Pain Management and Post Operative Care Case Studies

Pain Management and Post Operative Care Case Studies This is a scenario based essay in which two scenarios will be looked at. One is on osteoarthritis and osteoporosis patient and the other one is based on oesophageal reflux disorder and peptic ulcer disease. The clinical manifestations of these two health problems and post-operative care of patients with these issues will be discussed in this paper. Complications of gastric diseases here in will also be discussed Osteoporosis also known as porous bone or fragile bone is a chronic form of metabolic bone disease characterized by a significant weakening in the structure of bone tissue and a low bone density (Brown and Edwards, 2012).This occurs when there is an imbalance between the bone formation and bone resorption. Under normal circumstances, osteoblasts constantly deposit bones which are resorbed by osteoclasts. This process is termed remodelling. In this case, the rate of deposition equals that of resorption such that for the total bone mass remains constant .However in osteoporosis, the bone resorption exceeds bone formation which leads to thin, fragile bones that are subject to spontaneous pathological fracture ( Craft et al,2011 ).Osteoporosis has some risk factors which are classified as modifiable and non-modifiable risk factors. Some of the modifiable risk factors include; low birth weight, cigarette smoking,malnutrition,low calcium intake, deficiency of vitamin D, deficit of oestroge n or androgen ,poor physical activity, some medications like steroids, anticonvulsants , vitamin A, and chronic conditions like thyroid, liver diseases as well as diabetes while the non-modifiable ones are race,sex,advanced aged,genetics,dementia, previous fractures as an adult(Kenny and Karen,2013).Osteoporosis is often regarded as a silent disease. This is because during the early stage, the bone loss is usually asymptomatic. At this point, Claire may not realise that she has osteoporosis but as the disease progresses, her bones become weaker such that even a slight or sudden bump or fall results to a fracture of either the hip, vertebral or wrist.However,Acute back pain is one of the earliest clinical manifestations Claire will be experiencing. This occurs due to vertebral compression fracture. Groin or thigh pain may also occur due to hip fracture (Brown and Edwards, 2012). Osteoarthritis on the other hand develops when the articular cartilage that protects the ends of bones in a joint begins to disintegrate. This disorder is more prevalent among the elderly and regarded as part of their aging process. Any localized wear and tear may hasten the situation and its symptom may be confined only in one joint. Early in the disease, the cartilage starts to break becoming roughened and thinner thereby interfering with easy movement.Cytokines which stimulate the release and production of an enzymes called protease are released( LeMone et al,2011)). This enzyme causes increase in the disintegration of the cartilage. To this end, the subchondral bone becomes damaged and exposed while cysts and osteophytes spurs developed around the margin of the bone. Osteophytes piece and cartilage starts to break off into the synovial cavity which further causes irritation and makes the joint space narrower. This exposes the bony surfaces hence they, rub against each other causi ng pain thus making the affected joint to become inflamed frequently (LeMone et al, 2011). Osteoarthritis has many clinical manifestations occurring due to body’s response to this degenerative change which ranges from mild discomfort to major disability. ( Brown and Edwards, 2012).some clinical manifestations Claire may experience may include joint pain.and swelling. It occurs due to weight bearing and movement. The pain may be unilateral and eventually becomes more severe as the degenerative changes progresses (Brown and Edwards, 2012 ).During the initial stage, this pain can be relieved by rest but as the disease advances, the pain may occur even at rest and Claire’s sleeping pattern may be interrupted as a result of joint discomfort. This joint discomfort may become more severe following a change in weather condition (Brown and Edwards, 2012).There will be limited joint movement due to loss of cartilage which is irregular and worn and osteophytes developed. Also crepitus may be heard as the joints become irregular, rubbing against each other.Towards the en d or middle joint of fingers, Claire may develop bony lumps known as herberden and bouchard nodes leading to structural deformity. (Brown and Edwards, 2012). Following Claire’s fracture repair, her post-operative nursing care and management are directed towards promoting safety, monitoring vital signs and applying the general principles of post–operative nursing care. The nurse will ensure that all the necessary safety equipment’s are near the patient’s bed side and in good working condition in case of emergency. Assess