The War Powers Act of 1973

On June 3, 2011, Representative Dennis Kucinich (D-Ohio) attempted to invoke the War Powers Act of 1973 and force President Barack Obama to withdraw American forces from NATO intervention efforts in Libya. An alternative resolution floated by House Speaker John Boehner (R-Ohio) scuttled Kucinichs plan and required the president to give further details about U.S. goals and interests in Libya. The congressional wrangling once again highlighted nearly four decades of political controversy over the law. What Is the War Powers Act? The War Powers Act is a reaction to the Vietnam War. Congress passed it in 1973 when the United States withdrew from combat operations in Vietnam after more than a decade. The War Powers Act attempted to correct what Congress and the American public saw as excessive war-making powers in the hands of the president. Congress was also attempting to correct a mistake of its own. In August 1964, after a confrontation between U.S. and North Vietnamese ships in the Gulf of Tonkin, Congress passed the Gulf of Tonkin Resolution giving President Lyndon B. Johnson free rein to conduct the Vietnam War as he saw fit. The rest of the war, under the administrations of Johnson and his successor, Richard Nixon, proceeded under the Gulf of Tonkin Resolution. Congress had virtually no oversight of the war. How the War Powers Act Is Designed to Work The War Powers Act says that a President has the latitude to commit troops to combat zones, but, within 48 hours of doing so he must formally notify Congress and provide his explanation for doing so. If Congress does not agree with the troop commitment, the president must remove them from combat within 60 to 90 days. Controversy Over the War Powers Act President Nixon vetoed the War Powers Act, calling it unconstitutional. He claimed it severely curtailed a presidents duties as commander-in-chief. However, Congress overrode the veto. The United States has been involved in at least 20 actions -- from wars to rescue missions -- that have put American forces in harms way. Still, no president has officially cited the War Powers Act when notifying Congress and the public about their decision. That hesitation comes both from Executive Office dislike of the law and from the assumption that, once they cite the Act, they start a timeframe during which Congress must evaluate the presidents decision. However, both George H.W. Bush and George W. Bush sought Congressional approval before going to war in Iraq and Afghanistan. Thus they were complying with the spirit of the law. Congressional Hesitation Congress has traditionally hesitated to invoke the War Powers Act. Congressmen typically fear putting American troops in greater danger during a withdrawal; the implications of abandoning allies; or outright labels of un-Americanism if they invoke the Act.

Preparing a Career Development Plan Essay - 1038 Words

Reasons Scott did not seek or receive advice from her immediate supervisor Self-doubt Although Scott took a step in the right direction by beginning nightly accounting courses, all of her efforts may be in vain if she does not change her attitude. Burroughs has already given Scott valuable advice on how to change her attitude toward her qualifications and the advice proved to be a success. Now, Scott must continue to seek and present her positive qualifications and build her self-esteem. Each of the ways Scott may prepare herself for career advancement mentioned below can help her build self-esteem and always go into an interview with a positive demeanor. Lack of communication Whether Scott’s immediate supervisor did not notice her†¦show more content†¦Five ways she can do so is by attending career-planning workshops, improving her networking skills, seeking out a mentor, practicing her interview skills, and searching for training programs. Attend career-planning workshops Career-planning workshops provide employees with an interactive way to assess their own values, interests, abilities, and goals. Attending a workshop would allow Scott to compare and discuss concerns and thoughts about her career with employees who may have dealt with similar situations. Having a space where she can connect with other employees, rather than management, can provide Scott with the environment she needs to openly discuss problems she may be having. Scott would also be able to gather feedback from others in the group and use this to help make decisions about her career path. Improve networking skills While being a receptionist, Scott may not have noticed the informal network between men within the organization she works for. Such informal networks provide men with information on advancement opportunities and career tips given by senior (male) members. Now that she is beginning a career where she may encounter such groups, Scott must be prepared to deal with such networks between her male co-workers. Rather than wait and see a male counterpart prosper from such networks, Scott should search and join a female network with her company. Joining a women’s network within her company will give Scott a level playingShow MoreRelatedProfessional Development Plan1604 Words   |  6 PagesProfessional Development Plan The world is going through an era of rapid professional change and development. This has led to increased uncertainty for all professionals in the world of work. To ensure sustained growth in success and longevity of ones professional career, it is important to develop a strategic plan that focuses on training and developing a professional. 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Report On A Richard Rogers Architecture Essay Free Essays

