Treatment of Tb Essay Example for Free

Treatment of Tb Essay Tuberculosis, they say, is a disease of the poor and truly it is a disease that puts us high above other nations in the world. We are currently among the 22nd high TB burdened countries and are under the WHO TB watch list. Tuberculosis is such a problem for us. Imagine, 75 of our fellowmen die each day because of TB. Tuberculosis, however, is not a terminal disease. Before, people thought once you have TB you’ll just die not cured with the disease. But now, it is actually very curable. Our government, in addressing to this dreaded disease, formulated the National Tuberculosis Program or NTP. This program envisions our nation as a country where TB is no longer a public health problem. The goal therefore is to reduce the prevalence and mortality from TB by half by the year 2015. Now, this is where DOTS comes in. At first, I thought DOTS is just about making sure that the patient is really taking in his TB regimens – like literally swallowing the medicines on schedule. It, however, is not just as simple as that. DOTS or Direct Observed Treatment, Short-Course is the WHO-recommended strategy for diagnosis, treatment and management of TB. Since TB is curable, the WHO believes that the best way to cure TB is through DOTS. It is a health strategy made up of five important components: Political Commitment for TB Control; Facilities for Microscopic Diagnosis of Sputum Positive Smear Patient; Unlimited Supply of Good Quality Anti-TB Drugs; Direct Observation of Therapy; and, Good Record Keeping. Through these components, it is made sure that the program is managed properly and that the sputum microscopy is of good quality. The program is embraced by the government and made sure it is implemented. Health professionals are taught and trained well on the importance of the program, precautionary measures, how to deal with the TB patient, and, most importantly, on the proper identification and reporting of sputum microscopy results. There is therefore uniformity in the reporting of laboratory results. The government has also allotted a specific monetary budget for the services of the health professionals under this program. There is also the regular supply of drugs, not only just drugs but medications that are of good quality and recommended by the WHO. More importantly, these drugs are FREE! All the patient has to do is to comply with the treatment. But, there are still patients who are, well, â€Å"human† – remarkably wise, talented entrepreneur (because some sell their TB medicines to others who also present with TB symptoms as they have). They have a mind of their own; they have their own treatment strategy. These make TB treatment difficult and pose threat on the development of resistant organisms because the medications are not taken on proper dosage and duration. It is because of this that there is this 4th element of the DOTS strategy – the direct observation of the treatment partner (treatment partners could either be a Staff of the Health Center, Member of the Community , or Member of the patient’s family (last priority)) of the patient taking in the TB medications. With good record keeping, the patients are properly monitored and followed up wherever they may be in the country. With just one missed appearance on treatment appointments, the in-charge health partner is alerted. There’s no reason at all for non compliance. What is more wonderful with DOTS in our country is that we have this PPMD or the Private – Public Mixed DOTS. This is very important because even the private health institutions apply DOTS so that wherever may the patient consult he or she is directed to the same treatment strategy for TB which ensures patient receives proper treatment and program benefits. Upon enrollment with the DOTS program, there is an allotted box of medications both for the intensive phase and the maintenance phase – the Stop TB Kit. With those new pulmonary smear positive cases and new seriously ill pulmonary smear negative cases, the intensive treatment is made up of four regimens: Isoniazid, Rifampicin, Pyrazinamide and Ethambutol. The number of capsules taken will depend on the weight of the patient (since usually the four drugs mentioned are formulated on a single capsule). Like for example, a patient weighing between 38-54 kg will be taking 3 tablets each appointment time with the treatment partner. The intensive treatment lasts for 2 months then a sputum smear will be requested. If patient is still sputum AFB smear positive there will be a month extension for the intensive phase. Afterwhich is the 4 months of maintenance phase. The regimen usually is composed of Isoniazid and Rifampicin. The kind and number of treatment regimens for tuberculosis is such because the TB bacilli, although TB is curable, is very difficult to eradicate and are prone to resistance. This is also why compliance is very important to prevent further development of resistant organisms. Whenever there are MDR TB patients (Multi Drug Resistant TB), they are referred to a higher center in Manila. There, patients are housed for 24 months, still free treatment. I think each MDR patient is budgeted with 500 1 million pesos such a huge amount. It is important therefore for us to prevent the development of such resistant organisms if we want our taxes serve the majority and give us better lives. Through the exposures regarding the DOTS, I now have a great appreciation for this program of the government. Whenever I will have an encounter with a possible TB patient, I could confidently refer him to a DOTS facility. I am hoping that we will truly be able to achieve our vision with regards to tuberculosis control as a nation.

