Wednesday, November 27, 2019

PMS Defense essays

PMS Defense essays The question has been posed, What characteristics of employees, other than those explicitly covered by the Americans with Disabilities Act, can employers consider when hiring, firing, or promoting employees?. This is a question that has become critical to answer, as ADA claims exceeded 91,000 in number between 1992 and 1997. Of these claims, the agency discovered reasonable cause to believe that discrimination occurred in only 3.1% of the cases. Many of these claims were built on seemingly weak foundations. Actual cases of discrimination have been brought (and denied) on claims of disability due to myopia, body odor, infertility, and anxiety brought on by admonishment from a supervisor. Considering the costs of defending oneself against a claim, how likely are firms to capitulate to the specter of impropriety? Put another way, even if a firm believes that a candidate for hiring or promotion is not qualified for advancement, is the possibility of the candidate raising issue under the ADA enough to scare the company into selecting them? This question becomes even more convoluted when the malady in question is a legitimately recognized disability, but is itself an offshoot of some other syndrome. Pre-menstrual syndrome (PMS) affects nearly all women at some point during their reproductive years. Fifty percent of women suffer from PMS regularly throughout their lives, and as many as 10% of women seek medical help to alleviate the symptoms of PMS. While the question of whether or not PMS is disabling is a contestable topic, the symptoms of PMS are widely accepted as having a debilitating effect on ones life functions. These symptoms range from headaches and insomnia to irritability and fatigue and their negative affect on ones ability to work at peak performance seems to be a reasonable inference. You will have to search under many rocks to find a company that will disc ...

Saturday, November 23, 2019

Risk management and the identification and analysis of risk The WritePass Journal