string(279) " was confident that the Gallic authorities would turn it down, but as it has it, they did n’t, and although it was criticized at first and claimed to be ‘ugly ‘ it is now complimented on being â€Å" one of the most singular edifices of the twentieth century\." This study is written to admit an architectural design icon, Richard Rogers. I will be looking at this adult male ‘s life and his achievements. Richard Rogers is my design icon because his edifices are bold, make bolding, attention-getting and of class, inspirational. We will write a custom essay sample on Report On A Richard Rogers Architecture Essay or any similar topic only for you Order Now To acquire the information and research I need, I will be chiefly garnering it from the cyberspace, interviews and picture every bit good as any books I can come across. Hopefully, after reading this study you will understand why Richard Rogers is considered a design icon non to merely myself, but the remainder of the universe. Richard Rogers As a individual, Richard Rogers has lead an unbelievable life, born in Italy, he trained at the AA ( Architectural Association ) and Yale University go forthing with an impressive sum of makings. Richard Rogers, his spouse Norman Foster and their married womans Su Brumwell and Wendy Cheesman, set up an architectural pattern called Team 4, although this partnership merely lasted a 4 old ages, Richard continued to get married Su, and make a new partnership with Renzo Piano when they so designed the first of many inspirational edifices, the Pompidou Centre. Richard won assorted awards for many different edifices, even though he did hold some jobs with the populace about his edifices, he did travel on to plan another edifice, the Lloyd ‘s edifice in London, which is much more popular today than it was when it was being built. Richard has visited many different states go forthing his grade in many of them, including the United Kingdom, Spain, France, Germany, New York and Japan. He has inspired many people with his edifices and his finding. He has non being afraid of seting his thoughts frontward, and has been given both heartache and congratulations by the populace. He is committed to guaranting that his edifices should be â€Å" people ‘s topographic points † . The BBC invited Richard as the first designer to give the BBC Reith Lectures for a series called ‘Cities for a Small Planet ‘ . Richard even became the Chief Advisor on Architecture and Urbanism to the Mayor of London, he has besides been a president of the Tate Gallery and Honorary Trustee of the Museum of Modern Art in New York. If that was n’t plenty, he even went on to be knighted and became Lord Rogers. Richard Rogers has many accomplishments and has done many, many things over his life-time, below is a short timeline of some of his most singular accomplishments. Richard Rogers was born in Florence, Italy in 1933. Richard moved to London to travel to the Architectural association. He so went on to derive a maestro ‘s grade from Yale University in 1962. Richard met up with former Yale pupil Norman Foster and began an architectural pattern called Team 4 with their married womans, although the partnership merely lasted a few old ages, Richard rapidly found a new spouse, Renzo Piano, who together won the Prizker Price their edifice the Pompidou Centre which was built in 1977. His following chief edifice was Lloyds edifice in London which was completed in 1986 which became merely every bit much of a memorial as large ben. The European Court of Human Rights ( 1995 ) is really popular in France, for its antic expressions. The Barajas airdrome in Madrid was besides a caput Turner. The Millennium Dome though truly was a antic construction, stand foring so much in such a alone manner, this was completed in 1999. Another large undertaking was London Heathrow Terminal 5, there was so much to this undertaking, but it was eventually completed in 2008. And eventually, a existent memorial, Three Word Trade Centre, it is said to be completed between 2011 and 2015, it is to stand following to two other towers built by other designers utilizing the same manner. Born in Italy 1933 Architectural Association, Yale University 1954 1959 Fullbright, Edward Stone and Yale Scholar 1961 1962 Team 4 1963 1967 Pompidou Centre 1977 Richard Rogers Partnership 1977 RIBA Gold Medal 1985 Lloyds edifice 1986 Knighted 1991 BBC 1995 The European Court of Human Rights in Strasbourg 1995 Lord Rogerss 1996 Barajas