful listening part should be by the various AFLAC agents. The auditors and CEO should be giving the individual feedback and the agents should listen on how they can improve their working practices. The third phase is the analyze phase. A huge flaw that happens in problem solving teams and approaches is a lack of emphasis on the analysis portion (Evans, 266). A lot of the time, companies just want to jump into a solution and miss the step of understanding how serious the problem is and identifying where it is coming from. This phase focuses on why defects and errors occur in the organization. The AFLAC auditors need to conduct experiments to be one hundred percent sure that the scope of the problem is accurate. These experiments generally consist of formulating some type of hypothesis and then collecting data and analyzing it (Evans, 266). AFLAC needs to implement a statistical thinking tool. This tool is a philosophy of learning and action based on three principles. These principles include all work occurring in a system of interconnected processes, variation exists in all processes, and understanding and reducing variations are keys to success (Evans, 323). Analyzing statistical thinking in AFLAC would be an immense of help regarding not paying the claims in a timely manner. Variation must exist in this process and AFLAC does not have variation in this type of process. This is why statistics is an important part of the Six Sigma training. Also, what also needs to be analyzed in AFLAC is to see if their also is a computer problem regarding the claims not going through their system. AFLAC pays all their claims online and doing a computer simulation of all computers in the offices would scope out if there is a possible problem with the computer. Once the cause is determined, the analyst, auditors, and teams needs to generate ideas for removing or resolving the problem and improve the performance measures (Evans, 266). One of the difficulties in this section of the DMAIC phase is the natural instinct to prejudge ideas before thoroughly evaluating them in full detail. â€Å"Effective problem solvers must learn to defer judgment and develop the ability to generate a large number of ideas at this stage of the process, whether they are practical ideas or not (Evans, 266). AFLAC needs to improve their customer service and paying their claims in a timely fashion. One idea that needs to be implemented is to have an online website to file the claims to AFLAC. This would be a big convenience to all AFLAC’s clients. On the website, it should also have a spot where you can track the status of your claim. This would save AFLAC lots of money and it would cause less hassle on the customer service line of all the customers asking if their claim has been paid or not. Switching it to online would be more efficient, save money and also would be easier to keep track of every claim. It is way more efficient being on the computer and being well organized than searching through a person’s file looking for it. Implementing the websites to file claims will make the turnover be lower of the amount of complaints regarding the customer service, but there still needs to be improvements. As for the poor customer service, their needs to be extensive training for the many insurance agents that are employed with AFLAC. It has become apparent that these agents were not trained fully on the job when they were originally hired. Implementing a plan where training must exist upon hiring an agent and it should be done every two years to ensure quality in these individuals. The final phase of DMAIC is the control phase. This focuses on how to maintain the improvements AFLAC has implemented. This means putting tools in place to ensure the key variables remain within the maximum acceptable ranges under the modified process (Evans, 266-267). Controlling these plans are vastly important. AFLAC should hire an individual outside of the organization to solely work and monitor the website where claims are filed and to see the status of the claims that are filed. The company will be paying the individual, but in the end, it will save them money and turnover will have gone down significantly. The individual will control these websites and make sure there are no downturns or technical difficulties in the operation of this website. As for the training process improvement, the individual will be trained by top management on an individual basis once every two years. This might seem to be a lot of training by retraining them every two years. Technology changes from year to year and different programs will most likely be established in the near future and it is very important that the agents learn the new development in technology to help them do their jobs on the computer. Training the individual might seem like a hassle to the co-worker, but in the end they will become a more positive individual because they will know that they are doing their job in the most efficient and successful way possible. VI. Identify Management Planning Tools (Tree Diagram, Process Decision Program Chart) Planning is one of the basic functions of every manager out there. The complexity of the business environment today means that planning is not always the easiest thing to do (Evans, 302). However, many different types of tools have been developed by several Japanese companies over the last half century as part of their planning processes (Evans, 302). These tools can be used to address problems typically faced by managers in an everyday role. There are all different types of management tools that can be used to show the improvement in a chart or just explaining it in words. These help the manager understand what exactly needs to be done to improve the process it is struggling or needs â€Å"help† in. With AFLAC, showing these different management tools to management and the lower level employees will help them understand what AFLAC is trying to do as a company and is finding many ways to improve themselves in the

