Career Management in an Organisation

Literature Review

With the fast paced and unprecedented development of the workplace, every organisation must grow in correspondence with the changes (Hall & Moss 1998; Metcalf & Briody 1995; Watts 1996). In order for an organisation or industry to be more competitive in the marketplace, the management must always see to it that they use a management system and strategy that would sustain the capability, strength and competitive position (Pearce & Robinson 2000; Thompson & Strickland 2003). Industries which consider changes with their management system or any other critical aspects of their business operation are those industries which are aware of the positive benefits that these changes may bring (Yee 1998). Hence, the emergence of effective career management is vital and goes hand in hand with career development.
Career management (Wikipedia 2006) is the process of making career choices and decisions, managing the organizational and boundless careers, and taking control of one’s personal development. As applied to an organisational level, it is the key to achieve goals of ensuring the skills and competencies of people for future employment and management of new work and life realities (Moses 1995). For organisations need people who are multitalented, effective in managing changes, and adaptive to new organisational directions, career management serves as the key for individual and organisational development.
In view of this, the researcher has referred to several existing articles and studies that have presented different views on how career management affects an organization. The gathered literatures have been compared, collated and referenced by the author. It is greatly believed that the cited literatures have sought to quantitatively and qualitatively analyze the effects of career management, thus they have been included in this review.
By conducting this literature review, the researcher may: discover precise recommendations for further research and thus may find justification for one’s own research objectives; avoid repeating works that has been already done; gain noteworthy insights into the aspects of one’s research objectives; and, discover research approaches, strategies and techniques that may be appropriate to one’s own research (Gall et al. 1996).

Career and Career Management
    Career is a course of a person’s successive situations in his/her work life (Wikipedia 2006). For the past decades, it has been figured out by experts to plan and design career. Hence, career management was innovatively introduced to serve as the blueprint for success.
    On an interview, Rowan Manahan of Fortify Services, he believed that: “full-on career management requires professionalism, total commitment and large reserves of enthusiasm and energy every step of the way.” He added that career management is not an innate talent but a process to be learned. It is not a ‘frivolous luxury’ but a ‘necessity’ in the workforce. Career management is, at its most fundamental level, all about survival in these increasingly uncertain times. It is about carefully building and nurturing people’s skills and reputation (Manahan 2004).
The concept of career management has expanded in recent years because of ‘simple economics’. (Manahan 2004) People recognise a need for it. A comprehensive review of how diversified organizational career management techniques influence business strategy was documented by Stumpf (1988). Literatures on individual and organisation career planning indicate the variation of goals and responsibilities of each. The extent of career management creates stronger organisational incentive to promote efficiency; firms are likely to restructure employment relationship toward more meritocratic distribution of material rewards and career chances (Pfeffer & Salancik 1978). Individual and organisational career management offers advances for career progression. The most excellent career management systems combine these advances in order to achieve its respective objectives (Schein 1978; Vardi 1980). For instance, in building alternative career management systems on future officer (Berends et al. 2001), organizations used variations available to policymakers in the design features of four personnel functions such as accessing, developing, promoting, and transitioning. These personnel functions integrate the individual's capabilities with the requirements of the position and affect outcomes. Manipulating personnel functions can provide variation within a career system depending on the choices made about the system's various aspects.
Furthermore, Ornstein and Isabella (1993) and Chartrand and Camp (1991) presented extensive literature reviews from the employee's perspective, while Feldman (1989) and Russell (1991) provided summaries of the research from the organizational perspective. In connection to the role of human resource management, Vaughn and Wilson (1994) described a technique to help human resource specialists, line managers and interested employees identify previously uncharted career paths for internal transfers using Job Trees. In this article, the authors combined some of the traditional skill identifications with organizational trait characteristics, work flow patterns, and existing internal and external relationships representing how the organization actually operates.
The prevalence of formal employment in the urban economy necessitates a fine-tuned fundamental model that takes organizations into account (Stolzenberg 1978). Although spontaneous routines may indeed emerge in response to state plans and other external demands (e.g., Stark 1986), insofar as bureaucratic control dominates organizational design
    The anthologies of researches and studies on career management obviously tackle to the systematic and progressive growth of people’s and organisation’s careers. It primarily dealt on the subjects of individual and organizational development and improvement. Using such references, it could be supposed that career management is applied as essential aspect of management in order to go along with the current changes of the competitive marketplace.