airdrome 1997 Tomas Jefferson Medal 1999 Millennium dome 1999 Chief adviser on architecture 2001 2009 Stirling Prize 2006 Minerva Medal 2007 Pritzker Prize 2007 London Heathrow terminal 5 2008 Three World Trade Centre On-going Buildings Richard Rogers has designed many edifices, most popular are the Pompidou Centre in Paris, in London he designed the Lloyd ‘s Building, the Millennium Dome and London Heathrow Terminal 5. The European Court of Human Rights edifice in Strasbourg, Barajas airport terminal 4 in Madrid and the National Assembly for Wales edifice were besides antic constructions. The Pompidou Centre The Centre Pompidou was Richards first edifice created aboard Renzo Piano in 1977, the design of which won the Prizker Prize in 2007 by fundamentally making the edifice inside out. This meant that all the parts you would normally anticipate to see indoors, like the stepss, air canals, plumbing, overseas telegrams, etc. were all on the exterior of the edifice making monolithic indoor infinite, which is peculiarly utile as this peculiar edifice was used as an art museum, in fact, it is the largest museum for modern art in Europe. Not merely was this edifice functional, it besides complimented its usage for an art museum, affecting its visitants before they even entered the edifice. In theory, holding the internal care, such as the plumbing and air canals, should besides do the edifice easier to keep. Another congratulating facet of the edifice is how each external portion has being colour coded to do certain they stood out instead than intermix in. The Pompidou ‘s original programs were really much more excessive to get down, including traveling internal walls and adjustable floors, which unluckily, did non do it into the concluding design. Richard was at first loath to set this design frontward as he was confident that the Gallic authorities would turn it down, but as it has it, they did n’t, and although it was criticized at first and claimed to be ‘ugly ‘ it is now complimented on being â€Å" one of the most singular edifices of the twentieth century. You read "Report On A Richard Rogers Architecture Essay" in category "Essay examples" † The central office for Lloyd ‘s of London Richard used the Pompidou centre as an inspiration for his following edifice, the Lloyds edifice in London. This was a monolithic undertaking as the old edifice was created in steel where as this one of concrete. Once once more the edifice was designed with its internal parts, outdoors, this even included glass lifts which were the first of their sort in the UK, every bit good as the overseas telegrams, stepss, pipes and even the lavatories. This, of class, left big unfastened infinites on the interior. Once once more the Lloyds edifice was brilliantly coloured and brilliantly lit. The populace at first feared this would do this edifice an ‘alien ‘ is really â€Å" regarded as one of the finest edifices on London since the 1980 ‘s † The Millennium Dome The millenary dome is another 1 of Richards ‘s creative activities. It is a really cagey design with 12 towers or ‘arms ‘ squeeze outing from the white canopy which support the roof of the construction. Stretching out a monolithic 365m diameter, the Dome is the biggest 1 in the universe. The design of the construction is besides cagey as you will detect 365m in diameter, one metre for each twenty-four hours of the twelvemonth, every bit good as one tower for each month of the twelvemonth. Although you would of ne’er of realized until person mentioned it, it ‘s still a singular thing to hold built in. On the interior there was a big unfastened infinite with a fanlight in the centre of it all to make full with whatever the users would wish, which for the millenary, was split into 13 different zones to educate the populace in an synergistic manner, unluckily, the ?43 million constructing merely brought in half the expected visitants and was eventually converted into the 02 Arena. The millenary dome was a singular construction built for the millenary and had been planned for since 1996, and was originally planned as a impermanent construction to last merely 1 twelvemonth, but as it happens, it ‘s lasted much longer. 175 Greenwich Street 175 Greenwich Street is the future site of the 3rd universe trade centre. The construction will stretch up to 1155 pess with 71 narratives, four of which will be below street degree. The edifice will busy 200x 198 pess. The edifice itself has been designed to the highest energy efficiency evaluations. It is to hold a cardinal concrete nucleus utilizing a steel frame on the exterior of the edifice. It is planned to be completed between 2011and 2015 depending when the site is available to developers. The edifice will besides be accompanied by two other towers built by separate designers but hired by the same company, Silverstein Properties. All three edifices are to hold the same manner. London Heathrow Terminal 5 Terminal 5 was eventually approved in 2001 after a 46 month public enquiry, the longest public enquiry in British history. In 2002 work had eventually