Risk management and the identification and analysis of risk INTRODUCTION Risk management and the identification and analysis of risk INTRODUCTIONImportance of risk managementCauses of pressure ulcerPressure ulcer gradingPrevalence and IncidenceCost of pressure ulcersIdentification and Assessment of riskNorton scaleStrengths and Limitations of Norton ScaleBraden scaleConclusionBibliographyRelated INTRODUCTION Risk management is the identification and analysis of risk. This leads to planning and implementation of control measures which may be physical, clinical, financial or cultural. The intended objective or aim being to eliminate, reduce or transfer risk. (Wilson.J. and Tingle.J. ed (1999)). Risk is defined as the possibility of incurring misfortune or loss and may be associated with patients, visitors and staff. It may also be associated with buildings and estate, equipment and consumables, systems and management. (Dobos C (1992)). Alaszewski et al (1998) a social scientist defines risk as the possibility that a given course of action will not achieve its desired and intended outcome and that some undesired and undesirable situation will develop instead. In the case of pressure ulcers, the nurses’ objective is to prevent them or stopping them from deteriorating any further. To do this there is need to identify the best assessment tool that can identify those that are at risk. With several assessment tools out there, there is need to identify a tool that is able to measure what it is supposed to measure and more accurately. (Dougherty et al 2008) Importance of risk management All organizations, public or private, large or small, do regularly face internal and external uncertainties that affect their ability to achieve their objectives. Effective implementation of risk management can help Organizations improve their chances of survival and success. Risk management encourages organizations to rely on proactive management to promote high quality care; deal effectively with opportunities and threats; comply with regulatory requirements. It also encourages them to improve on mandatory and voluntary reporting; improve on governance; encourage stakeholder confidence and trust; enhance strategic planning; minimize financial, environmental and safety losses; and improve on organizational resilience and performance. (Shortreed ,2010:p 8 ).There is little evidence though which testifies that   risk management reduces litigation, controls or reduces the incidence of adverse events or produces improvements in quality of care (Walshe and Deneen 1998.p 12-3). Risk management    is a fundamental element of the nurse’s role which is expected to lead to health and safety promotion of the members of the team and the patients with whom they come into contact. Pieces of legislation like the Health and Safety at Work Act 1974, The Management of Health and Safety at Work Regulations 1999 and Mental Health Act 1983. Also Human Rights Act 1998, Data protection Act 1998 and Mental Capacity Act 2005 do support the need for risk management. Patient safety in particular has been placed high on the Government’s agenda, the focus of guideline documents including ‘Organization with a memory’ (DH, 2000), ‘Building a safer NHS for patients’ (DH, 2001) and ‘Doing less harm’ (DOH and NPSA 2001). Also ‘Learning from Bristol’ (DOH 2002), ‘Design for Patient Safety’ DOH 2005, ‘Safety First’ (DH, 2006) and in ‘The operating framework for the NHS in England 2009/10à ¢â‚¬â„¢ (DH 2008), do give patient safety top priority. The NHS Plan reiterates the need for risk management by mentioning that all health organizations now have a statutory duty of quality and a responsibility to reduce the number of mistakes. (Department of Health, 2000). In the case of pressure ulcers it is the duty of the nurses to make sure that they are prevented and research shows that it is possible in 95% of the time (Waterlow 2005). Causes of pressure ulcer Pressure ulcers, are commonly referred to as pressure sores, bed sores, pressure damage, and pressure injuries. They are areas of localised damage to the skin, which can extend to underlying structures such as muscle and bone. Damage is believed to be caused by a combination of factors including pressure, shear forces, friction and moisture .EPUAP (2009) Pressure ulcers can develop in any area of the body. In adults damage usually occurs over bony prominences, such as the sacrum. (Dougherty et al 2008). People who are more prone to ulcers are those in most cases with the following intrinsic risk factors namely reduced mobility increasing age, incontinence, poor nutritional intake/dehydration, acute, terminal or chronic illness, neurological deficit, poor oxygen supply to the tissues, diabetes ,obesity/reduced body weight, sepsis/pyrexia, mental state/depression, medication .(NICE 2003). In community the changes in health environment and demographic set up have further compounded the problem of pressure ulcers as the health service changes have led to more patients being discharged earlier from acute care into the community. This, together with demographic changes, has given rise to increasing numbers of immobile elderly patients being cared for by the already short staffed community nursing staff. (Chaloner et al 1999.p 1142) Pressure ulcer grading EPUAP (2009) came up with four Category/Stages in grading pressure ulcers. Stage I pressure sore is a Non-blanchable erythema intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible blanching; its color may differ from the surrounding area. The area may be painful, firm, soft, warmer or cooler as compared to the rest of the tissue. Category I may be difficult to detect in Individuals with dark skin tones. In risk management this category is usually a sign that the patient is at risk of pressure sores. Category/Stage 2 presents clinically as an abrasion or blister. It is a partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled or sero-sanginous filled blister. This category is sometimes confused with tape burns, incontinence associated dermatitis, maceration or excoriation. Category Stage 3 is superficial lesions.   Subcutaneous fat may be visible but bone, tendon or muscle is not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunnelling. The depth of the pressure sore depends on the location of the ulcer. Category/Stage 4 results in full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar   Ã‚  may be present. Often includes undermining and tunneling. The depth of a Category/Stage 4 pressure ulcer just like stage three varies by anatomical location. They can extend into muscle and/or supporting structures. Bone and muscle is left exposed. Prevalence and Incidence It is estimated that approximate pressure ulcer prevalence is 6.7% of the UK patient population (DH 1992). Kaltenthaler, E et al (2001) reviewed sixty research papers that were written between 1980 and 1997 and a few before 1980. In the review they were able to establish that Prevalence reported for hospitals in the UK ranged from 5.1to 32.1%.The range for community settings was 4.4 to 6.8% and that for nursing homes was 4.6 to 7.5%.The highest reported prevalence was 37% for a palliative care unit. Incidence reported for hospitals in the UK ranged from 2.2% per annum to 29% over a maximum period of six weeks. Only one study, which included patients who were bedfast and chair fast, was reported for community settings giving an estimate of 20% over a maximum period of six weeks. No incidence studies were found for nursing homes. The highest reported incidence was for older patients with hip fractures which was 66% over an 18-month period. There were discrepancies   in measuring prev alence and incidence which can affect the findings, namely, substitution of incidence for prevalence in analysis,   use of different classification systems, under-reporting of pressure ulcers on transfer from different care facilities, overestimation of prevalence data by not taking case-mix into account, use of pressure ulcers as a measurement of quality, causing under-reporting, use of different study designs (prospective versus retrospective, observation versus chart review). (Sternberg, J. (1989.p 50). Moffatt, and Franks (1997:p.96-105) came to the conclusion that prevalence in community may be higher than stated since it is difficult to gain all information about patients in community. Cost of pressure ulcers The total cost of pressure ulcer care in the UK is said to be between  £1.4 billion– £2.1 billion which constitute four percent of total NHS expenditure. More than ninety percent of the cost of treatment is the cost of nurse time. (Bennett et al 2004). Modern dressings accounted for eighty million pounds worth of sales and traditional (dry, gauze based) dressings accounted for twenty one million pounds in the UK in 1999 (Russell, 2000). This can be divided into hospital (fourteen million pounds, six million pounds) and community (sixty four million pounds, fifteen million pounds for the modern and traditional respectively (Dealey, 1994). Patients in the UK are increasingly aware of their political clout and litigation against the NHS when it delivers below expectation is becoming a common occurrence (Walshe and Deneen 1998.p 9-10). The NHS receives around ten thousand new claims for clinical negligence annually, and this number is rising (National Audit Office 2001). The t otal annual charge to NHS accounts for settling claims has risen seven-fold since 1995–1996. Relatively few of the current claims relate to pressure damage and in the UK the mean value of settlements in these cases is relatively low compared to other countries like the United States of America (typically less than ten thousand pounds). (Tingle J. 1997.p 757-8). The emotional costs of living with a pressure ulcer are difficult to quantify. What is known is that patients experience pain, dependency, fear of the odor from the ulcer as well as feeling unclean. In a nutshell, negative effects on quality of life are real but impossible to quantify. (Bush 2002.p 34) (Reed et al 2001). All this according to Walshe and Dineen (1998.p 1-37) justifies the case for risk management. Identification and Assessment of risk Part of risk management requires that patients be screened on initial contact and if identified to be at risk of developing pressure ulcers should receive a full assessment of that risk. This is considered best practice. It is also best practice to use evidence based tools and scales in the process. (DH 2010). The rationale for trying to identify those that are at risk of pressure ulcers is that it is cost effective to prevent pressure ulcers than to cure them. This can be achieved considering that up to 95% of the pressure sores are said to be preventable (Waterlow 2005).   Also it is cost effective to catch them early than later ((Touche Ross, 1994). There are a number of tools and scales that have been devised over a long period of time. The most widely used are the Norton (Norton et al, 1962) and Waterlow (Waterlow, 1985.) scales in the UK and the Braden Scale (Braden and Bergstrom, 1988.) in the USA. Although precise figures on the use of these scales is unknown, it is acknowl edged that the Waterlow scale is the most frequently used risk assessment score in the UK ,especially in secondary care and some community setting. In community  Ã‚   in the UK ,The Walsall Community Risk Score Calculator   has been in use for   about twenty years but further research on validity of the tool is needed .(   Chaloner.D.M, and   Franks .P .J. (1999.p 11 42-1156)). The predictive validity of these assessment tools and scales in predicting which patients go on to develop pressure ulcers has   shown that there are clear variation in sensitivity, which means some tools are more effective in identifying and predicting those who are at elevated risk, and   thus may go on to develop a pressure ulcer. (NICE 2005.).Some researchers like Edwards (1996.) do doubt the rationale of applying measures of sensitivity and specificity to the scales when mathematical models were not used in designing them. There is an also ethical issue that arises in testing because it is not possible to have a sample of patients who are at risk who are not receiving intervention, which may have an effect on specificity (Deeks, 1996). Using the development of pressure ulcers as the only criteria for measuring the tools has its own weakness in that it misses those that were at risk but were rescued by good nursing and medical care .Waterlow (1996.)   argues that there is b ound to be statistical fallacy in the use of sensitivity and specificity because conditions never in most cases remain static especially in the face of good or bad   preventive nursing and medical interventions. Norton scale The Norton scale was the first tool used for pressure sore risk prediction, although it was originally intended for use as a research tool for studies in geriatric populations and not as a risk predictor (Norton et al, 1975). The scale contains assessments of general physical condition, mental status, activity, mobility and incontinence.   The Norton Scale is designed to identify the need for preventive pressure care in older hospital patients and aged care home residents.   Each of the five items is scored from 1 to 4, with a maximum total score of 20. Scores of 14 or less rate the patient as at risk of developing pressure sores, the lower the score, the greater the risk. The cut off point for at risk patients was later raised to 15 or 16 by Norton (Norton et al 1985). Strengths and Limitations of Norton Scale The tool has received wide spread criticism. Its simplicity which is supposed to be it strength has been identified as a weakness. The weakness identified is the assessor subjectivity (Dougherty et al 2008). It has been accused of both over predicting and under predicting   patients who are at risk of developing pressure ulcers   especially in patients undergoing surgery or recovering from myocardial infarction (Flanagan, M., 1993.),(Pritchard 1986). According to Bergstrom et al 1987 the Norton scale in his test over predicts by 64% while the Braden scale over predicts by 36%. This over and under predicting can have an effect on the resources that are to be utilized in dealing with the risk. The result may be wastage or use of less than adequate resources. The Norton is said to acknowledge that the tool was not intended as a universal tool, otherwise age and nutrition would have formed part of the criteria (Waterlow 2005). Deeks (1996.) used five separate studies to assess the predictive abilities of the Norton scale.   