Planned Happenstance Theory
    In the discussion of career management, the presence of Planned Happenstance Theory is expected. It provides a strong framework from which to research career management. As a career theory, planned happenstance offers an additional dimension to Krumboltz's (1979) career decision-making model (Mitchell, Levin, & Krumboltz 1999). Within this career theory, there are several individual attributes and attitudes acknowledged as potentially helpful in managing careers in the often chaotic world of work. As understood, the ideas of curiosity and openness from this theory is a commitment to continuous learning and skill development–which involves ongoing self-assessment and realistic feedback from others, as well as “benchmarking” skills and keeping them current. This is central to most literature on career management (Bridges 1997; Hill 1998; Kaye 1997; Kidd 1998; Moses 1995, 1999; Porter, Porter, & Bennett 1998; Shahnasarian 1994).
    There are five attitudes that are essential to recognizing, creating, and using chance as an opportunity (Hagevik 2000):
1. curiosity - which will prompt you to explore new learning opportunities;

2. persistence - which means you exert extra effort despite setbacks;

3. flexibility - which enables you to change attitudes and circumstances;

4. optimism - which will allow you to view new opportunities as possible and attainable; and

5. the willingness to take risks, which will enable you to act in the face of uncertainty.

A good career management theory must account for the limited degree to which workers have control over their own career experiences and satisfaction and organizations have control over the work environments that they provide. Gelatt (1991) spoke of approaching careers with an attitude of “positive uncertainty.” Further, Savickas (1997) suggested that “career adaptability” may be the core construct in Super’s life-span, life-space theory. Literature from employer surveys that flexibility, adaptability, and problem solving skills are held in high regard in the corporate world (Business Council of British Columbia 1999; Corporate Council on Education 1992). Many recent articles have recognized the impact of “serendipity” on career management, especially in these times of rapid change (Krumboltz 1998; Watts 1996; Williams et al. 1998).