started and was non completed until 2008. The new terminus means that the airdrome can back up a much higher rider capacity, but it will non hold any more flights, although conservationists say it will take to more flights and pollution. For the terminus to be built, two rivers had to be diverted. Using unreal waterways to successfully deviate the rivers allowed the ?4.2 billion edifice to be built. Terminal 5 had to include a railroad station and several other edifices every bit good as a control tower ; this truly shows how large the undertaking really is. Manner Richard Rogers has been accused of holding several different manners, he himself is committed on his edifices being â€Å" people topographic points † , although this is non usually classed as a manner, he surely has made it into 1 with his constructions have extremely big indoor infinites. Bowellism is another manner related to his first edifice, the Pompidou Centre. Having the internal constituents such as the lifts, pipes, stepss and overseas telegrams externally, means that there is an unreal sum of floor infinite, which, for an art museum, is really utile. Post-modern is referred to another one of his constructions, the Lloyds edifice in London, holding all the constituents clearly seeable, and so brilliantly painted, and so brilliantly illume When Richard was younger, he dreamed of constructing a Zip-up house where his parents would populate, a zip-up house fundamentally means ready to piece or a level battalion house. Having walls, floors, panels and so on prebuilt and fabricated doing the edifice energy efficient, and easy to set. Decision As you can see, Richard Rogers has lead a singular life, constructing many inspirational edifices such as the Pompidou Centre, go forthing his grade in many states such as England, and many metropoliss such as Strasbourg, he has received many good merited awards for his edifices and has even been knighted by the queen. He has an unbelievable design oculus, and is non afraid to travel outside of the box, or in some instances, the edifice, and even though some of his edifices have been criticized severely, in the terminal, they ever came out positive. The fact that Richard is still planing, and his designs still make the public pant is astonishing, hopefully he will go on to construct and design for every bit long as possible, and I ‘m certain that many people will be inspired by his work and his life. All of these things, and many, many more, rebelliously make him a supreme pick of a design icon. Recommendations Trying to urge anything for Richard Rogers is highly hard as he has done it all, he ‘s traveled, he ‘s married, he ‘s left his grade, he ‘s divine, he ‘s lived, if anything people should look at his life and do recommendations for themselves. Make what you love making, and do it until you die, do n’t be afraid of seting your thoughts frontward, and battle for what you want. How to cite Report On A Richard Rogers Architecture Essay, Essay examples

The Primary Duty Of A Surgeon Samples †MyAssignmenthelp.com

Question: Discuss about the Primary Duty Of A Surgeon. Answer: Paediatric Preoperative care: The primary duty of a surgeon after entering the Operation Theatre or OT, is studying the patient and their clinical account. The initial patient observation is based on visual perception; this helps us gather general overview about the patients health such as state of consciousness, breathing pattern, pigmentation, and body temperature (Yentis et al. 2009). More importantly, post-operative survival rate depends on the initial assessment of the distressed patients before operation (McFadyen et al. 2012). If this issue arises, the change of pigmentation and body temperature of the affected area will signify blockage of blood circulation to the limb, as a result, the patients pulse could be checked accordingly. The Royal College of Nursing RCN recommends that, OT surgeons and nursing staffs should be skilled enough to recognise the ailing patient (Royal College of Nursing RCN 2013). The College of Operation Department Practitioners CODP states that surgeons play an important role in analyzing, devising and delivering the services required in an OT. Observation of a recognizable bruise on the head of a patient should be considered as a possible brain injury from trauma and the patient should be subjected to CT scan immediately. The recommendation provided by National Institute for Health and Care Excellence (NICE 2014) states that it is the duty of the OT surgeon to make sure that the scan is thoroughly completed and make further observation to check for abnormalities like; dizziness, memory-loss, spasm to detect any potential head injury or major/minor skull rupture, and report immediately. The TBI patient should be subjected to clinical observation for at least 2 days post damage and monitoring for blood and intracranial pressure is important. Association of Paediatric Anaesthetists of Great Britain and Ireland recommends that if the pre-operational vaccine was not activated the surgery should be postponed for 48 hours after the administration of the vaccine, for which it is essential to check the immunisation history (APAGBI 2007). The British Medical Association (BMA) suggests that the consent form is to be passed on to only the person who signed the form in the reception desk (BMA 2000). Adolescent and underage patients who are unable to sign the consent form should be accompanied by a parent or guardian who can responsibly sign on behalf of them, as recommended by the National Health Services (NHS). In case of separated parents, the custodial parent or the parent with a legal permission or either parents legal partner may have the ability to sign the consent form on behalf of the minor, according to the norms of the Department of Health (DH 2006). The patient if in case is a minor, using the Gillick competency assessment can be analyzed whether he is consciously mature enough to understand the severity of his condition and consequences of the surgery (Griffith 2013). In the given case the patient seems to be in distress and indifferent to the surrounding and succumbed to crying which may oppose the Gillick competency. Fasting time before the surgery is an important issue in emergency cases which is to be taken seriously and reviewed with the respondent nurse in the respective department. This step is important to avoid the ascending of digestive materials during anaesthetic conditions. (Maltby 2006). It is recommended by the Association of Anaesthetists of Great Britain and Ireland AAGBI (2010) the individual healthcare facilities should have their own policies regarding Fasting time. According to RCN, medications prior to operation do not react with the fasting recommendations. Even in cases with children with supra-condylar fracture issues are recommended fasting (RCN 2005). A survey on 399 children with supra-condylar fracture surgery was studied and found that delay in surgery due to fasting did not complicate the outcome of the surgery in any way (Larson et al. 2013). Nevertheless, the research team suggests more in depth study that will establish the beneficial effects of intervention during supra-condylar fracture surgery. A different controlled study performed by Kronner and his has reflected postponement of supra-condylar fracture surgery in minors did not affect the outcome of the procedure (Kronner et al. 2013). Nowadays, practitioners administer fasting time, approximately 18 hours before the surgery (Absug and Herman 2012). Engagement with patient and their family is essential after the patient is checked into the OT. Self introduction is important to ensure effective communication with the patient party (Health and Care Professions Council HCPC 2012). Decreasing the preoperative nervousness of minor patients is important and surgeons should effectively communicate to ensure that (Murphy and Taylor 1999). Parents of the minor undergoing surgery should be informed about the surgery, the type of anaesthesia administered and the post operational pain treatment that will be commenced. Some minors show high levels anxiety and demoralised condition before surgery (Li and Lopez 2006). Details of the anaesthetic procedure, pain of the surgery should be kept from the minor as they show signs of anxiety and the family will be in distress (Smith and Callery 2005). Attractive informative flyers can be handed out to them. In the given case, since the minor is under stress, sympathetic engagement is important to assess his condition. Effective communication engagement is an important skill possessed by nurses and practitioners to make sure that patient and his family does not succumb to pain and address any issue immediately (RCN 2012). The biological parents were absent in case of the minors surgery, the severity of the childs outcome could not be foretold. Support from the parents or guardians during surgery should always be encouraged. If such situation is faced where the parents are unavailable, a staff should be assigned to the minor at all times to distract the child from anxiety or meet their needs (RCN 2011). The minor is this case, as directed by the mothers partner had fallen from a slide, showed multiple bruises and scars apart from his injury, which raises suspicion of physical abuse. Professional and moral duties of the surgeon prohibit them to take legal actions in these cases (HCPC 2012) , but the assigned doctor can express concern or query if deemed necessary and a team of doctors can be consulted for this case and a vigilant nursing staff should be assigned to the minor to ensure child protection by the Royal College of Paediatric and Child Health (RCPH 2008). Local authorities can be informed so that evaluation of the childs suspected abuse can be done and commence legal action under the child protection act (Working Together to Safeguard Children 2010). Protection of the welfare and health of the possibly abused minor is recommended by the Royal College of Anaesthetists (RCOA) and Anaesthetists of Great Britain and Ireland (APAGBI) in 2010. Intra-operational Paediatric care: The injury treatment procedure