Cultural Assessment – Nursing

Cultural Assessment The population of the United States is continually rising. The birth rate continues to rise, but more importantly, the number of foreign-born immigrants that relocated to the United States in 2003 was a staggering 33. 5 million, and that number rises every year (Jarvis, 2008). With such a large immigrant population comes the need for medical professionals that are culturally competent.Being culturally competent means that the caregivers, â€Å"understand and attend to the total context of the individual’s situation, including awareness of immigration status, stress factors, other social factors, and cultural similarities and differences† (Jarvis, 2008, p. 38). Because the United States is so diverse, it is a federal law that all caregivers must be culturally competent. It should be noted, however, that is not something that can be accomplished so easily. It is a process that can take a lifetime. To become culturally competent one must have knowledge in several areas.These include, but are not limited to, knowing one’s own personal heritage, the heritage of the nursing profession, the heritage of the health care system, and the heritage of the patient (Jarvis, 2008). When performing a cultural assessment of an individual one must take into account five important aspects of the individual’s heritage. These aspects will give the nurse an idea of the patient’s heritage consistency. First, is the individual’s culture. Everyone has a culture. There are four basic characteristics of culture. First, it is learned; from birth one is learning the language and socialization of that culture.Second, it is shared. All the members of the same group share that culture. Third, it is adapted. Culture adapts to environmental and technical factors, as well as the groups availability to natural resources. Finally, it is dynamic. Meaning, it is always changing (Jarvis, 2008). The second aspect of one’s heritage is ethnicity. This is a group within the social system that have a common geographical origin, race, religion, values, traditions and food preferences. The term ethnic is tricky in the United States (US) because of how large the US is, and the large diversity of ethnic differences it has.Religion is the third aspect of one’s heritage. Religion is extremely important because an individual’s religious beliefs play a huge part in one’s health-related behaviors and how someone perceives illness and death. There are roughly 1500 different religions in the United States which is why this aspect is so important when performing an individual’s cultural assessment (Jarvis, 2008). The fourth aspect of one’s heritage is socialization. When someone is raised in a specific culture, the person naturally acquires the characteristics of that group.Many people in the United States are bicultural, acquiring certain customs and traditions of the United States while stay ing loyal to their traditional culture as best they can. Time orientation is the fifth and final aspect of one’s heritage. Every culture has a different understanding of each other’s perception of time. Depending on the individual’s heritage, that person may focus on the past, the present, the future, or a combination of the three. It is important for the nurse to recognize the individual’s perception of time to gain a better understanding of how to individualize a plan of care.To gain a better understanding of cultural assessment and how it relates to health care and being culturally competent, a sit down interview was performed with an 84 year old female of German-American heritage, who believes that any belief or view differing greatly from hers are strange, and usually wrong (Riley, 2008). In order to preserve her right to privacy, she will be referred to as G. E. Heritage Assessment Cultural Group G. E. is 84 years old and was born and raised in the United States. She considers herself an American who is extremely proud of her German heritage. She is 100% of German decent.She had one older sister who is deceased. Her immediate family was all born in rural Illinois. Her father built a house in Coal Valley, IL when she was very young, where she lived until she was married at the age of 18. Her paternal grandparents were both born in Germany. It is unknown what city or village in Germany they came from, other than the northern part of Germany. They immigrated to the United States shortly before her father was born. She remembers her grandparents speaking little to no English, then, eventually broken English. Her father spoke English as a first language and some German. Her mother, her sister and she ever learned the German language. English was the only language spoken in the home. Her father was a coal miner and her mother took care of the home. In her culture, each generation lived in separate homes, whereas in some cultures, mu ltiple generations live in the same household. However, her grandparents and extended family members did live nearby, so she spent