Three studies reported sensitivities of between 60% and 90% (Norton et al, 1975; Goldstone and Goldstone, 1982; Smith, 1989), one reported a sensitivity of less than 20% (Stotts, 1988), and one only had five patients developing pressure sores (Lincoln et al, 1986) and hence provided a very inaccurate zero estimate. The low sensitivity in this study may be attributed to the fact that it was based on patients who were admitted for an elective surgery and the Norton scores were taken on admission to predict pressure ulcers and the post operative data was not sufficient to come up with a sensible conclusion. On specificity the verdict was that it did vary a lot and variation was between 30% and 95%. All this shows massive inconsistence when it comes to sensitivity and specificity. Waterlow scale The waterlow scale is a popular scale in United Kingdom. It is seen as an improvement on the Norton scale (Heath (1995.p 625).Waterlow (1985) believed that many of the intrinsic factors, such as pain, nutrition, reduced cardiac output and anesthesia, had been omitted from the Norton scale   which had been developed for an elderly population. Consequently, the Waterlow risk-assessment scale was developed in 1984 (Waterlow, 1985) as a comprehensive tool to be used in conjunction with the nursing process. The tool was supposed to help nurses in the medical and surgical setting but not to replace clinical judgment. Unlike other tools which are based on an under taking of data collection, the aim of the tool is to provide guidelines on the selection of preventive aids and equipment as well as on management of established pressure sores. It is also to promote awareness of causes of pressure sores and provide a means to determine risk of pressure ulcer development. (Simpson et al (1997).T he waterlow has six main areas of risks namely build/weight, continence, skin type, mobility, sex/age and appetite. It also alerts the user to tissue malnutrition, neurological deficit, trauma and specific medication. The risk score threshold is 10, with 10-15 being ‘at risk’, 15-20 ‘high risk’, and above 20 being ‘very high risk’. (Dougherty 2008). Strength and limitations of the Waterlow On validity, Thompson (2005.p 455-459) cited Dealey (1989) comparative study of the Waterlow and Norton score. In the assessment of 175 elderly patients the waterlow had ninety eight percent sensitivity, and fourteen percent specificity. The Norton on the hand had had eighty eight percent sensitivity and twenty six percent specificity. The Waterlow was better on sensitivity but no so good on specificity. In another study by Wallard (2000), the waterlow scale was better than the Braden and Norton scale in terms of pressure sore predictive power in a study of 60 patients with spinal cord injuries. The Waterlow scored sixty four percent at high rate and thirty four percent at very high rate. Norton tool scored eighty six percent at no risk, eight percent at risk and two percent at high risk while the Braden scored four percent at no risk, twenty nine percent at low risk, forty six percent at moderate risk and twenty one percent at high risk. This shows that the Waterlow performs well in this group of patients. Although the waterlow scale is popular in UK, Edwards (1996) is skeptical on it’s inter reliability stating that Waterlow herself performed most of the observations during its development. Dealey (1989) in her research in which Student nurses from four wards assessed the same five patients using the Waterlow tool and the Norton tool. The results of that research showed 60% agreement on the Waterlow score and a 70% agreement using the Norton score .Despite this weakness on the part of the Waterlow it still is the most popular scale in UK. Edwards (1995) also assessed its inter-rater reliability using a cross-sectional observational survey of 40 community elderly patients with and without pressure ulcers. To minimize the risk of error, a research assistant with the same level of knowledge and experience participated with the researcher. 25% total agreement was reached and the specific low agreement categories were, mobility, build/weight for height and skin condition, suggesting that the tool is subjective. This means that patients may have received expensive equipment unnecessarily based on such unreliable scores. Waterlow (2005.) is the one to admit that it is a simplistic tool which needs the support of good clinical judgment and advice from the tissue viability nurses for it to be effective. This is true when choosing preventative aids. Also Waterlow (2005) is not confident that it will be effective in other areas other than in hospital and nursing homes were it was designed. This leaves the community and residential home settings with a tool that needs modification. Braden scale The Braden Scale was developed in the 1980s  Ã‚   in the USA for use  Ã‚   in medical and surgical acute units. It was developed following a prospective investigation of risk factors in the development of pressure sores (Moffatt, and Frank, (1997). The Braden scale has been widely utilized in United States of America. It does get backing from the Agency for Health and Research which recommended it for use in predicting pressure sore development in hospital and nursing homes in the United States of America. (Simpson et al (1996.)).Unlike the Norton and the Waterlow scales which assess risk it is a pressure ulcer predictor (Dougherty (2008.)).The Braden scale is a twenty three point instrument composed of six subscales namely sensory perception, moisture, activity, mobility, nutrition, friction, and shear (Heath (1995)) .They are scored from 1 to 4 depending on the severity of the condition except for friction and shear which is scored 1 to 3. The total score is then added up with a range which can go from 6 to 23.The lower the score, the higher the risk of developing a pressure ulcer. (Dougherty et al (2008). Strengths and limitations Unlike other tools the internal ratings of the six categories are supported by assessment guidelines. These guidelines seek to clearly describe the behavior and experience of the patient. The Braden Score has been validated in a number of patient populations (Bergstrom et al 1987 cited by Moffatt, and Frank, (1997)).For example, 99 medical and surgical patients assessed by registered nurses had an agreement between staff 88 per cent of the time. A sensitivity of 100 per cent, a specificity of 90 per cent and a negative predictive value of 100 per cent. A licensed practical nurses study had an agreement in only 19 per cent of 100 patients; sensitivity and negative predictive value were 100 per cent and a specificity of 64 per cent. These shows a poor inter rater reliability even though the prediction value is high. Bergstrom et al (1987) in a further study of 60 adults in intensive care showed a sensitivity of 83 per cent, a specificity of 64 per cent and a negative predictive value o f 85 percent. This shows that the Braden scale has very good sensitivity and reasonable specificity levels in patients in hospital if not better than all the above mentioned tools. In negative specificity it proved that it can identify those that will not end up with pressure sores in medical, surgical and intensive care. (Moffatt, and Frank, (1997).   It has been criticized for being difficult to use in a working environment and that it is still to prove itself in different settings in UK especially in community. (Dougherty (2008) (Simpson et al (1997). The Walsall score The Walsall Community Health Trust undertook to develop a tool for use in patients within the community .The development came about as a result of examining the existing risk scores and evaluating factors which they felt were likely to be important in the development of pressure sores. Each factor was then ascribed a score based on the influence it was felt it had on increasing the risk of pressure ulcer development. The development was based on clinical opinion and not epidemiological evidence to determine risk factors and scoring methods. (Chaloner.D.M and Frank’s .P .J. (1999) The Walsall tool looks at the following, predisposing disease, level of consciousness, mobility, skin condition, nutritional status ,bladder incontinence ,bowel incontinence .These are factors which other tools look at with one exception which makes it more relevant in community where the benefit of the 24 hour nursing care which is provided in hospital does not exist. The exception is the carer input which is particularly relevant to patients being treated in the community where care is intermittent, and often provided by informal carers who may be relatives or friends. Nursing intervention is expected in the following mobility, skin condition, nutritional status, bladder incontinence, bowel incontinence, and carer input categories. (Chaloner.D.M, and Franks .P .J. (1999).The â€Å"Total Risk Scores† determine the category as less than 4 (not at risk), 4 – 9 (low risk), 10 – 14 (medium risk), and 15 and over (high risk). Strengths and limitations All the mentioned tools were developed in hospital in some cases specifically for inpatients and the Walsall is meant specifically for patients in community and residential homes. To assess validity, a cross sectional study of 720 patients in Walsall, was under taken looking at the incidence of pressure damage, despite intervention, over a 12-week period. The study was in two phases. The first phase looked at nine categories which included pain and in the second phase they decided that pain was not relevant in determining pressure sores and left it out. Using ROC curve analysis highest sensitivity after adjustment was 80% with a corresponding specificity of 54%.The original weightings which included pain and predisposing diseases with an equivalent specificity could only achieve a sensitivity of 64 %.( Chaloner.D.M, and Frank’s .P .J. (1999). Although not better than other tools in terms of sensitivity and specificity, this modified tool is the first risk tool, developed specifically for the community environment to be scientifically tested.   It is also yet to be subjected to rigorous tests .Like all risk tools it is not supposed to replace clinical judgment.    Conclusion From the critical analysis of the above mentioned tools the only conclusion is that no single tool is considered reliable for universal use. Also some tools even in their intended areas of use do not always produce consistent result. The only way forward is for areas of care to produce their own hybrid risk assessment tool tailored to specific patient needs. This tool would be used as an ‘aide memoire’ to be used in conjunction with clinical judgment (RCN 2001).   The hybrid risk assessment tool creation to be effective should involve all health professionals, patients and carers. This makes sense because there is need to involve all the professionals and non professionals involved in the care of the patient in identifying risk. These professionals and non professionals should have the full knowledge that failure of one link in the chain of prevention will result in the development of a pressure ulcer. (Simpson et al 1997).    Bibliography Alaszewski A, Harrison L, Manthorpe J (1998) Risk, Health and Welfare: Policies, Strategies and Practice. Open University   Press, Buckingham Andersen KE, Jensen 0, Kvorning SA, Bach E (1982) Prevention of pressure sores by identifying patients at risk. Br MedJ284: 70-1 BENNETT,G.DEALEY,C, POSNETT,J.(2004).The cost of pressure ulcers in the UK. Age and Ageing 2004; 33: 230–235 Braden BJ, Bergstrom N (1988) Clinical utility of the Braden Scale for predicting tissue sore risk. Decubitus 2: 34–8 Braden BJ, Bergstrom N (1994) Predictive validity of the Braden scale for pressure sore risk in a nursing home population. Res Nurs Health 17: 45 9-70 Bush.C.(2002).Investigating the effects of living with a pressure ulcer.Nursing Times 3 september 2002. VOL: 98, ISSUE: 36, P: 34 Chaloner D (1996)   Pressure Damage Prevalence Study. (Report.) Walsall Community Health Trust, West Midlands (data on file; available from author) Chaloner.D.M, and   Franks .P .J.(1999). Validity of the Walsall Community Pressure Sore Risk Calculator. SKIN CARE MANAGEMENT. BRITISH JOURNAL OF NURSING, 1999, VOL 8, NO 17 Dealey C (1994)   The Care of Wounds. Blackwell Scientific, London Deeks. J. J.(1996)Pressure sore prevention: using and evaluating risk assessment tools. British Journal of Nursing  5(5): 313 320 (14 Mar 1996) Department of Health (2000)   The NHS Plan: A Plan for Investment, A Plan for Reform. Cm 4818-1. HMSO, London Department of Health (2007) ‘Best practice in managing risk: principles and guidance for best practice in the assessment and management of risk to staff and others in mental health services’Accessed electronically at dh.gov.uk/en/Publicationsandstatistics/ Publications/ PublicationsPolicyAndGuidance/DH_076511  on 18.04.2011 DoH (1992) The Health of the Nation. London: The Stationary Office Department of Health (2010) Essence of care 2010 : Benchmarks for the fundamental aspects of care. Leeds:The Stationary Office. Accessed at on 17/05/2011 Department of Health (2000) An organisation with a memory. London:   The   Stationery Office. Department of Health (2001) NationalService Framework for Older People.Department of Health: London accessed 16/02/2011. dh.gov.uk/prod_ consum_dh/ groups/dh _ digitalassets/@dh/ @en/ documents/digitalasset/dh_4071283.pdf Department of Health (1999) Saving Lives Our Healthier Nation.   London, The Stationery Office. Department of Health (2003) clinical governance reporting processes. www. doh. gov. uk/ clinicalgovernance/reportingprocesses.htm. Department of Health (2008) ‘The operating framework for the NHS in England 2009/10’ Accessed electronically at dh.gov.uk/en/Publicationsandstatistics/Publications/ Publications PolicyAndGuidance/DH_091445   on 15/03/2011 Department of Health (2006) ‘Safety first: a report for patients, clinicians and healthcare managers’ accesed at Error! Hyperlink reference not valid.   on 16/05/2011 Dobos C (1992) Defining risk from the perspective of nurses in clinical roles. J Adv Nurs 1(7): 1303–9 Dougherty,L., Lister,S.   ed (2008). THE ROYAL MARSDEN   HOSPITAL: Manual of Clinical Nursing Procedures. Student Edition .7th edition.West Sussex:Blackwell publishers. Edwards .M.(1996).Pressure sore risk calculators:Some methodological issues. Journal of Clinical Nursing 5(5):307-12 European Pressure Ulcer Advisory Panel (2009) Pressure Ulcer Treatment Guidelines European Pressure Ulcer Advisory Panel website at epuap.org/ gltreatmen t.html accessed 15/02/2011 Flanagan, M., 1993. Pressure sore risk assessment scales.Journal of Wound Care 2 (3), 162–167 Fox C (2002) Living with a pressure ulcer: a descriptive study of patients’ experiences. Br J Community Nurs 7(6;Suppl):S10–S22 Goldstone, AL., Goldstone, J., 1982. The Norton score: an early warning of pressure sores? Journal of Advanced Nursing 7, 419–426. Heath.H.B.M (1995).Porter and Perry’s Foundation in Nursing Theory and Practice. London :Mosby Halfens RJ,Van Achterberg T, Bal RM (2000) Validity and reliability of the Braden scale and the influence of other risk factors; a multicentre prospective study. Int J Nurs Stud 37(4): 313–19 Kaltenthaler,E. Withfield,M.D.. Walters, S.J .Akehurst, R.L.   Paisley  , S.(2001). UK, USA and Canada: how do their pressure ulcer prevalence and incidence data compare?  .Journal of Wound Care  10(1): 530 535 (Jan 2001) Leyshon  .S.(2005).Principles of risk management in community nursing.  British Journal of Community Nursing  10(7): 330 333 (Jul 2005 Moffatt,C. Frank,P(1997). Pressure sore risk: a challenge in the community  .British Journal of Community Nursing  2(2): 96 105 (Feb 1997) Moore .Z and Cowman .S (2010)Risk assessment tools for the prevention of pressure ulcers.(Review).Copyright  © 2010 The Cochrane Collaboration. Published by JohnWiley Sons, Ltd Morrison.M.J. ed (2001).The Prevention and Treatment of Pressure Ulcers.London:Harcourt Publishers Limited. National Audit Office (2001). Handling Clinical Negligence Claims in England. Report by the Comptroller and Auditor General, HC403 Session 2000–2001. London: Stationery Office, 2001. NICE (2005) The Management of Pressure Ulcers in Primary and Secondary Care. NICE, London .accessed on www.guidance.nice.org.uk/CG29/quickrefguide/pdf/English. Viewed on: 15/03/2011 Norton D, McLaren R, Exton-Smith AN (1962)   An Investigation of Geriatric Nursing Problems in Hospital. Churchill Livingstone, Edinburgh Norton, D., 1996. Calculating the risk: reflections on the Norton Scale. Advances in Wound Care 9 (6), 38–43. Reed.S. and Hambridge.K.(2001). Implementing best practice in pressure ulcer prevention. Nursing Times   14 June 2001. VOL: 97, ISSUE: 24, P: 69. Reid J, Morison M (1994) Towards a consensus classification of pressure sores.   J Wound Care 3(3):157–60 Russell L (2000) Understanding physiology of wound healing and how dressings help.   Br J Nurs 9(1): 10–21 RCN (2001) Pressure Ulcer Prevention.Royal College of Nursing.London. Accessed via NICE:www.nice.org.ukon15/04/2011 Shortreed,J. (2010) Enterprise risk management and ISO 31000. The Journal of Policy Engagement. Volume 2/Number 3 Simpson.A.,Bower. K.,Weir-Hughes.D. (1996)Pressure Sore Prevention. Whurr Publishers. London Sternberg, J.(1989) Prevalence of decubitus ulcers: issues of concern. Decubitus 1989; 2: 2, 50 Tingle J. (1997).Pressure sores: counting the legal cost of nursing neglect. Br J Nurs 1997; 6: 757–8. Thompson.D.(2005). An evaluation of the Waterlow pressure ulcer risk-assessment tool.   British Journal of Nursing  14(8): 455 459 (28 Apr 2005) Touche Ross (1994) Report on the cost of pressure sores to the health service. In: NHS Management Executive. Pressure Sores: A Key Quality Indicator.Department of Health Guidance EL (94)3. Health Publications Unit, Heywood, Lancs Vincent C ed (2001).CLINICAL RISK MANAGEMENT:Enhancing patient safety.2nd edition.London :BMJ Books. Walshe,K. and Dineen,M. (1998).Clinical risk management :making a difference ?. The NHS Confederation. Birmingham UK .Issue date 1998. Waterlow J (1985) Assessing the risk of pressure sores. Nurs Times 81: 48–55 Waterlow J (1996) Pressure sore assessments. Nurs Times 92(29): 53–8 Wilson.J. and Tingle.J. ed (1999).Clinical Risk Modification: A ROUTE TO CLINICAL GOVERNANCE?.Oxford:Butterworth Heinemann.