The Roaring Twenties and the Prohibition

The Roaring Twenties and the Prohibition Roaring 20s Essay The 1920s were a time of tremendous change in America. It was a period of time called The Roaring Twenties, where America becomes urban and commercial and gets to know the speed, spending, mobility, entertainment and fearlessness. Separating the two wars( World War I and World War II), the 1920s followed significant events such as the sinking of the Titanic (1912), the invention of the stainless steel (1913) and the completion of the Panama Canal(1914), the first transatlantic flight (1927-Charles Lindbergh). Unfortunately, this period could not last forever; the 1930s soon led to the beginning of the World War II, a conflict that cost 6, 700, 000 civilian deaths in the Soviet Union alone. During the Twenties, new aspects of culture were established, the economy was prosperous, there was a widespread social reform, and people found a better way to enjoy their lives and improve their lifestyle. Most of the population preferred to move in urban areas rather than living at rural farms, the main reason being an agricultural depression (U.S lost agricultural markets in postwar Europe). Americans were making and spending more money. As well as having more money, Americans also had more free time because the labor movement reduced to only eight hours in a typical work-day. Furthermore, there were introduced more and more applications suited to the personal lives of individuals and available to a mass market (vacuum-cleaners, fridges, radios). Business taxes were low (presidents Harding, Coolidge and Hoover did not interfere in business) and import taxes were high (tariffs), protecting American industry. Also, advertising industry started to flourish and change: for example before, the producer announced the existence of a product in a dull, dry fashion, but in the 1920s, the producer persuades the public. During those years, people bought different appliances and cars, which gave them more free time and made their lives easier (Henry Ford uses TV newsreels to advertise the new model T). The number of cars increased quickly; in Chicago, in 1915, there was one automobile for 61 persons and in 1930, one for 8 persons. Ford offered big wages (5$/day), as he correctly assumed that mass production economy would eventually fail, unless workers were paid enough to buy the products they made. The main convenience of a private care in the 1920s was great mobility, followed by traveling for fun (rural people were now likely to spend the time in town and were less isolated), better employment possibilities, not only in the car industry, but also other industries such as rubber, steel, oil, glass. Education also increased, and by the 1920s many states passed laws requiring children to attend school, helping force children out of workplaces. Throughout the 1920s, people were more and more interested in music, the period was also called The Jazz Age. The core of jazz music was in Harlem; a musical form belonging to the South and played mostly by black people. From the most known jazz musicians we remember Louis Daniel Armstrong (1901-1971) from New Orleans, Louisiana. During the decade, a new woman was about to be created. Women smoked and danced and wore make-up. They were called flappers- because of their giddy attitude and their outer clothing(looking like a boy). Flappers mostly lived in cities, though, rural people read about them in magazines. In much of the U.S, women only read about flappers in magazines but many disapproved of flappers or would not dare to be so reckless. The 1920s were a prosperous time, but not for everyone. It was also a period of intolerance and isolationism. There were imposed new restrictions on immigration, minority groups were still being discriminated and the Ku Klux Klan was powerful in the South. In addition to this, because of having too much free time and influences of a new lifestyle, urbanization and modernization, the alcohol consumption became excessively. At first, the focus was the moderation of the consumption, but then turned to be a complete prohibition of alcohol. The Prohibition Prohibition (the noble experiment) had quite an effect on American life in the 1920s. People hoped that a result of the Prohibition would be the reducing of crimes and corruption, solving social problems, improving health and hygiene in America, creating a moral society; but it had the opposite effect. Drinking, transporting, making and selling alcohol became illegal and many found it to be exciting and glamorous so, illegal clubs sprang up where people could go socialize and drink. Over the years, a number of states passed anti-alcohol laws, and World War I helped the cause when grain and grapes (which most alcohol is made of) was needed to feed the troops. The fight against alcohol was also used against immigrants, portraying them as groups of alcoholics. Fundamentalists and protestant religious groups favored the liquor ban because it was considered that alcohol contributed to societys sins and evils, especially in cities. America stood at a crossroads between tradition and innovation. What was going to ban the manufacture, sale and transportation of alcohol was the Eighteenth Amendment of Constitution. The 18th Amendment was originally announced in Congress on June, 1917. It was sent to the Senate and in the same year, was passed to the House of Representatives. Moreover, in order to enforce the 18th amendment, it was created the Volstead Act, in 1919. Federal Prohibition Agents (they were about 3,000 agents) was to investigate who were about to sell and transport illegally alcohol; if they were found guilty, they were arrested. The same thing was in the case of owning any item designed to manufacture alcohol, to the guilty ones were applied specific fines and jail sentence(Making own beer will be difficult under new regime!). However, even if there were numerous reports of liquor clearing, the authorities missed confiscating several cases in May, 1926. Another one hundred twenty-five cases made it past the enforcement agencies in September, 1926 and one hundred twenty cases disappeared from a Canadian warehouse due for American shores in October, 1926. Speakeasies started to be popular and increased their number during the decade. They represented illegal bars selling alcohol. There was estimated over 100,000 speakeasies in New York City in the 1920s and it was the most popular way to obtain alcohol. Other ways of obtaining alcohol during the Prohibition: if was prescribed by a doctor, or secretly smuggling from other countries, such as Canada. Initially, many Americans supported the idea of Prohibition. It was thought that Prohibition will reduce the number of divorces, deaths, accidents and poverty. Supporters believed that drinking liquor was immoral. Nevertheless, there were a lot of different opinions about whether it was successful or not. Drinking was part of everyday life and people enjoyed being able to have alcohol when they wanted and they did not want the right to be taken away from them. Two of the most important supporters of Prohibition were Womens Christian Temperance Union and Anti-Saloon League. In Womens Christian Temperance Union, women were one of the main groups fighting for prohibition. Their efforts made prohibition attractive to many reformers and these women changed the opinions of many people. Reformers were also attracted to prohibition because they were able to take out many urban political bosses at the same time (since many bosses operated out of these saloons). The Anti-Saloon League was another prohibition powerhouse. The members from the league tried to get support from churches, law makers, business men and political figure heads in order to get the law passed. Prohibition and Gangsters (organized crime in the 1920s) Bootlegging became one of the most profitable business of those times. Illegal Saloons could be found all over larger cities and almost every city. The owners of these saloons produced their own homemade alcohol but also many imported it. Prohibition gave rise to huge smuggling operations, as alcohol slipped into the country through states like Michigan or on the Canadian border. One of the inherent dangers involved in the business of smuggling liquor was the possibility of a hijacking. Gangs fought for control over the speakeasies which created a lot of violence within the city. Mobsters and gangsters started to take an initiative in the demand for alcohol and saw a chance to make a huge profit. Even if gangsterism was dangerous, this was the easiest way of making money. Criminals got richer and gained more and more power; once they were armed with their guns, no one dared to stop them. If they were caught by police, they often bribed or killed the police. Also, they started bribing public officials; many lawmakers, judges and Prohibition Bureau members were all involved in various crime organizations. Not only the number of crimes increased, but crime was going to be organized. The business was profitable for everyone involved. They defended their high profits by murdering hundreds of their competitors and infiltrating legitimate businesses, labor unions, and government. Most of Mafia or gangs members were young immigrants. Criminals like Al Capone, John Dillinger, Jack Legs Diamond, Bugsy Siegel and Vito Genovese were headliners of the era. To summarize, I would say that the Prohibition was thought to be more moral but it did not realized its main goals. The ones who beneficiated were gangsters and other forces of government. Americans enjoyed drinking alcohol and they even broke the law to do so; as a result, the number of prisoners was larger. A consequence was the lack of respect for the law(was seen as something which was not important) and also lack of respect for religion, because preachers thought that alcohol is the main reason for societys sufferings. People also suffered, because making illegal alcohol was not so healthy; some of them were poisoned, went blind or even died.

