Mainstream internationalisation theories

Mainstream internationalisation theories Mainstream Internationalisation Theories Instead of looking at the global strategy of the MNE from the viewpoint of management science, marketing, and decision theory, it is necessary to consider more explicitly the economics of the foreign investment decision. International business activity is not a recent phenomenon. However, the great majority of foreign investment until the late 1940s was in the form of portfolio capital, which international capital theory explained as the flow of capital among countries in the pursuit of higher returns. After World War II, the volume of foreign direct investment (FDI) grew tremendously and was increasingly directed away from primary goods and towards knowledge-based products that could be produced in developed countries. Neoclassical economic theory, with its assumption of perfect markets and internationally immobile factors of production, could not easily accommodate this post-war boom in FDI. So, beginning with the publication of the product cycle theory by Raymond Vernon (1966) and Stephen Hymers dissertation (written in 1960 and published 1976), an outpouring of literature has focused on extending the theoretical foundations of the concept of foreign direct investment. The objective of this chapter is to provide a review of the mainstream literature on internationalisation. Given my research problem, the focus is on theories that consider transnational expansion at the firm level. Among others, the investment development path (IDP) concept and Ozawas tandom growth treatment of the flying geese metaphor are popular frameworks for considering FDI. They are not included, however, since their research setting is that of the economy as a whole. Despite considerable disciplinary diversity, a mainstream internationalisation construct with three major approaches can be identified: Theories of the MNE, Internationalisation Process Models, and Network-based Approaches to Internationalisation. The first of these, Theories of the MNE, is outlined in Section 2.1. Since these MNE theories have been criticised on the grounds that they may explain the existence of the international firm but not how the firm got there, Section 2.2 reviews Internationalisation Process Models, which more explicitly focus on the dynamic process of internationalisation. Section 2.3 examines leading network-based approaches to internationalisation. The chapter concludes with a summary of the points that are most applicable to my thesis and an assessment of the limitations of the mainstream internationalisation literature. Theories of the MNE This section presents the economics-based literature on MNEs, beginning with Hymers seminal work. Following a review in Sections 2.1.2 and 2.1.3 of Internalisation Theory and Dunnings OLI framework, Section 2.1.4 focuses on theorisations specific to developing-country MNEs. Monopolistic Advantage Theory Hymers (1960) work represented a major departure from the standard orthodox theory of international trade and capital movements. The standard neoclassical trade theory of Heckscher and Ohlin, for example, carried restrictive assumptions about the immobility of factors of production and identical production functions across national boundaries. And in the neoclassical financial theory of portfolio flows, multinational enterprises had been viewed simply as arbitrageurs of capital in response to changes in interest rate differentials. Hymer argued that explanations for why firms engage in international production should be based on an analysis of the MNE from an industrial organisation perspective. According to Hymer (1976), Kindleberger (1969), and Caves (1971), MNEs emerged because of market imperfections. These imperfections were structural in nature and resulted from the control of ownership advantages, such as special access to inputs, scale economies, gathered managerial expertise, proprietary technology, and product differentiation (Kalfadellis and Gray: 2003: 3). The result of these barriers to entry was a divergence from perfect competition in the final product market. MNEs would seek to internalise these ownership advantages by establishing monopolistic-type advantages through the vertical integration of the potential licensee (Hymer 1976). Internalising operations could lead to gains such as cost reductions, product quality improvements, and innovation. For Hymer, though, the firm internalises or supers edes the market (1976: 48) primarily because, by internalising international economic activity, the MNE has an opportunity to further advance its monopolistic advantage. In short, it is the pursuit by firms of market power and monopolistic advantages in a foreign market that largely drives the international expansion of domestic firms. Internalisation Theory A criticism raised in the 1970s about Monopolistic Advantage theory was that it did not differentiate between imperfections brought about by market structure (i.e., the number and size of enterprises on both the demand and supply sides) and those associated with transaction costs. By not doing so, Buckley and Casson (1976) and others argued Hymer had failed to incorporate the insights of Coases (1937) concept of market failure. Coases theory of the firm contended that, contrary to the classical understanding in which price mechanisms optimally coordinate markets, market failure can occur as costs associated with the price mechanism develop (such as finding buyers and sellers, and the