Placement Reflection With Memory Service Health And Social Care Essay

Placement Reflection With Memory Service Health And Social Care Essay This essay will include an introduction providing an overview of the placement undertaken and the relevant client group who access the service, a critical evaluation of three assessments that have been used within the service, one being Occupational Therapy specific, a discussion and examples given of how risk is assessed and managed within this practice setting, a discussion of the models of practice used, one intervention plan used with a particular client with an analysis of how the interventions were identified and prioritised, appraisal and justification of other potential intervention strategies, identification and evaluation of the impact of relevant legislation upon service provision within the practice setting, finally an evaluation of own performance as a student Occupational Therapist, and a conclusion. The practice placement setting was a city-wide Memory Service situated in North Yorkshire. The Memory Service is made up of a multi-disciplinary team of mental health professionals, working alongside the Alzheimers Society. The service facilitates early detection, diagnosis, and assessment of needs for older people with a memory problem, as well as giving support to their carers. Group support is also provided. Clients who are referred to the Memory Service are generally older adults who are experiencing early-stages of dementia. This essay will focus on one service-user who has been referred to the service diagnosed with Alzheimers Dementia, we will call him Max. The NHS website defines Alzheimers as being the most common form of dementia, which is a group of symptoms associated with a decline in mental abilities, such as memory and reasoning (NHS.uk, 2010) Max is in the early/forgetfulness stage of dementia (Schneck, Reisberg, Ferris, 1982) This includes mild impairment in memory and language, personality alterations, increased depression and anxiety, although there is no significant deterioration in ADL and is still able to live independently, however, it is apparent that Max is in need of some support. Moniz-Cook Wood (1997) suggest that psychosocial interventions are more effective in the early stages of dementia and memory services have great potential to provide early interventions for the service user. Max is experiencing difficulties in certain areas of his occupational performance, such as cooking/social isolation ASSESSMENT Identify and critically evaluate 3 Axs that are/could be used with the client group. The first step toward intervention is to assess the cognitive level of the client. An example of a standardised assessment is the Mini Mental State Examination 27/30 (MMSE) Folstein et al (1975) but in Memory Service the Addenbrookes cognitive examination (ACE-R) is used. The ACE-R is a brief cognitive test that assesses five cognitive areas: attention/orientation, memory, verbal fluency, language and visuo-spatial abilities. The total score is 100 of which Max scored 85/100. The ACE-R is easy to administer and only takes approximately 15 minutes to complete. The ACE-R results can vary depending on the intelligence of the client and their previous education, and also how literate they are. The Hospital Anxiety and Depression Scale (HAD) was used to find out if Max was anxious or depressed. The results proved that Max was very anxious with him scoring 9/10 anxiety, however only 2/10 for depression which is not significant, therefore this score was discarded. it was highlighted that Max was anxious about beginning social contact again and integrating into the community A kitchen assessment was undertaken with Max and the Occupational Therapist to assess and observe any risks to Maxs well-being. It was highlighted that Max often left pans on the gas cooker and ended up burning them, therefore setting off the smoke alarm, worrying the neighbours. The unstructured observational assessment took place in Maxs kitchen at home which is a familiar environment and in keeping with his daily routine. Max decided to cook scrambled egg on toast as he felt comfortable making this. At the time the Occupational Therapist was also asking Max questions relevant to his daily routine and cooking, therefore also making it an informal interview. Although unstructured assessments cannot provide the reliability that structured assessments can, Kielhofner (2002) mentions several reasons that can justify the use of unstructured assessments, such as, to add to information previously gained through a structured assessment, lack of time, unacceptability of structured assessment by a client, lack of an appropriate structured assessment. The negative points of carrying out a kitchen assessment are that quite often each client has a certain time of the day when they may function a lot better, Jack functions well around midday once he has taken his pain medication for arthritis and he is more able to focus on tasks. The client may also know that they are being assessed and may do things differently to how they would if they were alone. The evidence gathered from these assessments showed the Occupational Therapist that Max is only slightly cognitively impaired and is still able to function relatively well and therefore it is important to support Max as much as we can in his own