Effects of Career Management in Organisations
The issues of career mobility and employment relationship cannot be adequately addressed without systematic incorporation of organisations. Given the longstanding theoretical and practical interests in markets and economic development (e.g., Bates 1989; Evans 1995; Sachs 1992), important questions related to the impact of career management on organisational practices in hiring, promotion, and compensation have yet to receive their share of attention. However, career management effects on every organizational environment are undeniably useful.
One persuasive reason on why organizations offer career management is that the process serves as a means to recruit and retain the best employees for the job to sustain competitive advantage. Believing that the most important asset of a business is the people, appropriate recruiting and retention of workforce to achieve sustained business success is vital. Therefore, the crucial role of human resource professionals in career management must include employee recruitment and selection, performance evaluation, compensation and benefits, professional development, safety and health, forecasting, and labour relations (Lipiec 2001). David Baxter (2000 p.1) warned every organisation that “the challenges of retaining and recruiting human resources will become a paramount in the operations” more so that many sectors of every company is entering an era of critical labour shortages. And with effective career management, human resource and its scientific process will not be at risk. Vaughn and Wilson (1994) described a technique to help human resource specialists, line managers and interested employees identify previously uncharted career paths for internal transfers using Job Trees. In this article, the authors combined some of the traditional skill identifications with organizational trait characteristics, work flow patterns, and existing internal and external relationships representing how the organization actually operates.
Recruiting the best person to occupy a position in a company means higher chances of efficiency. Retaining company’s best work assets is sustaining the growing competitive edge of the organisation. Hence, by doing such career management, productivity and progression is ensured. This is another reason why organizations engage in career management is productivity. The quality of the workforce predefines the possible outputs of the organisation. A weak workforce means poor labour while a strong workforce is more. Productivity is the measurement of organizational growth. By utilizing career management systems, the productivity of the organisation is near at hand. Orpen (1994) stated that productivity may come from a dedicated and well-motivated workforce. Through motivation, it can be assumed as the reason or the force behind why a person does well in work. Sometimes, it is also a means to make the person perform better and more efficient. Basically there are three assumptions in human motivation established in research. The first one assumes that motivation is inferred from a systematic analysis of how personal, task and environmental characteristics influence behaviour and job performance (Wiley 1997). The next one infers that motivation is not a fixed trait; but rather it refers to a dynamic internal state resulting from the influence of personal and situational factors (Wiley 1997). This means that motivation may change with changes in personal, social or other factors (Wiley 1997). Finally, motivation affects behaviour, rather than performance (Nicholson, 1995; Wiley, 1997). Wiley explained: “Initiatives designed to enhance job performance by increasing employee motivation may not be successful if there is a weak link between job performance and an employee’s efforts” (p.263). Additionally, productivity also comes from the workforce that is equipped and prepared with the right mixture of talent and skills or ‘hot skills’ to do the work required by an organisation (Cole-Gomoloski 1998; Griffith 1998; Hayes 1999; Young 1999). By means of effective recruitment and employee motivation, development is workable.
Aside from organizational results, career management may also help individuals to balance their work and family life, and link their personal career goals to the emerging needs of their employer, industry, or community (Moses 1995; Simonsen 1997). By means of balancing work and life of employees, the contributions in the progression of the organisation is focused and defined. Since market-dependent firms have more at stake in maintaining a high level of employee competence, these organizations should be more likely than others to adapt effective career management processes in favour of human capital. In order for an organisation to take advantage on the effects of career management, career managers and administration should equip people to benchmark their skills, anticipate upcoming skill demands, and commit to continuous learning (Kaye 1997; Moses 1995; Simonsen 1997). During these rapid and competitive changing times, employees as well as organizations need to help each other to facilitate the achievement of company’s goals and objectives. Organizations must identify specific skills and competencies that will maximize the company’s growth.
Lastly, career management may also help individuals to balance their work and family life, and link their personal career goals to the emerging needs of their employer, industry, or community (Moses 1995; Simonsen 1997). Balance is not so much a career management variable as it is a life management variable that permits one to achieve career success while remaining satisfied. This explanation would support Moses’ (1999) call for workers of the future to take time to recharge. However, the idea that every employee possesses a succinct picture of the goals and objectives s/he wants to achieve is finite.
    Career management affect the organisation in terms of the workforce and its productivity. The bottom line is the effectiveness of the process in making career choices and decisions, managing the organizational and boundless careers, and taking control of one’s personal development.