costs involved with negotiating, coordinating, monitoring, and enforcing contracts, and costs associated with government regulations and taxes). The operation of markets is therefore not costless, and the firm is an organising unit that supplants the price mechanism. Domestic firms would prefer to use internal prices in the face of excessive costs in the outside market. Firms therefore seek to avoid these costs by internalising them wherever the market is non-existent or when it is cheaper for the firm to undertake the activity internally rather than via the market mechanism. To Coase, markets and firms were alternative methods for organising economic exchanges. The choice between the two depended on whether a firm evaluated the transaction costs of an exchange to be lower if carried out within the firm than through the market. Where the costs of such transactions are lower when carried out within the firm than through the market, the activity will be internalised under the firms ownership and control. The concept of transaction costs was more fully developed by Williamson (1975) and Chandler (1977). Transaction cost theory extended Coases work by substituting a conception of contractual man for neoclassical theorys economic man. Its starts with the assumption that markets are the natural mechanism of economic organisation (Williamson 1975: 21), and that market failures lead to the replacement of certain market relations by internalising these relationships within a firm. The deficiencies of the market system are seen to be rooted in bounded rationality (i.e., the lack of perfect knowledge which means that agents cannot foresee all possible circumstances to incorporate in the contract) and opportunism (i.e., agents make decisions based on self-interest, thus making the contract difficult to enforce). Drawing upon Coases (1937) theory of the firm and Williamsons (1975) and Chandlers (1977) transaction cost theory, Buckley and Casson (1976) argued that these same insights can be applied to the global arena to explain the growth of MNEs. Accordingly, Buckley and Casson explained international expansion as occurring whenever a market imperfection exists and a firm can gain strategic benefits by internalising a market across national boundaries and exploiting the advantage this gives it in competition with others. This results in the growth of the firm. Just as a firm may increase its efficiency through internalising transactions, the vertical integration of global operations may lead to economies and efficiencies. These include long-term contracts through more efficient governance structures, the chance to exploit tax differentials and foreign exchange controls, better quality control, and RD benefits. Brown (1976) also combined insights from Coases theory with transaction cost theory and applied it to international expansion. He put particular emphasis on the point that there are higher market transaction costs and more expenses associated with internal organisation abroad than in the domestic environment. Teece (1983) added the insight that internalisation can also be advantageous when vertically-integrated firms need to secure their supply of intermediate goods. So, whereas transaction cost theory aims to explain the existence of the firm, the aim of internalisation theory is to explain its multi-plant operation over space (Casson 1982). And whereas Hymer argued that it is the pursuit of market power that drives MNE growth, Buckley and Casson (1976) argued that once transaction costs are internalised they do not necessarily lead to an increase in rent by the MNE. However, they can result in savings for the MNE, and it is this potential cost minimisation that provides the impetus for MNEs to expand their operations via the internalisation of transaction costs. Internalisation theory has been a dominant construct in the last quarter century of international business literature in relation to the growth of the MNE and FDI. However, it does have weaknesses. For instance, internalisations inherent intangibility makes it difficult to empirically test (Kalfadellis and Gray 2003: 10). Buckley, describing internalisation as a concept in search of a theory (Buckley 1983: 42), argued that a theory needs to do more than assert firms will internalise when the cost of using markets or contractual agreements is higher than that of organising it within the firm; it needs to explain why there were differences in costs between market and intra-firm organisation (Hennart 1986: 791). It has also been seen as overly-preoccupied with the costs of organising transactions in markets, leading it to under-appreciate other relevant costs, especially those associated with managing firms across borders (Demsetz 1988). An argument has been made that it does not sufficiently distinguish between a firms willingness and its capability to become more international (Dunning 1993). These types of limitations led Calvet (1981), among others, to question whether the assertion that firms expand overseas because they can internalise transactions within their hierarchies (just as they do within a domestic context) is a full enough explanation. Calvet argued instead for a theory of transnational expansion that explicitly included both the multinational-the foreign-character of the activity as well as the internalisation of transactions within a single firm. Dunnings OLI Paradigm A third landmark development in MNE theory was Dunnings OLI paradigm, sometimes referred to as the eclectic paradigm. Countering Rugmans (1982; 1985) claim that internalisation is a general all-encompassing theory which can explain FDI, Dunning (1980; 1988; 1993; 1995; 2000) acknowledged the importance of internalisation theory but argued that set[ting] out to explain the growth of international production as a market replacing activity (Dunning 1988: 24) explains only part of the FDI phenomenon. Dunning argued that a full explanation required the integration of the insights from three strands of economic theory industrial organisation, international trade theory, and internalisation theory into a general theoretical framework.