home. Discuss relevance of risk AX and provide examples of how risk is assessed and managed Risk assessment and management is an important part of professional processes in Occupational Therapy practice. Legislation and policies have been implemented to guide practice such as Alzheimers Society The risk profile section of the Functional Assessment of the Care Environment (FACE) assessment and outcomes system (Clifford, 1999) is used to allow the Occupational Therapist to assess and document any clinical risk that an individual may pose. FACE provides outcome data that enables a patients progress to be followed and also compared with other individuals. The FACE risk profile comprises of a front sheet that summarises a patients contact details, and ratings of risk which are placed on a five-point scale ranging from 0=no apparent risk, through to 4=serious and apparent risk. The second sheet is a checklist of historical and current indicators of risk grouped into categories e.g. clinical symptoms indicative of risk and treatment-related indicators of risk. The third sheet comprises free text boxes where a description of the specific risk factors, both current warning signs and risk history, can be fully describes and individualised for the patient. The fourth sheet comprises r elapse and risk management plan which can be specified and tailored for an individual. Some specific events from Maxs past were documented: Social isolation and exclusion. Max hardly ever left the house apart from to do a weekly shop on a Saturday morning; his wife died two years ago and has since been living alone. Max had very few leisure interests apart from painting, and there was no close family support. As the course of Alzheimers progresses, the global function of individuals with Alzheimers decline. (Kuo, 2009) Max may therefore become increasingly unable to look after himself which could pose a risk in the future i.e. self-neglect? Thom and Blair (1998) describe the role of Occupational Therapy in identifying actual risks to the individual through the use of functional assessment based on observation and interview. (MENTION ABOVE AX) It was observed that Max has limited mobility due to arthritis in his knees, this poses a physical risk of falls. Max is aware of his limited mobility, however does not walk with a stick unless outside as he feels a stick inside is a hindrance. All loose rugs have been removed and the access to Maxs house is flat. He is aware of falls prevention techniques but has requested a pendant alarm from Telecare, as he feels this is appropriate in case he has a fall at home. The furniture is placed so that Max can use this as an aid for walking from the lounge into the kitchen if he feels the need. It was also highlighted that there was a risk operating household appliances safely after the Occupational Therapist carried out a kitchen assessment with Max. It was noted that once Max had started cooking he left the pans on the hob and went off to watch television because he got bored and then consequently forgot about the pan. From the kitchen assessment the Occupational Therapist was able to intervene and reduce the potential risk by suggesting Max engage himself in an activity in the kitchen whilst the food was cooking. Therefore Max could watch over the food but also read a newspaper, or do a jigsaw puzzle to keep himself entertained. Explore application of a model of practice and a therapy approach that were/could be used The Model of Human Occupation (Kielhofner, 1995) is founded on the belief that meaningful occupation is central to our well-being and that human occupation can best be understood as a dynamic system. (Duggan, 2004) This looks at physical and social environments, habituation, skills, and personal causation. As dementia is a progressive disease, the physical environment may become less accessible. Dementia may also cause disorientation, making it harder for the individual to make their way around places they are not familiar with. Occupational Therapists focus on Occupational performance, therefore we are interested in how individuals function on a day-to-day basis with their work, leisure, domestic life, and personal care. We follow a person-centred approach A person-centred and holistic approach.; A holistic approach:leisure, personal care and occupation in relation to the physical, psychological, social, economic spiritual aspects of life, (Reed Sanderson, 1992) Creek, 2002. Kitwood describes: Personhood promotes older people as having the same basic rights to dignity, privacy, choice, independence fulfilment as people of any other age group. Social interaction will help maintain well-being (Kitwood Bredin, 1992), preventing deterioration of mental function. People in a state of well-being are active occupationally engaging by nature (Turner, 2001). . INTERVENTION PLANNING Provide 1 intervention plan which you have implemented and justify this with evidence and clinical reasoning Following Maxs assessment, an occupational strengths and needs list was drawn up for Max and from this an intervention plan was made based on Maxs desired aims, including long-term goals. Goals are targets that the client hopes to reach through involvement in occupational therapy (Creek, 2002, p.129) STRENGTHS NEEDS Insight into condition Socially isolated although Max is very easy to get on with Enjoys