Career Development vs. Career Management
    Poehnell and Amundson (2000) argued that the term “management”. The term has been traditionally used but it seemed to be problematic when applied to careers. It may entail a degree of control over career development that is unrealistic in today’s climate of unprecedented organizational change. Although the terms career development and career management are used somewhat interchangeably in career-related literature, in the present study the term “career management” is preferred as it tends to emphasize an active, purposeful approach. However, the interconnectedness of the two synonymous terms is both vital. In an organizational perspective, the application of such concepts is equivalent to the nature of the organizational success.
Career development in an organisation is directed on ‘how individuals manage their careers within and between organizations and how organizations structure the career progress of their members’ (Wikipedia 2006).
In developing effective workforce, the management should always bear in mind that they are accountable for the growth and development of the organisation and the employees as well.  Employees must be given a chance to develop their career in the organisation, not only for the advantages that they can get for themselves but also for the organisation.  One of the obligations of the an organisation, specifically the management is to be able understand that the primary goal of career development is to help employees analyze their abilities, skills, and interests to better match personnel needs for growth and development to the needs of the organisation (Johnson & Scholes 1997). Secondly, the company must be able to identify the factors in maintaining a successful career development program. There are three type of planning which is relates to career development: Broad Life Planning, Development Planning and the Performance Planning. The organisation should incorporate each of these into the career development program. Moreover, the human management of the company should be able to identify their general obligations in the area of career development as well as their specific responsibilities to their employer and the organisation (Gallie 1998).The management should also be able to identify methods for improving the harmony between the individual and the organisation related to the development of their career. Lastly, the management should be able to apply career development in the setting of the organisation (Henderson 1996).
There are organisational activities designed to enhance the career development. These include the following: the establishment of the job posting system, the development of career resource centres, the training of managers as career counsellors, the planning, and implementing of career development workshops, human resource planning, and forecasting, utilizing performance appraisals and developing career pathing programs (Eggland, Gilley & Wesley 1998). According to Zenger (1981), the organisation maintains several fundamental responsibilities regarding career development. The organisation must be able to agree that that career pathing is a vital part of the organisation.
    Career development describes the structure and longitudinal nature of career behaviour, as well as the psychological, cultural, economic, and political influences that involvement strategies might transform in order to facilitate more positive and purposeful career behaviour than would likely occur randomly (Borgen & Young 1990). Furthermore, agility, strength, precise movement and the ability to deal with continuous change are key attributes in career development (Aldisert 2000).
    Meanwhile, in a study conducted by Magnuson, Norem and Wilcoxon (2003), professional growth provided support for applying the planned happenstance theory of career development to leadership development. With the presence of the aspect of continuous learning in this theory, learning in the organisation occurs.

Career Management Strategies and Attitudes
    In line with the Planned Happenstance Theory, there are some management strategies and attitudes to be applied in career. Among these are:
    Continuous learning – continuous learning makes work interesting and satisfying. It allows employees to achieve success to some specified points in their careers. However, it may not be directly related in preparing them for upcoming changes in their occupations or organization.
    Planning – appears to be foundational to effective career management (Blustein 1997; De Voe 1998; Kaye 1997; Moses 1995; Orpen 1994; Shahnasarian 1994). Corporate managers have long recognized the importance of planning to the long-term success of their organizations (Wack 1985). It helps individuals and organizations enhanced their coping ability with tumultuous change.
    Risk-taking – risk-taking is another valued attribute for career management (Hakim 1994; Posen 1998). Hakim provided a significant number of examples on employees who set boundary in their career potential by refusing to take risks.
    Flexibility, Optimism, and Persistence – these attributes and attitudes serves a predictors and indicators of a career success (Champy & Nohria 2000;
Posen 1998).
Work-Life Balance – The importance of achieving balance between work and other life roles has also become an emerging topic in the career management literature (DeVoe 1998; Moses 1995, 1999; Shahnasarian1994). This aids the employee to focus on the achievement of the goals imposed by the organisation and to his/her self.
    Networking - networking is an effective strategy used more consistently by individuals who actively engaged in either job search (as promoted in such programs as job clubs) or in building their careers in the organisation where they belong.

The combination of specific individual attitudes, attributes and strategies emerges an effective career management. A dedication to lifelong learning (based on ongoing and realistic self-assessment), alertness to opportunities and the ability to keep diverse options open (adaptability and flexibility), persistence, optimism, the willingness to take risks, and planning are all personal attributes theorized to foster career management success. In addition, networking and balancing work with other significant life roles are seen as important components of a systematic approach to career management. The outcome of effective career management is expected to be successful careers that meet the needs of the individuals, their employers, and the organisation they belong.