Thursday, November 21, 2019

Coca-Cola Coffeehouse Essay Example | Topics and Well Written Essays - 750 words

Coca-Cola Coffeehouse - Essay Example In the case of individual consumers, buying decisions are largely driven by the individual's needs, preferences, lifestyle, values, and other things which are innate to the customers. On the other hand, the buying decision process in organizational groups are more complicated, requires more formality, and seeks the approval of a set of decision makers based on the values and goals of the institution (Kotler 2002). In recognition of these various factors, Coca-Cola Coffeehouse will be creating two sets of strategies geared in capturing organizational buyers and individual consumers. Coca-Cola Coffeehouse will be serving organizational buyers like airports, commercial companies, non-governmental organizations and educational institutions. As discussed above, these organizational buyers usually have their own formal procedures in their buying decisions. We have identified three important factors which Coca-Cola Coffeehouse will take into account in order to influence the buying decision process of these institutions: budget allocations; organization's culture and values; and product quality. Organizational buyers, whether profit-making or not, are often very much concerned with the cost of their purchases. Higher costs entail less profit and lower level of financial resources which can be allocated to other projects. Thus, in their buying decision processes, organizations seek proposals from different product providers in order to get an idea on the costs that they will be incurring. If a certain product is homogenous and standardized, organizational buyers will prefer to acquire it from the supplier with the lowest price. In consideration of this, Coca-Cola Coffeehouse will then strive to price its product more competitively than its rivals. An organization is highly influenced by its unique set of values and culture. In their buying decisions, companies always takes into account the image of their suppliers and ensure that it matches theirs. In order to do this, Coca-Cola Coffeehouse will position itself in the market as a drink which stimulates the spirit in order to boost productivity. The ambiance of the Coca-Cola Coffeehouse will also presents a calming and relaxing refuge from office works. Lastly, organizational buyers' transactions are very much dependent on the quality of the product offered. Coca-Cola Coffeehouse will aim to establish relationship with its buyers by maintaining product quality. The company will see to it that it fully delivers its promises. Individual Consumers As mentioned above, individual consumers are largely influenced by their values, needs, wants, preferences, lifestyle, and the opinions of other people. An individual purchases products which further strengthens his or her own set of values and reveals his identity and image. It is irrefutable that individual consumers usually associate a certain product to certain characteristics and qualities. With the wide range of customer in the market, Coca-Cola Coffeehouse will offer coffee products that will carry on the identity and image of its