drawing/painting-expresses interest in joining a local group Lost wife 2 years ago-feels as though he has lost his role in life Physically functions quite well apart from arthritic knees Burnt Pans Identifies positive qualities: kind, talkative, sense of humour Appears anxious about social involvement Prioritising the plan involved negotiating with Max and other members of the mental health team e.g. community support team, and making sure that Maxs goals were realistic in terms of being achieved within the 6 weeks. Cox (2007) states that symptoms of dementia can significantly disrupt a persons ability to set or meet realistic goals, therefore it is important to make sure each goal is achievable within the six weeks. By prioritising which goals Max wishes to achieve first this highlights the use of a person-centred approach, although risk factors must be taken into consideration e.g. Maxs top priority is to be able to make an evening meal safely and independently without burning pans, this is obviously a potential risk to Max and should be carried out with a member of the mental health team first. To meet the following goals, SMART (specific, manageable, achievable, realistic and time specific) objectives were also established. Long-term goal 1 Max to make some of his historically favourite meals safely and independently. Week 1: Max and the Occupational Therapist will meet on Monday morning at Maxs house, to discuss the risks of cooking with a gas cooker and write these down. Week 2: Max and Occupational Therapist to discuss whether Max would like some reading material in the kitchen to engage Max whilst his meal is cooking, therefore allowing Max to be occupied but also to check his food regularly to prevent burning pans and potential fire hazards. Week 3: Max and Occupational Therapist to walk to the local shop on Monday morning, to gather ingredients for the meal Max has chosen and Occupational Therapist to write down basic instruction for making of the meal. Week 4: Max and Occupational Therapist to make the meal together at 5.30 pm on Tuesday, using the gas cooker and ingredients that were previously bought Due to the nature of dementia, cognitive abilities decrease over time, the environment must be adapted accordingly. People with dementia may be unable to learn new skills; however old skills and habits remain deeply ingrained, and these can be used long into the disease Basic Living skills can be of more purposeful and value to the older person than leisure, PADL skills have been found to be important in the goals of treatment with early onset dementia as they value their independence, dignity privacy (Willard Spackman, 2001) It is important to facilitate plenty of praise and encouragement, through positive reinforcement. It is easier for Max to complete a cooking task when it is broken down into sections, so putting out the ingredients on the worktop in the order they need to go in the pan. Achieving only one or two steps of a task may help to give Max a sense of achievement. Max has a short attention span and finds it hard to remember instructions, so writing down a list of short instructions on how to make his favourite meal will facilitate him in the cooking process. When making the meal for the first time the Occupational Therapist gave tactful verbal reminders and simple instructions to encourage Max. Long-term goal 2 Max will attend creative community based activities and social groups every week for 10 weeks. Max is a friendly and sociable person once he is around people, and he shows a strong interest in art and has many paintings around the house. Aims of the art group: to meet new people and develop social interaction through art work. Week 1: Provide Max with information about his local neighbourhood network, available Memory Service groups, and provide transport information so that Max can attend. Week 2: Accompany Max to attend a local art gallery, and establish a therapeutic relationship with him. Allow Max to socialise with other people at the Art Gallery and start to build up his confidence whilst getting him to talk about his favourite interest. Week 3: Support Max to access the service for the first time; attend a Memory Service lunch club on a Wednesday morning for two hours accompanied by the Occupational Therapist. Week 4: Max to attend a local Memory Service Open Art group for service-users once a week on Monday morning for two hours for 10 weeks. Week 5: Max to continue attending the open art group and aim to achieve a higher level of occupational performance, by grading activities. For an occupation to have any therapeutic benefit it must have purpose, value and meaning to the individual (McLaughlin-Gray, 1998). For Max, this is taking part in Art based activities, in his past he was a strong artist and spent most of his free time outside painting, therefore attending a local art group with similar people with memory loss this is an ideal chance for Max to express his creativity and becoming more socially integrated into the community. It is important that we find out what Max wants to do and what he would enjoy, otherwise there will be little therapeutic benefit. This is an example of Person-centred care: we look for the client to lead us into an understanding of what is good and right for them. Perrin May (2000, p.77) Research is beginning to indicate the value of providing