Consultancy
    Consultancy is becoming more pervasive in career management in an organisational level for two main reasons. In the first place, it is a trend which reflects the increasing complexity of business. Secondly and partly as a result of this growing complexity, the line which has traditionally separated consultancy advice from management action is becoming blurred (Czerniawska 1999). Career management consultancy is an independent and objective advisory service provided by qualified persons to clients in order to help them identify and analyse management problems or opportunities. Career management consultancies also recommend solutions or suggested actions with respect to these issues, and help, when requested, in their implementation (Barcus & Wilkinson 1995).
Consultancy means taking the ideas, suggestions, recommendations  from those people who are knowledgeable enough in the implementation of change management process or those who have devoted themselves in analysing different approaches and strategies to ensure successful implementation of changes.  In this case, job searchers, employees, or even managers may seek help from other consultancy companies available or establishing a management team which are experienced in this kind of venture.

Suggested Topics of Future Researches
There are several numbers of researches done in career management. These studies are exploratory in nature and offer a fundamental understanding of effective career management in the changing world of work. There are no experimental researches or studies in the interpersonal aspects of career management. Basing it from the records of literatures obtained, there are no indications of any applications or tools used in career management. To this point in time, there has been limited interface between theories in the fields of career counselling and corporate management. As such, there has been little research testing the effectiveness of career management in achieving its stated goals.
Hence, future research on career management should tackle the incorporation of interpersonal variables such as management styles and contextual variables such as personal crises. A qualitative design of research that would facilitate individuals telling their own career management stories is necessary to consider.
Another functional centre for future research would be to development of dynamic, scientific and better measures for career management. It may also include some variables for career success and job satisfaction. It would be helpful for career practitioners and coaches to have an easily available, concise assessment tool to screen effective career management attributes, attitudes and behaviours. Further, it could be useful in directing individuals’ career management involvement or resources that would become the most suited element in promotion and enhancement of their job or career success.














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[Literature Review] Palliative Care

Introduction

By definition, palliative care (or hospice care) is among the various forms of medical care or treatment which concentrates in reducing the severity of the symptoms of a disease (Barraclough, 1997, p 1367; Portenoy and Bruera, 1997, Ch 2; Field et al., 2001, pp 8-10). It is often regarded as slowing the progress of a terminal illness rather than providing for a cure (Mcnamara, 2001, p. 121; Geisler, Krabbendam & Schuring, 2003, p. 103). The World Health Organization (WHO, 2005) generally define the term as “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.”

The Hasting’s Center Report (2003, pp.6-8) enumerated the services in palliative care, which include professional nursing care, personal assistance with activities of daily living, various forms of rehabilitation therapy, dietary counseling, psychological and spiritual counseling for both patient and family, volunteer services, respite care, provision of medical drugs and devices necessary for palliative care, and family bereavement services following the patient’s death. Nurses, social workers, pastoral counselors, nursing assistants, and other health professionals under the management of a physician comprise the interdisciplinary care team.

In palliative care, pain is the most evident symptom that causes difficulty to treat. Palliative care is sometimes used in referral to the addition of symptom control and pain management services with the mainstream health care system (The Hasting’s Center Report, 2003, pp.6-8.) Thus, a health care practitioner or any individual associated with this kind of specialized medical care should be well equipped with the most comprehensive knowledge and application on pain and its management.

Pain and its Management

Pain is one of the most common human experiences, as no one is spared from such suffering, whether such to the physical or emotional. Yet for the longest time, pain has never been fully considered as a medical problem. It may be due to the fact that it is a subjective and a highly personal experience. Though pain can be measured, it cannot diagnose, felt (unless it is your own), imagined or proved its existence. Pain as a sensation differs from one person to another. LaPorte Matzo & Sherman (2001) says “pain is not just from physical disorders but also from combinations of physiological, pathological, emotional, psychological, cognitive, environmental, and social factors.” Hence, no person can exactly feel the same degree of pain at the same time. But pain is as real as the symptoms it shows, it is the reason why approximately 70 million visits were made by people to health care professionals every year (National Women’s Health Resource Center, 2004).