The Ebl Concept Essay Nursing Essay

The Ebl Concept Essay Nursing Essay The purpose of this essay is to elaborate on the Enquiry Based Learning presentation and discuss in depth the given concept. The concept given to my group is empathy to support this concept relevant literature will be used along with example experienced during my clinical placement. To maintain patients confidentiality pseudonym name will be used in the example. This is in line with the Nursing and Midwifery council code of conduct guideline (2010), which states that the people in our care have every right for their privacy and confidentiality. The EBL process will be reflected upon with supporting literatures and critically discussed using Gibbs (1988) model of reflection followed by a conclusion. Critical discussion Empathy is widely accepted as a basic component of all helpful relationships, including relationships in nursing practice (Williams Stickley, 2010). Walker Alligood (2001), criticised empathy in nursing as a concept borrowed from the Carl Rogers field of counselling psychology. Despite all these criticisms, it suggests that empathy will continue to be a fundamental concept in the nursing practice. According to Carl Rogers (1980) as cited by Vincent (2005), empathy can be describe as entering the private perceptual world of another person and becoming completely at home in it, being sensitive, moment by moment, to the changing felt meanings which flows in this other person, to the fear or whatever the person is experiencing. More specifically empathy forms part of the Carl Rogers core conditions along with genuiness and positive regard that are vital for the formation of relationships in counselling. According to Rogers (1980) as cited by Vincent (2005), being empathic is a complex, demanding and strong yet also a subtle and gentle- way of being. This is in contrast with the interpretation of empathy nursing literature. In nursing literature, empathy seems to be valued as a concept to be used alone rather than within a relationship that contains all the core conditions as used in counselling literature. In the nurse patient relationships, empathy is theorised as having therapeutic value and, as such, is promoted to nurses as being desirable ( McCabe, 2004). Empathy within the nursing relationship is defined as the ability to understand the patients situation, perspective and feelings, and to communicate that understanding to the patient (Coulehan et al. 2000 cited by Mercer and Reynolds, 2002). This definition emphasises that empathy is a way of perceiving, as well as a way of communicating. It has shifted the emphasis from a personality trait that individual possess to a form of interaction. This definition of empathy would also appear to be congruent with the cognitive and behavioural components of empathy alluded to by Morse et al. (1992). Following an extensive review of the literature, Morse et al. summarised the components of empathy under four key areas: moral, emotive, cognitive and behavioural. The moral element shows an internal altruistic force that motivates the practice of empathy, the emotive element shows the ability to subjectively experience and share in anothers psychological state, the cognitive element show the intellectual ability to identify and understand another persons feelings and perspective and the behavioural element shows the communicative response to convey understanding of anothers perspective. This shows that clinical empathy can be seen as a form of professional skills rather than personal characteristic (Mercer and Reynolds, 2002). Similarly, Rogers (1975) as cited by Vincent (2005) who tended to view empathy as an attitude highlighted the communicative part of the construct. This suggests that when attitudes and understanding are shown to the patient, empathy is skilled behaviour. Also Zoske et al. (1983) views empathy as an interpersonal skills, rather than being an instinctive quality possessed by individuals. In addition, Yu and Kirk (2008) also suggest that empathy can be taught as a skill and developed with practice and experience. In this context empathy is not only a way of being with another as stated by (Rogers, 1975) but it also communicates to the patients the professionals understanding of their world so that this perception can be validated by the patient. In effect, both are necessary and one without the other is rather hollow. Despite the differences between counselling and the nursing practice, what the empathy outcome research have shown is that even if nothing else happens with a patient, being exposed to an empathetic person who can accurately communicate that empathy can have a healing outcome on the patient health (Williams Stickley, 2010). Therefore, empathy can be a vital component of any nursing plan of care. For example, La Monica et al. (1987) explored the effect of nurses empathy on the anxiety, depression, hostility and satisfaction with care of clients with cancer. They found less anxiety, depression and hostility in clients being cared for by nurses exhibiting high empathy. Reynolds (2000), says to achieve above outcomes is dependent on the ability of the nurses to offer high levels of empathy to their patients. In addition Moore (2006) suggests that the connection between the patient and practitioner that facilitate a positive influence in treatment is empathy. According to Tschudin (1995), some people communicate their understanding of empathy through action, others might use words, and still others might use both to communicate empathy to the patient. For instance, a nurse can explain medical diagnosis and results to the patient in lay terms so that the patient can understand and feel in control of the situation. Researchers agreed on the positive role empathy plays in interpersonal relationships when providing health care. However, Hills Knowles (1983) reported that nurses do not show empathy by actually blocking clients expressions by changing the subject. It could be argued that nurses lack the skill to communicate empathy with their patient. Although, William (1992) said hospital systems seem conducive to flattening the humanity of its employees. Also Wong (2004), have questioned the importance of seeking to develop empathetic nurse patient relationship within busy acute healthcare settings. This suggests it might be difficult to develop an empathetic relationship in this setting. However, Yu and Kirk (2008) asserted that empathy can be taught as a skill and developed with practice and experience. Clinical