educational and supportive memory groups for people in the early stages of dementia. This can be seen as a cost effective, successful intervention that provides an alternative treatment for people in the early stages of dementia (Knapp, 2006) When looking at the College of Occupational Therapists online dementia clinical forum, there was evidence by Graff et al, 2006, for community based occupational therapy for people with dementia and their caregivers. It found that ten sessions of community occupational therapy over five weeks improved the daily functioning of patients with dementia. Creative activity in groups has also been shown to reduce depression and isolation, offering the power of choice and decisions. Non-verbal therapy methods, such as painting, are able to influence the well-being of the patients positively. (Hannemann,2006) The role of the OT with general goals is in promoting occupation, health well-being taking into consideration that dementia is progressive when making intervention plans (Pedretti, 2001). Analyse how the interventions implemented were identified and prioritised Appraise and justify other potential intervention strategies Another potential intervention strategy was to install Just Checking, a web-based activity monitoring system that provides a chart of daily living activity via the web, allowing the Occupational Therapist to track (via sensors in each room) where the individual has been, for how long, and at what time. A Just Checking system could be used for Max to establish his daily routine and activity levels during the day/night. Max states that he is anxious and sits on the sofa most of the day, Just Checking can monitor what he gets up to on a daily basis for 2-3 weeks and then the Occupational Therapist can be sure that the care plans and interventions that they put into place are based on objective information, rather than on supposition. They can be confident that the plan more closely meets Maxs needs. It may highlight that Max needs extra support which can be provided by the Community Support Team. It was suggested to Max that he try a dosset box for his daily medication, as it was noted that Max was not always compliant with his medication. However, Max refused this idea as he was happy taking his medication from the packet, and he felt that a dosset box would upset his daily routine. Another suggestion for Max could be for him to keep a diary so he can note down everything that is important like taking medication at a certain time, and attending any necessary appointments. The Occupational Therapist also gave Max some information about a Reminiscence group that is starting in the New Year. On nearly every visit Max would get round to talking about his past or photographs that he had on the wall, so it seemed like a good suggestion for Max to attend this group. When searching the Cochrane Library database, Woods et al (2005) looked at the effects of reminiscence therapy for older people with dementia and their care-givers. The results were statistically significant for cognition (at follow-up), mood (at follow-up) and on a measure of general behavioural function (at the end of the intervention period). The use of reminiscence therapy with people with dementia has been linked with improvements in behaviour, well-being, social interaction, self-care and motivation (Gibson 1994) Although there is little specific evidence for the effectiveness of reminiscence in dementia care (Carr, Jarvis and Moniz-Cook 2009) Max has expressed an interest in joining because he feels as though he would gain some therapeutic benefit being able to talk about past events with people of a similar age and with memory problems. The Cochrane review concluded that there was inconclusive evidence of the efficacy of reminiscence therapy for dementia. However, taking studies together, some significant results were identified, including improvements in mood and cognition, lessening of care giver strain and improved functional ability. No harmful effects were identified. Identify and evaluate the impact of relevant legislation, health and social policy and clinical guidelines upon service provision overall It is important that Occupational Therapists have a clear set of principles to work alongside when working with a person with Dementia. Also it is important to follow the Codes of Ethics and Professional Conduct (COT, 2010) The Mental Capacity Act 2005 (MCA) is underpinned by 5 guiding principles which all staff must follow These are an assumption of capacity supporting people to make their own decisions people have the right to make eccentric or unwise decisions where someone lacks capacity staff must act in the persons best interests where someone lacks capacity any action we take on their behalf must generally be the least restrictive option The National Dementia Strategy for England (DoH, 2009a) is a five-year plan which has three main aims: to ensure better knowledge, to ensure early diagnosis and to develop services. The strategy has put a focus on improving support for this large and growing group of people. It sets out a vision to raise the standards of care for people with dementia and is of great significance to Occupational Therapists working in the Memory Service. Occupational therapists can ensure that both the clients and their carers have a better understanding about the