a lot of time playing with her cousins, and saw her grandparents, aunts and uncles on a regular basis. They would all get together on Sundays after church, and have lunch together. She lived at home until she married at the age of 18. G. E. ent to public schools, then to secretary school after graduation. Her husband was also 100% of German decent. They had two sons and a daughter. Both of her sons live close by, but her daughter lives in Nebraska. Her daughter and she talk on the phone every day. Her husband was in the US Navy during WWII and her husband and she were very patriotic. Like she has stated earlier, she is an American. Other than that, she did not know much about the war or Hitler or just did not remember. What she did remember when asked about this subject was the fact that a few of her husbands’ ancestors were drivers for Hitler dur ing his reign.Ethnic Group G. E. ’s ethnicity focuses around her family and church. Even though her father’s parents were born in Germany, there is no indication that they were passing down many values, traditions, or food preferences to the new generations. By all accounts, they wanted to completely immerse themselves into the American way of life. The only German recipes that were passed down to her were for sauerkraut, German pigs-in-a-blanket, which included sauerkraut, and German potato salad. Her family also eats a lot of beef, pork, and chicken. Potatoes are also a staple of her diet.For many years, G. E. and her husband would grow a big garden and produced enough vegetables for the entire winter months. Traditions are very important to G. E. For many years her family would come to her house after church for Sunday lunch and also for Thanksgiving. The day after Thanksgiving the grandchildren would come over to decorate the Christmas tree. She still has her famil y over every Christmas Eve. She says she does not cook a meal anymore, she orders a meat and cheese tray, and makes some side dishes. The other family members bring over the desserts.She also used to have a birthday party for her children and grandchildren. She baked a cake and the family would come over and eat dinner. The birthday person got to pick the dinner, and would then open presents. Her grandchildren bring her great-grandchildren to see her at least once a month. She says she enjoys it when they come to visit. She really enjoys seeing the great-grandchildren. She says that it makes her feel proud. Religious Group Religion is the most important aspect of G. E. ’s life besides her family, and always has been. G. E. and her family are Protestants.Knowing that most of her ancestors came from the northern part of Germany, this is interesting because in Germany, Protestantism is practiced predominantly in northern Germany (Fuller & Vossmeyer, 2004), which is where her anc estors lived. This is proof that their religion has been passed down through the generations and still continues to be practiced. Her husband and his family, who are all deceased now, shared the same ethnic and religious background as her family. She regularly attends a Presbyterian church at least once a week and is a very active member of the church.Her husband would fill in as pastor when the regular pastor could not. She practices her religion in her home every day by praying and reading the Bible. G. E. celebrates all of the holidays of her religion which are Easter, Thanksgiving, and Christmas with her family. She states that her religion has no influence on her diet or health practices. G. E. believes in heaven and hell, which is common to many German religions (Fuller & Vossmeyer, 2004). She insists that younger family members who do not go to church attend church with her at least once a year. She does not like the fact that her other family members do not attend church.She feels in order to get into heaven one has to attend church occasionally. Social Group Most, but not all, of her friends share the same ethnic and religious background. She also has a few Hispanic friends whom she enjoys spending time. She still lives in her home in the same neighborhood in which she has lived for over 50 years. The neighborhood is located close to the church and most of her neighbors are close in age. Most of them attend the same church and are of the same ethnic background. She has always had a very active social life which can contribute to her excellent health.She goes to a senior activities hall twice a week to play bingo and has a swimming class twice a week to exercise and socialize with friends. She goes to have her hair done every Saturday which she has done for many years. She regularly goes out to lunch and to watch a movie with friends once or twice a month and is on the phone a lot with family and friends. She made sure to mention is that she absolutely does not like to travel and has never been outside of the United States. When her children were young they would take camping trips to Wisconsin and Minnesota. That was pretty much the extent of her travels.As a result, her sons do not like to travel much either but her daughter enjoys traveling. Her daughter has been to many countries and G. E. does not understand why she enjoys it so much. Time Orientation G. E. ’s time orientation focuses on the present and the future with little to no focus on the past. She feels at her age, focusing on the past is a waste of time. She says, â€Å"I just move on† (G. E. 2011). She does not like to dwell on the past. She says, â€Å"what’s done is done†. Although she