placement example This example was when I had the opportunity to experience working as a student on a breast unit. The patient that are seen in this unit are those with breast cancer and those with family history of breast cancer. Joan came to the hospital for an appointment following her GP referral due to a painful lump on her breast. Joans both family have a history cancer, her mother died fourteen months before the day of her appointment and she lost her mothers younger sister 3 years ago to cancer also the fathers side have a history of bowel of cancer. I was chaperon the doctor whom Joan came to see and my mentor asked me to follow her up throughout her treatment. She has not seen the doctor before, but was so kind to her and understands how devastated Joan was. The doctor did physical examination on her breast and discovered the lump; he said it could be benign or cancerous. She realised that this was the same thing the doctor told her mother the first day she was diagnose. All the feelings of anxiety and distress came to her. The doctor requested her to for Scan and mammogram same day and come back to see him. Joan went to the nurse that book patients for investigations and the nurse quickly said sit down and continue looking at the computer screen. Joan sat in the chair facing the nurse, who still did not look up to see the anxiety on this patient. After sometime, she told Joan I will be with you in a minute; Joan sat still, waiting, but feeling apprehensive more and more. It became worse for the fact that she want to go for these investigations because she is having that gut feeling it could be cancer. I could see her anxiety levels rising and considering that she has history of panic attacks and depression. And hope she really she could hold it all together at that moment. The nurse been on her own and seems to have a lot of paper work to complete and feels that the paperwork got in the way of her relationship with patients at times. The nurse told Joan I need to ask some quick questions about her health and family history with a frown face. The nurse started with family history without still looking up to her patient and asked about her parents history. Joan said her father is alright and was silence when asked about her mother. The nurse looked up and was surprised to Joan crying and the anxiety on her face. Before the nurse realise what is happening Joan had run out from the room, saying she could not stay any longer. The nurse had no idea of what had just happened or why Joan was dismayed and felt that she must have done something to hurt her, but could not understand what she did to Joan. Discussion Judging from the above example, it is clear that the nurse was not able to form an empathetic relationship and unable to deliver empathetic care. Is not as if the nurse does not want to deliver an empathic care, but she was so preoccupied and focused on the paper work and also considering the fact she is the only one at that moment. The nurse did not communicate to the Joan as she should and did not even look up to see the anxiety on Joans face. According to La Monica et al. (1987) explored the effect of nurses empathy on the anxiety. They found out that patient exhibit less anxiety, depression being cared for by nurses exhibiting empathy. As stated by Moore (2000) cited by Chambers and Ryder (2006), if the clinician is in a bad mood, this may put the client in a bad mood as well; basically, it is like looking into a mirror. In Joans case, it was not the fact that the nurse was necessarily in a bad mood that was the issue. However, the nurse frowning during the short time they had together, which could have been seen as her being in awful mood. Joan so felt that she was not interested in her, and possibly that she was causing a problem by just being around. In addition, Reynolds (2000) raised a concern that low level of empathy in professional relationships can make the recipients of help may not perceive that their situation is understood. As nurses, we need to be aware that if seem unconcerned or stressed it will have a negative impact on the relationship with patients. Cowdell (2010) refers empathy as feeling into anothers world to comprehend that persons world experience. The nurse was not able to form a relationship with Joan, and was totally unable to sense her anxiety and distress. Furthermore, McCabe and Timmins (2006) say that if nurses fail to empathise with their patients then they cannot help them to understand effectively as individual with their illness. In other words, it was certainly the case in the lack of effective interaction between the nurse and Joan. In addition, Vincent (2005) says that nurses find it more difficult to sustain empathy if they are extremely tired or distracted. As already stated it could be because the nurse was the only one attending to the patients. This could hinder her ability to perceive and reason as well as to communicate understanding of Joans feelings. Reflection According to Johns (2005), reflection is a fusion of sensing, perceiving, intuiting and thinking related to a specific experience in order to develop insights into self and practice. Reflection promotes actions that transform individuals practice so they resolve contradictions, to build on their strengths. According to Sully and Dallas (2010), reflection also allows for the structured exploration of the knowledge, skills, attitudes and perceptions tacit and overt- that underpin professional practice. Gibbs (1988) reflective cycle will be used as indicated in my introduction. It was used because the reflective cycle encouraged me to think systematically about the phases of the EBL process. Description; my group subgroup was the video group and everyone was allocated a role play. My role was to act as the ward sister who showed no empathy to her junior staff who came to ask her for information regarding the patient she is looking after. Feeling; The EBL process gave me the opportunity to know what it feels like to be the nurse in charge were you have to use your management skills effectively. Also a nurse in charge not shown empathy could send wrong message to the junior staff. I think the whole process promotes my personal research skills and made me becomes more familiar with the various resources at my disposal, such as databases and e-journals. Evaluation; During the EBL process my sub-group were very supportive to each other, listen to other peoples opinion and communicated with other as professionals. As stated by Sully and Dallas (2010), that