Author: chris

Starwood Hotels and Resorts is one of the world’s largest high-end hotel and resort companies. One of Starwood’s divisions, W Hotels, is upgrading their existing online reservation system. You are a project manager at Starwood and will be leading the SDLC for a website project that W Hotels is initiating. An overview of the company, the specific case information, and your responsibilities are included in this document. You will be using this case information for several of the labs in this course.

Begin this lab by familiarizing yourself with the company.

Overview of Starwood Hotels and Resorts

“Through our brands, we are well represented in most major markets around the world. Our operations are grouped into two business segments, hotels and vacation ownership and residential operations. Our revenue and earnings are derived primarily from hotel operations, which include management and other fees earned from hotels we manage pursuant to management contracts, the receipt of franchise and other fees[,] and the operation of our owned hotels.

Our hotel business emphasizes the global operation of hotels and resorts primarily in the luxury and upscale segment of the lodging industry. We seek to acquire interests in, or management or franchise rights with respect to, properties in this segment. At December 31, 2006, our hotel portfolio included owned, leased, managed[,] and franchised hotels totaling 871 hotels with approximately 266,000 rooms in approximately 100 countries, and is comprised of 85 hotels that we own or lease or in which we have a majority equity interest, 426 hotels managed by us on behalf of third-party owners (including entities in which we have a minority equity interest) and 360 hotels for which we receive franchise fees.

Our revenues and earnings are also derived from the development, ownership[,] and operation of vacation ownership resorts, marketing and selling vacation ownership interests (VOIs) in the resorts[,] and providing financing to customers who purchase such interests. Generally[,] these resorts are marketed under the brand names described above. Additionally, our revenues and earnings are derived from the development, marketing[,] and selling of residential units at mixed use hotel projects owned by us[,] as well as fees earned from the marketing and selling of residential units at mixed use hotel projects developed by third-party owners of hotels operated under our brands. At December 31, 2006, we had 25 vacation ownership resorts and residential properties in the United States, Mexico, Aruba[,] and the Bahamas.

The Corporation was incorporated in 1980 under the laws of Maryland. Sheraton Hotels & Resorts and Westin Hotels & Resorts, Starwood’s largest brands, have been serving guests for more than 60 years. Starwood Vacation Ownership (and its predecessor, Vistana, Inc.) has been selling VOIs for more than 20 years.”

Source: Starwood Hotels & Resorts Company Information

“W Hotels (luxury and upscale full service hotels, retreats, and residences) feature world class design, world class restaurants and ‘on trend’ bars and lounges and its signature Whatever\Whenever service standard. It’s a sensory multiplex that not only indulges the senses, it delivers an emotional experience. Whether it’s ‘behind the scenes’ access at Whappenings, or our cutting edge music, lighting[,] and scent programs, W delivers an experience unmatched in the hotel segment.”

Source: Starwood Hotels & Resorts Company Information

Also, familiarize yourself with W’s current website.

Specifics of the W Hotel Website Project

As you have seen above, W Hotels currently has a website to handle online reservations at its 20+ hotels. The site is also used for information and promotions of W’s restaurants, bars, spas, and meeting facilities. W is now investing in a project to upgrade their online reservations website. The typical guest at a W Hotel is technically savvy, expects a superior level of service, and is willing to pay for it. The high-level requirements of this project are listed below:

• Handle increased traffic – W Hotels currently has 22 hotels. They are expanding at a rate of about four new hotels per year. W expects an increase in traffic of about 15% per year. The increase in online traffic is not only due to the hotel expansion, but also due to new services that will be available online (details are below).
• Fault tolerant – W’s current website has experienced regular outages of service. They are concerned that this is affecting reservations revenue and is a disservice to the customer. They would like to maximize the reliability while keeping costs within limits.
• Customer service – This is of extreme importance to W because of the high-level service they offer and which their guests expect. With this in mind, the website must be seamlessly integrated with customer service.
• Hip feel and appeal – W’s guests appreciate the trendy accommodations, style, and edginess. This look and feel must be represented in the design and services of the website.
• Handheld devices – The website must function well with cell phones, PDAs, and other handheld devices. The site should also be easily upgraded to handle new devices as they come to market.
• Notifications – Cell phone, PDA, and e-mail notifications from the W website are needed to distribute confirmations, changes, messages, and so forth.
• New media – W’s website will use video, 3-D virtual imaging, and other media for promotional purposes, tours, and information on events. Note that these media capabilities are an extra, so they are not required in order to make a reservation, gather information, or use the basic functionality of the W Hotel website.