[1] Each dimension on its own was insufficient to explain the multinational firms engagement in foreign production. According to Dunning, a firm must perceive certain advantageous conditions before it engages in cross-border investment. These advantages are rationally considered within the firms decision-making process. The first relates to ownership (O) advantages, which, following Hymer, refer to assets or resources capable of generating a future income stream that could compensate for the higher costs of operating abroad. Ownership advantages are endogenous to the firm and refer to intangible assets and/or property rights. These O advantages give the firm a competitive edge vis à   vis other firms. The second factor is internalisation (I) advantages, which encourage a firm to internalise operations for production via foreign direct investment rather than through exporting or licensing to a local producer. In other words, the firm must perceive the benefits of internalising of operations to be greater than the need to utilize markets. If a firm perceives it has sufficient O and I advantages, th en it will examine a third set of conditions, location (L) advantages. Choosing a foreign location is one of the key decisions made by a firm since the financial and human capital invested must generally be long-term in nature. Drawing upon the insights of location theory, Dunnings L advantages were considered to be external to the firm and determine which host country is selected for expansion. (A fourth condition later added by Dunning [1993] asserted that a firms international investment activities must harmonize with its long-term management strategy.) In the eclectic paradigm, all three of these conditions must exist for FDI to occur. If a firm only perceives it has ownership advantages, then it would be likely to license abroad. If it also perceives internalisation advantages, then it would be likely to exploit its O advantages through exporting. It is only when location advantages are also perceived that the firm may consider FDI (Dunning 1993: 196). Dunnings OLI paradigm has been welcomed for its conceptual richness-it integrates many partial approaches to the subject and therefore addresses a larger number of the factors considered in the decision to internationalise-and it has withstood some empirical testing (Dunning 1979, 1983, 1988). However, it has also frequently been criticised, particularly on definitional grounds. For example, Rugman and Dunning had a long-running public debate over whether Dunnings concepts of ownership and location advantages were already encompassed in the theory of internalisation (Parry 1985). In a similar vein, Buckley (1988) suggested that considering ownership advantages as a separate category results in double counting as the O advantage of Dunnings OLI triumvirate is already accounted for by I (internalisation advantages) since the firm seeks to carry out a strategic move by internalising the market and thus exploits this advantage in competition with other firms. Responding to definitional criticisms, Dunning (1995) argued that, in contrast to how they are conceived in internalisation theory, ownership advantages are endogenous rather than exogenous variables already belonging to the firm. Accordingly, he stressed a definitional division between ownership advantages, which are already possessed by firms, and internalisation advantages, which result from the firms exploitation of market imperfections. The electric paradigm has become a leading conceptualisation for FDI, and as such there now many variants within the approach. For example, another eclectic framework that is pertinent to my thesis concentrates on understanding how a firm chooses among various entry modes. In comparison to Dunnings OLI paradigm, the framework by Hill et al. (1990) emphasised the control of resources, resource commitment, and the dissemination risks of entry. They argued that firms rationally weigh different entry modes with the need to control their foreign operation. The amount of control a firm can exercise varies from minimal in the case of licensing to maximally high in wholly-owned subsidiaries. A firm also weighs the resource commitment that is involved with the different entry modes, and the risk that its firm-specific advantages could be disseminated or expropriated by a partner. As discussed in Chapter 5, the latter danger was frequently highlighted by my interviewees as an influence on thei r internationalisation decisions. Though eclectic models such as those by Hill et al. and Dunning have a dominant place in the MNE and FDI literature, they do have significant shortcomings. Some critics find the emphasis on the initial phase of internationalisation makes them unhelpful. Others have argued that inadequate attention was given to the insight that firms make cross-border investments not just to reap benefits from existing ownership advantages but to