patient’s airway, circulation and breathing sounds for patency and check vital signs and pulse oximetry for baseline (Perry et al, 2012). Determine patient’s pain level using the pain rating. This will reveal the nature of pain and as well direct the nurse towards suitable interventions. Assessment of Claire’s neurological status is also of paramount important to ascertain the level of consciousness and movement of extremities (Perry et al, 2012). Observe IV access for patency and signs of infection, noting the rate to avoid insufficiency and overload. Check catheter drainag e for patency, colour, amount, ensuring frequent emptying and proper documentation in the intake and output chart (Perry et al, 2012). Also neurovascular assessments of the affected extremity are very important in order to detect changes while movement restraints or activities related to the turning, positioning and extremity support should be monitored closely and proper alignment and positioning to minimize discomfort and pain should be encouraged. Also, cast or dressings should be observed closely for signs of bleeding or drainage. It is pertinent to note that, any significant increase in the size of the drainage should be reported and documented (Perry et al, 2012). It is expected that Claire’s mobility will be impaired following surgery. Therefore, frequent assessment of common complications of immobility like pressure sore formation, renal calculi, deep vein thrombosis, pneumonia, paralytic ileus and pulmonary embolism are necessary and appropriate measures taken to alleviate it must be taken. Some of these measures include two hourly change of patient’s position according to hospital policy .This can be done by assisting in repositioning while stabilizing the fracture site (Lewis et at,2006).Other measures can be deep breathing and coughing exercise, active range of motion exercise, providing TED socks as well as early ambulation. Immobilization of the elbow to prevent wrist supination and pronation is necessary while the nursing management should include steps to prevent or reduce oedema and regular neurovascular assessment. Extremity should be supported and protected along with active movement of the fingers and thumb. This ex ercise helps reduce oedema, avert stiffness and increase venous return (Lewis et al, 2006). Active movement of the shoulder to prevent stiffness or contraction should be frequently performed by patient and must be encouraged. Deep venous thrombosis and subsequent pulmonary embolism which may occur due to venous pooling can be alleviated by using techniques to promote lower limb blood flow. Electrical stimulation induced contractions have been shown to improve skeletal muscle movements preventing venous stasis and oedema (Broderick, 2010). Regularly assessing the pin insertion sites and providing pin site care as per hospital policy is highly important and any signs of infection like redness, purulent drainage and increases tenderness must be reported and documented ( LeMone et al,2011). Prescribed medications such as antibiotics and analgesics per physicians order must also be administered and charted. The patients may also require assistance with ADLs especially where the stronger hand is the one affected (Farrell Dempsey, 2011). Following Claire’s complain of pain, it is important to assess patient’s level of comfort and the character of her pain. This can be done by asking her about the precipitating factor, quality, radiation ,severity and timing and also asking patient to rate the pain level using a scale of 1 to 10.All this measures will assist to determine the type and level of pain the patient is experiencing and to decide the type and dose of prescribed analgesic that will best suit patients pain where there is a choice .It can also help to decide whether her pain can be managed with non- pharmacological measures like arm elevation, ice application or even finger exercises (Perry et al, 2012 ). After these measures have been taken, neurovascular status fine and patient still in severe pain, the nurse will check the last time patient was given analgesic, route ,dose, frequency and as such its effectiveness .This is to determine the need for another dose and if the dose need to be increase d. However, before administration, the order must be checked by two nurses, the six rights of medication administration observed and patient’s identity confirmed using two identifiers such as name and date of birth for safety. After administration, the nurse will re-assess patient for effectiveness (Perry et al, 2012). Following Claire’s fracture and surgical procedure, some of the post-operative complications she may experience include compartment syndrome, fat embolism, deep vein thrombosis, pneumonia, pulmonary embolism, pressure sore, paralytic ileus, renal calculi, loss of appetite. This potential problems can be prevented by early ambulation which will help promote muscle tone, improve urinary and GIT, promote circulation