impact of dementia. Occupational Therapists working in the Memory Service get to see clients performing various activities that are directly or indirectly affected by memory and other cognitive functions through observation and assessment and are, therefore, able to identify early signs of cognitive impairments and raise awareness about the functional implications of memory and other cognitive impairments. In the UK, the National Service Framework for Mental Health (DoH, 1999) has been the main guide for how services should be run. It is now being replaced by the New Horizons strategy (DoH, 2009b), which aims to promote good mental health and well-being whilst improving services for people who have mental health problems. Occupational Therapists need Includes early intervention: to improve long-term outcomes, personalised care: ensuring that care is based on individuals needs and wishes, leading to recovery New Horizons sets out an intention across a wide range of agencies to move towards a society where people understand that their mental well-being is as important as their physical health if they are to live their lives to the full. It describes some of the factors that affect well-being and some everyday strategies for preserving and boosting it. It is important that Occupational Therapists specialising in the field of dementia ensure that they have a copy of the National Service Framework for Older People and use it a guide for the minimum level of service provided. EVALUATION Analyse how evaluation of interventions was completed Analyse your own performance as a student OT Having completed this 7 week placement I feel as though I have grown in confidence and learned so around the field of Dementia. I have had the chance to observe and assess many people with different diagnosis of dementia and every single person has been different and unique, with different goals they want to achieve and what they wish to receive out of the service. I have learned that communicating with a person with dementia can be a slow process, it is important to be able to actively listen not only to the service-user but to the carer as well as they provide so much valuable information and they are usually so much involved in the care of the service-user. Reflective practice has been identified as one of the key ways in which we can learn from our experiences. It helps to develop knowledge and skills towards becoming professional practitioners. (Jasper, 2003)  Ã‚   It is important that as a student Occupational Therapist I learn from my experiences on placement in order to understand and develop my practice, this involves consciously thinking about things I am doing, actively listening and making decisions. From what I have observed I can then start the reflective process and describe the experience and analyse it. I used Gibbss reflective cycle (Gibbs, 1988) that consists of six stages of the reflective process and asks cue questions to prompt the memory. CONCLUSION Provide summary of key points Every individual has certain strengths and weaknesses, likes and dislikes, emotions and habits, needs and preferences, and this makes them unique. People with dementia are often denied these things as their disease progresses, therefore it is important to try and maintain as best as possible the individual characteristics that makes up that person. As Occupational Therapists we need to acknowledge the uniqueness of the person and realise that even if they have dementia they are still living their life. Structure and predictability are important aspects of the environment in which people with dementia live. Summarise how the interventions improved or maintained health and well being for the individual Brooker p.44 (2007) states that It is important to and appreciate that all people have a unique history and personality, physical and mental health, and social and economic resources, and that these will affect their response to dementia. There is good evidence that people with dementia can learn, and respond to their environment, and through groups they can experience an improvement in the quality of life. It may not be possible to reverse the effects of dementia, but some of the major difficulties for Dementia sufferers are caused by under-stimulation, withdrawal, depression, and anxiety, and these can be reduced. This can make a real difference to the person. Max has lost his motivation and he was anxious about leaving the house and becoming socially involved again because of his memory deficits and it took some gentle persuasion to get him involved again. However, the Occupational Therapist described to Max what was going to happen, and what he would be doing, and reminded him when to attend the group sessions so he did not need to worry. The Art Group is a closed group, and the same people meet for a number of sessions and they get to know each other and become familiar with the routine of the group. This is good for Max as he is able to make some new friends, return to a familiar environment each week, and start to establish a routine. The leaders of the group get to know the members and are able to plan activities according to each member. Max expressed a strong interest in watercolour painting, and the art group leader was able to accommodate this. The achievement of leisure goals helped Max to sustain his self-esteem and morale.