create new ones, such as acquiring knowledge in new markets or access to resources. Also, the broadness of the eclectic decision-making framework has made it difficult to formulate operationally testable theories of foreign direct investment processes, especially given the heterogeneity of firms. Various proxy measures have been employed as a means for measuring internalisation, but the validity of proxies in general has been contested (Kalfadellis and Gray 2003: 11). Similarly, ranking the large variety of strategic alternatives the firm can choose among is methodologically problematic. Two other criticisms of the eclectic decision-making paradigm have been particularly acute and are of specific concern given the subject of this dissertation. The first is that they principally focus on relatively large firms from developed countries. Dunnings OLI paradigm, in common with the other theories of the MNE reviewed in Section 2.2, was developed primarily in response to the experiences of post-war expansion by developed-country multinationals. Transnational firms from developing countries, it has been argued, require a different approach (Lall 1983a; Wells 1983a; Khan 1986a; Yeung 2004). For instance, as they are frequently much smaller than developed country MNEs, their transnational investment choices may be more chunky in nature, in the sense that certain costs that are incurred in international activity will loom relatively larger for small firms than big ones. Second, the eclectic framework has been criticised for its lack of dynamism. While it is not true that Dunnings OLI model has no dynamic dimension, Buckley (1985: 18), for example, argued that it does adequately consider the deployment of advantages over time.[2] Both of these shortcomings are apparent when eclectic frameworks are applied to the phenomenon of Singaporean SME transnational expansion into China. Developing-Country MNE Theories A dramatic growth in outward FDI flowing from developing countries has occurred over the last three decades. Prior to the 1980s, more than 90 per cent of global FDI originated from developed countries. Since the early 1990s, though, the share of outward FDI from developing countries has rapidly grown; it was over 14 per cent in 2006 (WorldBank 2008). Moreover, aggregate figures conceal the relative intensity of developing-country FDI flows from, and into, certain countries and regions The bulk of this outward FDI-some 67 per cent-has originated from South, East, and Southeast Asian countries (WorldBank 2008). Though the availability and quality of FDI data has been problematic-an important point which is discussed in Chapter 6-it is clear that China has received a particularly large percentage share of FDI originating from developing countries. A number of researchers have argued that MNEs originating in developing countries possess distinctive characteristics in comparison to their counterparts from developed countries (Lall 1983a; Wells 1983a; Khan 1986a; Yeung 1996). One obvious difference is that they are generally much smaller, which may make locational advantages and the internalisation of transactions costs less plausible explanations for internationalisation (Wells 1983a). Though still dwarfed by the number of theoretical and empirical studies investigating developed-country MNEs, research into these unconventional MNEs (Giddy and Young 1982) has by now developed into a large body of literature that can be divided into two categories: first-wave and second-wave literature. The so-called first-wave literature emerged in the late 1970s and was primarily concerned with the cost advantages of developing-country firms in comparison with their competitors from developed countries. Two strands of literature dominate. One is based on Wellss (1983) application of the product cycle concept (originally associated with Vernons seminal article [1966]) to the situations found in developing countries. The second dominant strand of first wave literature is associated with Lall (1983). Wells contended that an understanding of developing country transnational firms could be undertaken by applying Vernons concept of the product cycle (1966), which explained changes in production locations as a reaction to different stages in a products life cycle. Vernons argument was that a new product had to be produced in the home country since it was unstandardised and thus production needed to be monitored close to the products source of innovation and markets. As the product matured and became standardized, producers would increasingly become concerned about production costs and seek cheaper production sites elsewhere. Thus, Vernons model suggested that locations of production moved from developed countries to less developed ones as products went through their life cycle over time. This would then explain investment flows from developed- to less developed-countries, and flows among less-developed countries. The uniqueness of Wells approach lies in his application of the product cycle concept to explain the emergence of developing-country transnational firms. Wells suggested that the markets and characteristics of developing countries influence local firms to innovate in ways that are more suited to the development conditions found in their country. In particular, he pointed to the smaller size of the markets and relative abundance of cheap labour in developing countries as key influences on local firms. Wells suggested that firms developing in this kind of environment could build their initial