Narrative essay

Whenever I think of the incident that transpired on that particular Thursday afternoon, I get a nasty feeling about the challenges of working as a respiratory therapist. Is it that all the health care practitioners should have a calling to their work or should work as a profession? As a respiratory therapist, I usually work in the intensive care and the operating rooms, but I also engage in the outpatient activities. I am a specialist and an educator in the fields of cardiology and pulmonology. Most of the patients I attend to are in the ICU and the emergency departments struggling for their lives. At times, I manage the pre-hospital and the hospital to hospital patient transport by air or by mobile road ambulance. Most of the patients have illnesses ranging from asthma, bronchitis, and emphysema. Other have a heart attack and sleep disorders. On a certain Thursday afternoon late last year, I had one of the many challenges in my line of service.

I reported to work as usual and said a prayer before the start of my daily chores. I attended to several patients having varying illnesses, and most of them had a hope of getting well in due time. I decided to take a short rest during lunch hour after realizing that there were no more patients to attend. However, after few minutes, I received a call from the hospital superintendent that there was an emergency case I required to attend. The details clarified that I had to travel with several nurses to a nearby village to seek what we could do to save the situation. There was a man in his later forties who lived with asthma for a long time. I looked at him in desperation knowing that I could do my best to save the situation though he was in a life-threatening stage. He could not talk, had flared nostrils, his skin was bluish tint from the mouth region and under the fingernails. The man lacked adequate oxygen circulation in the blood stream.

My professional’s values require that I serve to the best of my ability to save lives and restore health. We teamed up with the nurses to address the condition, but our attempts seemed futile. All our first aid attempts failed to change the situation. I instructed the nurses to lay him in the ambulance and rush to the hospital for further treatment. I think that it was a rough day for me since every other attempt to save the man failed. He lost his life as we worked tirelessly to save it. I felt discouraged, guilty, and emotionally disturbed and could not attend to other patients that day. I questioned my work as a respiratory therapist and whether it was a calling or out of influence to study the particular discipline. According to my understanding, such occurrences were inevitable, but some could be saved regardless of their severity. I did not understand why the man could lose his life in the hands of professionals and experts in the field.

It was sad news to the close family members and very challenging to break the same news to the wife who was also ill of another health condition. In some instances, the experiences of healthcare practitioners are hard to relate with though they form part of the daily life. The work of a respiratory therapist is challenging, but the desire to continue improving the quality of life compels me to serve wholeheartedly.

Verifying the variance

Variance shows the change from a particular period to another which can be in months, quarters, or years. According to Garrison, Noreen, and Brewer (2003), variance analysis is necessary when evaluating the financial statements and departmental level budgets for the overall financial health of an organization or department. The calculation of variance helps to establish whether an organization is growing or not and at what rate. Variance analysis provides the management team with concrete information on how to make business decisions that would strengthen the financial position of an organization (Garrison, Noreen & Brewer, 2003). The Northeast Health System appears stable in various financial aspects but with normal changes between 2010 and 2011. The health system income statement shows that there was a decrease in the total unrestricted revenue and support in 2011 as compared to 2010 though the total expenses reduced from 2010 to 2011. However, the changes in unrestricted net assets show that year 2011 ended with negative (-) changes as compared to 2010 probably due to huge pension and post-retirement remittances in 2011.

From the variances data obtained, the major positive variances between 2010 and 2011 are observed in cash and cash equivalents (41.3), excess of revenue and gains over expenses (223), net assets from restrictions of purchase of property (68.3), and pension and post-retirement related adjustments (390.3). The significant negative variances are observed in prepaid expenses and other current assets (-87.9), non-operating gains (-197.4), change in net unrealized gains and losses on investments (-170.9), total other changes in unrestricted net assets (-578.1), and a decrease in unrestricted net assets (-283.6). The variances show that there were significant differences in particular aspects of the financials of Northeast Health System both positive and negative.

According to the proportional allocation analysis data, the most significant positive proportions are net patient service revenue for both 2010 and 2011[98.0 (2011); 97.7 (2010], income from operations in 2011 (211.9), change in net unrealized gains and losses on investments in 2011 (167.1), and decrease in unrestricted net assets in 2011 (158.1). The most significant negative proportions from the analysis data are non-operating gains in 2011 (-111.8), and pension and post-retirement related adjustments in 2011 (-76.4).

Most of the financial aspects of Northeast Health System are not heading in the right direction since most of the variances are negative. It shows that the financial health of the firm in 2010 was better than that of 2011. However, the variances in pension and post-retirement related adjustments and excess of revenue and gains over expenses shows that there were more expenses on the two items in 2011 than 2010. Regarding the firm liabilities, the changes were not significant that showed a level of stability. The firm’s assets appear to be on a downfall trend which reveals of some losses or depreciation. For the proportion allocation analysis, it is evident that unrestricted revenues and support decreased in 2011 as compared to 2010, total expenses also reduced in 2011 thereby making the gains over expenses to increase in 2011 as compared to 2010. The major problem experienced in 2011 was the increase in pension and postretirement adjustments as well as fluctuations in unrealized gains and losses on investments.