You are now the project manager who is responsible for overseeing the SDLC of this website project.

In this lab, you will determine the staffing needs, responsibilities of the team members, and how your staffing budget will be spent.

The following are some guidelines you must follow:

• The project is projected to be completed in a six month time period.
• You have a budget of $500,000 for staffing. (You do not need to include benefits in your budget calculation.)
• You are responsible for all of the staff on the project, including technical staff.
• You must include your own salary in the budget calculations.
• You may hire full-time employees, part-time employees, contractors, or any combination that you determine is best.
• You must justify each position that you have chosen to include on your team.
• You are limited to hiring a maximum of three full-time employees (W Hotels does not want to hold on to your entire team after the project is completed).

Upon completing this lab, you will be able to do the following:

1. Review the systems development life cycle (SDLC) approach to completing a project, with special emphasis given to the system implementation and user training phases of the project.
2. Consider such variables as the project size, priorities, constraints, budgets, and the structure and culture of the organization.
3. Post to the SharePoint website, an online collaboration tool.

Necessary Material(s):

1. MS Word*
2. MS Excel*

1. Word file of staffing research
2. Excel file with budget of staffing needs

1. Read the case information given above. (You will be using this case for several labs in this course.)
2. Research the following items about Starwood Hotels and Resorts.
   1. Read the full overview of the company.
   2. In what city is the company headquartered? Place this information at the beginning of your report and save it in a Word file named “FiLastname_Lab01.docx”.
   3. What is the stock symbol for this company? Place this in the FiLastname_Lab01.docx file.
   4. What is the company’s website address? Place this in the FiLastname_Lab01.docx file.
   5. What companies does Hoovers list as the “top competitors” of Starwood? Place this in the FiLastname_Lab01.docx file.
      • Hoovers information can be found at the following website: www.hoovers.com.

Create a list of positions that you would like to have for this project. Save this list to your FiLastname_Lab01.docx Word file.

To help you decide on your list of positions, consider the phases of the systems development life cycle as it applies to this project, and select positions with the appropriate skills to carry out each phase. For example, if you are using a structured SDLC, you may decide that you need a business analyst position for the analysis phase. Pay particular attention to the positions needed to implement the upgraded reservations website and to train W Hotel’s personnel to use it.

1. Using www.salary.com, or a similar site, locate a job profile for each of the positions on your staffing wish list. Add the profiles to your FiLastname_lab01.docx file.
2. Using www.salary.com, or a similar site, locate a salary for each of the positions on your wish list. Be sure that the salaries are reflective of the geographic area in which you are located. Add the salaries to your FiLastname_lab01.docx file.

1. Using MS Excel, develop a budget containing the salaries of each staff member. Remember to follow the guidelines you were given above. Save the file as “FiLastname_Lab01.xlsx”.
2. Take the FiLastname_lab01.xlsx file, and embed it in the FiLastname_lab01.docx file.

1. Format your document so that it is professional and presentable.
2. Post one of your position profiles to the announcements area of the online collaboration tool, SharePoint. Your classmates will be reviewing the document and making comments in the TDA for next week. For a tutorial on how SharePoint can be used for collaboration, please refer to theSharePoint tutorial.

   To access the SharePoint site for this course, log in to the iLab platform, and on the main iLab applications menu, click the Internet Explorer icon (blue “e”) labeled “BIS360 iLab SharePoint Site.” This will take you to the top-level SharePoint site for all BIS360 sections. Review any announcements you see there. On the right side of the page, under Section Links, click the link for the particular section of BIS360 in

Homework consists of a about a 6-7 page research paper about Chinese economy. How it had impacted the world? how they’ve gotten to where they are now, and what the future looks/holds for the chinese nation. I would like to divide it in three parts so I can expose it better to the class:

1) what was done in the past that lead china to become a powerful economy that is nowadays.