to eliminate venous stasis and hasten wound healing (Mak et al, 2010). Additionally, problems associated with bony union and possible infection may occur. If adequate muscle and tissue coverage is not achieved following muscle and flap grafts, amputation may be needed (Mak et al, 2010). SCENARIO TWO Gastroesophageal reflux disease is a condition caused by the reflux of gastric contents into the oesophagus which aggravates symptoms and alters ones quality of life. This structural change produces heartburn and regurgitation. Reflux occurs when the lower oesophageal sphincter pressure is deficient or pressure in the stomach exceeds the lower oesophageal sphincter pressure. This leads to reflux of acid, bile, pepsin and pancreatic enzymes thus resulting to an injury in the mucosal lining (Giorgi et al 2006). Peptic ulcer disease generally known as painful sore or ulcers is most commonly found in the proximal duodenum and also in the antrum of the stomach or lower oesophagus (Brown Edwards, 2012). Normally, water, electrolytes and water soluble substances like glucose pass freely through the mucosal barrier while acids and pepsin are denied entry. This defence mechanism can be altered in certain conditions allowing backflow of acid and pepsin. As hydrochloric acid or pepsin penetrates the mucosal barrier, the tissues are exposed to continue damage due to acid diffuses into the gastric wall. Ulcers may erode more deeply into the muscularis and then perforate the wall. As erosion invades the blood vessel wall, bleeding takes place (Brown Edwards, 2012). This peptic ulcer disease has various clinical manifestations. Pain is one of the symptoms patient is experiencing. Its nature is typically described as burning, gnawing, aching or hunger-like and is often felt in the epigastric region, sometimes radiating to the back mainly when the stomach is empty (WebMD,2014). The pain is usually relieved by eating or by ingestion of antacids. Other symptoms the patient may be presenting with are loose of appetite and weight loss, heartburn or regurgitation, vomiting. Chest pain or dysphagia, anaemia. As patient’s condition become more severe, there may be malaena .This occurs due to bleeding from perforated mucosal wall.Haematemesis may also result (Brown Edwards, 2012). Helicobacter pylori infection are amongst the most common cause of peptic ulcer disease which directly and indirectly weakens the protective mucosal lining of both the stomach and duodenum allowing easy access of acids to the sensitive areas. As this happens, the lining becomes irritated and wears off resulting to sore formation (Duggan Duggan, 2006). Other factors includes excessive intake of NSAIDS such as aspirin or ibuprofen,genetic,smoking,high consumption of alcohol and coffee, liver or lung diseases, starvation, stress and certain diets(Duggan Duggan,2006). Histamine 2 receptor blockers like ranitidine are indicated for a patient with peptic ulcer disease. These drugs act by inhibiting histamine binding to the receptors on the gastric parietal cells to reduce or stop secretion. Proton pump inhibitors such as omeprazole which stops the acid secreting enzymes functioning as proton pump, disabling them for a period of 24hours also provides effective pain relief and promotes rapid ulcer healing (Brown Edwards, 2012). Antacids also stimulate gastric mucosal defences thereby aiding in ulcer healing. Other mucosa agents that can be helpful include sucralfate, Bismuth compounds and prostaglandin analogs (Brown Edwards, 2012). Many disease conditions can present with symptoms found in peptic ulcer thus making its diagnosis difficult. However to avert this, certain diagnostic procedures such as gastroscopy and colonoscopy need to done and the nursing care of a patient undergoing these procedure shall be explained in this part of the paper. Firstly, the nurse will ensure that consent is obtained, explain procedure to the patient, informing the patient his role.Prepre patient’s bowel by checking when last patient eat or drink, ensuring patient is on nil by mouth for 8hours prior to surgery (Perry et al, 2012).Depending on physicians order, patient may be on clear fluid for 1 to two days pre- procedure and enema given the previous night to permit easy insertion and clear visualisation. Checks vital signs and assess oxygen saturation level to obtain baseline and to compare post-operatively. Provide patient with gown, carefully remove patient’s dentures and artificial prosthesis patient may have an d storing them in a safe place (Perry et al, 2012). After the procedure, vital signs should be monitored closely especially temperature as sudden rise in temperature may indicate perforation, patient’s level of consciousness must be assessed to determine his ability to comprehend and follow instructions. Flatus, abdominal discomfort, fever, rectal bleeding, chills, swallowing difficulty, malaena, haematemesis are common therefore should encourage patient to report if notice any (Brown Edwards, 