There has been a clear lack of knowledge when it comes to the overall nursing knowledge, whether when it comes to the physical practices that come with nursing care, the attention that they must give to the pharmaceutical concerns for their patient, and especially when it comes to the management of their patients' pains (Buschmann, 2001). Pain and its management is one of the most important parts of the nursing education which has been widely ignored by many nurses that only seek to gain monetary advancements. Palliative care is achieving the best quality of live for the patient and their families. The role of the health care provider like the nurse is to deliver the most effective and maximum utilization of resources and the proper observance of the standard operating procedures of palliative care (Marelli, 1999; Paice, 2005, p. 95). Thus, there are many aspects of caring that have been forgotten or disregarded in the effort to gain more advantage economic-wise. This ensures that the nursing profession continues to be a holistic practice that involves not only one aspect but the whole. Holistic professions do not only provide care for one of the body functions but the entire, which include the emotional health, physical health, and mental health of the patient (LaPorte Matzo & Sherman, 2001). Nurse must remember that care should be provided up to their best efforts in order to ensure that their patients are provided with the care that they are entitled to as their human rights.

At the same time, holistic care also refers to the knowledge concerning the pharmaceutical needs of the patients. Every year there have been several researches done concerning the removal of pain, whether temporarily or permanently (King, 1991) and recent studies have shown that nursing knowledge has continued to increase when it comes to the nurses’ identification of pain (Buschmann, 2001). However, studies also show that despite the knowledge many nurses have when it comes to emotional pain management, they believe that it worries them and does not give them enough to time to complete their work (Buschmann, 2001). At the similar point in time, it was shown that nurses, compared to physicians, therapists, and pharmacists, have more knowledge and experience when it comes to pain assessment, which makes them the best professionals who have the ability to judge the degree of pain that a client may have. Physicians and those in the pharmaceutical business may also be able to offer assistance when it comes to pain relief however they will still have to rely on the nurses’ ability to asses the extent of pain as well as their judgment on the immediate care for the patients once these problems start.

As a consequence, nurses should have already trained and prepared for their possible confrontation with several bioethical issues. They must then be prepared to face some matters that will need to be cleared as well as have to do intense soul searching in order to help them achieve better status and deal with their own emotions as well as their patients in order to establish a caring relationship between them. In order for this to happen, it is advised that the nurses avail or establish a team pain management plan which will help standardize their goals and hoped achievements when it comes to their patients’ welfare (Angelucci, Quinn & Handlin, 1998), especially since nurses’ decisions and the patients’ pain management programs may highly affect the patients’ emotions, physical reactions, spiritual beliefs, mental health, and overall quality of life. With such, it is suggested that nursing pain management should be as thorough and ethically charged as possible in order to ensure the best quality of care that the patients will receive.

Pain management, in this case, is an important aspect of caring for patients. However, despite of the available pain management guidelines, many patients complain incessantly about the pain after surgery or as a symptom of a terminal disorder (Buschmann, 2001). This perhaps implies the important correlation of theories and the role of nurses to pain management. Nurses should do more than administer methods or means to control the pain. As care providers, they should feel what their patients are feeling by establishing a personal bond with them and by being effective listeners.