2) what is the status of the chinese economy now? what are they doing or implementing to prevent or at least to cure their sluggish economic growth?

3) What does the future holds for China’s economy? will it be the a sustained economy? I want to emphazise their role in the BRIC block, and their plans on signing free trades with nordic nations––I read something about it days ago–– or other free trade agreements pending, as well their economic power globally. I want it to be written in an ANALYZE style, MLA form.  Remember that I will present it to the class and my other 3 peers are going to present their Culture and backgroud, SWOT analysis, and other subjects about China. Remember my part is the Economy(Past, present and future) well analysed of China. Thank you

Starwood Hotels and Resorts is one of the world’s largest high-end hotel and resort companies. One of Starwood’s divisions, W Hotels, is upgrading their existing online reservation system. You are a project manager at Starwood and will be leading the SDLC for a website project that W Hotels is initiating. An overview of the company, the specific case information, and your responsibilities are included in this document. You will be using this case information for several of the labs in this course.

Begin this lab by familiarizing yourself with the company.

Overview of Starwood Hotels and Resorts

“Through our brands, we are well represented in most major markets around the world. Our operations are grouped into two business segments, hotels and vacation ownership and residential operations. Our revenue and earnings are derived primarily from hotel operations, which include management and other fees earned from hotels we manage pursuant to management contracts, the receipt of franchise and other fees[,] and the operation of our owned hotels.

Our hotel business emphasizes the global operation of hotels and resorts primarily in the luxury and upscale segment of the lodging industry. We seek to acquire interests in, or management or franchise rights with respect to, properties in this segment. At December 31, 2006, our hotel portfolio included owned, leased, managed[,] and franchised hotels totaling 871 hotels with approximately 266,000 rooms in approximately 100 countries, and is comprised of 85 hotels that we own or lease or in which we have a majority equity interest, 426 hotels managed by us on behalf of third-party owners (including entities in which we have a minority equity interest) and 360 hotels for which we receive franchise fees.

Our revenues and earnings are also derived from the development, ownership[,] and operation of vacation ownership resorts, marketing and selling vacation ownership interests (VOIs) in the resorts[,] and providing financing to customers who purchase such interests. Generally[,] these resorts are marketed under the brand names described above. Additionally, our revenues and earnings are derived from the development, marketing[,] and selling of residential units at mixed use hotel projects owned by us[,] as well as fees earned from the marketing and selling of residential units at mixed use hotel projects developed by third-party owners of hotels operated under our brands. At December 31, 2006, we had 25 vacation ownership resorts and residential properties in the United States, Mexico, Aruba[,] and the Bahamas.

The Corporation was incorporated in 1980 under the laws of Maryland. Sheraton Hotels & Resorts and Westin Hotels & Resorts, Starwood’s largest brands, have been serving guests for more than 60 years. Starwood Vacation Ownership (and its predecessor, Vistana, Inc.) has been selling VOIs for more than 20 years.”

Source: Starwood Hotels & Resorts Company Information

“W Hotels (luxury and upscale full service hotels, retreats, and residences) feature world class design, world class restaurants and ‘on trend’ bars and lounges and its signature Whatever\Whenever service standard. It’s a sensory multiplex that not only indulges the senses, it delivers an emotional experience. Whether it’s ‘behind the scenes’ access at Whappenings, or our cutting edge music, lighting[,] and scent programs, W delivers an experience unmatched in the hotel segment.”

Source: Starwood Hotels & Resorts Company Information

Also, familiarize yourself with W’s current website.