2012).Assess patient bowel sound and swallowing reflexes and encourage to eat and drink when present. Normally patient’s are not allowed to drive or operate machinery 24hours following procedure, therefore nurse should ensure that patient is accompanied home by an identified driver (Perry et al, 2012,). In a case of rectal bleeding, the nurse will support patient to bed to ensure comfort. Check vital signs because any significant drop in blood pressure and sudden rise in heart rate may serve as a good indicator for severe blood loss. If noticed any deviation, patient appears weak and unstable, urgent fluid replacement with 0.9% normal saline must be given to replace fluid loss. Closely monitor his abdomen for tenderness and distension. If after all these measures his condition still remains the same, medical team must be alerted for further treatments (Craft et al, 2011) Putting in place the above nursing interventions will help alleviate pain and manage post op complications in patients. Nursing care considerations always need to be specifically befitting the patient’s condition and their current presenting problem. As in the above the care consideration for a patient with musculoskeletal problems is definitely different from the other patient with gastrointestinal system diseases.

Encounter Part Ii– John Mcphee

Encounter Part II–John Mcphee An Island introduces Charles Fraser and David Brower, the two on a tour of Cumberland Island, Georgia. Charles Fraser, a real estate developer in Hilton Head Island, South Carolina with David Brower, a conservationist, the leader of a conservation organization called Friends of the Earth, the most effective single person on the cutting edge of conservation in this country.Charles Fraser has obtained 3000 acres of undeveloped Cumberland Island and he has bent over backwards in previous developments to preserve as much of the original landscape as he could, but he considers all environmentalists to be â€Å"druids† who will sacrifice people to save trees. Fraser considers himself a true conservationist, and he will say that he thinks of most so-called conservationists as â€Å"preservationists† but that he prefers to call them â€Å"druid. † â€Å"Ancient druids used to sacrifice human beings under oak trees,† â€Å"Mode rn druids worship trees and sacrifice human beings to those tree.They want to save things they like, all for themselves. † Fraser's characterization of environmentalists as modern druids who â€Å"worship trees and sacrifice human beings to those trees† provides the charge against Brower that forms the title of the book. Brower came to Georgia in order to stop Fraser's plan to develop Cumberland Island. Actually, Brower agreed that it would be a better candidate if Fraser developed Cumberland Island with federal protection. I think that both of them have common sense.Even though Fraser is a businessman, but he cares about the environment. I agree with Brower and I believe everyone has their own responsibility to get involved with environmental issues. Developing and environmental issue are always conflicted in current. Maybe we will find out the best solution to solve this puzzle. According to environmental ethic, we have to protect our environment first. I agree with t hat it is priority to protect our Earth Planet. I think it might be human nature, we always realize our mistake after we actually have made the mistake.For example in China, compare to 20 years ago, China’s economy has been developing to a very higher level, but the environment condition is going down to the hell. China has been studying and learning economic developing from Western for a long while and realized that economy is the most important thing for the country. Most of Chinese think that America is the superpower state in the world because our super economy and technology. Previous Chinese President, Mr. Deng Xiaoping, after his economic reforms, the whole country’s living standard has been increased enormously.During developing, Chinese has realized that economic developing has destroyed the country’s environment. Now it is the payback time for Chinese, even they want to spend 10 times more it won’t get the nature environment back. I don’t think that all the Chinese realize how important environment it is. I agree with most of Brower s opinion and I like to protect our green earth, but I believe that developing is very important too. Some of Fraser’s thoughts are right to me. I would like to see the developing with good environmental protection. The best asset religion offers is the moral framework by which practitioners must abide. 