The Luxury of the Bellagio Las Vegas

The Bellagio in Las Vegas is a four star resort that captures the essence of Vegas. It combines elegance with old world charm to provide its guest with one of the most luxurious stays in this colorful city. The rooms are divided into guest rooms, suites and luxury villas. The rooms range from 510-626 square feet.They are modern and well appointed. Each has modern amenities that one would expect at a 4-star establishment. (Bellagio) The suites are characterized by their decorating style and range from 800-4075 square feet. (Bellagio) Their styles appeal to executives and fun-seekers alike.These are truly rooms to be indulged and service should follow accordingly. The villas are designed for guests that seek luxury and the best in life. The Bellagio website describes them as such. â€Å"Each of our 6,500 square foot, two bedroom, five bathroom Villas and 8,000 square foot, three bedroom/seven bathroom Villas feature an in-suite workout facility, a massage room, a private kitchen, a fu ll bar stocked with guests favorite beverages, a duel fireplace, and a gorgeous private terrace and garden with a pool and a whirlpool. † (Bellagio) Obviously these villas are designed for the most exclusive clientele.The hotel itself is known for its beautiful fountains that dance on cue to music several times a day. Additionally, they house botanical gardens, pools and courtyards, art galleries and concierge service. A feature that should not be missed is the lobby ceiling adorned with a blown glass sculpture created by Dale Chihuly. Of course the hotel is known for its gambling floors and Cirque O is now housed within its buildings. Fine dining opportunities are offered in various price levels. This hotel is the embodiment of luxury, convenience and fine living. Training Program for Villa employeesThe Villas require an employee that is versed in excellent service techniques as well as discretion. As this section of the hotel caters to our most exclusive guest, the service m ust mirror their expectations. This is a challenge as these are at times the most demanding of all our guests. There are three groups of employees—floor managers, guest service associates and cleaning personnel. The ongoing training starts with the first day of employment within the division. It is seen as an advantage to work in the Villas because of the high profile of our clientele.Thus most of these employees are promoted from other divisions. They require two weeks of additional training before they are allowed to work with the customers. All require a background check. Training Objectives We employ a program that focuses on consistency, innovative techniques and dedication to upkeep of the reputation of the hotel. (Signature) The first phase is consistency. Each employee must be educated about the hotel’s visions and values. This will inform all their decisions as they need to act in accordance to those expectations. Floor Managers Our first step is to empower th e floor managers.The floor managers should start the day by reviewing their staff’s appearance. Each staff member should be briefed on the guests staying in the Villas and their anticipated needs. The floor manager can do this electronically (as in a daily webpage) or as a face to face meeting. This is the point in the day where the vision of the Bellagio is demonstrated and actualized. It is up to the floor manager to do this accordingly. The floor managers are usually promoted guest service associates. Their two week training session focuses on management techniques and personnel skills.â€Å"Before I can hold my managers accountable for the performance of their staff, I have to make sure they know how to educate their employees. †(Westminster) They are also shown what they are allowed to do. It is the hotel’s goal to solve altercations on that level before they are given to the general management. This is done in an interactive workshop environment and then r einforced with on-line activities and assessments. â€Å"eLearning can effectively deliver the theory behind your service philosophy along with the procedure and policy. † (Duprey) This allows employees to be able to show their advancements both in person and on-line.As well, the online resources provide a point where employees can check their progress and reference prior information. All of the training focuses on hands-on learning and working to resolve real world situations. (Westminster) In particular, floor managers are taken through a series of role-playing activities. The real world aspect of this part of the training is indispensable. Upper management can see exactly how they might solve a problem and assist them in making positive situations. (DeLollis) Once they are trained, they are given the job of training their guest service and cleaning personnel.They are encouraged