misses her husband very much she believes she will meet up with him in heaven one day. She enjoys the thought of that.She does not think of health care in terms of the past either. She follows her doctor’s advice and is open to new treatments and m edications. This is another reason she is in excellent health for an 84 year old woman. She does not like the thought of a doctor not knowing the latest in medical technology and treatments. She also is not bothered if health care personnel are not culturally sensitive to her heritage since she sees herself as an American who is proud of her German heritage. G. E. is uncomfortable with doctors who are not Caucasian. She also does not like to be cared for by male nurses or other male caregivers who are not doctors.Health Related Beliefs and Practices G. E. has health insurance and Medicare, so she is able to see the doctor on a regular basis. Lack of insurance coverage is not a factor for her. She never goes without her medication because of lack of prescription coverage. Also, with the money she and her husband saved over the years, plus both of their retirement packages and social security benefits, she lives comfortably and does not have to worry about not having enough money to l ive out the rest of her life in the lifestyle she leads. Developmental Situation G. E. remembers things her mother did when G.E. was a child to maintain and protect her health. She had to wash her hands regularly, especially before and after meals and after using the bathroom. She always had three meals a day which consisted of foods from all of the food groups. In the winter she could not go outside until she was bundled up. When she did get sick, she had to stay home in bed until her mother thought she was feeling better. This was solely the job of her mother since her father worked long hours in the coal mines. She states that her mother was the stereotypical strict, but loving, German mother.When she started her own family, she ran her home in the same manner. She was raised during the Great Depression and was raised to be hard working and to appreciate what one has, which G. E. has instilled in her children. G. E. is accomplishing all the developmental tasks of her age group an d has successfully resolved Erickson’s last ego stage, which is the psychological conflict of ego integrity versus despair. In this stage, â€Å"resolution to this final conflict occurs when the adult accepts one’s one and only life cycle as something that had to be and that, by necessity, permitted of no substitutions† (Jarvis, 2008, p. 8). Causes of Illness G. E. describes illness as not being able to do the things she normally does and she defines health as having no aches or pains. She rates her health as good to excellent for a woman of her age. She has never smoked, however, her husband smoked a pipe for years. She does not use any devices to help her get around and she still goes up and down the stairs to do laundry. She states she has fallen a few times but has never broken a bone as a result, and was able to get back up on her own. She has never been hospitalized as a result of an illness, only for an occasional elective surgery.What she believe causes illness are environmental change, God’s punishment, grief and loss, stress and anxiety, incorrect food combinations, poor eating habits, smoking, inactivity, and viruses and bacteria. Cultural Practices in Healing and Health She maintains and protects her health by washing her hands regularly, taking her prescribed medications, staying active, eating a well-balanced diet based on the food pyramid, taking vitamin supplements, seeing her doctors regularly, staying inside when it is too hot or too cold, avoids people who are sick, and does not take on more than she thinks she can handle.When she does get sick she does not make a big deal out of it and does not feel the need to worry family members. She stays at home because she fears getting others sick as well, especially her great-grandchildren. She takes care of herself by getting enough rest, keeping herself hydrated, not eating certain foods she knows will make her feel worse, taking needed medications, and calling her doct or when she feels she needs to be seen. When G. E. feels she needs some lab work done, other tests, or has any concerns, she immediately calls her doctor. She trusts in her doctor’s advice and always follows his or her orders.It is because of all of this, she believes she is still living an active and healthy life. G. E. is also extremely concerned with the health and well-being of her family. When her children, grandchildren and great-grandchildren are sick, she worries about them and calls them regularly to check on them. She also prays for them to get well. Cultural Expressions of Illness G. E. does whatever her doctor suggests and does not believe he would do anything to jeopardize her health. However, as far as family and friends go, she will not outwardly express indications of pain.She states that it is because she does not want people to worry about her. G. E. believes this is due to her strict German up-bringing and growing up during the Great Depression. She believe s one can never work too hard, so pain is seen as a weakness to her. The more she expresses pain or illness, the weaker she is seen, and possibly unable to effectively take good care of herself. Alternative assisted living is not an option G. E. needs at this point. G. E. feels she does not need it, and she absolutely will not burden her