through effective communications, information sharing and partnership nurses can deliver excellent care. We were able to achieve our aim through effective communication between the team. The EBL experience becomes one of interchange where we shared our opinions, research and experience in order to achieve an end result. However, we faced some challenges with fixing the time and getting the right venues for the recording, sometimes we have to travel the main campus even when we do not have lectures over there. On the first day our equipment disappointed us, but we stayed positive and rearranged time. We had criticisms of ideas but we accepted it and created room for improvement. For example I did not support the video from YouTube by Hepburn and Astaire that was included in the presentation. Cottrell (2008) says that, if you disagree with another persons idea in a positive way and suggest ways forward for improvement rather than criticising. Analysis; the EBL process gave the group the opportunity to improve their wide range of skills: knowledge creation; presentation; creative skills; problem-solving skills and team-working. The EBL made us gain extra perspective and point of view about the given concept, which otherwise we might not have considered. It has been shown in Cottrell (2008), group working create the opportunity to tap into a wider pool of experience, background knowledge and styles of work. Conclusions; looking back at the EBL presentation, we should have explained the video we used. Also recognise that I need to develop the confidence to challenge ideas that I do not agree to, as well as how it could be improved. I could have used other strategies to get my point across to the group. Action plan; In future, I will aim to develop my assertive skills when working in a group, in order to ensure that we are awarded great marks. I will make this a goal for my learning, and work out strategies for how I can achieve this in future. As suggested by Sully and Dallas (2010) that using assertive skills is an essential component of working in a proficient manner. Conclusion In conclusion, empathy whether borrowed from the counselling literature or derived from nursing practice (Walker Alligood 2001), empathy is widely considered as a crucial component of multiple helping professions, including nursing practice. How empathy is portrayed in nursing literature seems different from its portrayal within counselling literature. The concept of empathy in nursing literature is separated from the core conditions of congruence and unconditional positive regards, so therefore it is presented as tool. As stated by Yu and Kirk (2008), empathy can be taught to healthcare professionals and also be taught how to improve their level of empathy through experience rather than formal instructions. Empathy is crucial to a non-defensive relationship and can facilitate satisfactory and productive outcomes for patients. Lack of empathy could mean that patient who needs to be understood, may not be understood, or feel understood. Lack of empathy in nursing could prolong healing process in a patient. In addition, the EBL process played an important role in promoting the group interaction, we shared opinions and experience. All this suggest that, empathy is a vital part of caring in nursing practice and especially critical to the provision of quality nursing care. Thus can be effectively taught to student and experienced nurses. REFERENCES Chambers, C. and Ryder, E. (2009) Compassion and caring in nursing Oxford: Radcliffe. Cottrell, S. (2008) The Study Skills Handbook. 3rd edn. Basingstoke: Palgrave MacMillan. Gibbs, G. (1988) Learning by doing: A guide to teaching and learning methods. Oxford polytechnic: Oxford. Hills, M., and Knowles, D. (1983) Nurses levels of empathy and respect in simulated interactions with patients. International Journal of Nursing Studies. V20, pp. 83-87. Johns, C. (2005) Expanding the gates of perception. Transforming Nursing Through Reflective Practice. Oxford: Blackwell. La Monica, E., Madea, A. and Oberst, M. (1987) Empathy and nursing care outcomes. Scholarly Inquiry for Nursing Practice. V1, pp. 197-213. McCabe, C. and Timmins, F. (2006) Communication Skills For Nursing Practice. Basingstoke: Palgrave MacMillan. McCabe, C. (2004) nurse-patient communication: an exploration of patients experience. Journal of Clinical Nursing; 13, pp.41-49. Mercer, S.W. and Reynolds, W. (2002) Empathy and quality of care. British Journal of General Practice. 52, S9-S13, Available at: http://www.ncbi.nlm.nih.gov/pmc/articules/PMC1316134 (Accessed: 20 December 2012). Morse, J., Anderson, G., Bottorff, J., Yonge, O., OBrien, B., and Solberg, S (1992) Exploring Empathy: A Conceptual Fit for Nursing Practice? Image: Journal of Nursing Scholarship. V24, pp. 273-280. Morse, J.M., Bottorff, J., Anderson, G., OBrien, B., and Solberg, S. (2006). Beyond empathy: Expanding expressions of caring. Journal of Advanced Nursing, 17, pp. 75-90. Nursing and midwifery council (2010) The code standards of conduct. Performance and Ethics for Nurses and Midwives. London: Portland place. Reynolds, W. (2006) Expanding expression of caring. Journal of Advanced Nursing, 17, 809-821. Reynolds, W. (2003) Developing empathy. In P. Barker (Ed.), Psychiatric and mental health nursing: The craft of caring, pp. 147-154. United Kingdom: Arnold. Reynolds, W. (2000) The measurement and Development of empathy in Nursing. United Kingdom: Ashgate Publishing Limited Sully, P. and Dallas, J. (2010) Essential Communication Skills for Nursing and Midwifery. 2nd edn. Edinburgh: Mosby Elsevier. Tschudin, V. (1995) Counselling Skills for Nurses. 4th edn. London: Baillià ¨re Tindall. Walker, K.M. and Alligood, M.R. (2001) Empathy from a nursing perspective: Moving beyond borrowed theory. Archives of psychiatric Nursing, 15, 140-147. Vincent, S. (2005) Being empathic: A companion for counsellors and therapists. United Kingdom: Radcliffe Ltd. Williams, J. and Stickley, T. (2010) Empathy and nurse education. Nurse Education Today, 30, pp. 752-755. Williams, A. (1992) Where has all the empathy gone? Professional Nurse (Nov), pp. 134. Wong, W.H. (2004) Caring holistically within new managerialism. Nursing inquiry; 11: (1) pp.1-13. Yu, J. and Kirk, M. (2008) Measurement of Empathy in Nursing Research: systematic review. Journal of Advance Nursing, (64), pp. 440-454. Zoske, J. and Pietrocarlo, D. (1983) Dialysis Training Exercise for Improved Staff Awareness. American Association of Nephrology and Technicians Journal. pp. 19-39.