to share what they learned. They will be taught how to appeal to and train people with many diff erent learning styles and skills. Guest Services and Cleaning Personnel The employees will be assessed in person and on-line. The cleaning personnel will be trained with hand-on modules and will be evaluated based on an on-site observation. They will work in tandem with an experienced cleaner for the first month of their service. Cleanliness is our top priority, so this is a major area of need. Each six months, employees will attend another training session.The purpose of these follow up sessions are to critique their performance, provide them with new information and acknowledge their successes. At this point in their employment, they are offered incentives for retention. Their service is rewarded. For every additional training session they attend or online training they pursue, they will also receive rewards and incentives that lead to promotion and salary increase. Employee Value Each employee, whether manager or cleaner, is valued. Part of the training is to demonstrate this val ue and to show them their importance. This is done through incentives and awards.(Atkinson) We believe the greater the share they have in the overall success of the hotel, the greater effort they will demonstrate. Along with that value, we also seek to challenge the employees. We feel this increases their sense of worth. We challenge them through task achievement, weekly goals, excellence performance levels, and as mentioned additional training incentives. We give the employees space to succeed. â€Å"Today’s workplace can be highly stressful, and the pace is unlikely to slow down. A key challenge is helping people learn in a highly stressful environment.One way that companies can help is by providing learning opportunities that balance challenge and support. † (Atkinson) The bottom line is that we want our employees to feel how important they are to the overall success of the team. We feel that the more training we provide, the more supported they feel. As employees m ake who we are, the Bellagio always provides opportunities for and expects feedback. We seek to create an environment that encourages open discussion and unfettered communication. In that spirit we have weekly meetings where the employees can voice concerns.For more sensitive issues, there is an online journal employees can fill out and floor managers can answer. (Atkinson) We agree with Starwood resorts that although our buildings are beautiful, it is our people that create an unforgettable experience. â€Å"Our guests value the design of our hotels, but what they really remember are the people. Their loyalty was often to a specific employee who had gone out of their way for them. † (DeLollis) Advantages and Disadvantages The employee training program is one with strength but can always be improved. As well, its goal has to be retention otherwise it is extremely expensive and ineffective.The chart divides each section of the training process and assesses its effectiveness. I t also discusses its disadvantages or areas that we can improve. Our hotel is about service people, thus our employee training is about service. Overall our goals are to ensure continuity, offer fresh and interesting training programs and demonstrate the value of our employees. It is absolutely essential that our managers are empowered to make decision. As well, they should be empowered to show their employees appreciation and recognize their growth and development. Working in this section of the hotel is seen as an accomplishment.In order to maintain that mentality, we must focus our training program on what our employees need rather than what we want them to know. Working with the select clientele that the Bellagio attracts requires devotion and knowledge. This can only be developed through a comprehensive training program that consistently communicates value, growth and the image of the hotel. Works Cited Alejandro, C. â€Å"Employee Training, Incentives Boost Conservation Progr ams. † Energy User News 4 October 1982. Atkinson, Tom. â€Å"Helping Hotel Employees Learn—Without Reservation. † Hotel Executive. 2003 Cummins Communications 2 May 2008.Bellagio Las Vegas. 2008. MGM Mirage. 2 May 2008 (www. bellagio. com). De Lollis, Barbara. â€Å"Hotels Train Employees to Think Fast. † USA Today. 2006 USA Today 2 May 2008 (www. usatoday. com). Duprey, Robert. â€Å"Is eLearning On Your Hotel’s Training Menu? † Hotel Online. Hotel Online 2 May 2008 (www. hote-online. com) Hotel and Motel Management. 2008 Questex Media Group. 2 May 2008 (www. hotelmotel. com). â€Å"Lodging Managers. † Bureau of Labor Statistics. 2007 2 May, 2008 (www. bls. gov). Signature World Wide. 2006 Signature Inc. 1 May 2008 (www. signatureworldwide. com). Yahoo Travel. 2008. Yahoo! Inc. 2 May 2008 (travel. yahoo. com).