New Breakthroughs in Other Symptoms and Pain Management

Other symptoms such as gastrointestinal, dyspnoea, confusional states, depression and distress are encountered in palliative care (Billings, 2000). Gastrointestinal symptoms include gastroparesis, nausea, and vomiting present in cancer related ailments. Diarrhea is also common to AIDS victims. With the help of new pharmaceutical substances, medicines to alleviate these symptoms are useful. Examples include the use of prokinetic drugs and new serotonin antagonist antiemetics to cancer related symptoms; Octreotide relieves AIDS related diarrhea; and progestational drug, such as megastrol acetate and glucocorticoids improve anorexia (Bruera & Neumann, 1998, pp. 1717-26). Dyspnoea, on the other hand, is perceived as the difficulty or pain in breathing. This is considered to be a common symptom of a serious many disorder. But now, breathlessness is manageable by using opioids and oxygen. Confusional states like delirium are under-recognized and under-treated in terminally ill patients (Billings, 2000). Using some drugs like haloperidol, chlorpromazine, and lorazepam alleviates the delirious behaviour of AIDS patients. Depression is also under-recognized and under-treated although it is very much common to everyone who suffers in a terminal ailment. According to Block SD for the ACP-ASIM End-of-Life Care Consensus Panel (2000), there is a significant number of clinicians who incorrectly presume that the stage of depression is natural and normal or expected to anyone, rather than a biologically based and treatable form of emotional suffering distinct from the state of sadness. J Andrew Billings (2000) affirmed that “the biological signs that usually form the basis of a diagnosis of major depression are often present in a terminal condition but are attributable to the medical illness rather than the psychological state. Clinicians must assess patients for classic depressive signs that cannot be ascribed to the underlying illness (for example, early morning waking that is not due to pain) and rely more on such psychological findings as excessive hopelessness, helplessness, worthlessness, and guilt and suicidal ideation.” With the suppressing effects of psychostimulants like dexamfetamine or methylphenidate, depression to such patients was use as treatment. Other advances on drugs in pain management were comprehensively presented in Billings’ work.

Palliative Care: an ethical “end-of-life” responsibility

"Ethical dilemmas have always been with us, but their nature in health care settings has changed radically with the development of new knowledge and technology" (Thompson & Thompson, 1990, p. 89). Nurses caring for terminally ill patients hold a great responsibility in numerous aspects. The many problems and difficulties encountered by nurses in the course of palliative care are numerous. A survey conducted to identify the five most frequent and five most difficult problems perceived by nurses in hospice, community and acute care settings revealed physical problems, emotional problems, work-related, death-related, and nurse-related problems as a result of caring for dying patients and their families (Copp & Dunn, 1993, pp. 19-25). Central issues are also identified such as talking to patients about dying, the decision to die at home or not, 'difficult' patients (or family), quality-of-life versus prolonging life and pain management (McGrath, Yates, Clinton & Hart, 1999, pp, 17-33).

Nurses handle not only a huge social responsibility by a great moral responsibility as well. In relation to palliative care, Jameton (1984) stated:

Patients, their families, and clinicians make decisions

about the treatment of dying patients against a background of 

conflicting feelings about death,varying evaluations of death as 

a way of escaping painand suffering, and great uncertainty about

its timing. Clinicians now recognize that dying people are still 

actively engaged in life. Respect for persons demands a response to their needs even if they have a brief future; care is not an investment, but an ongoing human response. (p. 225)

With the ethical considerations and debates on palliative care, nurses must handle the severe problems and dilemmas occurring in practice through more research, study, training, and education.

Conclusion

Palliative care is an integral part of all health care. It neither aims to hasten nor to postpone death and involves much more than fast-acting pain relief medications; but a psychosocial and spiritual goal and dimension should be met through the building of trust, communication, and relationships not only for the body but with self of the patient and the system of the family.

The best rationale of palliative care in the society today was captured by science-fiction writer Phillip K. Dick (1965) where he stated that: “Life itself was unendurable and hence had to be ameliorated. As a thing in itself, it could not be actually lived. There had to be some way out (p. 90)”.

Palliative care still challenges the ability of every health care profession to provide the highest quality of life especially to those who are at the end of life. Thus, nurses must be equipped with competent skills acquired from continued education and training along with future researches on the effectiveness of palliative care management. With these, there is an assurance for optimum growth, development and availability of this specialized, comprehensive and functional end of life care.

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Baily, MA, D’Onofrio, C, Jennings, B & Ryndes, T 2003, ‘Access to Hospice

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Confusion. Journal of the American Medical Association, 279, pp. 1365-1368.

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and managing depression in the terminally ill patient’, Ann Intern Med, vol.132, pp. 209-18.

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patients receiving palliative care’, Can Med Assoc, vol. 158, pp. 1717-26.

Buschmann, MT 2001 Pain Management: ‘An Assessment of Surgical Nurses' Knowledge’, MedSurg Nursing, 1st August.