3] Since many environmental problems have stemmed from human activity, it follows that religion might hold some solutions to mitigating destructive patterns. Buddhism idealizes and emphasizes interconnection,[4] thereby creating a mindset that creates a productive and cooperative relationship between humans and nature. That all actions are based on the premise of interconnection makes the Buddhist mindset affective in generating modesty, compassion, and balance among followers, which may ultimately mitigate the harm done to the environment.One benefit of the Buddhist interconnected mindset is the inevitable humility that ensues. Because humans are entwined with natural systems, damage done upon the Earth is also harm done to humans. [5] This realization is quite modifying to a human race that historically pillages the Earth for individual benefit. When rational humans minimize the split between humanity and nature and bridge the gaps,[3] only then will a mutual respect emerge in which all entities coexist rather than fight.Buddhism maintains that the reason for all suffering comes from attachment. [6] When release from the tight grasp humanity has on individuality and separateness occurs, then oneness and interconnection is realized. So rather than emphasizing winners and losers, humanity will understand its existence within others; this results in a modesty that ends egoic mind. Another benefit of Buddhist practice to the environment is the compassion that drives all thinking. [3] When humans realize that they are all onnected, harm done to another will neve r benefit the initiator. [5] Therefore, peaceful wishes for everyone and everything will ultimately benefit the initiator. Through accepting that the web of life is connected[4]—if one entity benefits, all benefit[5]—then the prevailing mindset encourages peaceful actions all the time. If everything depends on everything else, then only beneficial events will make life situations better. Acceptance of compassion takes training and practice, which is also encouraged by Buddhist moral conduct in the form of mediation.This habitual striving for harmony and friendship among all beings creates a more perfect relationship between humanity and nature. Lastly, Buddhist mindset relies on taking the middle road or striving for balance. Siddhartha Gautama, the founder of Buddhism, spent his life searching for the outlet of human suffering, eventually concluding that a balance must be established between self-destruction and self-indulgence. [7] While modern, industrial humans emp hasize economic and social aspects of life and lastly environmental aspects, this view is lopsided. 5] When human preferences are leveled with environmental preferences—giving a voice to natural systems as well as human systems—then can balance and harmony be realized. Therefore, using this idealized and disciplined framework that Buddhism has to offer can create lasting solutions to amending the broken relationship between humanity and nature. What ensues is an ethic, rather than a short-term policy or technological fix. [5] When never-ending consumption patterns cease for the betterment of the world as a whole, then all systems will harmoniously interact in a non-abusive way. 5] Without needing to adopt a new religion, just recognizing and accepting this mindset can help to heal the environmental injuries of the past. Buddhists today are involved in spreading environmental awareness. In a meeting with the U. S Ambassador to the Republic of India Timothy J. Roemer, th e Dalai Lama urged the U. S to engage China on climate change in Tibet. [8] The Dalai Lama has also been part of a series on discussions organised by the Mind and Life Institute; a non profit organisation that specializes on the relationship between science and Buddhism.The talks were partly about ecology, ethics and interdependence and issues on global warming were brought up [9] According to some social science research, Christians and members of the Christian right are typically less concerned about issues of environmental responsibility than the general public. [1][2] Green Christianity is a broad field that encompasses Christian theological reflection on nature, Christian liturgical and spiritual practices centered on environmental issues, as well as Christian-based activism in the environmental movement. citation needed] Within the activism arena, green Christianity refers to a diverse group of Christians who emphasize the biblical or theological basis for protecting and celeb rating the environment. [citation needed] The term indicates not a particular denomination, but a shared territory of concern. [citation needed] http://en. wikipedia. org/wiki/Religion_and_environmentalism#Religions_and_the_environment

Ethics: Social Responsibility and Strategic Planning Essay