Wednesday, November 20, 2019

Fixed and floating charges Essay Example | Topics and Well Written Essays - 2000 words

Fixed and floating charges - Essay Example However, on the other hand, companies often tend to offer such collaterals in order to gain relaxations in obtaining debt including reduction in the interest rates as well as margin requirements. Thus providing a security not only has a legal implication but also offer influence to creditors in controlling the future events. However, from the perspective of a firm, the nature and impact of providing assets of the firm as security carry different significance and as such depends largely upon the credit worthiness of the firm. Better a firm has a creditworthiness chances are that the firm will be able to get larger concessions in providing assets as security.2 It is however critical to note that from legal perspectives, the claim or charge of creditors on the assets of the company are created through different charges created over the assets of the firm with relevant regulatory authorities. These charges can be of either floating nature or of fixed nature depending upon the nature of the mutual agreement between both the parties. It is however also important to understand that the significance of floating and fixed charge to both creditors and the firm may be different again depending upon the nature of agreement made between both the parties. There are generally two sources of funds for an organization i.e. equity contribution made by the shareholders of the firm and the funds acquired from external sources such as bank loans and bond issues. Equity issues or equity contribution is the most risky investment because it is clean i.e. shareholders are offered no guarantee or security that their investment will be paid back and as such shareholders have the least claims against the assets of the company in case of its liquidation because all the claims of company’s creditors are settled first and remaining is distributed to the shareholders. On the other hand, debts obtained from various sources such as banks and capital markets are less risky as compared to

Sunday, November 17, 2019

Nissim Ezekiel Treatment of Poetry Essay Example for Free

Nissim Ezekiel Treatment of Poetry Essay Nissim Ezekiel’s poem Enterprise describes a metaphorical journey toward a specific goal. The travelers on this journey begin in a real physical place, a desert, and argue about how to cross this challenging landscape. One of the members of the group, who writes the most stylish prose, goes his own way. The rest of the group is left on its own. Some quit the team. The group is attacked by travelers, and over time become unmoved by anything they witness. Fatigue and the stresses of travel have settled in and many of the members of the group cannot go on. By the fifth stanza, the picture ahead is grim. The enthusiasm has faded and their burdens are heavy. Their vision is clouded with the disintegration of the group and their exhaustion. The well-focused goal presented in the first stanza is lost. The travelers are a disorganized group of aimless wanderers unaware any longer of the original motivation for their expedition. Their observations at this point in the poem are about trivial things. In the last stanza, the travelers reach their destination; however, it is not quite home. Ezekiel concludes that this type of expedition is not a worthy undertaking; living â€Å"at home† with inner satisfaction is the greatest achievement of all. The travelers’ consider their journey and have moments of introspection. They come to the conclusion that their expedition has been neither pioneering or notable for any reason. They had thought their journey would make a mark in history. The only problem is that others have made this journey before. It is nothing new. The journey of â€Å"Enterprise† is a metaphor for life and our focus on the destination as the only means for our goals. Some critics have noted that Ezekiel’s â€Å"Enterprise† is also his attempt to bring together two â€Å"homes†: his place of birth and his journey to a European city. His exploration of the idea of â€Å"home† is sophisticated enough to be compared to the same themes in the poetry of Robert Frost, for example.

Friday, November 15, 2019

Holocaust Rememberance Day :: Free Essays

Then they came for me - and there was no one left to speak for me.   Ã‚  Ã‚  Ã‚  Ã‚  We’ve been taught that it is important to know history so that we can understand and learn from past mistakes and avoid repeating them in the future. On May 2nd, millions of people worldwide will remember the victims of the Holocaust as we observe the Holocaust Remembrance Day.   Ã‚  Ã‚  Ã‚  Ã‚  Holocaust is the term that refers to the tragedy of the World War II, specifically the ethnic cleansing carried out by the Nazis. Counting around 11 million deaths, it is undoubtedly one of the most horrendous crimes committed against humanity. Holocaust encompasses the time period from 1938 to 1945; its victims range from Jews to physically disabled. Singled out as the primary target, the Jewish people suffered around 6 million deaths during the Holocaust, that being nearly 65% of European Jewry. However, they were not the only ones.   Ã‚  Ã‚  Ã‚  Ã‚  Germans sought to really â€Å"cleanse† the human race. They targeted all the people who were somehow different from their â€Å"norms†. 5 million people other than Jews were killed during the Holocaust; these included homosexuals, gypsies, disabled, Jehova’s witnesses and Polish people, the list goes on and on. Asides from all the deaths, Nazis are famous for notorious experiments that they performed on â€Å"lower† races in and outside of their concentration camps. They tore apart families, often making parents watch their children being escorted to the gas chambers. 11 million people fled during the Holocaust, imagine how many lost their families.   Ã‚  Ã‚  Ã‚  Ã‚  On May 2nd you will see black tablecloths and burning candles on them. You can also see some movies and statistics. When you do see this, stop for just a second and think about those 11 million. If anything good can ever come out of the Holocaust, let it be the lesson for future generations. This lesson can be summarized in words of Martin Niemoller, an anti-Nazi German

Tuesday, November 12, 2019

Culinary Arts Essay

Culinary Arts is a broad field that contains many different specializations. Culinary Arts is something that will never go away, you have to eat everyday to live and lead a healthy life. Food as we know is essential for the growth and maintenance of the human body. Culinary Arts enhances your knowledge of life skills and cooking. Being in the Culinary Arts career field you have to have a specific set of skills to make delicious appetizing meals. For example you have to follow safe food handling procedures, learn the dos and don’ts of food safety and sanitation. see more:why do you want to be a chef Learning the proper knife skills is one of the first things you learn in culinary arts; knowing the proper cutting techniques. Something I didn’t know about Culinary Arts was that a Pastry Chef is the number one culinary careers. Pastry Chefs are skilled in the making of pastries, desserts, breads and other baked goods. I Chose Culinary Arts because I always aspired to be a chef since I was a child. I’ve always wanted to start my own restaurant or little bakery to show off my culinary skills. My FootPath) Culinary Arts started off as a work of apprenticeship, daughters would learn recipes from their mothers, and traditional recipes passed on through oral history. The first academic Culinary Arts program was started back in 1800. The Boston Cooking School was emphatically popular drawing a vast amount of international students. The Boston Cooking School was founded by the Woman’s Educational Association of Boston. They started the school to offer instruction in cooking to those who wished to earn their livelihood as cooks, or who would make practical use of such information in their families or business. One of Boston’s most famous students was Fannie Merrit Farmer; she published the world’s first cookbook in 1896. â€Å"The Boston Cooking School Cookbook† which is still a reference book for students of Culinary Arts today. Ernie Kovacs hosted the first televised cooking show â€Å"Deadline for Dinner† (aka â€Å"Dead Lions for Breakfast† as Ernie liked to call it). The show premiered on Monday, March 20, 1950 at 3 pm for a half-hour. The show aired on Mondays, Tuesdays and Fridays. (Broad Casting Pioneers) There are millions of people in this world, but what sets individuals apart from one another, it is our personal qualities and characteristics. We come from different backgrounds. However, everyone has one special quality that makes him or, her a unique individual, different from anyone else. For me it’s my passion for cooking. Most people would not consider cooking a quality, but for me it is. Ever since I was a child, watching my grandmother and my great grandmother cook, they are the ones that gave me aspirations to pursue a career as a chef. With the time and effort they put in the kitchen their food is always delicious. I started out at two years old, going to get my grandmother ingredients and her cooking utensils. As she would measure out her ingredients she would let me pour it into what it was she was cooking. I used to stand on a stool just so I could stir the food as it cooked and sometimes when she wasn’t looking I would try to add my own little ingredients. As I got old around four or five that’s when she taught me how to make simple things such as cereal and milk, peanut butter and jelly sandwiches, and sometimes she would get a little advanced and show me how to make soups, desserts and show me some of her special recipes that she wouldn’t show anyone else. Even though I was to young to make them or remember them I felt special because she shared something special to her that she wouldn’t share with anyone else. I would always be the first person up in the morning climbing on the counters like a little monkey getting the cereal off the top of the refrigerator, and getting a two bowls out of the cupboard just so I could make me and my brother breakfast every morning. I was always there when anyone was cooking in the kitchen; I was very curious, ready to learn something new, and ready to give my assistances to anyone who needed it. My favorite foods to cook till this day is desserts, but anything I could get my hands on to cook I surly would no questions asked. I have a clear vision of my career goals, and after high school I will attend the culinary arts program at the Raleigh-Durham Art Institute. There culinary arts program comprises exactly the skills and tools I need to succeed in becoming a Pastry Chef, and starting my entrepreneurship. Because I am determined and focused, I do not need anything more than the training and education the Art Institutes will provide. I have visited there campus and viewed some of their classes, they have a extraordinary culinary arts program. They focus mainly on cooking; The Art Institute does not waste time on classes that won’t help you excel in life, that’s why I know The Art Institute is the perfect school for me to shine and show off my culinary skills. First, because I know exactly how I want to apply my new skills, I do not need any extraneous courses. The Art Institute program perfectly reflects my own pragmatism and professional sensibility because it is focused and directly related to my goals. Second, I do not want to alter my lifestyle by engaging in a four-year program. I want to incorporate this education into my life seamlessly and smoothly. The Culinary Arts program will allow me to express myself creatively and professionally in the field of my choice. This program offers practical education and training that I can immediately apply to the workplace, preferably as a Pastry-chef in my own restaurant. The Art institute provides a seven-quarter culinary arts program, which prepares their students for various careers in the food industry field. The program includes simulated situations and real-world production applications in the dining lab and in internship environments. The Art Institute focuses on enabling there students to be well-rounded citizens by offering them a few general study classes in the culinary program. The Art Institute has a steep tuition which is 42,570 a year. Apply for financial Aid, and scholarships will cut down the tuition expense. There are also three other fees that include books and digital resources, program fees, and room and board if you plan on living on campus. This all together adds up to a total of 29,410 in addition to the tuition. This is assuming that I would do the four year program in earning my bachelors degree. Even though the expenses are lofty I still aspire to attend The Art Institute. (The Art Institute of Raleigh-Durham) The Art Institute has a career service department that provides assistance in employment, career counseling, and professional development. Their staff helps students and graduates network, cultivate, explore career opportunities, and provides individualized job search assistance. Many students choose to seek part-time employment while they attend school. This employment is an excellent opportunity to make industry contacts while building a portfolio of work. The Art Institute is the all around perfect school, you gain an astounding education, along with individual assistance with finding a job while your attending school, or after you completed the culinary program.