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caring for the dying in community, hospice and acute care settings’, Palliat Med, vol. 7, pp. 19-25

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qualitative findings on dilemmas in palliative care nursing’, Hosp J, vol. 14, pp. 17-33

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Nest, N.S.W. pp. 120-135.

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November 2005, <http://www.ivillagehealth.com/library/nwh/content>.

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Management, vol. 25, pp 93-102.

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6-8.

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Kreiger, Malabar, FL.

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Mythological Aspect in American and African Literature

Introduction

In writing, the authors are bound to collect the necessary information that can be the essential factor in their novel, stories, or report. Anything that is related to their work can be based on reality or fantasy and sometimes the combination of the two. In terms of culture, the writers are very strict to use the information with basis to avoid the any offensive on the group of people. Since the writers are viewing the culture they often unfold and get fascinated with the traditional beliefs and mythological aspect of the cultures.

Background and Problem Statement

Everyone is fascinated with the stories served by the mythologies. The myth varies depending on the country. The most popular mythology that is now a movie is the Greek Mythology that tells the story of the 12 deities or the Olympian Gods. The Roman Mythology also tells the same story of the Gods, however, the name are replaced (e.g. Zeus in Greek and Jupiter in Roman, yet same God). The writers of the modern generation are very fond to discover the literatures and mythological aspects of the various nations. They collect it and include it in their work. The question is how the writers use mythological aspect in their works by combining the works of African and American author?

Research Aim and Objectives

The main aim of the study is to describe the behavior of the author in combining the American and African mythological aspect. In order to achieve this goal, the study should consider the three objectives. First is to search the author/s that is apt in the investigation of the mythological aspect in writing. Second is to determine the knowledge and the influential factors that can be consider in the ability of the author to address the mythological aspect of two cultures. And third is to describe the presentation the author crafted in order to describe the mythological aspects of African and American authors, without being offensive to the culture and to the authors.

Literature Review

Mythology, based on the Greek term, is the combination of the word “myth or mythos” which means speech or discourse. But in later time, the word came to mean the fable or legend. Because of the continuous story telling of the early people, the main origin of the story has been forgotten until it appears to be a religious and supernatural in nature which seeks to explain or rationalize the aspects in the world or a society. For the purpose of learning, the mythology is used as to describe the system used in the particular area. Thus, there are number of mythologies like the Egyptian Mythology, Welsch Mythology, Greek Mythology, Celtic Mythology, and many others. Mythologies had been addressed in the particular time of the early people and thought them the concept of right and wrong, which deliberately passed in the modern societies. There are two writers that can contribute in the African and American culture and mythological aspects. First is Gloria Naylor and her “Mama Day”. This novel explores the issues of the person’s cultural heritage. In the place where the characters live nestled the African beliefs that had been brought in America. The African mythology and religion is about the power to conjure and heal. In addition, the African religion centers in the idea that death is a door to another world and, as such, it allows contact with the living. So long as the dead are remembered, they are immortal. The second author is Elizabeth Brown-Guillory and her “Beacon Hill”. Her novel is almost the same with Naylor’s “Mama Day” because it focused in the African-American literature. The healing and connection of the past to present is the main theme. The role of the healer in African-American literature often resembles the dual role played by the priest/physician in traditional African culture. The spiritual power of the people, especially those black women are emphasize which connects to their traditional beliefs and respect in their myths.

Methodology

The suggested method in the study is through the use of the secondary information. It is time consuming because of the need for the thorough investigation. The materials that can be used are the literature books, novels, stories, and online sites that can answer the study’s demand on the mythological aspect of African and American. With the help of those materials, the study can start its investigation and generate its analysis based on the prepared objectives.

Source:

Jones, V.K., (2003) “Overcoming Obstacles and the Search for Identity: Literature of Multicultural Women Writers”, Accessed 04 Aug 2010, from http://hti.math.uh.edu/curriculum/units/2003/04/03.04.06.pdf