advantages from descale manufacturing, a process of adapting technologies from developed countries to suit less developed markets by reducing scale, replacing machinery with manual labour, and relying on local inputs. The cost advantages to be derived from descale manufacturing would constitute a very important ownership advantage, and, to exploit these costs advantages, developing country firms w ould concentrate on serving the price-sensitive market instead of the specialty markets dominated by firms with the resources for massive marketing. This kind of low-cost, low-price competitive strategy would largely confine the transnational expansion of developing country firms to those markets of other developing countries at or below the host countrys economic status. Changes over time in investment flows would occur as this cost advantage was gradually undercut by the catch up of local firms or affiliates of advanced-country multinationals. Wellss model has been influential, though it does seemingly suggest a rather pessimistic future for developing-country transnational firms (Wells 1983 and Aggarwal 1984). Taking a different approach, Lall (1983) argued that the smaller size of production in developing countries was not by itself evidence of a descaling advantage (1983: 11). He did not share Wellss pessimism over the sustainability of developing-country firms, asserting instead that such firms could generate their own sustainable proprietary assets to be exploited successfully in transnational operations. Lall saw the development of these proprietary assets as entailing different innovations than those used by multinationals from developed countries; for instance, they would come from widely diffused technologies and from a special knowledge of developing-country markets. They would be sustained, Lall contended, by the localisation of technical change and the irreversibility of such change. So, developing-country firms could develop products more suitable to developing-country markets, and innovations could be localised around techniques more relevant to developing-country market condi tions (such as cheap labour). Thus, according to Lall the ownership advantages of developing-country transnational firms come about not because of their ability to descale manufacturing technologies to smaller markets, but rather are derived from their greater knowledge of operations and conditions in developing-country markets (see also Kimura 2007). Such advantages would not necessarily be eroded over time, as suggested by Wells, since firms could engage in RD and continued learning. Challenging these models by Wells and Lall is the so-called second-wave literature that emerged in the early 1990s. This new strand was a response to the apparent changes that were seen to characterize more recent developing-country transnationals. For instance, it was observed that they were investing in markets farther away from home, in some cases in highly competitive markets such as the United States and European Union, and in new sectors, some of which did not depend on labour-intensive techniques. Moreover, the ownership-specific advantages of the newer transnational firms had changed. No longer did they seem primarily dependent on small-scale, labour-intensive technology, low-price, and low-cost operations. Now, they appeared to also derive ownership advantages from their ability to accumulate technological capabilities and to improve their production efficiency (Dunning 2000). This last observation in particular encouraged second-wave theorists to apply the concept of technological accumulation to try to understand the more recent transnational expansion of developing-country firms (e.g., Dunning 2000; Ulgado et al. 1994). The result was a model that proposes that over time technological accumulation can lead to a more sophisticated structure of outward investment. This gradually comes about, it was argued, as firms accumulate technological expertise and experience in foreign markets. Although their technological capabilities are not based on frontier technology, developing-country firms are believed to innovate and accumulate technological skills that will be appropriate to the environment of developing-country markets. Thus, a firms initial outward investment, which is originally centred on resource-based and simple manufacturing activities in markets close to home, changes to focus on more sophisticated manufacturing activities, eventually even to resea rch-intensive and differentiated products. Through this path, second-wave theorists suggested, firms can enhance their technological capabilities over time, which will improve their ownership advantages, and, eventually, allow them to catch up with competitors from developed countries. A variant within the second-wave approach was proposed by van Hoesel (1997). He argued that firms from developing countries begin their technological accumulation process by gradually climbing the value-added ladder, from shop floor production operations upward to other value-added functions such as marketing or RD activities. They need to do this, according to van Hoesel, because developing countries are latecomers to the industrialisation process and therefore their firms do not have significant proprietary innovations (in some respects, van Hoesels approach is similar to the Late Industrialisation framework, reviewed in Section 2.3.3). The ownership advantages of developing-country firms are therefore seen to lay initially in the lower value-added production