The lost boy :: essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚  `  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Abbie Rader Title: The lost boy Author: Dave Pelzer Publisher: Health Communications, Incorporated Publication Date: September 1997 Number of pages: 250   Ã‚  Ã‚  Ã‚  Ã‚  Lost boy is a follow up to Dave Pelzer’s book A Child Called It. This Novel Is a Auto-biography by Dave Pelzer. It follows his experiences in the foster care system. After being taken from his mother Dave goes from one foster home to another and he describes his life there.   Ã‚  Ã‚  Ã‚  Ã‚  The Novel starts out where it left off in the novel A Child called â€Å"It† which is his mother as always abusing him. To better knowledge you on this book the first paragraph of this novel reads ( I’m alone. I’m hungry and I’m shivering in the dark. I sit on top of my hands at the bottom of the stairs in the garage. My head is tilted backward. My hands became numb hours ago. My neck and shoulder muscles begin to throb. But that’s nothing new- I’ve learned to turn off the pain. I’m Mother’s prisoner.) This nine years old boy was treated worse then the animals he lived with. He was told when to move, when to eat, and when he was aloud to sleep. This novel takes you threw him being taken from his mother which made him a ward of the state to going threw series of foster family and also in a juvenile detention center.   Ã‚  Ã‚  Ã‚  Ã‚   I think that everyone in the world should read this book because it is a very indebt novel. Any one that wants to pursue a career dealing with child abuse or anything related to it should also read this book so they can see a abused child’s point of view. The main reason that I love this book dearly is because it is a very emotional novel and also because it really metaphorically put you in Dave’s life situations.

The Healing Power of Poetry Essay -- Writing Essays

"The Healing Power of Poetry" The devastations and repercussions of war are inimitable, and can sometimes be left unhealed. However, men and women have had to find cures to lick their wounds and resettle the turbulence existing within their minds. In Pat Barker's emotionally powerful war novel Regeneration, we are introduced to a war journal, called the Hydra, on page 84, which served as healing tool for WWI soldiers. This journal contained articles, cartoons, poetry, letters, and all kinds of other different types of writing. Barker uses the Hydra in her novel to mark the healing power of writing in the lives of these men. Poetry therapy has a long history, being recognized as far back as the first songs chanted around the camp-fires of primitive people. To these people, the chant is what heals the heart and soul. In the English language, the word "therapy" comes from the Greek word "therapeia," which means to nurse or cure through expressive arts such as dance, song, poem and drama. The Greeks have also informed us that Asclepius, the god of healing, was the son of Apollo, the god of poetry, medicine and the historical arts (Longo). In addition, mythological beliefs say that Oceanus told Promethus that "words are the physician of the mind diseased." The use of poetry therapy has therefore been discovered by numerous cultures since the beginning of language (Longo). Once recognized for its healing power, this therapy quickly moved to the North American continent. Within the American colonies, the first American hospital to care for the mentally ill was founded in 1751 by Benjamin Franklin, called the Pennsylvania Hospital. This hospital is known to have included reading, writing, and then also the actual publishing of... ...f writing to these men. Not only does it convey the effects of writing, it may also project the idea that reading poetry may also be just as therapeutic. Poetry therapy is not a theme that people would generally relate to the cure of barbaric men at war, which is indeed what makes this novel so brilliant. Soldiers too have a sensitive side, and Barker has proven to acknowledge and praise it. Works Cited Barker, Pat. Regeneration. New York: Plume, 1993. Lee, Stuart. "The Hydra." HTML JTAP Virtual Seminars Project. April 1998. 8 April 2004. <http://www.hcu.ox.ac.uk/jtap/hydra> Longo, Perie J. "Poetry as Therapy." Sanctuary House of Santa Barbara, Inc., 1996-2003. 13 April 2004. <http://www.spcsb.org/advoc/poetrytx.html> Rusche, Harry. "Lost Poets of the Great War." Emory University, 1997. 3 May 2004. <http://www.emory.edu/ENGLISH/LostPoets/>

Political Concepts Essay

1) Mass Media as the `Fifth Branch` of government Definition: Mass Media is the fifth branch of government because it can shape public opinion and influence the national agenda. Importance: It is important because today’s media is so assertive and liable to such adversarial, negative reporting that they can be downright obstructive of government policy 2) Agenda Setting Definition: On a national level, this is a role usually reserved for the President, such as when he makes his State of the Union Address. Importance: As the leader of the nation it is his duty to set the Agenda for the coming year. Without a clear vision the nation will drift aimlessly. 3) Electoral College (how does it work?) Definitions: A ‘vote’ that will be counted purposes of electing a president; each state has a set number of electoral colleges.   The term refers to a â€Å"collegium† or assembly of 538 President Electors who meet after the popular vote and cast their votes for President and Vice-President. Importance: A presidential candidate may have technically ‘won’ by getting more of the popular vote overall but if he loses in too many States with a high number of Electors, he can still lose the elections. 4) Who votes (what kind of person is MOST likely to vote)? Why has voter turnout in America declined since 1960? A person who is involved in the campaign of some one running for election is most likely to vote. A charter member of the Republicans or the Democrats because they owe it to their group.   Those at the extremes of political opinion, who feel strongly for or against the candidates in question. Importance of voting: Voting is an essential political right, a chance to speak and be counted and an opportunity to affirm or reject state policy. It is often the only political exercise that the average person will have a say in. 5) Congress: What do they do? The Congress makes laws for the President to sign as well as attend to the needs of their constituency. Importance of what they do: Congress also provides an important check-and-balance to the power of the Executive, the President and the line departments because the framers of our Constitution did not wish the President to act arbitrarily without enabling laws from Congress. For example, he cannot wage war on Iraq without going to Congress to ask for appropriations that will cover soldiers’ salaries, aid to civilians, ammunition, fuel and support services. 