Strategic planning can be defined as the formulation of plans that will lead to well informed and sound decisions and actions that when implemented will help achieve all short and long term organizational goals. During this process, the creation of well defined mission and vision statements along with organizational values and policies that are directly related to the company’s goals will help the business organization achieve long term success. Because success or failure directly impacts all stakeholders, whether employees, suppliers, investors, the local governments or community in general, special considerations of their needs should be included in the strategic planning process. Because of recent well known corporate scandals, business organizations have incorporated business ethics codes and social responsibility programs as part of their strategy to boost their public image and reputation in the community along with the reduction of potential legal fees or financial settlements resulting from legal actions against the organization. Ethics refer to the fundamental principles of an individual or a group. Social responsibility is how a business performs its activities to meet its wider obligations toward the society and environment, such as by avoiding activities which may be harmful. Strategic planning is an essential preliminary step in the corporate world in which senior management defines the organization’s strategy, direction and decision-making. Ethical values and social responsibility serve an important role in the strategic planning process. Social Responsibility To the Stakeholders o Management must ensure that strategic decisions are reached after taking into account the possible impact on the stakeholders. Stakeholders are suppliers, customers, societies and anybody who is affected by the activities of the business. A socially responsible company treats stakeholders equally. Wider perspectives also have to be considered in terms of environmental and social impact of planned activities. Transparency o Members of management should provide information transparently and honestly to help all involved discuss, debate and reach better decision-making. This enables the team to identify and monitor any potential risks which may arise and find an alternative solution. In terms of social responsibility, transparency also enhances the company’s credibility toward its external stakeholders. Independence o A management meeting provides an opportunity for management team members to raise concerns and come up with new ideas. It should be conducted in a professional and coherent manner and everyone should be independent in providing ideas without fear or hesitance as this helps improve the quality of the discussion and the decisions reached. Respect o Members should respect others’ opinions by giving them the opportunity to speak and by listening to their ideas with interest. Constructive comments develop more intellectual discussion but should be dealt with in a way which does not hurt the other members’ feelings. Discussion in a friendly environment improves the relationship among the members, strengthens the strategic planning process and results in better decision-making. Fairness and Truthfulness o During the planning process, the team should take a fair and truthful look at the possible risks and impact of decisions reached. These need to be thoroughly considered to maintain the welfare of the stakeholders such as employees and the society at large. Members should be truthful and frank in providing ideas and comments. Loss of employment and retirement funds, double bonuses, tax evasion, and the dark side of office politics are some of the challenges affecting organizations like a virus causing professionalism and efficiency to be questioned. Walker and Lanis (2009) found that an organization influences and is influenced by the society within which it operates (Cengage, 2009); therefore, an organization needs to take into consideration issues such as product safety, regulations, legal, ethical and economic responsibilities to the society within which it functions. One of the methods which could be used to do so is to integrate ethical and socially responsible techniques in an organization’s strategic plan whilst taking into consideration the needs and agendas of stakeholders. This concept is supported by Drozdenko, and Jin (2010) who suggested core values and beliefs exhibited at the strategic level influences decision making and outcomes throughout an organization. The objective of this research is to explain the role of ethics and social responsibility in developing a strategic plan while considering stakeholder needs and agendas, including an example of a company which overstepped ethical boundaries and preventative measures which could be taken to avoid this type of situation. Ethics appears to be a subject most people take for granted. According to Ciulla (2004), most people think of ethics as practical knowledge and common sense as opposed to theoretical knowledge. Social responsibility involves operating in a society or environment not only to gain or increase profits but to do so in accordance with legal and ethical standards therefore making a positive contribution by adding to the value of life in an area of operation. What is strategic planning and what is the role of ethics and social responsibility when developing a strategic plan? Strategic planning as defined by Bryson (2004 cited from Olsen & Eadie) is â€Å"a disciplined effort to produce