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For a corporation to carry on successfully there is a need for an effective human resource department as one of the principles of health system inputs. It develops the strategies of improving the overall quality of care in the hospital and re-examining the corporate culture of the organization. This can occur through defining the values, behaviors and the characteristics of the needed culture of the organization.

HR plays a role of empowering employees by designing new models of care to facilitate team building amongst the nursing staff, which enables the employees to attain a high-quality work in the work place. The HR department also plays a role in employee investment. This can be assisting employees to either market themselves or pursue employment opportunities (Brunstein, 1995).

They also deal with performance management in that, they make the nursing staff accountable to their work given which eventually reward them in persons or team performance. In the case of negligence by the staff, acting against the ethical rules of health care the HR takes a disciplinary measure.

HR department also helps in job analysis. This comprises the determination of skills and experience necessary in adequately perform a certain job. In doing all this, it provides support for management when dealing with an employee's issues and disciplinary. Barrier to communication in a health care organization, ways of overcoming these barriers and the reason of the effectiveness of these ways

Communication being the key feature in the interaction of the patient with the nursing staff, there is still some hindrances to its effectiveness. One of these hindrances is a language barrier. This is due to the growing diversity in the nation's need for more health care providers and corporation into contact with patients with different languages. This will remain to be a barrier as long as we seek health care providers from many nations with different languages and meet with different patient globally.

Another barrier is the cultural barriers-the perspective of sickness and the medical care offered to the patient. This can be eradicated by training the people on the various kinds of sicknesses and how to treat them. This can be effected since the trainers can use a language understandable to the people also they can reach their vicinity (Edge,1994)..

The dynamism in the health information technology is another barrier whereby hospital workers are becoming more reliant on high-tech devices and less on written communication. According to National Center of Policy Analysis (NCPA), health information systems can intensify problems when an electronic medical record contains false information relied upon by nursing staff. This can be overcome by training the nursing staff on how to use technology in term of seeking the understanding of the various treatments (Pozgar, (2005)

Communication management procedure is also another barrier, which is, stipulated mostly in the nurse-to-patient ratio in a health-care environment. In this way, communication practices can be improved by providing guidelines and basic terminologies booklet to patients which is effective as the patient will read them and follow the instructions given.

Did the hospital violate the rights and responsibilities of the nurse

The hospital did not breach the right and responsibilities of the nurse. According to the nurse practice act, it defines and limits the practice and determining what constitutes unauthorized practices of nursing. In this case, the nurse should not have ordered the change of the physician before the response of the other physician. However, the family members have no legal authority to make decisions unless legally appointed.

The ethical issues in this case

Confidentiality and autonomy. In this case, the nurse should not have revealed the all information to the family of the patient. Consent and capacity.-according to the patient bill of right of the American hospital association "a patient has the right to be informed of his or her medical consequences and the decision of the way forward of the treatment." Therefore, the nurse was right in the decision she made since the physician did not report on the calls.

Issues and roles of ethical committee

Serve as channels of communication from the front-line experience to the rear line of decision-making. They should have made decision either remove the respiratory or not.

They also provide a forum for the disciplinary actions towards Barry the son for breaking the ethics of the father's treatment (Frolik, (1999).

Ethical dilemmas in the case

Ethical dilemmas related to this situation include such questions like; whether it was right for the son to decide the treatment of the father even when  the treatment benefits has been proven; whether the son was fully competent when he rejected the treatment; whether the family has a right to ask for treatment against the patient's wishes; etc.

Pros and cons of employment-at-will doctrine

Prons- It is advantages in a way that it benefits the employees in that they can quit or bargain any time if a better offer comes their way. It also makes employer much more willing to take a chance on a new hire (Edge, 1994). It also benefits the employer in that they can get rid of employees who are less productive.

Cons - the main con is that most employees came to depend more on the job. Also for employers, it brings problems in that they invest so much on employee training and education. An employee may also start performing poorly due to a lot of reluctance.

Circumstance where an ethical committee serves as legal guardian

According to Frolik (1999) a committee serves as legal guardian where a decision is to be made between the patient and there clinicians if the patient is not a competent adult. They also serve to a situation where they assist the patient in coming up with the best options to meet for patients goal for care. They also assist in promoting fair policies and procedures in maximizing the likelihood of the patient -centered outcome.

Pros and cons of an ethic committee serving as patient's guardian

Pros-the committee can provide emergencies in which patient's protection in providing life -sustaining care. In the case where the patient is mentally impaired, the committee can provide informed decisions (Edge, 1994).

Cons- the committee may have no relationship with patients and would simply provide an opinion about the quality of life based on their own ideas. They can also fail to disclose a foreseeable risk that could have been dealt with.

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