Sunday, November 10, 2019

Our Home and Racist Land Essay

Being one of the most socially developed and multicultural countries in the world everyone probably sees Canada as a Utopian country. Unfortunately Canada isn’t as perfect as everyone thinks it is, and a major persisting issue is racism. Being a multicultural there are many minorities and this usually results in racism, isolation, and unequal treatment amongst everyone. Unfortunately, racism gets more serious and turns into hate crime and that is a federal offence. Racisms not only affects adults at work or on the streets but also affects children in schools and daycare centers as kids are treated differently based on their skin color. We can all imagine that racism has disappeared but in reality we know that it will never leave. Racism is defined as a belief that inherent differences among human race, does that mean that all of us have to be one race in order to eliminate racism in our society? Practically, it is impossible to get rid of racial prejudice. Racism is common amongst the streets of Canada and especially Toronto as we are the most diverse city in Canada. Racism occurs everywhere from schools to workplaces. Even where I volunteer the guy who runs is racist, he is known for only hiring white people as his staff and Hispanic people to do the cleaning. Everywhere we turn we see racism. When a lady crosses the street and sees a person of African descent she will either take a different road or being to walk really fast. This is because we are all racist by habit now. We have been influenced by movies, TV shows, and the media. We are always bombarded by â€Å"20-year old black male wanted for robbery† or â€Å"32 year-old male black wanted for murder† in the media that everyone has come to a conclusion that all black people are criminals and that is wrong. To make matters worth parents will tell their kids not to hang out with â€Å"African† people and when that one African child gets secluded he will do anything to be part of the â€Å"group† and this is when the child starts to befriend the wrong people and he is now in a gang. He gets into unnecessary trouble and now is the top news on CTV and all of this was because one arent was racist and told his/her child not to be friends with a black person. A more severe case of racism is hate crime, and that is very common in Canada. Statistics Canada has released the numbers and it states that there have been 1473 hate-motivated crimes in 2009 and 52% was because of race/ethnicity, which means there have been 766 racist crimes. To be more specific almost 300 incidents were intended toward black people, 95 towards south Asians, and 75 towards Arabs. Even in the 21st century we are still witnessing violence toward people because of their skin color. Just by viewing these statistics you can conclude that Canada is still racist. To be more precise Canada has increased in hate crimes toward race from 2006-2009 by roughly 61%. Racial discrimination must stop immediately; it is not progressing society forward it is pulling us backward. At the end of the day we are all humans and we are all one race and this prejudice towards others because of the color of their skin is barbaric. Canada is most definitely still racist, we might seem like the perfect country to the eyes of others but we are far from a utopian society. Regardless of the fact you are Caucasian, African, Sri Lankan, Arab, and Chinese we are all humans, and racism just degrades us. Abraham Joshua Herschel, a Polish-born American rabbi once said â€Å"Racism is man’s gravest threat to man – the maximum hatred for a minimum of reason. â€Å" Racism was once the reason WWII had started and it was the reason we went through a terrifying era of slaves in North America. Both Canada and the global society are frequently showing racial animosity and this should not be tolerated.

Friday, November 8, 2019

What For- Is For

What For- Is For What For- Is For What For- Is For By Mark Nichol The element for-, though it stems from the same Proto-Germanic word that gave us the preposition for, deviated from the common ancestor to serve as a prefix meaning â€Å"away,† â€Å"opposite,† or â€Å"completely.† That’s the sense that contributes to the meaning of most words beginning with for-. Notice that these words have in common that their connotations are definitive: The verbs forbid (â€Å"prohibit,† with a root cognate with bid and meaning â€Å"command†), forget (â€Å"fail to remember† or â€Å"inadvertently neglect,† with a root cognate with get and meaning â€Å"grasp,†), and forgive (â€Å"pardon,† with a self-evident root) are potent; so, too, is the adverb forever (â€Å"always,† with a self-evident root). Other words in the for- family have not only that strong sense but also an archaic ring to them, and most are rare: the verbs forbear (â€Å"refrain† or â€Å"endure†; the root is self-evident), forfend (â€Å"prevent† or â€Å"protect†; the root, fend, is the word meaning â€Å"ward off†), forgo (â€Å"refrain from†; the root is self-evident); forlorn (originally â€Å"disgraced,† later â€Å"wretched† and â€Å"abandoned†; the root- also seen in lovelorn, meaning â€Å"pining for love†- means â€Å"lost†), forsake (â€Å"abandon†; the root, cognate with sake, means â€Å"blame† or â€Å"dispute†), and forswear (â€Å"renounce†; the root is self-evident) and the adverb forsooth (â€Å"indeed†; the root, cognate with sooth, means â€Å"truth†). Other intensive terms, which are so archaic as to be obsolete, are the verb fordo (â€Å"destroy† or â€Å"kill†; the adjectival form, fordone, survives in an inverted version as the idiomatic phrase â€Å"done for†) and the adjective forblak (â€Å"exceedingly black†). Several for- words are only partially related: The first syllable in the adjective foreign (â€Å"from beyond one’s own country†) and in forfeit, both a verb and a noun (â€Å"give up† or â€Å"something given up,† respectively), is from a Latin element meaning â€Å"outside,† which is distantly akin to the other for-. The verb and adverb forward (the word retains a noun function only in reference to a position held by certain athletes) was spelled forewearde in Old English. Like words that still begin with fore-, it pertains to something located before something else (or, in the case of some of these words, something occurring before something else); for- and fore- are distant relatives. Fortune and fortuitous are unrelated outliers based on the Latin root that means â€Å"chance† or â€Å"luck.† The second element in therefor and therefore- the distinction between the first rare form and the more common second one is â€Å"by reason of that† versus â€Å"in consequence of that,† respectively- is the conjunction for (â€Å"because†). Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Vocabulary category, check our popular posts, or choose a related post below:Apply to, Apply for, and Apply withWhat to Do When Words Appear Twice in a Row5 Examples of Insufficient Hyphenation