children with having to care for her.Cultural use of Alternative Therapies G. E. sometimes uses home remedies when she is ill. When she was a child her mother would use some vapor rub then put a sock around G. E. ’s neck. G. E. ’s mother would feed her chicken soup and give her juice or hot tea to drink, and keep her in bed. G. E. believes that healing and curing are the same and believes that praying, following the doctors orders, getting recommended treatments and taking prescribed medications brings healing. In the past few years G. E. has used alternative therapies to help with pain and arthritis.She gets acupuncture once a week, a nd sees a massage therapist occasionally. She admits, ten years ago she would have never done these types of alternative therapies, but her daughter is a nurse, and recommended it as an alternative to pain medication. She also admits that it does help, or she would not pay to go, but she feels it does not cure anything. She still has to supplement the pain with medications from time to time. Summary G. E. ’s interview was conducted at her home, and it took about an hour and a half. She would often change the subject, so having to restate questions happened often.She felt comfortable being in her home answering these questions, but often asked why an assessment of this type was so important. She has no issues with cultural sensitivity, or nurses being culturally competent, and has had little experience with other cultures. G. E. does not understand the need for such learning. Her views are ethnocentric, and at 84 years old, that will probably not change. During the interview, both open-ended and close-ended questions were used to gain the most information. She was very open to doing the interview, but stated she did not think she had much to contribute.She states she has lived a wonderful, privileged life with a loving husband, and a great family. She has never been disappointed by her family and is extremely proud of them. The only regret she has, has to do with her sister. They lived about five properties apart from each other, and some land next to her sister that G. E. owned, her sister planted a garden there for years. Well, G. E. gave the property to her daughter and son in-law to build a home. Her sister got extremely upset, which ended up with their families not talking for years. Then she received word that her sister was diagnosed with breast cancer, and G.E. called her up, and they reconciled. Unfortunately, she died shortly after that. G. E. has never gotten over that. Because of that, she is continually telling her family not to bicker over the small stuff, and that one’s family is all one has, and the people who love them the most in this world. Even though G. E. will not openly express pain to anyone except her doctor, the rest of her family will openly talk about any illness they have or pain they are experiencing. This is something she practically requires of them. She says it is like â€Å"do as I say, not as I do†.This goes back to her not wanting to be a burden on anyone, yet she has to know that her family is alright. It is perfectly fine for her family to be a burden on her, because to her it is not a burden. She sees it as her responsibility. She states that her family always tells her she will never be a burden, but she is too stubborn to listen to them. She is the mother and she knows best. She says her family jokes to her that they are 50 something year old adults, yet they still feel like children when they are around her and have to do what their mother says or there will be trouble. She fi nds this very amusing.She does not believe in cremation and plans to be buried alongside her husband. She has all of her final arrangements already planned and paid for, again, as not to burden her family. Many members of her family plan to be cremated and she cannot understand why. She believes one’s soul will not go to heaven if the body is cremated. There were no communication barriers while interviewing G. E. It was a very easy and pleasant interview. G. E. enjoyed talking about her heritage and family. G. E. is a very active and healthy woman for her 84 years, and she cannot wait until she can reunite with her husband in Heaven.She prays to her husband every night. Personal Reflection Writing a cultural assessment about someone from a different generation was very interesting for me. While some of the information I received during the interview was similar to my own personal beliefs, most were not. Being two generations younger than G. E. makes a huge difference in certa in beliefs. My mother is 100% Swedish and my father was a Vietnam veteran who is 50% German, with some English, French and more German. Growing up, my family did not follow any ethnic traditions and had no heritage related beliefs other than being American.We were a middle class family and as a child I thoroughly enjoyed life. I have one younger sister, and we, for the most part, were spoiled. I think that has to do with having baby boomers for parents. We took dance classes and I was a gymnast through junior high school. We had a whole neighborhood of other children our age. We were outside from morning until evening, especially in the summer. Both of my parents worked and provided us with whatever we needed. My parents made me attend Sunday school every week until I was about 12. After that, I attended church only a few times a year. Religion does not play a big role in my culture.Even at Sunday school, it did not make much