I would recommend certain actions to the Northeast Health System regarding decreasing or increasing the significant variances and proportional allocations. First is to reduce the accrued wages and vacation payable, the accrued pension liability, and professional liability reserves. The Health facility ought to diversify on the mechanisms of revenue generation to ensure there is an increase in cash flow. The allocations for pension and post-retirement adjustments ought to be controlled to avoid the rapid changes in unrestricted net assets.

Italian language and culture

THREE WORKS BY ANDREA PALLADIO
Andrea Palladio is among the foremost architects of his time. His works helped to change the face of the Renaissance architecture despite working during a time when the Council of tent aimed at reforming the religious architectures as per the Protestant Reform criticism as well as criticism from with the church itself. Thus, Palladio’s architectural designs were limited to a large extent. One of his work was the Basilica di San Pietro di Castello in Venice which was publicly commission buildings. Basilica di San Pietro di Castello is a building that dates from the 16th century. It was the cathedral church of the city. Andrea Palladio was nominated to provide ideas for additions and alterations of the prominent early architects of Venice. His work was to rebuild the interior and faced of St Pietro. The church has a large dome showing the ecclesiastical importance of the church. The drum supports the dome with rectangular windows for letting in light. The interior has a large nave at the central with Latin aisle. There is a transept crossing the church separating the presbytery from the navel.

However, few years later he was commissioned to construct a private chapel for the Barbaro brothers who became his central opportunity of having a perfect plan of the church. Tempietto Barbaro is, therefore, his most crucial work that is a vehicle for discussing his other entire central plan and understanding the theories of architectural planning during the Renaissance. The Barbaro brothers were the Venetian aristocrats prominent for their goal of establishing a humanistic society and educated in humanistic educations. The final architectural work was a product of Palladio’s and Marcantonio Barbaro ideas. The church’s location at the Barbaro estate bounded in the village of the Maser. Its primary purpose was to become a private chapel for the function of the village parish and the Barbaro (Figure 1). The churches plan design is from the Greek cross but in a smaller version of the chapel. It has a semi-circular dome and four arms (Figure 2).

The construction’s facade transports the viewer immediately to the Pantheon in Rome, with its portion and pediment fronting the great dome. There is minimal extravagant ornamentation inside the church. It has no paintings but white walls; the decorations comprise of the statuary. The function of the church to become the village parish was secondary to its purpose of being the Marc’antonio and his family mortuary chapel. Therefore, the church is constructed to bring in muted lighting, and its decorations are not over the top There are repeated sets of Corinthian columns within the triumphal arch motif replicated throughout the room (Weissmuller, 2007).

Il Redentore is another work by Palladio has the Aedicules that feature on the walls encrypted with the Barbaros’ patron saints pictures. The Il Redentore was Palladio’s idyllic church that he has always had in his mind. Palladio’s ideas and thought in designing the Il Redentore had their way in planning for the Tempietto Barbaro. Each feature in Il Redentore is well elevated showing the steps leading to the front entrance. The Il Redentore is a square shape outwardly but the inside there is a faint Greek cross plan that is more pronounced that the Tempietto. The front features of Il Redentore comprise of four engaged columns that are Tempiettos temple front. In general, the initial ideas that Palladio conceived for the Il Redentore were revived and rejuvenated in the construction of Tempietto Barbaro (Weismuller, 2007).

Other architects and their importance
Girolamo Savonarola was a friar Dominican, who preached in Florence in the Renaissance period. His preaching was to seek both political and spiritual reform. Savonarola preached against the materialistic lifestyle of Florence, which was the great center of literature, architecture, and Renaissance art. Sandro Botticelli during his time produced many volumes of paintings and drawings such as the ‘Divine Comedy’ manuscript by Dante. With Botticelli’s work were mainly church related.

For instance, the Adoration of the Magi’ (c.1481) provides heavy details with well elaborated architectural representations and expressive set of figures within religious contexts. He had a good reputation in religious art and was invited to work in decorating the Sistine Chapel in Vatican. By the turn of the century, he had readopted the Gothic principle and abandoned modern architecture in place of rural elements for framing subjects.

The Scrovegni Chapel Giotto di Bandon’s masterwork that he completed in 1305 in Padua, Italy for the Enrich Scrovegni family. The forgoes that adorn the ceilings and walls of the chapel relate to an emotional and complex narrative of the lives of Jesus and Mary. The narrative outlook forms the genius aspect of this chapel. Bandon’s settings and themes are exclusively religious as seen in the ionic scenes that depict Jesus, Mary, and Joachim.

Scrovegni Chapel

Leon Battista Alberti in 1435 gave the first theory about the modern day linear perspective ion his book the painting. This new system has a major impact on measurements in paintings to many artists after 1435. The artist created a floor on the ground of the painting and drew another receding grid to guide the reflective scale on other elements in the picture. It was the first step that painting was not just for the purpose of God’s glorifications as it was the case of the Medieval Europe. Instead, painting during the Renaissance was for the people looking at the painting.