Specifics of the W Hotel Website Project

As you have seen above, W Hotels currently has a website to handle online reservations at its 20+ hotels. The site is also used for information and promotions of W’s restaurants, bars, spas, and meeting facilities. W is now investing in a project to upgrade their online reservations website. The typical guest at a W Hotel is technically savvy, expects a superior level of service, and is willing to pay for it. The high-level requirements of this project are listed below:

• Handle increased traffic – W Hotels currently has 22 hotels. They are expanding at a rate of about four new hotels per year. W expects an increase in traffic of about 15% per year. The increase in online traffic is not only due to the hotel expansion, but also due to new services that will be available online (details are below).
• Fault tolerant – W’s current website has experienced regular outages of service. They are concerned that this is affecting reservations revenue and is a disservice to the customer. They would like to maximize the reliability while keeping costs within limits.
• Customer service – This is of extreme importance to W because of the high-level service they offer and which their guests expect. With this in mind, the website must be seamlessly integrated with customer service.
• Hip feel and appeal – W’s guests appreciate the trendy accommodations, style, and edginess. This look and feel must be represented in the design and services of the website.
• Handheld devices – The website must function well with cell phones, PDAs, and other handheld devices. The site should also be easily upgraded to handle new devices as they come to market.
• Notifications – Cell phone, PDA, and e-mail notifications from the W website are needed to distribute confirmations, changes, messages, and so forth.
• New media – W’s website will use video, 3-D virtual imaging, and other media for promotional purposes, tours, and information on events. Note that these media capabilities are an extra, so they are not required in order to make a reservation, gather information, or use the basic functionality of the W Hotel website.

You are now the project manager who is responsible for overseeing the SDLC of this website project.

In this lab, you will determine the staffing needs, responsibilities of the team members, and how your staffing budget will be spent.

The following are some guidelines you must follow:

• The project is projected to be completed in a six month time period.
• You have a budget of $500,000 for staffing. (You do not need to include benefits in your budget calculation.)
• You are responsible for all of the staff on the project, including technical staff.
• You must include your own salary in the budget calculations.
• You may hire full-time employees, part-time employees, contractors, or any combination that you determine is best.
• You must justify each position that you have chosen to include on your team.
• You are limited to hiring a maximum of three full-time employees (W Hotels does not want to hold on to your entire team after the project is completed).

Upon completing this lab, you will be able to do the following:

1. Review the systems development life cycle (SDLC) approach to completing a project, with special emphasis given to the system implementation and user training phases of the project.
2. Consider such variables as the project size, priorities, constraints, budgets, and the structure and culture of the organization.
3. Post to the SharePoint website, an online collaboration tool.

Necessary Material(s):

1. MS Word*
2. MS Excel*

1. Word file of staffing research
2. Excel file with budget of staffing needs

1. Read the case information given above. (You will be using this case for several labs in this course.)
2. Research the following items about Starwood Hotels and Resorts.
   1. Read the full overview of the company.
   2. In what city is the company headquartered? Place this information at the beginning of your report and save it in a Word file named “FiLastname_Lab01.docx”.
   3. What is the stock symbol for this company? Place this in the FiLastname_Lab01.docx file.
   4. What is the company’s website address? Place this in the FiLastname_Lab01.docx file.
   5. What companies does Hoovers list as the “top competitors” of Starwood? Place this in the FiLastname_Lab01.docx file.
      • Hoovers information can be found at the following website: www.hoovers.com.

Create a list of positions that you would like to have for this project. Save this list to your FiLastname_Lab01.docx Word file.

To help you decide on your list of positions, consider the phases of the systems development life cycle as it applies to this project, and select positions with the appropriate skills to carry out each phase. For example, if you are using a structured SDLC, you may decide that you need a business analyst position for the analysis phase. Pay particular attention to the positions needed to implement the upgraded reservations website and to train W Hotel’s personnel to use it.

1. Using www.salary.com, or a similar site, locate a job profile for each of the positions on your staffing wish list. Add the profiles to your FiLastname_lab01.docx file.
2. Using www.salary.com, or a similar site, locate a salary for each of the positions on your wish list. Be sure that the salaries are reflective of the geographic area in which you are located. Add the salaries to your FiLastname_lab01.docx file.

1. Using MS Excel, develop a budget containing the salaries of each staff member. Remember to follow the guidelines you were given above. Save the file as “FiLastname_Lab01.xlsx”.
2. Take the FiLastname_lab01.xlsx file, and embed it in the FiLastname_lab01.docx file.