units, with international expansion largely a function of the incremental accumulation of technology that moves the firm up to more sophisticated operations. This incremental technological accumulation process is also held to determine the organisational form of the firm, with early investment forays typified by lower-risk and less-committed forms, such as sales representatives and joint ventures with local partners, and later investment characterised by more complex forms, such as wholly owned subsidiaries or acquisitions of local firms. Despite the valuable insights provided by both the first- and second-wave literature, it has generated criticism on methodological, empirical, and theoretical grounds. From a methodological point of view, Ulgado et al. (1994: 125) raised the important point that most of these studies of investment by developing-country firms consist mainly of macro-level considerations at the expense of micro-level studies of organisational, operational, and managerial workings. These aggregate analyses often fail to reveal the detailed dynamism of the internationalisation process and the other aspects of business organisation, such as the cultural, political, and social context. Moreover, the FDI from some countries is heavily concentrated in particular markets or industries, and this may lead to research bias. For example, van Hoesel acknowledged that, as his study was of Korean and Taiwanese MNEs in the electronics industry, his conclusions might not be applicable to other developing country MNEs (1997: 239). In fact, it should be more pointed out more generally that the availability and quality of FDI data from developing countries is limited and therefore conclusions drawn from it may not be reliable. In short, more studies at the firm level are called for to provide insights on the internationalisation behaviour of MNEs from developing countries. Section 2.1 has reviewed a number of conventional economics-based theories of FDI. They share the perspective that FDI is motivated by a firms desire to exploit its proprietary advantages abroad. These advantages are seen as transferable from country to country within a firm, but transferred only with difficulty between firms. While the proprietary advantages from developed-countries are derived from frontier technologies and sophisticated management and marketing, those for investors from developing-countries are embodied in imported technologies that have been localised through imitation and adaptation. These theorisations, however, are often criticized for their rather aggregated analyses and for their emphasis on explaining the structure of MNEs as opposed to the process by which firms internationalise. The following section reviews models that explicitly concentrate on the dynamics of transnational expansion. Internationalisation Process Models Internationalisation process theorising began with the early studies carried out in the 1970s by a group of Scandinavian scholars. Unlike the economics-based theories reviewed in Section 2.2 which accept the neoclassical economic model of rational agents exhibiting optimizing behaviour as a core assumption, the so-called Scandinavian School is rooted in the behavioural theory of the firm (Cyert and March 1963; Hosseini 2005: 528-9). The behavioural dimension is the assumption that learning takes place in response to limited cognitive capabilities in a complex and uncertain environment. Accordingly, internationalisation process models attribute the timing of market entry, its structural form, and its development over time as functions of the increasing commitment of managers to foreign markets. The process behind this increasing commitment is not (neoclassical) rational executive decision-making but an incremental learning trajectory that is human- and history-dependent. A variety of internationalisation process models can be found in the literature. These have often been divided into two groups (Andersen 1993). The first group is the so-called innovation-related lear

Curleys Wife in Chapter 4 of Of Mice and Men

1. What does Curley’s wife mean when she says, ‘They left all the weak ones here’? 2. State the three things that you think are most significant about Curley’s wife’s character, situation or behaviour in this chapter. 3. Find and copy down the quotations which show how Crooks reacts to the threats of Curley’s wife. What exactly is she threatening, and why does Crooks react in the way he does? 4. What is Candy referring to when he says that Curley’s wife ‘can move quiet’? 5. (Links to question 2) How does Curley’s wife come across to you in this extract? Compare how she has been portrayed before to how she is now. 6. How do you think Lennie feels about Curley’s wife now? Extension: There are some descriptions in this extract which suggest disturbance. These create a mood for the final events in the novel. Find these, and comment on them. Answers: 1. When Curleys wife says they left all the weak ones here I think she is referring to the reality that because of their circumstances; candy, crooks & Lennie were not capable of visiting the whore house like the other men. Curelys wife is suggesting that they are weaker because of their incapacity to take part in some of the activities other men can. 2. In this chapter I think that Curleys wife comes across as unkind cruel and nasty. She gives off the impressions that she likes feeling higher than others and she seems as though she can be quite dishonest with a inclination to lie. 3. â€Å"Crooks stared hopelessy at her and then sat down on his bunkk and drew into himself† i wrote in my opinion candy says curleys wife can ,move quite because he is making reference to and notifying the fact that curley;s wife is quite sly in what she does as she causes problems and looks for trouble without being seen or heard from others especially curley

Drawing Blood

Drawing blood is not as challenging as you may think. When I started my job at the hospital, I had no previous experience in drawing blood. They put me through a training that lasted about five days, eight hours per day. There are many simple steps to drawing someones blood. The three biggest steps are waiting for a requisition to print off, preparing all of your equipment, and finally draw the blood. Step one is to get the requisition and take it into the patients room, you use this to verify the patient. You first identify yourself and indicate the procedure that is about to take place. Check the date and order time on the requisition form. Verify their name, date of birth, and sex. You have to verify the patients allergies to make sure they are not allergic to latex or any of the antiseptics or adhesives that are to be used. If patient is unresponsive you are not allowed to draw the blood unless they have a patient sticker on their armband. You have to verify who the person is. You then check the requisition form for what tests are being requested so you will know what and how many of each tubes to draw blood into. Step two is to prepare your equipment that will be used in this process. The number one item would be gloves, you use these to not only protect yourself but also the patient. You will need to have a tourniquet, 70% isopropyl alcohol wipes, gauze sponge, to apply to site after needle is withdrawn, an adapter to use with the evacuated collection system, needles, adhesive bandage, to protect site after collection, and tubes to place the blood into. After getting all of this together properly you move on to the final step. Step three, this is the final process, the actual blood draw. First tie the tourniquet about 3 inches above the site you are wanting to withdraw blood from. Have the patient make a fist but do not have them pump their first. Then palpate and trace the path of the vein with the index finger. The vein should feel cord-like and it should roll easily. When you find the vein you are wanting to draw blood from you then prepare the site. Using an alcohol pad, clean the site in circular motion. Let the site air dry. Next, grasp the patients arm firmly. Place needle in a fifteen to thirty degree angle with the arm. Swiftly insert needle through the skin into the vein. Then fill the required tubes. In the meantime of you filling the last tube you will remove the tourniquet from the arm. You then swiftly remove the needle from the arm and safely lock the needle. Immediately following, apply the gauze to the site with addequette pressure to avoid a hematoma. After applying pressure for approximately fifteen seconds you bandage the site. Then dispose of the needle in a sharps container and throw contaminated materials in their proper containers. Mix blood in a shaking motion. Then label all tubes of blood in the patients room. Finally you are ready to deliver it to the lab.

Ludwig Van Beethoven Essay - 1285 Words

German composer and pianist, Ludwig van Beethoven, was born December 1770 and spent most of his life in Vienna, Austria. His first teacher was his alcoholic father, who worked as a musician at the Court of Bonn. Teaching him day and night, Ludwig suffered from his fathers harsh and erratic behavior. For a time, he and his father played at the Church. As his fathers alcoholism increased, Ludwig became the main musician. Beethovens talents were discovered at an early age, and he was sent to Vienna to study under different teachers including Mozart and Hayden. There, Beethoven quickly adopted a reputation of a great piano player, a child prodigy. He gave his first public performance at the age of eight and published his first†¦show more content†¦Music was his life and he was deeply depressed and angry at the thought of being deaf. He even became suicidal. His relationship to his music was very serious, and though he continued to compose music, he never performed again following a failure to perform his Piano Concerto No. 5 Emperor in 1811. Following many personal crises in his life, Beethovens music reflected his mood. His masterpieces depicted struggle followed by triumph. Later, his worked was influence by the ideals of Enlightenment, leading him to dedicate the symphony Erotica to Napoleon. The symphony Ode to Joy was believed to be about the brotherhood of humanity. His works are admired for intellectual depth, intense expression, and experimental forms. He is considered one of the greatest minds of humanity. His ambitious works made him prominent in the transition between eras of Classical and Romantic music. Music had driven Beethovens life from a small child to an adult. It helped him overcome an alcoholic father, his mothers death, failed love, and provided a means of support for his family. It carried him through personal crises including the loss of his hearing and won him critical acclaim in social circles. His life ended in 1826 following complications of a cold and chronic health problems. He used his music to preach through art and has remained a model to later composers in the use of classical principles ofShow MoreRelatedLudwig Van Beethoven945 Words   |  4 PagesLudwig van Beethoven Beethoven was born in Bonn, Germany in 1770 to Johann van Beethoven and his wife, Maria Magdalena. He took his first music lessons from his father, who was tenor in the choir of the archbishop-elector of Cologne. His father was an unstable, yet ambitious man whose excessive drinking, rough temper and anxiety surprisingly did not diminish Beethoven s love for music. He studied and performed with great success, despite becoming the breadwinner of his household by the time heRead MoreThe Music Of Ludwig Van Beethoven900 Words   |  4 PagesLudwig van Beethoven All throughout music history lived many composers that have impacted not only the societies in which they have lived in, but modern-day society as well. These particular composers have given many societies the chance to listen, feel and express themselves through music and instruments that were invented centuries ago that still remain essential components of music today. One example of a composer that changed the music world drastically was a man by the name of Ludwig van BeethovenRead MoreThe Talent Of Beethoven By Ludwig Van Beethoven1331 Words   |  6 PagesMany of my family members along with some family friends suffer from an extreme lack of hearing just like one of the greatest composers of all time, Ludwig van Beethoven. However, my family members and family friends are not musicians. The talent of Beethoven is very inspiring for not only the deaf, but for other people as well. He created most of his music while suffering from hearing loss which seems to be quite impossible , but somehow he managed to do it. Though his music is without a doubt unbelievablyRead MoreEssay on Ludwig Van Beethoven1148 Words   |  5 Pagesthe people on it as a whole, you see that there are very few influential people whose actions or opinions strongly influence the course of events. Ludwig Van Beethoven, a German musician, is one of those very few. He was an extraordinary musician that lived through hardship and had the horrific fate of deafness, any musician’s worst nightmare. Beethoven left a wall standing in history that captured the art of sounds and worked it beyond imagination into music so fragile and pure yet onerous, unableRead MoreThe Music Of Ludwig Van Beethoven1408 Words   |  6 PagesLudwig van Beethoven When I was 7 years old, my parents signed me up for music school. I did not want to go to music school, but they wanted me just to try. In first class we were just listening classical music and it really sounded boring. But when Beethoven’s fifth symphony came on, I fell in love with classical music and I wanted to study it even more. My sister was also in musical school and she played piano and when I came back from school, I was begging her to play me some of Beethoven’s piecesRead MoreThe Music Of Ludwig Van Beethoven1600 Words   |  7 PagesLudwig van Beethoven is known for much of his musical accomplishments. One of his most famous is that he is deaf and yet one of the best musical composers of the classical and romanic area. Beethoven has always been one of my personal favorite composers. When I grew up and started taking piano, Beethoven s Fur Elise was my first large classical piece. Ever since that point on I insisted that when we were in Germany we see his home, and that we did. In this essay I will be explaining Ludwigs YouthRead MoreThe Rise Of Ludwig Van Beethoven1458 Words   |  6 PagesThe rise of Ludwig van Beethoven into the ranks of history s greatest composers was paralleled by and in some ways a consequence of his own personal tragedy and despair. Beginning in the late 1790 s, the increasing buzzing and humming in his ears sent Beethoven into a panic, searching for a cure from doctor to doctor. By October 1802 he had written the Heiligenstadt Testament confessing the certainty of his growing deafness, his consequent despair, and suicidal considerations. Yet, despiteRead MoreLudwig van Beethoven Essay952 Words   |  4 Pagesmusic period. Ludwig van Beethoven was one of the composers, along with other greats of the time like Haydn and Mozart, which helped to create a new type of music. This new music had full rich sounds created by the new construction of the symphony orchestra. Ludwig van Beethoven was born in the town of Bonn, Germany on December 16 of 1770. Bonn is located in western Germany on the Rhine River. Beethoven showed an affinity for music at an early age. His father, Johann, taught Ludwig to play theRead MoreMusic: Ludwig Van Beethoven1670 Words   |  7 Pagesexpressiveness music is Ludwig van Beethoven. He was a musical genius whose composed some of the most influential pieces of music ever written. During the Classical period, Beethoven’s compositions were the expression as one of the most powerful musical personalities. Although Beethoven was influenced by most of the famous composers such as Franz Joseph Haydn, Wolfgang Amadeus Mozart, etc. but he was also innovated new techniques that will be seen in the next music period. Beethoven built a musical bridgeRead MoreThe Music Of Ludwig Van Beethoven1701 Words   |  7 Pages Ludwig van Beethoven Music has been around a long time and is a big part of America’s history. There are many styles of music such as, Rap, RB, Jazz, Classical, Oldies and so on. There has been many great composers throughout the years, these people are legends that will stand for ever such as, Beethoven, George Frideric Handel, and Wolfgang Amadeus Mozart. The one artist that I’m going to write about in this paper is the one and only Ludwig van Beethoven. Beethoven was a deaf German