Tuesday, November 5, 2019

How to Write a Great College Essay, Step-by-Step

How to Write a Great College Essay, Step-by-Step SAT / ACT Prep Online Guides and Tips Writing your personal statement for your college application is an undeniably overwhelming project. Your essay is your big shot to show colleges who you are - it’s totally reasonable to get stressed out. But don’t let that stress paralyze you. This guide will walk you through each step of the essay writing process to help you understand exactly what you need to do to write the best possible personal statement. I'm alsogoing to follow an imaginary student named Eva as she plans and writes her college essay, from her initial organization and brainstorming to her final edits. By the end of this article, you'll have all the toolsyou need to createa fantastic, effective college essay. So how do you writea goodcollege essay? The processstarts with finding the best possibletopic, which means understanding what the prompt is asking for and taking the time to brainstorm a variety of options. Next, you'll determinehow to create an interesting essay that shows off your unique perspective and write multiple drafts in order to hone your structureand language. Onceyour writing is as effective and engaging as possible, you'll do a final sweep to make sure everything is correct. This guide coversthe following steps: Organizing Brainstorming Picking a topic Making a plan Writing a draft Editing your draft Finalizing your draft Repeating the process Feature Image: John O'Nolan/Flickr Step 1: Get Organized The first step in how to write a college essay is figuring out what you actually need to do. Although many schools are now on the Common App, some very popular colleges, including University of Texas and University of California,still have their own applications and writing requirements. Even for Common App schools, you may need to write a supplemental essay or provide short answers to questions. Before you get started, you shouldknow exactly what essays you need to write. Having this information allows you to plan the best approach to each essay and helps you cut down on work by determining whetheryou can use an essay for more than one prompt. Start Early Writing good college essays involves a lot of work: you need dozens of hours to get just one personal statement properly polished, and that's before you even start to consider any supplemental essays. In order to make sure you have plenty of time to brainstorm, write, and edit your essay (or essays), I recommend starting at least two months before your first deadline. The last thing you want is to end up with a low-quality essay you aren't proud of because you ran out of time and had to submit something unfinished. Determine What You Need to Do As I touched on above, each college has its own essay requirements, so you'll need to go through and determine what exactly you need to submit for each school. This process issimpleif you’re only using the Common App, since you can easily view therequirements for each school under the "My Colleges" tab. Watch out, though, because some schools have a dedicated "Writing Supplement" section, while others (even those that want a full essay) will put their prompts inthe "Questions" section. It gets trickier if you’re applying to any schools that aren't onthe Common App. You'll need to look up the essay requirements for each college - what's required should be clear on the application itself, or you can look under the "how to apply" section of the school's website. Once you've determined the requirements for each school, I recommend making yourself a chartwith the school name, word limit, and application deadline on one side andthe prompt or prompts you need to respond to on the other. That way you'll be able to see exactly what you need to do and when you need to do it by. Decide Where to Start If you have one essay that's due earlier than the others, start there. Otherwise, start with the essay for your top choice school. I would also recommend starting with alonger personal statement beforemoving on to shorter supplementary essays, since the 500 - 700 word essays tend to take quite a bit longer than 100 - 250 word short responses. The brainstorming you do for the long essay may help you come up with ideas you like for the shorter ones as well. Also considerwhether some of the prompts are similar enough that you could submitthe same essay to multiple schools. Doing so can save you some time and let you focus on a few really great essays rather than a lot of mediocre ones. However,don't reuse essays for dissimilar or very school-specific prompts, especially â€Å"why us† essays. If a college asks you to write aboutwhy you're excited to go there, admissions officers want to see evidence that you're genuinely interested. Reusing an essay about another school and swapping out thenames isthe fastest way to prove you aren't. Example: Eva's College List Eva is applying early to Emory University and regular decision to University of Washington, UCLA, and Reed College. Emory and Reed both use the Common App. College Essay Prompt University of Washington December 1st 600 words Discuss how your family’s experience or cultural history enriched you or presented you with opportunities or challenges in pursuing your educational goals. OR Tell us a story from your life, describing an experience that either demonstrates your character or helped to shape it. University of Washington December 1st 300 words The University of Washington seeks to create a community of students richly diverse in cultural backgrounds, experiences, and viewpoints. How would you contribute to this community? OR Describe an experience of cultural difference or insensitivity you have had or observed. What did you learn from it? UCLA November 30 1,000 words total Describe the world you come from - for example, your family, community or school - and tell us how your world has shaped your dreams and aspirations. AND Tell us about a personal quality, talent, accomplishment, contribution or experience that is important to you. What about this quality or accomplishment makes you proud and how does it relate to the person you are? Common App November 1 650 words 1. Some students have a background, identity, interest, or talent that is so meaningful they believe their application would be incomplete without it. If this sounds like you, then please share your story. 2. The lessons we take from failure can be fundamental to later success. Recount an incident or time when you experienced failure. How did it affect you, and what did you learn from the experience? 3. Reflect on a time when you challenged a belief or idea. What prompted you to act? Would you make the same decision again? 4. Describe a problem you’ve solved or a problem you’d like to solve. It can be an intellectual challenge, a research query, an ethical dilemma-anything that is of personal importance, no matter the scale. Explain its significance to you and what steps you took or could be taken to identify a solution. 5. Discuss an accomplishment or event, formal or informal, that marked your transition from childhood to adulthood within your culture, community, or family. Emory University 500 words November 1 Last August, Susan Grant, chief nurse executive for Emory Healthcare, said this of Emory’s choice to treat patients with Ebola: "We can either let our actions be guided by misunderstandings, fear and self-interest, or we can lead by knowledge, science and compassion. We can fear, or we can care." Consider her idea of doing what is in the public interest despite potential cost. Please discuss an example in your life or the life of another that's come to your attention. OR In the spirit of Emory's tradition of courageous inquiry, what question do you want to help answer and why? Reed College Jan 1 200-500 words For one week at the end of January, Reed students upend the traditional classroom hierarchy and teach classes about any topic they love, academic or otherwise. This week is known as Paideia after the Greek term signifying â€Å"education† – the complete education of mind, body and spirit. What would you teach that would contribute to the Reed community? Even though she's only applying to four schools, Eva has a lot to do: two essays for UW, two for the UC application, and one for the Common App, plus the supplements for Reed and Emory. Manystudents will have fewer requirements to complete, but those who are applying to very selective schools or a number of schools on different applications will have as many or even more responses to write. Since Eva's first deadline isearly decision forEmory, she’ll start by writing the Common App essay, and then work on the Emory supplement. (For the purposes of this post, we’ll focus on the Common App essay.) Colored paper clips: functionaland fun! (At least if you love organization.) Step 2: Brainstorm Next up in how to write a college essay: brainstorming essay ideas. There are tons ofways to come up with ideas for your essay topic: I've outlined three below. I recommend trying all of themand compilinga list of possible topics, then narrowing it down to the very best one or, if you're writing multiple essays, ones. Keep in mind as you brainstorm that there’s no best college essay topic, just the best topic for you. Don’t feel obligated to write about something because you think you should - those types of essays tend to be boring and uninspired. Similarly, don't simply write about the first idea that crosses your mindbecause you don't want to bother trying to think of something more interesting. Take the timeto come up with a topic you’re really excited about and that you can write about in detail. Want to write the perfect college application essay? Get professional help from PrepScholar. Your dedicated PrepScholar Admissions counselor will craft your perfect college essay, from the ground up. We'll learn your background and interests, brainstorm essay topics, and walk you through the essay drafting process, step-by-step. At the end, you'll have a unique essay that you'll proudly submit to your top choice colleges. Don't leave your college application to chance. Find out more about PrepScholar Admissions now: Analyze the Prompts One way to find possibletopics is to think deeply aboutthe college's essay prompt. What are they asking you for? Break them downand analyze every angle. Does the question include more than one part? Are there multiple tasks you need to complete? What do you think the admissions officers are hoping to learn about you? In cases where you have more than one choice of prompt, does one especially appeal to you? Why? Let's dissectone of the University of Washington prompts as an example: "Discuss how your family’s experience or cultural history enriched you or presented you with opportunities or challenges in pursuing your educational goals." This question is basically asking how your family affected your education, but it offers a number of possible angles. You can talk about the effects of either your family life (likeyour relationship with your parents or what your household was like growing up) or your cultural history (like your Jewish faith or your Venezuelan heritage). You can also choose between focusing on positive or negative effects of your family or culture.No matter what however, the readersdefinitely want to hear about your educational goals (i.e. what you hope to get out of college) and how they're related to your personal experience. As you try to think of answers for a prompt, imagine about what you would say if you were asked the question by a friend or during a get-to-know-you icebreaker. After all, admissions officers are basically just people who you want to get to knowyou. The essay questions can make a great jumping off point, but don’t feel married to them. Most prompts are general enough that you can come up with an idea and then fit it to the question. Consider Important Experiences, Events, and Ideas in Your Life What experience, talent, interest or other quirk do you have that you might want to share with colleges? In other words, what makes you you?Possible topicsinclude hobbies, extracurriculars, intellectual interests, jobs, significant one-time events, pieces of family history, or anything else that has shaped your perspective on life. Unexpected or slightly unusual topics are often the best: your passionate love of Korean dramas or your yearly family road trip to an important historical site. You want your essayto add something to your application, so if you’re an All-American soccer player and want to write about the role soccer has played in your life, you’ll have a higher bar to clear. Of course if you have a more serious part of your personal history - the death of a parent, serious illness, or challenging upbringing - you can write about that. But make sure you feel comfortable sharing details of the experience with the admissions committee and that you can separate yourself from it enough to take constructive criticism on your essay. What do you see when you look in the mirror? Think About How You See Yourself The last brainstorming method is to consider whether there are particular personality traits you want to highlight. This approach can feel rather silly, but it can also be very effective. If you were trying to sell yourself to an employer, or maybe even a potential date, how would you do it? Try to think about specific qualities that make you stand out.What are some situations in which you exhibited this trait? Example: Eva's Ideas Looking at the Common App prompts, Eva wasn’t immediately drawn to any of them, but after a bit of consideration she thought it might be nice to write about her love of literature for the first one, which asks about something "so meaningful your application would be incomplete without it." Alternatively, she liked the specificity of the failure prompt and thought she might write about a bad job interview she had had. In terms of important events, Eva’s parents got divorced when she was three andshe’s been going back and forth between their houses for as long as she can remember, so that’s a big part of her personal story. She’s also played piano for all four years of high school, although she's not particularlygood. As for personal traits, Eva is really proud of her curiosity - if she doesn’t know something, she immediately looks it up, and often ends up discovering new topics she’s interested in. It’s a trait that’s definitely come in handy as a reporter for her school paper. Step 3: Narrow Down Your List Now you have a list of potential topics, but probably no idea where to start. The next step is to go through your ideas and determinewhich onewill make for the strongest essay. You'll thenbegin thinking about how best to approach it. What to Look For in a College Essay Topic There's no single answer to the question of what makes a great college essay topic, but there are somekey factors you should keep in mind. The best essaysare focused, detailed, revealing and insightful, and finding the righttopic is vitalto writing a killer essay with all of those qualities. As you go through your ideas, be discriminating - really think about how each topic could work as an essay. Butdon’t be too hard on yourself; even if an ideamay not work exactly the way you first thought, there may be another way to approach it. Pay attention to whatyou're really excited about and look for ways to make those ideas work. Once you have a bunch of "idea"s, you have to decide which one really stands out. Does ItMatter to You? If you don’t care about your topic, it will be hard to convince your readers to care about it either. You can't write a revealing essay about yourself unless you write about a topic that is truly important to you. But don’t confuse important to you withimportantto the world:a college essay is not a persuasive argument. The point is to givethe reader a sense of who you are, not to make a political or intellectual point. The essay needs to be personal. Similarly, a lot of students feel like they have to write about a major life event or their most impressive achievement. But the purposeof a personal statement isn't to serve as a resume or a brag sheet - there are plenty of other places in the application for you to list that information. Many of the best essays areabout something small because your approach to acommon experience generallyreveals a lot about your perspective on the world. Mostly, your topic needs to have had a genuine effect on your outlook, whether it taught you something about yourself or significantly shifted your view on something else. Does It Tell the Reader Something Different About You? Your essay should add something to your application that isn’t obvious elsewhere. Again, there are sections for all of your extracurriculars and awards; the point of the essay is to reveal something more personal that isn't clear just from numbers and lists. You also want to make sure that if you're sending more than one essay to a school - like a Common App personal statement and a school-specific supplement - the two essays take on different topics. Is ItSpecific? Your essay should ultimately have a very narrow focus. 650 words may seem like a lot, but you can fill it up very quickly. This means you either need to have a very specific topic from the beginning or find a specific aspect of a broader topic to focus on. If you try to take on a verybroad topic, you’ll end up with a bunch of general statements and boring lists of your accomplishments. Instead, you want to find a short anecdote or single idea to explore in depth. Can You DiscussIt in Detail? A vague essay is a boring essay - specific details are what imbueyour essay with yourpersonality. For example, if I tell my friend that I hada great dessert yesterday, she probably won't be that interested. But if I explainthat I ate an amazing piece of peach raspberry pie with flaky, buttery crust and filling that was both sweet and tart, she will probablydemand to know where I obtainedit (at least she will if she appreciates the joys of pie). She'll also learn more about me: I love pie and I analyzedeserts with great seriousness. Given the importance of details, writing about something that happened a long time ago or that you don’t remember well isn't usually a wisechoice. If you can't describe something in depth, it will be challenging to write a compelling essay about it. You also shouldn't pick a topic you aren't actually comfortable talking about. Some students are excited to write essays about very personal topics, like their mother's bipolar disorder or their family's financial struggles, but others dislike sharing details about these kinds of experiences. If you're a member of the latter group, that's totally okay, just don't write about one of these sensitive topics. Still, don’t worry that every single detail has to be perfectly correct. Definitely don’t make anything up, but if you remember a wall as green and it was really blue, your readers won'tnotice or care. You don't have to know exactly how many dewdrops there were on the leaf. Can It Be Related to the Prompt? As long as you’re talking about yourself, there are very few ideas that you can’t tie back to one of the Common App prompts. But if you’re applying to a school with its own more specific prompt, or working on supplemental essays, making sure to address the question will be a greater concern. Want to write the perfect college application essay? Get professional help from PrepScholar. Your dedicated PrepScholar Admissions counselor will craft your perfect college essay, from the ground up. We'll learn your background and interests, brainstorm essay topics, and walk you through the essay drafting process, step-by-step. At the end, you'll have a unique essay that you'll proudly submit to your top choice colleges. Don't leave your college application to chance. Find out more about PrepScholar Admissions now: Deciding on a Topic Once you've gone through the questions above, you should have good sense of what you want to write about. Hopefully, it's also gotten you started thinking about how you can best approach that topic, but we'll cover how to plan your essaymore fully in the next step. If after going through the narrowing process, you’ve eliminated all your topics, first look back over them: are you being too hard on yourself? Are there any that you really like, but just aren’t totally sure what angle to take on? If so, try looking at the next section and seeing if you can’t find a different way to approach it. If you just don't have an idea you're happy with, that’s okay! Give yourself a week to think about it. Sometimes you’ll end up having a genius idea in the car on the way to school or while studying for your U.S. history test. Otherwise, try the brainstorming process again when you’ve had a break. If, on the other hand, you have more than oneidea you really like, consider whether any of themcan be used for other essays you need to write. Example: Picking Eva's Topic After brainstorming, Eva has a list of five possible topics: Love of books Failed job interview Piano Parents’ divorce Reporting Eva immediately rules out writing about playing piano, because it sounds super boring to her and it’s not something she is particularly passionate about. She also decides not to write about splitting time between her parents because she just isn’t comfortable sharing her feelings about it with an admissions committee. She feels more positive about the other three, so she decides to think about them for a couple of days. She ends up ruling out the job interview because she just can’t come up with that many details she could include. She's excited about both of her last two ideas, but sees issues with both of them: the books idea is very broad and the reporting idea doesn’t seem to apply to any of the prompts. Then she realizes that she can address the solving a problem prompt by talking about a time she was trying to research a story about the closing of a local movie theater, so she decides to go with that topic. Step 4: Figure Out Your Approach You’ve decided on a topic, but now you need to turn that topic into an essay. To do so, you need to determine what specifically you’re focusing on and how you’ll structure your essay. If you’re struggling or uncertain, try taking a look at some examples of successful college essays.It can be helpful to dissect how other personal statementsare structured to get ideas for your own, but don't fall into the trap of trying to copy someone else's approach. Youressayis your story - never forget that. Let's go through the key steps that will help you turn a great topic into a great essay. Choose a Focal Point As I touched on above, the narrower your focus, the easier it will be to write a unique, engaging personal statement.The simplestway to restrict the scope of your essayis to recount an anecdote, i.e. a short personal story that illustrates your larger point. For example, say a student was planning to write about her Outward Bound trip in Yosemite. If she tries to tell the entire story of hertrip, heressay will either be far too long or very vague. Instead, she decidesto focus in on a specific incident that exemplifies what mattered to her about the experience: her failed attempt to climb Half Dome. She described the moment she decided to turn back without reaching the top in detail, while touching on other parts of the climb and trip where appropriate. This approach lets her create a dramatic arc in just 600 words, while fully answering the question posed in the prompt (Common App prompt 2). Of course, concentratingon an anecdote isn't the only way to narrow your focus. Depending on your