6) Congress: What are Standing, Joint, and Conference Committees? A standing committee is an ordinary permanent committee. By U.S. Congress rules, a conference committee is â€Å"A temporary, ad hoc panel composed of House and Senate conferees which is formed for the purpose of reconciling differences in legislation that has passed both chambers. Conference committees are usually convened to resolve bicameral differences on major and controversial legislation.† This means differences between the Senate and House versions of a bill.   A â€Å"joint committee† refers to all other bicameral committees convened for some special function or other except reporting legislation.   Examples of the latter are joint committee hearings on controversial matters or on impeaching the President. Importance of committee work: Laws are not made arbitrarily, often there is a need to consult with others before a bill is proposed in the floor. At the same time it is too chaotic present a half-baked bill to the general assembly of congress without refining it first. This is the work of committees. 7) Congress: How does a bill become a law? A bill must be authored, be deliberated on in committee then pass three readings in both houses of Congress. The President then signs the bill to make it law. Importance: On paper a bill must first pass through one house before it is forwarded to the other house for its own three readings there. But in practice a bill is often authored and filed simultaneously in both houses with each version differing little from the other. 8) Presidential Powers: The president is the commander-in-chief of the army. He can mobilize the armed forces even without a formal declaration of war for up to 60 days. Domestically, he has the power to make or break a bill with the stroke of a pen. He can also propose priority legislation to Congress. 9) Presidency: To be a successful leader of Congress, the President must be able to read the pulse of congress well. He must know when to act and push for his agenda. He is important because Congress must be united under strong leadership if it is to be an effective counter balance to the President’s domination. 10) Judiciary: Judicial Activists versus Judicial Restraintists. A Judicial Activist is a radical who tries to pursue social justice in his decisions. While a Judicial Restraintist is a conservative who tries to maintain the status quo. Importance: The judiciary needs a balanced mix of both kinds of Justices in order for it to be a fair and just final adjudicator of legal disputes. If it were made entirely of Restraintists or Activists, decisions would be biased. Section II: Short Essays. Answer ALL parts of each question in as much detail and depth as possible. 1)   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Mass Media is referred to as the fifth branch of government because of the sway it holds on public opinion. Media can reach into every aspect of our lives and influence us in ways the other branches of governance can only dream off. Regretfully, media is biased these days. It is biased for the highest bidder and for its own overly-liberal agenda. Media is a commercial proposition hence profitability is a concern. Since controversy creates cash, media is known to play up scandals and negative aspects of life because the shock value is known to create high ratings, which then attract more advertising money. As a result news today appears to be a parade of bad news and shocking events because media mercenaries know that by showing these they will get more advertising money and social responsibility be damned. 2)   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In 2000 George W. Bush won as a result of the disaffection people felt with the Democrats. Bill Clinton’s presidency was rocked by scandal (Monica Lewinsky comes to mind) and economic depression (among other things, the frenzied dot-com bubble burst). People were tired of what they thought was the misrule of the Democrats and were eager to try what the Republicans had to offer. In 2004 Bush was flying high on the euphoria generated by his still successful War on Terror; both Afghanistan and Iraq had fallen in just a few weeks of fighting. His bold fighting stance was still supported by many then.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   However Bush, in my humble opinion did not defeat Gore in 2000. Based on the total number of voters, first of all, Gore actually won the elections. He lost in the electoral vote, though. This is another reason why the electoral college system should be abolished, it devalues the principle of one man, one vote. In the extreme example, Gore could have had an overwhelming majority of the total voters but so long as he lost in enough large-college states like California, he would still lose the elections. Therefore, the electoral college system overvalues certain states if they have a large number of Electors. Kerry, for his part, lost during the 2004 elections because he could not present a strong alternative to Bush. 3.)  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The iron triangle is a corrupting influence in the American political process because it takes away from the sanctity of the political process enshrined in our Constitution. Congressmen are loved by their constituents for the benefits they can provide. A Congressman being a representative of his or her state tends to keep (and vote for) the best interest of the state in mind. After all if he votes or acts in a way detrimental to his constituents he will have to answer to them in the next elections. Also a Congressman’s recommendation is necessary to enter West Point.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Congress is hated, almost universally, because of its poor image. Recently, it has been unable to stem Bush’s warmongering. The economy is slowing down and Congress is getting a share of the blame for not doing anything to prevent it. Also, Congress is seen as a breeding pit of vested interests and lobbyists who push their agenda to the detriment of legitimate concerns of the country as a whole.

Defending Liberal Arts Essay

William Butler Yeats is accredited with once saying â€Å"Education is not the filling of a pail, but the lighting of a fire.† It seems this idiom no longer rings true; today’s preferred education encompasses the regurgitation of technical jargon in the hopes of finding a job. People now deem Liberal Arts degree worthless; it’s too expensive and impractical in today’s job market. The sciences and career colleges are where the jobs lie. In the battle over higher education, through his iconoclastic article â€Å"The New Liberal Arts,† Sanford J. Ungar stands as a lone crusader against an onslaught of â€Å"misperceptions.† I for one agree with and applaud his effort, although he could use some additional support in presenting some of his counter arguments. Unger first battles the misperception of the value in a liberal arts degree for first-generation, lower income college students; these degrees are for the elite upper-class. As Ungar’s imagined antagonists put it, â€Å"A liberal arts degree is a luxury that most families can no longer afford. ‘Career education’ is what we now must focus on† (191). Ungar contends that although skyrocketing tuition makes it increasingly difficult to pay for a college education it is now a more prudent investment than ever before (191). Continuing his crusade against naysayers by suggesting that â€Å"the career education bandwagon† (191) is not a smart investment, asserting that â€Å"It is far wiser for students to prepare for change—and the multiple careers they are likely to have—than to search for a single job track that might one day become a dead end.† (191) Ungar shows the pitfalls of having a narrowly focused education. Moreover, Ungar seems utterly disgusted with the notion that an education in the liberal arts is one for the upper class, the rich and the privileged; those who are not of this stratification are better suited implementing the ideas of the elite, not coming up with ideas of their own (192). He brands these accusations as â€Å"condescending† (192) and â€Å"prejudice† (193) and rejects the idea that the lower-class’ only duty is to implement the ideas of the upper-class. I believe that Ungar is correct on these assertions; however, Ungar’s argument would be better served if he acquiesced to the fact that a college education, much less one in the liberal arts, is not right for everyone. Higher education is not a one size fits all discipline. There has to be some to fill the factories, work the land, pave the roads and power the service industry. Unger is accurate in saying that the liberal arts should be available to everyone and everyone could benefit from this type of classical education; nonetheless not everyone is suited for such an education. The misperception that the liberal arts are for the elite is one that has been heard before but not nearly as much as the old â€Å"employers do not want to hire people with useless degrees† line which Unger obliterates with his next argument. Ungar continues his defense of a liberal arts education by refuting the claim that employers no longer hire someone with a â€Å"useless† degree, such as French. Showing how not only a specific degree such as a foreign language is one that is wanted by employers but the usefulness of other liberal arts degrees, emphasizing â€Å"A 2009 survey for the Association of American Colleges and Universities actually found that more than three-quarters of our nation’s employers recommend that college-bound students pursue a ‘liberal education.’† (192) Ungar deals with this common misconception methodically by first stating â€Å"what people believe† and then contesting that belief with facts diversified with his own opinions. Although he is correct and he brandishes documented facts to back up his assertions Ungar may have missed the mark by not including actual job numbers. By displaying irrefutable proof that those who have a liberal arts degree are more likely to get a job in any field and by showing those jobs are more lucrative for degree holders than those who are not, Ungar could put the nail in the coffin naysayers. For his next dose of perception breaking, Ungar skirmishes with the following idea: Liberal arts degrees are antiquated, the Sciences and Career colleges are where the smart money is, and the STEM fields are much better suited for today’s economic reality. Ungar contests this misperception by showing that a degree in liberal arts also includes the sciences. He illustrates that a traditional liberal arts degree includes the sciences: â€Å"the historical basis of a liberal education is in the classical artes liberales, comprising the trivium (grammar, logic, and rhetoric) and the quadrivium (arithmetic, geometry, astronomy, and music)† (193). Many of Ungar’s points are valid; his handling of this misperception is deft and detailed. However, I feel that Ungar is stretching with his response to this argument. Although a liberal arts degree does offer some glimpses into the STEM disciplines, it is not comparable to a degree in those specialties. A student wishing to become a chemist would not be well served pursuing a degree in History. In showing that these misperceptions are just that, Sanford Ungar single-handedly makes the case for a classical liberal arts education. He does a wonderful job tackling the misperceptions being thrown around today about a college degree in the liberal arts. He takes each one of these common misconceptions and thoroughly disproves each claim skillfully and without hesitation. By doing so he reopens the door to higher education. Perhaps if he and others like him continue to confront the onslaught of misinformation doled out upon the masses we can return to a world where a traditional liberal arts education is once again commended and no longer forsworn. Works Cited Ungar, Sanford. â€Å"The New Liberal Arts.† â€Å"They Say I Say†: The Moves That Matter in Academic Writing: with readings. Eds. Gerald Graff, Kathy Birkenstein, Russel Durst. New York: W.W. Norton and Company Ltd, 2012. 190-196. Print.