The Cold War Between Communism And Communism - 1721 Words

The Cold War The conflict in ideologies between capitalism and communism resulted in one of the greatest conflicts of the twentieth century. The belief that freedom and democracy would die under communist rule caused the United States to start a conflict that would last for decades. The decisions made by the United States in W.W.II caused tensions to rise between the U. S. and the Soviet Union. Fear of Communism in capitalist nations, caused the United states government to use propaganda to raise Cold War anxieties. Furthermore, the American media influenced the attitudes of Americans, making a hatred of communism spread though the nation. Thus, the United States caused the conflict known as the Cold War, through its political policy and propaganda. The political relations going on in Europe during and directly after World War II had an enormous effect on laying the foundation for the Cold War. War time conferences such as Yalta and Terhran harshened the relationship between the communists and th e capitalists. At the end of W.W.II American policy towards the Soviets changed drastically. The change in president in 1945 caused relations with Russia to worsen. Furthermore, other political contributions to the Cold War entailed the Truman Doctrine and the Marshall Plan. The division of Europe between the west and east drew physical borders which outlined that the war of misinformation that had began. Also treaties of the post war world further separated the two super powersShow MoreRelatedThe Cold War Between Communism And Communism1382 Words   |  6 Pagesdemocracy and capitalism. However, Soviet Union, which was the only power that could rival the United States, claimed that communism could make the world more organized and ordered. 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Taking Online College Courses to Earn a Degree

Online college courses can help you earn a degree, improve your resume, or develop a new skill just for fun. If you’re  interested in starting online college courses, this article will help you get started. Taking Online College Courses That Lead to a Degree A growing number of students are taking online college courses to earn their degrees. Some students earn entire degrees online, some transfer traditional college credits to an online program, and some transfer credits from their online college courses to a traditional school. Online college courses are convenient and many can be taken asynchronously, making it possible to be enrolled in a course and engaged in discussions even though you do not need to log on to a website at a specific time. Online college courses in thought-heavy topics (such as English, humanities, math, etc.) tend to be more common than online college courses covering action-specific subjects. If you are interested in taking online college courses that lead to a degree, make sure that the school you’re choosing is properly accredited. Keep in mind that many traditional and online colleges do not easily accept credit transfers. If your plan includes transferring schools at some point, talk to counselors at both schools to make sure that your online college course credits will be approved.   Taking Online College Courses for Professional Development Even if you don’t want to earn an entire degree through the internet, you can take online college courses to improve your resume and develop skills that are valued in the workplace. You may choose to take online college courses ala carte. Or, you may enroll in an online professional development program. Many programs like the  Ã¢â‚¬â€¹Stanford Center for Professional Development allow students to take a sequence of shorter online college courses leading to a professional certificate in a subject like project management, computer security, information technology, or sustainable energy. Check with your workplace or experts in your field to see how a particular online college course will be received in your industry. For example, some computer certification courses that are highly coveted for secretarial work would be considered unnecessary for those employed in a managerial position. Many students are able to take online college courses for free by asking their employers to cover the cost of their tuition. Tuition reimbursement programs are designed for employees that complete coursework or earn degrees related to their position or a position they may qualify for. Even if your employer doesn’t have a formal tuition assistance program in place, he or she may be willing to work with you to subsidize coursework that will help you do better at your job. Taking Online College Courses for Personal Enrichment Online college courses aren’t all about profit and degrees. Many students enroll in online college courses just to learn a skill they are interested in or explore a subject they are curious about. Some schools will allow students to take a class pass/fail so that students do not need to concern themselves with receiving grades. As an alternative to taking online college courses through formal enrollment, you may want to explore many of the free online classes that are now available. Dozens of traditional colleges make their course lectures, assignments, and reading guides openly available to the public as open courseware. By taking free online college courses, you won’t have access to an instructor to help you through the content. Nor will you receive graded feedback. However, you will be able to work at your own pace and learn without paying a dime. There is coursework available on just about every subject, from math to anthropology. Another option is to take advantage of the many free online courses offered outside of the education system altogether. While these aren’t technically â€Å"college† classes, many independent organizations and individuals offer in-depth instruction on a wide variety of topics. For example, Khan Academy provides down-to-earth video lectures on dozens of math topics. Many virtual learners have found these resources easier to understand more than when taking many traditional courses.