fundamental decisions and actions that share and guide what an organization (or other entity) is, what it does, and why it does it† (p. 6). One of the most important needs of a strategic plan is to determine the long term effects of decision making to ensure accountability. Therefore, if an organizatio n takes into consideration its ethical and social responsibilities to its clients, employees, and stakeholders when developing its strategic plan some important areas to focus on includes: Economic Responsibilities – A business should provide goods and services which the society wants at a fair price that provides adequate profits to ensure its long term survival and growth as well as to reward investors (Cengage, 2009). Therefore, although the main objective of an organization is to make a profit, it is imperative to remember profits made should not be made at the detriment of the society. Legal responsibilities – These are laws and regulations under which the organization is expected to operate (Cengage, 2009), however if the organization does not abide by these laws if needed, there is a mechanism in place to seek redress. Ethical responsibilities – The law, according to Cengage (2009) does not cover every issue or emerging issues which may be encountered by an organization. Ethics covers activities which are prohibited even though legislation may not exist at the time the unethical act occurred (Cengage, 2009). Philanthropic responsibilities – According to Cengage (2009) this is when an organization voluntarily â€Å"gives back† to the society by providing assistance, forming relationships and making contributions to improve the community. Kaufman, Browne, Watkins and Leigh (2003) indicated that one of the issues which caused the collapse of Enron, a giant US energy company was that the focus of its executives was for self profit as opposed to seeing to the well being of the stakeholders. By inflating stocks, presenting fraudulent financial reports, cheating, lying and intimidating employees Enron caused employees to lose their jobs, retirement plans, and stakeholders to lose billions of dollars. Additionally, hundreds of dot.com companies came crashing down, shocking international markets as stocks plummeted when it was discovered that â€Å"stocks were inflated through personal ambitions rather than the value they would deliver to shareholders and external clients† (p. 31). Johannesen, Valde, and Whedbee (2008 cited from Odell) stated â€Å"a society without ethics is a society doomed to extinction† (p. 5). This also applies to an organization. Therefore, an organization that is not ethical or socially responsible is doomed to fail. This is supported by Rhodes, C., Pullen, A., and Clegg, R., S. (2010 cited Verschoor, 2004) who believed there was a need to create moral strength and character by reintroducing personal conscience, responsibility, and values in organizations. The best measures to use in order to incorporate this type of behaviour, beliefs, and values within an organization is to integrate ethical and socially responsible objectives, goals, and activities into the strategic plan. Hence to prevent unethical behaviour and social irresponsibility it is important to put measures in place. Following the implementation of the Sarsbane-Oxley Act of 2002 it is imperative that organizations ensure financial reporting is done in a responsible manner. According to Cengage (2009) this legislation was implemented to minimize the use of fraudulent financial reporting and to protect the interest of all stakeholders. Creating policies and guiding principles are also measures which guides the organization to be ethically and socially responsible to its stakeholders by taking their needs into consideration. Last but not least creating a code of conduct which should be followed by all employees not only sets a standard within the organization but can be used as a criterion to reward and punish employees who adhere to or who do not adhere to the code. Conclusion: To create an ethical and socially responsible atmosphere within an organization it is imperative to put in place optimistic, high, achievable standards which must be incorporated at all levels of the organization. By focusing on legal, ethical, philanthropic, and economic responsibilities when creating a strategic plan which sets the direction and guiding principles of an organization ensures transparency and accountability. The world is changing and stakeholders are becoming more ethically conscious and prefer to develop relationships with responsible organizations. Therefore, employee safety, human rights abuses and other concerns such as bribes, corruption, the abuse of cheap labour, questionable payments and child labour which could negatively affect and organization, its image, and reputation should be at the forefront of the minds of executives when creating a strategic plan for the future of the organization.

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