1. Format your document so that it is professional and presentable.
2. Post one of your position profiles to the announcements area of the online collaboration tool, SharePoint. Your classmates will be reviewing the document and making comments in the TDA for next week. For a tuto

1.Wise leaders know that the key to balancing innovation and execution skills in a team or company is knowing who has what skills and then figuring out how to combine those complementary strengths within a team to generate quality ideas that will produce a positive impact. What is the difference between a discovery-driven team and an execution-driven team?

 

2.Critically examine the five team processes that encourage innovation. What is the significance of each process and how does it relate specifically to the team’s leader?

 

 

3.Once a leader has assessed his/her own personal discovery skills, the next step in development is to find a specific, current innovation challenge or opportunity to practice these skills with the team members.

4.Provide an example of a scenario that you participated in or witnessed in a work setting where a supervisor questioned members about his/her leadership performances and then explained how the results were used and future projects were executed. How did the group respond to the leader’s actions?

 

 

Dyer, W. G., Jr., Dyer, J. H., & Dyer, W. G. (2013). Team building: Proven strategies for improving team performance (5th ed.). San Francisco, CA: Jossey-Bass.

 

 

Your response should be at least 200 words in length for each question. You are required to use at least your textbook as source material for your response. All sources used, including the textbook, must be referenced; paraphrased and quoted material must have accompanying citations.

1,500 word essay on : What were the institutional reforms in transition countries of Central and Eastern Europe and what do we know about how they affected economic growth?
Harvard referencing is necessary and some relevant graphs and tables that are suitable and relevant. Not copied and pasted.

i want to know if you can provide any writer to do a work within 3 hours from now just to answer this questions:

What will your day to day (or week to week) schedule look like after graduation? How much leisure time will you have?

What do you envision doing with your leisure time at that point? Will exercise, physical activity, sports, and games be a part of it? Why or why not?

What health & fitness goals are important to you? Do you know how to achieve them? Is this realistic given your answers above?

How do you develop your imagination and creativity?

Do you allow yourself a “recess” each day? Why or why not?

Could you make more time to engage in imaginative activities, or give yourself more leisure time to be engaged in free thought, abstract thinking, and/or reading, music, and the arts?

Do you see a connection between these activities listed above (as examples) and increasing your synthetic learning or “consilience”?

We frequently hear about how athletics can teach life lessons, and how the lessons learned through participation in sports can help people lead a successful life, or cope with life’s ordeals (“sports as a metaphor for life”). What are these life lessons people learn from sports? What are the Take Home Messages that athletics can offer?

Which of these lessons should and should not be applied to youth sports?

Scenario:
As the newly appointed safety manager at a large plastics manufacturing company, you are called to the loading dock to find that a large truck, full of cartons of pellets used in the manufacturing process, is engulfed in flames. The truck slid on ice in the parking area and crashed into empty trailers. A call to the city emergency services indicated that they will be delayed indefinitely due to roads made impassible by the ice storm. The Material Safety Data Sheet (MSDS) for the pellets indicates that burning releases toxic smoke. Note that larger companies are likely to have their own emergency response teams equipped and trained to handle the most likely hazards found at the site.

Assignment:
Prepare an Incident Action Plan that includes all of the requirements shown below. Respond to each bullet point based on what you know of the situation. Clearly state any assumptions you make in your plan. The list is a subset of the United States Department of Health & Human Services’ suggested comprehensive Incident Action Plan available at www.phe.gov/Preparedness/planning/.

Identify at least two incident goals (i.e., where the response system should be at the end of response) and at least two operational objectives (i.e., major areas that must be addressed in the specified operational period to achieve the goals or control objectives).
Describe at least two response strategies (i.e., priorities and the general approach to accomplish the operational objectives) and at least two response tactics (i.e., specific methods developed to achieve the response strategies).
Prepare an organization list showing at least three primary roles and an assignment list with at least three specific tasks and their owners.
Explain a health and safety plan (to prevent responder injury or illness) that includes at least three provisions to ensure personnel safety.
Summarize a communications plan (how functional areas can exchange information) with at least a primary and secondary method of communication.
Locate the incident using a map or precise verbal description that allows responders to find the area and indicate an area that non-responders should avoid.
Writing the Final Paper

The Final Paper:

Must be seven to eight double-spaced pages in length (not including the title and reference pages), and formatted according to APA style as outlined in the Ashford Writing Center.
Must include a title page with the following:
Title of paper
Student’s name
Course name and number
Instructor’s name
Date submitted
Must begin with an introductory paragraph that has a succinct thesis statement
Must address the topic of the paper with critical thought.
Must end with a conclusion that reaffirms your thesis.
Must use at least six scholarly sources, including a minimum of three from the Ashford Online Library, in addition to the textbook.
Must document all sources in APA style, as outlined in the Ashford Writing Center.
Must include a separate reference page

Complaint:

ABC Consulting Corporation is charged with discrimination under Title VII of the Civil Rights Act. Specifically, Jane Doe has initiated a complaint that she is a victim of sexual harassment. The alleged sexual harassment is a result of being required to work in a hostile environment. She also alleges that she has been the target of retaliation after requesting that the harassment stop.

She seeks relief; the maximum that she is allowed in compensatory and punitive damages retroactive to the date of the complaint. Additionally, the organization and its management must create an environment free from sexual harassment.

Background:
Jane was transferred into the department in May 2010. She was assigned to a senior consultant for 4 weeks of training and orientation in the department. For each phase of training there was a performance checklist and she had to go to him for weekly reviews. After the second week, the feedback sessions felt uncomfortable as John Doe made a remark to her. She suggested a different way of doing the task and he replied, “You’re a woman, what do you know.” Jane ignored it as she did not want to make waves.

The following week they were working on a project with a male co- worker, Thorn Doe. Thorn asked John if he or Jane were thirsty. They both replied, “yes.” Jane asked to be excused to get her purse as she didn’t have any change. John replied, “Don’t worry about it, why don’t you reach down in my pants pocket and get some change.” Jane was appalled and when John noticed this he said, “Don’t worry, it won’t bite.” Thorn said, “I can’t believe he said that. Never mind, I’ll get the sodas.” From that point, Jane knew she was in a hostile environment. She began logging each encounter in a notebook.

By the fourth week, Brenda her supervisor began to notice some changes in Jane’s performance. She did not seem as eager to work on projects with John, her trainer. She came in a couple of days late without an excuse. At that point, Brenda called her in her office to determine the cause of this behavior. Jane gave an excuse that she was stressed about the newness of the situation. Brenda let her know that she could come to her with anything at anytime.

The verbal incidents continued and so did the display of pinup calendars. On July 3 before the holiday, Jane was working on a project with a deadline. Brenda asked her to stay late to finish the project; not knowing that John would also be working late. While she was working on her project, John came by her cubicle and asked if she needed any help. She hesitated; however, John had knowledge on the subject and she wanted to go home. So she said OK and they proceeded to work on the project. At the completion, she yawned and stretched. He said, What’s wrong?She said, It ‘s been a long day; I’m tired and want to go home. He said, Oh relax, we’re done. He proceeded to rub her shoulders. She asked, What are you doing and stop please. He continued. She jumped up from her chair and firmly said, stop. He replied, fine, but you don’t know what you’re missing and walked away.

She went home over the holiday weekend and thought about it and felt she needed to tell Brenda on Monday. Brenda suggested that maybe it would die down in a couple of months. If she (Jane) felt it was a serious situation, she should go to human resources. Jane went to personnel and they recommended she go directly to EEOC.

Word spreads fast and John got wind of it. One day in the lunchroom, John approached her and warned her about spreading rumors. He made the statement,If you keep it up, you’ll never be a senior consultant. Don’t you know, my analysis of your review counts? She knew he meant business as from that point she was assigned to fewer assignments than Thorn. She was also ignored at team meetings.

Thorn went to Brenda and asked her why was he assigned to so many projects, more than one person could possibly handle and Jane was only assigned to one. Brenda said she would investigate the matter and get back with him.

Since the July 3, incident, Jane didn’t know how to cope with her feelings so she sought outside counseling which her insurance did not cover. She felt at this point her reputation was damaged; her life wasn’t the same. She felt she had no future. She was stuck. It affected her social life as she didn’t want to be near a man because of fear of what he would do. She went to the doctor because she began having headaches and losing weight. She used to be calm and collected, but now she has become irritable and jumpy.