of supra-condylar fracture in case of trauma care patient is important segments to be considered, starting from anaesthesia, pain managing, homeostatic stability, and breathing control for minors (McFadyen et al. 2012). All required equipments should be made ready before the administration of anaesthesia to the minor (Gwinnutt 2008). Patient safety can be ensured by controlling the breathing of the minor during anaesthesia (Benumof and Klock 2007). Depending on the anatomy of the minor the surgeon should prepare various breathing device to avoid troubles during intubation (Finucane et al. 2011). The most common breathing device used for minors are Non-cuffed Endotracheal Tubes (ETT). Emergency drugs like atropine or succinyl-choline should be kept ready beforehand. In case, the child shows reluctant intravascular access, the anaesthesia can be administered through inhalation. Short trachea in children may hinder auscultation, which is why checking the p osition of the ETT is important (Hagberg et al. 2007). Accidental displacement of the ETT can be avoided by immobilising the tube (Hagberg et al. 2007). A newer approach to breathing management is rapid sequence intubation (RSI), utilizing a step by step approach to preparation, sedation, and paralysis which substantially minimizes patients consciousness (Ahcmedia.com 2014). There are three steps involved in Pain management: pre, intra, and post operative methods. Using pain management and assessing tools is important to evaluate the severity of the pain (APAGBI 2012). Lowering of the anxiousness and inhibiting the health deterioration of the minor is important in managing pain. Immobilizing or relaxing the minor can be effective in pain managing service. The response towards pain varies with every child, which makes it difficult to evaluate. The different tools for Pain assessment are implemented, like Face, Legs, Activity, cry, and Consolability (FLACC) used for children under 7 and above 2 years (McFadyen et al. 2012). Preoperative pain scales are also used in cases where the minor is unable to express the severity of the pain. This form of patient service is offered at the emergency unit by distracting the child with playing materials and non-clinical techniques, like showing an animated movie. Administration of analgesics and non-steroidal anti-inflammatory drugs (NSAIDs) reduce chances of opioid based medicines (APAGBI 2012). Blocking the peripheral nerves is an effective method to reduce pain. Marinating the homeostatic stability of the minor is essential and can be administered by controlling the fluid intake and temperature control in OT (Vincent et al. 2011). Loss of blood from the injured area can be inhibited to ensure blo od volume of the patient is up to threshold limit. Recommendations from APAGBI show that hypotonic fluids prepared with 4% dextrose and 0.18% salt is effective in such conditions (APAGBI 2007). The preferred solutions for intra operative fluid administration are isotonic solutions and Ringers Lactate (Vincent et al. 2011). Observations should be made if patient seems dehydrated and the issue is solved by checking vital signs (APAGBI 2010). Thermal regulations and management policies are provided to healthcare facilities which can be addressed in these cases to maintain the temperature (Bernardo et al. 1999). Administrator of anaesthesia should skilled enough to understand the clinical symptoms the minor may exude. The assigned nurse or doctor should be prepared to administer thermal heating tools, fluid and blood channelling conditions. If any such situation arises, pair-huggers, warming mattresses should be provided to avoid hypothermic conditions. Pain Management: According to the Guidelines of RCN, scheduled check-ups should contain a separate pain assessing segment to ensure that the child is properly diagnosed. The faces scale technique can be utilised to evaluate the pain of a child less than 7 years of age in the room where they recover (RCN 2009). A recent practice common amongst paediatric practitioners is using the cream for anaesthesia, like EMLA before administering intravenous cannula (Debeer and Lockie 2008). Analgesic medicines should be kept close in case of emergency during surgical procedure (Howard 2008). Generally, using opioid and NSAID based pain relief medicines are administered after the completion of the surgery (Howard 2008). A brachial plexus block method can be implemented to lower the pain levels and stress after surgery (Fiadjoe et al. 2013). A secondary, intraclavicular instead of supraclavicular block can be carried out (Marhofer et al. 2008). Children with a case of nerve blocks in the periphery, ultrasound guidance shloud be implemented so that post operative complication are lowered and patient safety is ensured (Fiadjoe et al. 2013). The Psychosocial Care of Children in Hospital: Separate setting for adults and children is recommended by the Royal College of Surgeons of England (RCSE 2007). It is important to set up the care facility and provide services, both according to the need of the child as well as their family (Department of Health 2003). The NHS has framed a set of guidelines to follow during such situations. Interdepartmental as well as inter agency connection is important to maintain the working flow of the care facility, if such issue arises where the child may need help from social work organizations. The child health unit of the care facility is expected to have the best possible service (RCSE 2007), where presence of minimum one assigned nursing staff at all times. Since I am an OPD myself, my paediatric training is limited to a certain extent, but fluency of information among the patient, assigned doctors, nurses and their family is very important to avoid confusion and child harming. Children are better provided age appropriate information for protection (Cunnington 2008). Parents or guardians are allowed to stay with the minor patient in the anaesthesia and recovery room (RCSE 2007). Studies have shown many psychological recompense when a parent or guardian is allowed to reside with the child patient instead of allowing them to visit at scheduled timings (Priddis and Shields 2011). Children have shown symptoms of anxiety and distress in absence of their closed ones with regards to the Attachment theory. Presence of a figure that the children are attached to makes them feel safe, this practice should be allowed (Priddis and Shields 2011). If the mother is unavailable, then the person who is second closest to the child should be allowed. Analysis of various research articles have shown the different psychological responses a child exudes after admission into the hospital are segregated in two three broad categories: ecological (family and hospital atmosphere), biological (sex, personality, clinical symptoms) and lastly development and cognitive functions (brain development, previous incident and coping mechanism). Studies have shown the importance of survival mechanism and plan of action that children utilize in the daily life to deal with stress is correlated with the genetic traits that define a childs character, like vigilant-active or avoidant-reactive (Vessey 2003). Similar survival instincts are seen when a child is ill and ailing (Ryan and Wenger 1996). Therefore, it is essential to gather knowledge about the childs survival instincts from previous experiences. Legal and Ethical Issues: The case study provided is an example of typical injury occurring from falling down from a height in children (Kemp et al. 2008). The problem is that the child has visible bruises and scars that are a result of possible physical maltreatment. In terms of ethics, beyond medical qualification, the safety of a child overrides, professional boundaries (RCPCH 2007). It the responsibility of the assigned healthcare staff to ensure that the child is safeguarded in the hospital premises (RCPCH 2010). In case of the given case study it is advised to contact a local child protection or social working organization , who may be able to provide the child proper protection they require (NHS 2012). The intercollegiate safeguard guidelines, state that assigned nurses and doctors are expected to provide level 2 competence (RCPCH 2010). These guidelines included state, recognition of signs of child abuse and reporting that incident to a higher authority and keeping written account of the incident to help with potential police investigative procedure. Clear distinction between assumption and clinical proof is important in this case. Intuitive conclusions should be taken without any proof of the incidence and every person should be held accountable without guilt during investigative procedure. A senior with level 3 expertise should be contacted for advice regarding the matter (RCA 2012). Proof of hypothesis should be investigated without relying on visual observations and the child can be questioned to make a statement regarding the truth of the issue. In case the child needs to make a statement, the responsible parent of guardian must be informed to gather their consent. The case c an be taken to the local police station or court depending on the childs statement to take legal action (RCPCH 2007). Consent of the parent should always be collected in both cases on emergency and non-emergency (Department of Health Social Services and Public Safety 2003). If the above mentioned Gillick competence method fails to prove the childs mental maturity, the child cannot provide consent for themselves (Department of Health Social Services and Public Safety 2003). In case of absence of biologiocal parents of the child, the legal partner cannot provide consent on behalf of the child without legal permission; in this case, the biological mothers partner. In case where the delay in operation is predicted either of the biological parents needs to be contacted as soon as possible. Protection of privacy and confidentiality is a duty of the assigned medical practitioner and information should be withheld from unknown parties, unless a case demands legal action or investigation with respect to the childs safety and well being (RCPCH 2007).