sense to me, but I was too young really understand. My pa rents and grandparents always had a strong work ethic and I also do as a result. My parents wanted me to be my own person and choose my own path as long as it was an honest path. I live within a mile from my parents and from my sister so we see each other frequently. My parents help out my husband and me with our children. I have two sons and a daughter who are ages three, four, and six. One thing that differs from G. E. and me is that I like to know about the past as well as the present and future.One thing that we agree on is that we see our doctor regularly and rely on the latest in medical technology and medications. When we are both ill, we tend to use the same methods to take care of ourselves. However, I am not one to hide any pain or illness I have from my family; when I am sick or in pain, everyone knows about it. Also, the way we in which we raise our children is different. G. E. raised her children in a loving, but more strict, manner. I do not raise my children in such a strict manner. I raise them like my parents raised me. They are very different styles, but I do not know that one is better than the other.They both have positive and negative parts to them. In G. E. ’s generation the woman usually stayed home to take care of the family. In my generation I feel many women enjoy getting an education and usually find it a necessity to work outside of the home. I know I would enjoy the best of both worlds, to contribute to the family income, yet limiting my work outside the home to part time until the children are older. One thing about religion I also learned was how important it was to G. E. Other than her family, her religion was most important to her life, which is very different from me.As I stated earlier, religion has virtually no importance in my life. Also, I do not consider myself to be ethnocentric. I have yet to meet a person whose religion, culture, ethnicity, or heritage shocked or bothered me. As long as I do not feel that I am b eing pushed into one belief or another, I am fine. Everyone needs to find the path that makes one happy, healthy, and whole. I want to be a nurse because I like people. I feel I can make a difference in this career by letting my patients know that I genuinely care for their well-being and want them to lead the best possible life they can.I have been a Certified Nursing Assistant for the last 6 years and I enjoy it. I think by becoming a nurse I can do even more to help them. It is an awful experience to go to see the doctor, and feel like cattle being shipped in and out of the office at record speed. I like the thought of, as nurses, we take a holistic approach to healing that I feel doctor’s lack. Patients need to feel they can openly discuss their problems and that someone is actually listening to them and taking time to talk about it with them without judgment or prejudice; to come up with a plan of care that suits everyone involved, as much as possible.I realize since I d o work in a hospital that there will not always be a happy ending. Some patients can be difficult to care for, but as a nurse, I need to understand that they are there because they are ill, which has an effect on their personality and mental status. I must have empathy for them, as difficult as that may be sometimes. I know that when I am not feeling well, my personality changes, as does everyone’s. I feel the issues I need to work on most is the language barriers when they arise, and patient’s family dynamics. The diverse and often complex dynamics of a patient’s family is extremely difficult to understand.It will take time to develop a way to handle these often difficult situations. No family has the same relationship, so as a nurse I must go in prepared for anything, and keep an open, non-judgmental frame of mind while performing a cultural assessment on the patient. Writing this paper has made me even more sensitive to people’s cultural differences. N o matter what background one comes from, most people essentially want similar things when it comes to healthcare. One wants to be seen as an individual, rather than a number. We want compassionate care. We want to be listened to. We want to get well. We do not want to be judged or belittled.We want to be understood and we do not want to be dismissed as just another â€Å"crazy patient†. Nobody reacts well to negativity especially when there is no need to be. These are the things I must keep in mind while doing cultural assessments in the future. References Alexopoulos Y. (2007). Illness, Culture, and Caring: Impact on Patients, Families, and Nurses. In Chitty, K. K. & Black, B. P. (Ed. ), Professional nursing concepts & challenges (5th ed. , pp. 237-269). St. Louis, Missouri: Saunders. Baxter, A. (2001). In search of your German roots, A complete guide to tracing your ancestors in the Germanic areas of Europe (4th ed. . A. Baxter (Ed. ), Baltimore, Maryland: Genealogical Publ ishing. Carter R. (2008). Cultural competence: Cultural care. In Jarvis, C. (Ed. ), Physical examination & health assessment (5th ed. , pp. 35-53). St. Louis, Missouri: Saunders. Downing J. (2008). Understanding each other: Communication and culture. In Riley, J. B. (Ed. ), Communication in nursing (6th ed. , pp. 46-62). St. Louis, Missouri: Mosby. Santos S. (2004). In Fuller, B. & Vossmeyer G. (Ed. ) Cultures of the world, Germany (2nd ed. ). Tarrytown, New York: Marshall Cavendish.

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