Thorn was assigned to a project with Jane and asked to be removed as she couldn’t concentrate on the issues and it was difficult to work on the project with her. Jane noticed a difference in herself and her working relationship with other men. She used to be able to joke and talk with Thorn, but now, all she does is get angry.

Jane went to Brenda and asked to work with a female consultant as she was having difficulty working with Thorn.

Imagine you are an HR consultant working with the organization involved in this situation. The organization wants to be responsive and fair. As the hr consultant, please consider the following questions:

1) How should Brenda (supervisor) handle the work situation? What are your thoughts about the recommendations provided to Jane by Human Resources?

2) Identify the laws, which regulate discrimination in the workplace and are pertinent to this case?

3) How do you think Joe should be managed? Please support your opinions?

4) Be certain to integrate reading and research from the online library to support your opinions.

5) You must cite within the text and include multiple references in addition to the text.

6) Please post your initial response by Thursday before midnight. Also, respond to at least two of your colleagues by Sunday before midnight.

Heather: A Sudden Death

Heather was 24-years old. She was just beginning her second year as a 7th grade math teacher and was to be married to her high school sweetheart in two months. Heather was driving to school when she was hit by a truck that ran a red light. She sustained multiple fractures, head injury, and extensive internal injuries. Her parents and older brother were informed on arrival at the E.R. that her chances for survival were extremely low. She was taken to the operating room but after 3 hours of surgery with uncontrollable bleeding and several resuscitation attempts, she died in the O.R. A clinical nurse specialist, who is on the rapid response team at the hospital, was called to be with the family when they arrived at the hospital. She stayed with them after they received the news of Heather’s death.

Discussion Questions:

1. How is grief from this sudden death likely to differ from death resulting from chronic illness?

2. What communication strategies would be helpful for the clinical nurse specialist to use with Heather’s parents on their arrival to the ER? While she is in surgery? At the time of her death?

3. What kind of grief would the fiancée likely experience? What types of interventions would be helpful? How might his grief differ from Heather’s parents and siblings?

4. How best would the grief of Heather’s students be assessed and managed?

Diana: Assessment/Barriers

Diana is a 40-year-old woman with a history of breast cancer. Five years ago she underwent a lumpectomy with radiation, following by chemotherapy. One year ago she developed bone metastases in the lumbar spine and right clavicle, documented by bone scan. She is currently being treated with another regimen of chemotherapy that includes paclitaxol (Taxol®). She is returning to the oncology clinic for chemotherapy administration. The nurse is concerned about Diana’s comfort and conducts a pain assessment.

History:

Diana at first reports no problems, but later admits that she developed very minor low back pain. She attributes this to increased activity as she has been remodeling her home. When the pain does not abate with over-the-counter medications (e.g., ibuprofen, acetaminophen) and non-pharmacological techniques (e.g., massage, heat), she will occasionally take a Vicoden® (5 mg hydrocodone/500 mg acetaminophen). When questioned why she does not take more, she states “I don’t like taking narcotics” and “My husband doesn’t like when I take the pills.”

Diana describes her pain as 2 or 3/0-10, located in her low back. The pain is aching and throbbing. When pressed to report other pain sites, she admits she has some shoulder pain, but rates it as a 1 currently. She also describes tingling in the feet bilaterally, extending to the ankles. “It is not pain really, just burning.”

Other history: Diana is married, lives with her husband and 2 teenage sons in a suburban home. She works as a receptionist in a dentist’s office.

Physical Assessment:

During the history, Diana’s posture indicated that she was not comfortable. When Diana gets up from her chair to get onto the exam table, the nurse notes that she does so with difficulty. Palpation of the lower lumbar spine (L3-4) produces pain. Diana denies pain when the clavicle is palpated. Straight leg raises of less than 30 degrees increase the low back pain significantly. Neurological examination reveals weakness in lower extremities, with R > L. Sensory loss is noted bilaterally in the toes and feet to the ankles. Reflexes are intact.

Discussion Questions:

1) What are the barriers to pain relief in this case?
2) What types of pain is Diana experiencing and what might be the underlying etiologies? What other questions should th