topic, it might make more sense to build your essay around an especially meaningful object, relationship, or idea. Another approachour example student from above could take to the same general topic would be to write about her attempts to keep her hiking boots from giving her blisters (in response to Common App prompt 4). Rather than discussing a single incident, she could tell the story of her trip through her ongoing struggle with the boots: the different fixes she tried, her less and less squeamish reactions to the blisters, the solution she finally found. A structure like this one can be trickier than the more straightforward anecdote approach, but it can also make for an engaging and different essay. When deciding what part of your topic to focus on, try to find whatever it is about the topic that is most meaningful and uniqueto you. Once you've figured that part out, it will guide how you structure the essay. To be fair, even trying to climb Half Dome takes some serious guts. Decide What You Want to Show About Yourself Remember that the point of the college essay isn’t just to tell a story, it’s to show something about yourself. It's vital that you have a specific point you want to make about what kind of person you are, what kind of college student you’d make, or what the experience you’re describing taught you. Since the papers you write for school are mostly analytical, you probably aren't used to writing about your own feelings. As such, it can be easy to neglect the reflection part of the personal statement in favor of just telling a story.Yet explaining what the event or idea you discuss meant to you is the most important essay - knowing how you want to tie your experiences back to yourpersonal growth from the beginning will help you make sure to include it. Develop a Structure It’s not enough to just know what you want to write about - you also need to have a sense of how you’re going to write about it. You could have the most exciting topic of all time, but without a clear structure your essay will end up as incomprehensible gibberish that doesn't tell the reader anything meaningful about your personality. There are a lot of different possible essay structures, but a simple and effective one is the compressed narrative, which builds on aspecific anecdote (like the Half Dome example above): Start in the middle of the action. Don't spend a lot of time at the beginning of your essay outlining background info - it doesn't tend to draw the reader in and you usually need less of it than you think you do. Instead start right where your story starts to get interesting. (I'll go into how to craft an intriguingopenerin more depth below.) Briefly explain what the situation is. Now thatyou've gotthe reader's attention, go back and explain anything they need to know about how you got into this situation. Don't feel compelled to fit everything in - only include the background details that are necessary to either understand what happened or illuminate your feelings about the situation in some way. Finish the story. Once you've clarified exactly what's going on, explain how you resolved the conflict or concluded the experience. Explain what you learned. The last step is to tie everything together and bring home the main point of your story: how this experience affected you. The key to this type of structure is to create narrative tension - you want your reader to be wondering what happens next. A second approach is the thematic structure, which is based on returning to a key idea or object again and again (like the boots example above): Establish the focus.If you're going to structure your essay around a single theme or object, you need to begin the essay byintroducing that key thing. You can do sowith a relevant anecdote or a detailed description. Touch on 3 - 5 timesthe focus was important.The body of your essay will consist of stringing together a few important momentsrelated to the topic. Make sure to use sensory details to bring the reader into those points in time and keep her engagedin the essay. Also remember to elucidate why these moments were important to you. Revisit the main idea.At the end, you want to tie everything together by revisiting the main idea or object and showing how your relationship to it hasshaped or affected you. Ideally, you'll also hint at how this thing will be important to you going forward. To make this structure work you need a veryspecific focus. Your love of travel, for example, is much too broad - you would need to hone in on a specific aspect of that interest, like how travelinghas taught you to adapt to event the most unusual situations. Whatever you do, don't use this structure to create a glorified resume or brag sheet. However you structure your essay, you want to make sure that it clearly lays out both the events or ideas you’re describing and establishes the stakes (i.e. what it all means for you). Many students become so focused on telling astory or recounting details that they forget to explain what it all meant to them. Your essay has to be built step-by-step, just like this building. Example: Eva's Essay Plan For her essay, Eva decides to use the compressed narrative structure to tell the story of how she tried and failed to report on the closing of a historic movie theater: Open with the part of her story where she finally gave up after calling the theater and city hall a dozen times. Explain that although she started researchingthe story out of journalistic curiosity, it was important to her because she'd grown up going to movies at that theater. Recount how defeated she felt when she couldn't get ahold of anyone, and then even more so when she saw a story about the theater's closingin the local paper. Describer her decisionto write an op-ed instead and interviewother students about what the theater meant to them. Finish by explaining that although she wasn't able to get the story (or stop the destruction of the theater), she learned that sometimes the emotional angle can be just as interesting as the investigative one. Step 5: Write a FirstDraft The key to writing your first draft is not to worry about whether it’s any good - just get something on paper and go from there. You will have to rewrite, so trying to get everything perfect is both frustrating and futile. Everyone has their own writing process. Maybe you feel more comfortable sitting down and writing the whole draft from beginning to end in one go. Maybe you jump around, writing a little bit here and a little there. It’s okay to have sections you know won’t work or to skip over things you think you’ll need to include later. Whatever your approach, there are a few tips everyone can benefit from. Don't Aim for Perfection I mentioned this idea above, but I can't emphasize it enough: no one writes a perfect first draft. Extensive editing and rewriting is vital to crafting an effective personal statement. Don’t get too attached to any part of yourdraft, because you may needto change anything (or everything) about your essay later. Also keep in mind that, at this point in the process, the goal is just to get your ideas down. Wonky phrasings and misplaced commas can easily be fixed when you edit, so don't worry about them as you write. Instead, focus on including lots of specific details and emphasizing how your topic has affected you, since these aspects are vital to a compelling essay. Want to write the perfect college application essay? Get professional help from PrepScholar. Your dedicated PrepScholar Admissions counselor will craft your perfect college essay, from the ground up. We'll learn your background and interests, brainstorm essay topics, and walk you through the essay drafting process, step-by-step. At the end, you'll have a unique essay that you'll proudly submit to your top choice colleges. Don't leave your college application to chance. Find out more about PrepScholar Admissions now: Write an EngagingIntroduction One part of the essay you do want to pay special attention to is the introduction. Your intro is your essay’s first impression: you only get one. It's much harder to regain your reader's attention onceyou've lost it, so you want to draw the reader in with an immediately engaging hook that sets up a compelling story. There are two possible approaches I would recommend. The â€Å"In Media Res† Opening You’ll probably recognize this term if you studied The Odyssey: it basically means that the story starts in the middle of the action, rather than at the beginning. A good intro of this type makes the reader wonder both how you got to the point you’re starting at and where you'll go from there. These openers provide a solid, intriguing beginningfor narrative essays (though they can certainly for thematic structures as well). But how do you craft one? Try to determine the most interesting point in your story and startthere. If you're not sure where that is, try writing out the entire story and then crossing out each sentence in order until you get to one that immediatelygrabs your attention. Let's look at some examples from real students' college essays: "Bottom of the ninth, two outs, the Red Sox down by four. We needed a miracle." Daniel J Shinnick, Connecticut College "I strode in front of 400 frenzied eighth graders with my arm slung over my Fender Stratocaster guitar - it actually belonged to my mother - and launched into the first few chords of Nirvana's 'Lithium.'" Anonymous, University of Virginia Both of these introsthrow the reader right intothe middle of the action. In the first, the game is already mostly over, and as we later find out, his sister is undergoing brain surgery the next day. The immediacy of this intro ("We need a miracle") gives a sense of high stakes, even though we don't know what the real topicis yet. In the second, the author jumps rightinto the action: theperformance. You can imagine how much less exciting it would be ifthe essay opened with an explanation of what the event was and why the author was performing. The Specific Generalization Sounds like an oxymoron, right? This type of intro sets up what the essay is going to talk about in a slightly unexpected way. These area bit trickier than the "in media res" variety, but theycan work really well for the right essay - generally one with a thematic structure. The key to this type of intro is detail. Contrary to what you may have learned in elementary school, sweeping statements don't make very strong hooks. If you want to start your essay with a more overalldescription of what you'll be discussing, you still need to make it specific and unique enough to stand out. Once again, let's look at some examples from real students' essays: â€Å"Pushed against the left wall in my room is a curious piece of furniture.† Neha, Johns Hopkins University â€Å"My name is Brontà «, and if you ask me, I’ll tell you my favorite book is Jane Eyre. This may or may not be a coincidence.† Brontà «, Johns Hopkins University Both of these intros set up the general topic of the essay (the first writer's bookshelf and and the second'slove ofJane Eyre) in an intriguing way.The first intro works because itmixes specific descriptions ("pushed against the left wall in my room") with more general commentary ("a curious piece of furniture"). The second draws the reader in by adopting a conversational and irreverent tone with asides like "if you ask me" and "This may or may not be a coincidence." I wouldn't recommend this intro - it's a bitof a cliche. Don't Worry Too Much About the Length When you start writing, don't worry about your essay'slength. Instead, focus on trying to include all of the details you can think of about your topic, which will make it easier to decide what you really need to include when you edit. However, if your first draft is more than twicethe word limitand you don't have a clear idea of what needs to be cut out, you may need to reconsider your focus - your topic is likely too broad. You may also need to reconsider your topic or approach if you find yourself struggling to fill space, since this usually indicates a topic that lacks a specific focus. Eva's First Paragraph I dialed the phone number for the fourth time that week. "Hello? This is Eva Smith, and I'm a reporter with Tiny Town High's newspaperThe Falcon.I was hoping to ask you some questions about - " I heard the distinctive click of the person on the other end of the line hanging up, followed by dial tone. I was about ready to give up: I'd been trying to get the skinny on whether the Atlas Theater was actually closing to make way for a big AMC multiplex or if it was just a rumor for weeks, but no one would return my calls. Step 6: Edit Aggressively No one writes a perfect first draft. No matter how much you might want to be done after writing a first draft - you musttake the time to edit. Thinkingcritically aboutyour essay and rewriting as needed is a vital part of writing a great college essay. Before you start editing, put your essay aside for a week or so. It will be easier to approach it objectively if you haven’t seen it in a while. Then, take an initial pass to identify any big picture issues with your essay. Once you've fixed those, ask for feedback from other readers - they'll often notice gaps in logic that don't appear to you, because you're automatically filling in your intimate knowledge of the situation. Finally, take another, more detailed look at your essay to fine tune the language. I've explained each of these steps in more depth below. First Editing Pass You should start the editing process by looking foranystructural or thematic issues with your essay. If you see sentences that don’t make sense or glaring typos of course fix them, but at this point, you’re really focused on the major issues since those require the most extensive rewrites. You don’t want to get your sentences beautifully structured only to realize you need to remove the entire paragraph. This phase is really about honing your structure and your voice. As you read through your essay, think about whether it effectively draws the reader along, engages him with specific details, and shows why the topicmatters to you. Try asking yourself the following questions: Does the intro make you want to read more? Is the progression of events and/or ideas clear? Does the essay show something specific about you? What is it and can you clearly identify it in the essay? Are there places where you could replace vague statements with more specific ones? Do you have too many irrelevant or uninteresting details clogging up the narrative? Is it too long? What can you cut out or condense without losing any important ideas or details? Give yourself credit for what you’ve done well, but don’t hesitate to change things that aren’t working. It can be tempting to hang on to what you've already written - you tookthe time and thought to craft it in the first place, so it can be hard to let it go. Taking this approach is doing yourself a disservice, however. No matter how much work you put into a paragraph or much you like a phrase, if they aren't adding to your essay, they need to be cut or altered. If there’s a really big structural problem, or the topic is just not working, you may have to chuck this draft out and start from scratch. Don't panic! I know starting over is frustrating, but it’s often the best way to fix major issues. Unfortunately, some problems can't be fixed with whiteout. Consulting Other Readers Once you’ve fixed the problems you found on the first pass and have a second (or third) draft you’re basically happy with, ask some other people to read it. Check with people whose judgment you trust: parents, teachers, and friends can all be great resources, but how helpful someone willbedepends on the individual and how willing you are to take criticism from her. Also, keep in mind that many people, even teachers, may not be familiar with what colleges look for in an essay. Your mom, for example, may have never written a personal statement, and even if she did, it was most likely decades ago.Give your readersa sense of what you’d like them to read for, or print out the questions I listed above and include them at the end of your essay. Second Pass After incorporating any helpful feedback you got from others, you should now have a nearly complete draft with a clear arc. At this point you want to look for issues with word choice and sentence structure: Are there parts that seem stilted or overly formal? Do you have any vague or boring descriptors that could be replaced with something more interesting and specific? Are there any obvious redundancies or repetitiveness? Have you misused any words? Are your sentences of varied length and structure? A good way to check for weirdness in language is to read the essay out loud. Ifsomething sounds weird when you say it, it will almost certainlyseem offwhen someone else reads it. Example: Editing Eva's First Paragraph In general, Eva feels like her first paragraph isn't as engaging as it could be and doesn't introduce the main point of the essay that well: although it sets up the narrative, it doesn't show off her personality that well.She decides to break itdown sentence by sentence: I dialed the phone number for the fourth time that week. Problem: For a hook, this sentence is a little too expository. It doesn't add any real excitement or important information (other than that this call isn't the first, which can be incorporate elsewhere. Solution: Cut this sentence and start with the line of dialogue. "Hello? This is Eva Smith, and I'm a reporter with Tiny Town High's newspaperThe Falcon.I was hoping to ask you some questions about - " Problem: No major issues with this sentence. It's engaging and sets the scene effectively. Solution: None needed, but Eva does tweak it slightly to include the fact that this call wasn't her first. I heard the distinctive click of the person on the other end of the line hanging up, followed by dial tone. Problem:This is a long-winded way of making a point that's not that important. Solution: Replace it with a shorter, more evocative description: "Click. Bzzzzzzz. Whoever was on the other end of the line had hung up." I was about ready to give up: I'd been trying to get the skinny on whether the Atlas Theater was actually closing to make way for a big AMC multiplex or if it was just a rumor for weeks, but no one would return my calls. Problem: This sentence is kind of long. Some of the phrases ("about ready to give up," "get the skinny") are cliche. Solution: Eva decides to try to stick more closely to her own perspective: "I'd heard rumors that Atlas Theater was going to be replaced with an AMC multiplex, and I was worried." She also puts a paragraph break before this sentence to emphasize that she's now movingon tothe background info rather than describing her call. There's a real Atlas Theater. Apparently it's haunted! Step 7: Double Check Everything Once you have a final draft, give yourself another week and then go through your essay again. Read it carefully to make sure nothing seems off and there are no obvious typos or errors. Confirm that you are at or under the word limit. Then, go over the essayagain, line by line, checking every word to make sure that it’s correct. Double check common errors that spell check may not catch, like mixing up affect and effect or misplacing commas. Finally, have two other readers check it as well. Oftentimes a fresh set of eyes will catch an issue you've glossed over simply because you've been looking at the essay for so long. Give your readersinstructions to only look for typos and errors, since you don't want to be making any major content changes at this point in the process. Thislevel of thoroughness may seem like overkill, but it's worth taking the time to ensure that you don't have any errors. The last thing you want is for an admissions officer to be put off by a typo or error. Example: Eva's Final Draft (Paragraphs 1 and 2) "Hello? This is Eva Smith again. I'm a reporter with Tiny Town High's newspaperThe Falcon, andI was hoping to ask you some questions about - "Click. Bzzzzzzz. Whoever was on the other end of the line had hung up. I'd heard rumors that the historic Atlas Theater was going to be replaced with an AMC multiplex, and I was worried. I'd grown up with the Atlas: my dad taking me to see every Pixar movie on opening night and buying me Red Vines to keep me distracted during the sad parts. Unfortunately my personal history with the place didn't seem to carry much weight with anyone official, and my calls to both the theater and city hall had thus far gone unanswered. Once you've finished the final check, you’re done, and ready to submit! There's one last step, however. Step 8: Do It All Again Remember back in step one, when we talked about making a chart to keep track of all the different essays you need to write? Well, now you need to go back tothat list and determine which essays you still need to write. Keep in mind your deadlines and don't forget that some schools may require more than one essay or ask for short paragraphs in addition to the main personal statement. Reusing Essays In some cases, you may be able to reuse the essay you've already written for other prompts. You can use the same essay fortwo prompts if: both of them are asking the same basic question (e.g. "how do you interact with people who are different from you?" or "what was an important experience and why?"), or one prompt is relatively specific and the other is very general (e.g. "tell us about how your family shaped your education" and "tell us something about your background"),and neither asks about your interest in a specific school or program. If you choose to reuse an essay you wrote for a different prompt, make sure that it addressesevery part of question and that it fits the word limit. If you have to tweak a few things or cut out 50-odd words, it will probably still work. But if the essay would require major changes to fit the criteria, you're probably better off starting from scratch (even if you use the same basic topic). Crafting Supplemental Essays The key to keep in mind in when brainstorming for supplemental essays is that you want them to add something new to your application. You shouldn't write about the same topic you used for your personal statement, although it's okay to talk about something similar, as long as you adopt a clearlydifferent angle. For example, if you're planning to be pre-med in college and your main essay is about how volunteering at the hospital taught you not to judge people on their appearance, you might write your secondary essay on your intellectual interest in biology (which could touch on your volunteering). There's some overlap, but the two topics are clearly distinct. And now, you're really, truly, finally done. Congrats! What's Next? Now that you know how to write a college essay, we have a lot more specific resources for you to excel. Are youworking on the Common App essay? Read our breakdown of the Common App prompts and our guide to picking the best prompt for you. Ormaybe you're interested in the University of California? Check out our complete guide to the UC personal statements. In case you haven't finished the rest of the application process,take a look atour guides to asking for recommendations, writing about extracurriculars, andresearching colleges. Finally, if you're planning to take the SAT or ACT one last time, try out some of our famous test prep guides, like "How to Get a Perfect Score on the SAT" and "15 Key ACT Test Day Tips." Want to improve your SAT score by 160points or your ACT score by 4 points?We've written a guide for each test about the top 5 strategies you must be using to have a shot at improving your score. Download it for free now: