Bulling in Schools Essay Example | Topics and Well Written Essays - 3250 words

Bulling in Schools - Essay Example This essay approves that the first solution offers the scope that since bullying usually happens in the school premises, teachers will be able to identify any such activity quickly and will be able to educate their students about it. However, teachers cannot be present everywhere all the time and they will not be able to do much about the bullying that happens outside of school premises. The second solution will be of help outside of school premises and since children fear their parents more, they would probably listen to them. However, this does not guarantee that the students will abide by what their parents tell them even in the school premises. The third method is a more direct approach and hence perhaps the best. Educating students directly will help in curbing the activity both within the school premises and outside of it. Though explaining things to students is always a difficult job, however, once the students decide to listen, this method will be the most effective. This report makes a conclusion that the project regarding the problem of bullying in schools was not just an interesting project for me but it also helped me understand the various factors that are associate with bullying. Bullying is a growing nuance in schools and the best solution that can help curb the nuance is to educate people involved in the cycle, the students, parents and teachers. Educating the three will help in complete elimination of the problem. This project helped in developing my knowledge about the problem of bullying and the research helped in increasing my understanding about the various factors associated with the problem. Bullying is certainly a major problem and stern measures need to be taken to curb this nuance.

Persuasive research paper Essay Example for Free

Persuasive research paper Essay Everyday as we commute down the road we see motorcyclist drive past us. What is the one thing that we can all agree individuals riding motorcycles have in common? It is not a trick question. The answer is very simple; they all share the commonality of riding a motorcycle. What is in fact is very distinct however, are the choices of attire when operating their motorcycle. Some individuals are brave enough to wear shorts, tank tops, and sandals. On the opposite end of the spectrum, you have some of the wiser ones that chose to wear a helmet, gloves, protective jacket, eye protection etc. Why the distinct difference? The fact is that a great percentage of riders refuse to wear the proper protective equipment. Due to an increase in motorcycle riders within the recent years, a national protocol requiring certain equipment, such as a helmet, to be worn when riding a motorcycle should be instituted. There are many contributing factors to motorcycle fatalities, however there can be a culture of change, specially with the proper knowledge on how each piece of safety equipment can help at preventing injury or death Every year that passes by, notice that more and more motorcycle share the road with our  automobile drivers. We might wonder why there has been a shift in choice of transportation. Is this a trend or fad that the population is going through? According to the Governors Highway Safety Association, â€Å"National data from 1976 to 2012 suggest that motorcyclist fatalities track motorcycle registrations quite closely and that registrations track inflation-adjusted gasoline prices. If the economy continues to improve and gasoline prices remain high, then motorcycle 1 Tenorio registrations, travel, and fatalities will continue to rise unless active measures are taken†. (Hedlund). Not only do we think there are more motorcycle riders on the road, they have proven this to be true. Motorcycles are generally more fuel-efficient than cars, making them a very good alternative mode of transportation when gas prices stay at a consistent high price. It is basic mathematics; if there are more motorcycles there is more individuals susceptible to accidents. Additionally, they have proven that motorcycles are more apt to be involved in a motor vehicle accident than any other vehicle. Data collected in 2007 proved that per vehicle mile driven,motorcyclist were approximately 37 times more apt to die in a motor vehicle accident and nine times more probable to be injured in an accident. They also researched the ability of a helmet to protect against fatal injuries in motorcycle accidents. NHTSA estimates that helmets saved the lives of 1,829 motorcyclists in 2008. If all motorcyclists had worn helmets, an additional 823 lives could have been saved. (Motorcycles: Traffic Safety Facts 2008 Data). As motorcycles become more abundant, it is imperative that we reduce the probability of death as much as  possible. As proven above, helmet wear can be a life or death-determining factor. You can force motorcycle operators to wear helmets by implementing laws, but the combination of alcohol and motorcycle operation can have a devastating impact despite helmet wear. When operating a motorcycle an operator needs all of their senses at full capacity. Alcohol is central nervous system suppressant substance, causing you body to have a reduced reaction time when the situation arises. The reported helmet use rate for motorcycle riders with BAC levels higher than  the legal limit killed in traffic crashes was 46 percent, compared with 66 percent for those with no alcohol (Motorcycles: Traffic Safety Facts 2008 Data). Not only does alcohol reduce reaction times, it also has an impact on your ability to make rational decisions. It makes individuals push the limits of their motorcycle and their riding ability to levels they normally 2 Tenorio would not, and the majority of the time while not wearing the equipment they should. In 2011, the NHTSA calculated 4,323 motorcyclists were killed, and 33% (1426) of the riders were under  the influence of alcohol (Watson). How can the country as a whole help reduce the amount of fatalities we currently have due to motorcycle accidents? It is not a very simple answer. It would require involvement from both the people and the government to make this happen. One way the government can aid in the reduction of motorcycle fatalities is through the implementation of regulations, which require and enforce the wear or motorcycle protective equipment. Dating back to 1966 the government tried to impose the requirement of helmet wear by the states. They tried to do this by threatening with the reduction of federal-aid highway construction funds for the states that did not comply with the implementation of universal helmet use law by 1967. By 1975 all but 3 states had adopted and implemented such laws. Unfortunately the Supreme Court deemed this law unconstitutional. Shortly after revoking the Act, states gradually began to weaken helmet wear laws, since it was no longer a federal requirement (Helmet Laws). Much like seat belt laws have been implemented across the majority of the states due to increased survivability rate when  involved in an accident, the wear of helmets when operating a motorcycle should be mandated. The responsibility should not only be weighted only on the federal and state governments, individuals should take responsibility also. Many non-profit organizations work diligently to tray and raise motorcycle safety awareness with thinks like bumper stickers, fund-raising rides, and bike meets. Additionally insurance companies have aided in the increased awareness by handing out information pamphlets at locations like Bike Week in Daytona Beach. Another factor that  aids in the reduction of motorcycle fatalities is proper operation education. Florida is one of many states that require the operator to take a Motorcycle Basic Riders course in order to be able 3 Tenorio to receive the motorcycle endorsement on their licenses. Without this endorsement you cannot legally operate a motorcycle. With this course even people that have never been on a motorcycle can learn the basic in order to operate it on the roads. The Motorcycle Safety Foundation (MSF) offers motorcycle rider education and training programs and courses, and supports governmental  programs by participating in research and public awareness campaigns and providing technical assistance to state training and licensing programs (Morris). The Department of Defense, more specifically the United States Air Force, uses courses from the Motorcycle Safety Foundation to teach the military riders how to operate a motorcycle. In order for an individual to operate a motorcycle they have to complete the basic riders course. Within one year of the completion of the initial course they are required to complete an intermediate course such as the basic riders  course 2, advanced riders course, or the sport bikes handling course. Once these two requirements are complete, they are required to do refresher training every five years. In addition to the training, the department of defense requires all members, military and civilian, to wear protective equipment while driving on any DOD installation. That protective equipment consists of: helmet, gloves, durable over the ankle footwear, long sleeve shirt or jacket, long durable pants, and eye protection. If not properly equipped, individuals are not allowed to enter the installation. If the DOD is doing this to help keep the members of the military community safe, why shouldn’t the rest of the country follow in those footsteps? When we think motorcycle safety, 90 percent of the time the first image that comes to mind is a helmet, as it should. The helmet is the single-handedly the most important piece of safety equipment that a motorcycle rider shouldn’t go without. However, there are many other rider protective equipment components that play a vital role in the safety of the person. Between 2001 and 2008, more than 34,000 motorcyclists were killed and an estimated 1,222,000 persons. 4 Tenorio were treated in a U. S. emergency department for a non-fatal motorcycle-related injury (Motorcycle Crash-Related Data). This data supports the thought process that even though helmets are crucial at protecting against head injuries, there are many other portions of the body that are at harms way if not properly covered. 75 percent of the non-fatal emergency room visits involved parts other than the head. The other attire that might contribute to a safer ride includes, but not limited to, long durable pants, durable top, gloves, durable over-the-ankle footwear, and reflective equipment. Despite that it will probably never be deemed mandatory to wear these items, it is important for riders everywhere to understand the devastating effects an accident can have on their bodies when choosing not to wear the proper gear. There is a common misconception that the gear makes the ride more uncomfortable and, it is believed that it makes it more difficult to operate and maneuver the motorcycle. That is a myth! Properly fitted helmets of decent quality not only will it protect your head, but also a full-faced helmet will make for a more comfortable ride. The helmet does this by preventing foreign objects and debris from  constantly hitting the riders face, and most importantly from landing in the eye. Gloves that fit snug the hand will protect it from road rash in the event that you make contact with the pavement and it also improves handgrip with the handlebars aiding with better handling. There are gloves out on the market that have additional padding in the palm of the hand, to help with comfort and provide support and a barrier in the event of a fall. The same concept can be applied to footwear. It is unbelievable that there are people out there that would ride a bike in flip-flops and think it is comfortable. Not only does it not protect the appendages, but also it makes it harder to control the bike. When choosing footwear you have to find a medium between protection and comfort. Wear something that provides the proper amount of protection but does not hinder your ability to control or maneuver the motorcycle. 5 Tenorio Choosing comfort over safety should never be an option. More specifically when you are talking about the portion of your body that controls all bodily functions. With the implementation and enforcement of a universal helmet law, the fatality rate of motorcycle accidents would  decrease. In the past the universal helmet law failed. With that in mind, we can learn from our mistakes and see trough an effective and legal legislation. The ultimate goal is not to interfere with he rights of individuals, but to help protect the citizens so they can continue to enjoy the freedoms we have in the United States. The amount of information revolving around motorcycle safety out for public access is almost overwhelming. Therefore, there shouldn’t be an excuse why people refuse to wear gear that will only help protect them and their bodies from the dangers of riding a motorcycle. Works Cited 6 Tenorio Hedlund, James. Spotlight on Highway Safety. Motorcyclist Traffic Fatalities by State: 2012 Preliminary Data. Governors Highway Safety Association, 1 Apr. 2013. Web. 09 July 2014. Helmet Laws. State Motorcycle and Bicycle. Governors Highway Safety Association, 1 July 2014. Web. 06 July 2014. Morris, C. C. , Ph. D. Motorcycle Trends in the United States | Bureau of Transportation Statistics. Motorcycle Trends in the United States | Bureau of Transportation Statistics. Bureau If Transportation Statistics, 14 May 2009. Web. 07 July 2014. Motorcycle Crash-Related Data. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 14 June 2012. Web. 06 July 2014. National Highway Traffic Safety Administration. Motorcycles: Traffic Safety Facts 2008 Data (2008): 1-6. National Highway Traffic Safety Administration. NHTSAs National Center for Statistics and Analysis, 1 Dec. 2008. Web. 22 June 2014. Watson, Tim. What The Latest NHTSA Fatality Stats Reveal About Motorcycle Safety. Ride Apart RSS2. Ride Apart, 29 May 2013. Web. 09 July 2014. Workman, Danny. Deadly Motorcycle Accident Statistics. Examiner. com. The Examiner, 28 May 2009. Web. 09 July 2014. 7.

Communication Is Important In Nursing And Nursing Process Nursing Essay

Communication Is Important In Nursing And Nursing Process Nursing Essay This essay will look at the importance of communication in nursing. To begin, the essay will consider the use of communication in nursing in the general context. The latter section will go on to reflect on the application of communication in practice in relation to conversation and basic psychotherapeutic support within the dementia care environment. Introduction Communicating is a fundamental skill in nursing. It governs every task a nurse undertakes from the point of admission to the point of discharge. There are a number of levels from simple phatic exchanges used to initiate conversation, extending to complex counselling techniques. Effective use of communication has been shown to benefit the nurse-patient relationship, contributing to overall well-being and accelerating the process of treatment. It is therefore an essential aspect of the nursing process. In some cases, it can even mean the difference between life and death. Good communication is often regarded as a delicate and complex art, requiring a good understanding of the interplay between numerous factors. This essay intends to provide a definition and to highlight a number of important professional, ethical, legal and moral responsibilities of the nurse in relation to communication (Sheldon, 2005). Discussion There are numerous definitions for communication. Potter and Perry (2001 p.445) offer a definition for communication as a process in which people affect one another through the exchange of information, ideas, and feelings. Thus, it is about sending and receiving a message, both verbally and non-verbally, with a shared goal of conveying a mutual understanding. In general regard to the verbal domain, the process is often reciprocal in nature as both informant and referent change role, seek clarification and offer an acknowledgement of understanding throughout the exchange. It is imperative to be aware of the effect that body language and paralinguistic features have on communication. Thinking about body posture and implementing the principles of SOLER (identified by Egan (1982) cited in Burnard and Gill (2009)) is useful in nursing. A relaxed posture can help in the process of active listening, helping to convey an empathic response to the patient. Argyle (1994) points out that people are often unaware of their own non-verbal communication, whilst it is clearly visible to the receiver. Incongruence between what is being said verbally and what otherwise is perceived does not help in facilitating a positive relationship from a patients perspective. However, for a nurse who is trained to be sensitive to such cues (particularly in mental health settings), it can sometimes present useful information about a patients mental state and is a possible indicator of deterioration. The Fundamentals of Care (2003) document published by the Welsh Assembly Government highlights that communication should take place using appropriate language and in a sensitive manner. Care should be taken to communicate effectively with people who are mentally impaired. In all patient communication the use of medical jargon should be limited wherever possible. As the Department of Health Valuing People Now (DH 2007) points out, as cited in Baillie (2009), people with learning disabilities have a right to healthcare just as much as other people and it should be just as accessible. In essence, nurses have to be open, flexible and versatile in their approach. Stuart and Laraia (2005) cited in Riley (2008) suggest that communication facilitates the development of a therapeutic relationship. Nurses should adopt a suitable style of questioning, using open and closed questions appropriately depending on the situation. It is always important to convey a warm and accepting attitude that is objective and value free, taking into account the different cultural variations that exist. Nursing is increasingly recognised as a holistic and person-centred process, with so many aspects of a patients life regarded as important to the process of recovery that communication in itself forms a significant aspect of treatment. Caris-Verhallen et al. (1999), cited in Crawford et al (2006), imply that communication promotes an increased level of self-esteem and reduces stress. These benefits also promote staff wellbeing. In addition, Watkins (2002) mentions the usage of self-disclosure as a factor that helps develop therapeutic relationships with patients, parti cularly within mental health settings. Teamwork is a factor too which relies heavily on good communication. Nurses are surrounded by different types of health care professionals and as Peate (2006) acknowledges, interdisciplinary communication can be difficult. The Nursing and Midwifery Council (2008) Code of Conduct states that, as a nurse you must work cooperatively within teams and respect the skills, expertise and contributions of your colleagues. It is often the nurse that acts as an intermediary between the patient and another healthcare professional, disseminating information and explaining it in terms suitably appropriate to the understanding of the patient. Poor communication creates barriers which can often lead to patients feeling alienated and making complaints as well as often being a significant factor in cases of malpractice, neglect and negligence. Within many clinical settings, a lack of time presents difficulties in utilising effective communication. Nurses often have to take opportunities to build rapport using synchronous communication whilst carrying out other tasks and duties. As Crawford et al. (2006) point out, healthcare professionals are increasingly task driven and laden with administration which prevents them from spending time talking with patients using the ideal but time consuming counselling type communication. Therefore, in modern healthcare settings, they suggest a newer model is used that encompasses Brief, Ordinary and Effective (BOE) communication Crawford et al. (2006). With regard to written communication, the NMC Code of Conduct (2008) highlights that nurses are expected to ensure that accurate and up to date records are maintained, with clear information about when the entry was made together with a signature of the person making the entry. Not only is this therapeutically useful, it is also an essential legal requirement and offers evidence that treatment has been carried out. Finally, Baillie (2009) explains that the telephone also forms an important, often overlooked mode of communication. As with all clinical work, it is essential for nurses to maintain professional etiquette and confidentiality, as well as acknowledge their level of competence to the caller and ensure that the call is documented where necessary (Baillie, 2009) Conclusion Communication has been demonstrated to have an important positive influence on treatment outcome. Nurses as a collective group represent a substantial aspect of all clinical health care professionals. They probably spend the most amount of time with a patient. As such, there is an enormous capacity for influence on treatment. It is therefore clear why there is a need for significant emphasis on this matter in nurse pre-registration programmes. Encouraging future and present generations of nurses to communicate more effectively could have a significant influence on increasing patient satisfaction and recovery time. It is therefore suggested that promoting effective communication has potential cost saving implications for local healthcare authorities too. This is important given the enormous strain that the NHS is under in the current economic climate. From a wider perspective, it could be speculated that effective communication indirectly has some bearing on aspects of future health a nd social policy. Reflection: Communication in The Dementia Care Context This next section looks reflects on communication within a dementia care setting and utilizes a Reflective Cycle model (appendix 1) adapted from Gibbs et al (1988) as cited in Bulman and Schutz (2008). The model begins by using a description about what has happened and then encourages the person whom is reflecting to acknowledge their feelings about the situation/event. From this, the evaluation phase encourages the reflector to make value judgements and to say what was good or bad about the experience. Next, an analysis can be made about the situation and this should hopefully generate ideas and themes about the situation. Through doing so, conclusions can be drawn both in the general sense and in terms of the reflectors specific personal experience. The final part of the reflection process with this model is the personal action plans stage whereby the reflector can suggest different, perhaps better ways of doing things in a similar future situation. Description The placement was a dementia care ward which was all-female bedded with people who were at various stages in terms of the development of their dementia condition. The majority of the patients were still relatively active in a physical sense and often quite talkative. I spent a significant amount of time sitting with various patients in the dayroom, often for observation reasons to help ensure their safety. This enabled frequent opportunity to talk to the patients and also to gain some insight into the nature of how dementia can affect people. There was one patient that particularly concerned me. In the interests of preserving confidentiality I will change her name and refer to her as Abigale. Although this reflection is predominantly focused on my interaction with Abigale, much of what I mention is relevant to the patient population at large in respect of dementia care. Abigale was an elderly lady, perhaps in her early 70s, who used to be a school teacher during her working years. Her condition was such that she was often quite talkative although the conversation was very much disjointed. She conveyed a range of emotions and often talked to me as if I resembled a particular character in her former life. Sometimes she spoke in a manner that suggested that she was seemingly happy about something and then for no apparent reason, she would become very upset and tearful. This happened on a frequent basis, with her emotions appearing to cycle between positive and negative affect in relatively short periods of time. Feelings Throughout the time I spent talking with Abigale, I always tried to talk warmly to her and convey an accepting attitude along with empathy, interest and compassion, reflecting the core principles of Rogers client centred therapy. I was aware that my non-verbal communication was very important both to her and other patients. Within the dementia care setting, non-verbal communication is often even more important because it is often relied to a great extent. I always tried to portray openness in my body language, using the SOLER principles acronym outlined by Egan (1994), (see appendix 2). I found that she often used the mode of touch to communicate when sitting and/or talking with people and I attempted to replicate this in a similar, acceptable manner. I found this to be very effective which did surprise me. With a younger generation, touch tends to be a form of communication that I tend to perceive as not working very well for me. This maybe because I just havent utilised this method very much outside of friendship and family settings. I enjoyed spending time talking with Abigale. I particularly liked the way she continued to speak with a degree of authority that would perhaps be commensurate with her former role as a teacher. Even though her conversation was markedly unfocused and incongruent, she spoke in a very articulate manner. When I was able to answer her with a response she appeared to find satisfactory, it felt quite rewarding and it was good to see when she appeared to be happy. Sometimes she acted as if I resembled various people from her life. It was difficult to know whether to simply accept these non-sequiturs and go along with them, or correct her and risk upsetting her. Unfortunately, there were also times when I could not give her a response that she needed. I occasionally found it difficult to determine what she was actually talking about and I didnt want to respond with something that wasnt relevant. Despite my best efforts, it was difficult to seek clarification from her as she would often move on to some other topic. I also found it emotionally challenging at the times where she was upset for no apparent reason and I would have liked to have been able to offer more support. Sometimes, I have observed staff using diversion techniques to help distract patients from distressing situations. I have tried to use these occasionally. However, I tend to be a little uncomfortable doing this and I would rather be able to help somehow by having a greater understanding of the person and addressing their questions and concerns more directly. Finally, not having access to the computerised notes system (PARIS) was very frustrating as it meant that I only had information passed verbally from staff. Evaluation Whilst communicating with Abigale and indeed, other patients within the setting, I tried to maximise my listening capacity by blocking out noises that were external to interactions. However, because I felt I had a duty to the other patients, blocking all noises was impracticable. The dayroom tended to be a difficult place to have a conversation. The television appeared to be more or less continually switched on, and there were often domestic staff performing various cleaning duties. The ambient noise levels tended to be quite high and somewhat distracting both for myself and no doubt, the patients. Access to PARIS would have allowed me to gain a greater awareness about the patient as I would have been able to read comments and assessments made by the whole multidisciplinary team. Analysis Good communication forms an intrinsic part of the nursing process and is part of many nursing models. Roper et al. (1996) as cited in Peate (2006) list it as an aspect of daily living. Unfortunately, people who suffer with dementia experience a number of cognitive difficulties according to Mace (2005) as cited in Adams (2008) (see appendix 3) which make communication very difficult. The associated pathological diseases and consequences of aging also exacerbate these difficulties making effective communication even more problematic (Adams, 2008). The role of communication is therefore especially important for dementia patients as they are likely to have difficulties with interpretation of messages (Kitwood, 1997 as cited in Adams (2008)). Indeed, I often found that what Abigale said and how she acted on the responses that I gave was often incongruent suggesting there was a problem with interpretation. However, when I attempted to seek clarification, it was very difficult or indeed imp ossible. According to Cheston and Bender (2003), dementia care can be improved by beingpsychotherapeutic and using every interaction as an potential opportunity to help and support them. The humanistic and Rogerian aspect of empathic listening is particularly important and provides clues about embedded emotional messages according to Cheston and Bender (2003). However, they go on to suggest that in order to be psychotherapeutic in an approach requires a good understanding of a persons life history. Unfortunately, the short term nature of the placement meant that I was likely to remain relatively naive in terms of understanding her history and condition to any useful extent, so being truly psychotherapeutic in my actions was difficult. Nevertheless, I attempted to provide a contribution to the nursing process. I found that some of the communication strategies that nurses are encouraged to use in many settings need to be changed when consideration is given to the dementia care environment. Watkins (2001) suggests that clients respond better when nurses ask open questions. However, for dementia patients, asking open questions would appear to have a tendency to induce cognitive overload. As such, the Alzeimers Society Advice Sheet (2000) recommends that carers should ask short questions, one at a time which require only short answers. The Alzheimers Society (2000) also highlight the need to try and see the person behind the illness: Interests, likes and dislikes, hopes and fears, early life, places they have lived and visited, working life, people they love/have loved, friendships and personality. I did try to find out from Abigale aspects of her former life but in truth, I had very little understanding about these factors. Abigale tended not to respond directly to questions but rather hinted certain aspects on an adhoc basis. Therefore, hypothetically, if I was a named nurse for Abigale in the future, it would perhaps be useful to speak to her close family to gain some insight and as well as potential stimulus for conversations. Perhaps a reminiscence box containing various items such as photographs and objects would be useful in terms of triggering memories and developing conversations. I think it is important to acknowledge that it would have been better to take Abigale to somewhere quieter when she was upset. This would have been more conducive to conversation as well as offering some level privacy for Abigale. However, in the reality of the situation, there were limited places that were actually available on the ward. In addition, it was likely there were other patients that were also episodically distressed that made it difficult to devote full time to Abigale. The other patients tended to demonstrate similar emotions which coincided with the majority; hence there were good and bad days in terms of patient behaviours. Overall, I feel that on balance I offered a good level of support for Abigale. At times, I believe that I could have offered her more in terms of conversation if I had a better level of knowledge about her background. Indeed, sometimes I felt that I lacked the relevant stimulus to have a lengthy conversation. Despite it being my first placement, there were times where I would have liked to have had the knowledge to use certain basic level therapeutic approaches that are applicable to patients whom suffer from dementia. My mentor also mentioned an interest in validation therapy and I am aware too of the existence of other forms of therapy such as pre-therapy, reminenscence therapy, resolution therapy and the person-focused approach. However, I can clearly appreciate that as a 1st year nursing student, to gain such knowledge is totally impracticable, as well as potentially unethical and unprofessional if actually used without proper registered status. Indeed, under the NMC Code of Cond uct (2008) I must recognise and practice within the limits of competency. As such, in order to be in a position to use many therapeutic techniques effectively, I would need significant further training and/or further professional accreditation. Conclusion (General) Communication with patients who have dementia is an extremely difficult and complex process. It is absolutely essential that nurses practice effective communication to help maintain the quality of life of the patients in their care. In practice, it is very difficult to ensure that psychotherapeutic support is well provided, particularly as psychological needs are more subtle and discrete. It could be argued that relatively low levels of staff and the often high levels of physical interventions often found within dementia settings means that the provision for effective communication regarding psychological care presents a significant challenge. I think the psychotherapeutic aspect of care is a important issue, particularly with the number of cases of dementia predicted to rise to almost 1 million in the UK by 2020 (according to Alzeimers Disease International, 1999, cited by Burgess, 2003). Conclusion (Specific) Overall, I feel quite positive about my experience on placement and about the use of communication. I believe that I worked to the best of my ability. Abigale and many other patients appeared to be quite advanced in terms of their dementia condition. This proved to be quite a challenge. I would like to have had more awareness about Abigales history. I can now more readily appreciate the importance of family and friends, not only in terms of direct contribution to care but also the indirect contributions that they make through providing information about the patient. Early recognition of emotional distress helps with the nursing process. It could have made it more feasible for me to talk to Abigale to provide reassurance and limit the likelyhood of her becoming upset, therefore preserving her dignity. I have gained a great deal of insight into dementia care both through the placement experience and through the process of reflection. In retrospect, I would like to have been able to offer more in terms of psychological support and this provides some insight into the psychotherapeutic aspect of care for future placements. Action Plan In future, I would like to have acquired a higher level of therapeutic skills to enhance my ability to communicate with people who have dementia. The predicted rise in dementia cases as previously mentioned means there is a greater likely hood of coming into contact and providing nursing care for a patient who has dementia. I think it would therefore be useful to develop a greater awareness into the condition, especially from a psychological perspective. I also hope to have training and therefore approved access to PARIS computerised notes system. References Adams T (2008) Dementia Care Nursing: Promoting Well-Being in People with Dementia and Their Families. Hampshire: Palgrave Macmillan Alzeimers Society (2010) Factsheet 500: Communicating. Alzeimers Society: London. http://www.alzheimers.org.uk/factsheet/500 Accessed: 30.06.10 Argyle M (1994) The Psychology of Interpersonal Behaviour (5th Edn). London: Penguin Books Baillie L (2009) Developing Practical Adult Nursing Skills (3rd Edn). London: Hodder Arnold. Bullman C Schutz S (2008) Reflective Practice in Nursing (4th Edition). Oxford: Blackwell Publishing. Burgess L (2003) Changing attitudes in dementia care and the role of nurses. Nursing Times, 99 (38) 18. http://www.nursingtimes.net/nursing-practice-clinical-research/changing-attitudes-in-dementia-care-and-the-role-of-nurses/205196.article Accessed: 30.06.10 Burnard P Gill P (2009) Culture, Communication and Nursing. Essex: Pearson Education Limited. Cheston R Bender M (2003) Understanding Dementia: The Man with the Worried Eyes. London: Jessica Kingsley Publishers. Crawford P Brown B Bonham P (2006) Foundations in Nursing and Health Care: Communication in Clinical Settings. Cheltenham: Nelson Thorns Ltd. Nursing and Midwifery Council (NMC) (2008) The Code: Standards of Conduct, Performance and Ethics for Nurses and Midwifes. NMC, London http://www.nmc-uk.org/aDisplayDocument.aspx?documentID=5982 Accessed: 12.04.2010 Peate I (2006) Becoming a Nurse in the 21st Century. West Sussex: Wiley. Potters P A Perry A G (2001) Fundamentals of Nursing (5th Edn). St Louis: Mosby. Riley J B (2008) Communication in Nursing (6th Edn). United States of America: Mosby. Sheldon L K (2005) Communication for Nurses: Talking With Patients. Massachusetts: Jones and Bartlett Publishers Watkins P (2002) Mental Health Nursing: The Art of Compassionate Care. Edinburgh: Butterworth-Heinemann. Welsh Assembly Government (2003) Fundamentals of Care: Guidance for Health and Social Care Staff. Welsh Assembly Government: Cardiff. http://www.wales.nhs.uk/documents/booklet-e.pdf Accessed: 12.04.2010 Bibliography Ellis R B Gates B Kenworthy N (2003) Interpersonal Communication in Nursing: Theory and Practice (2nd Edn). Churchill Livingstone: London. Hamilton S J Martin D J (2007) Clinical Development: A framework for effective communication skill. Nursing Times, 103: 48, 30-31. Appendix 1 The Reflective Cycle (adapted from Gibbs et al.1988) cited in Bulman and Schutz, (2008). Appendix 2 Egans SOLAR Principles (Egan, 1994) as cited in Crawford et al. (2006) S Face people Squarely O Maintain an Open shape to the body L Lean forward slightly E Use appropriate Eye contact R Relax

Race :: essays papers

Race When I was a little girl, my best friend's dad was a neurologist. He tricked us with color and number tests and other brainteasers. I was fascinated by how my brain reacted to the games, and ever since, I have wanted to study the brain. Later, as a high school sophomore, I still focused on being a doctor, and that year I was deemed worthy of an internship at a local hospital. So, the following summer, I gave up late mornings and relaxing by the pool to get up early and help doctors at the hospital. I had originally applied for a neurological internship, which the program did not offer, so I was shuffled into working with doctors in the maternity ward and the nursery. Nevertheless, by the end of the first week, I was feeding babies, checking vitals, changing diapers, and rolling them in carriages to their mothers and fathers. Each moment I spent helping the doctors with the newborns, I wondered if I should be an o.b./gyn doctor instead of a neurologist. One morning a few weeks after I began the internship, the doctors told me a mother was to deliver a baby, and she had given permission for me to view the delivery. For awhile the mother tried to deliver, but she was tense; the doctors kept telling her to relax and stay calm for the baby. The tense mother continued trying to deliver, and with the doctor's encouraging words and the heat of the small, boxy room, I became conscious of what I was about to witness and wondered if I could handle it all. Before I could change my mind, a small, smooth head slowly emerged. I discovered what I had expected - I could not take it. Tears filled my eyes along with the healthy newborn baby's. What I had seen, some never see -- including the father who had decided he should stay in the much calmer hallway. As the beautiful baby was carried around from doctor to doctor to be examined and then to the mother's arms, I realized that I did not want to be an o.b./gyn doctor. Residents had warned me that this job must be a passion or one would burn out from stress and constant fatigue, which I definitely felt after watching the birth of a baby. As my internship continued, I helped doctors in the neo-natal care unit.

Life of Pi book

In the book, Life of Pi[1], Yann Martel proposes many religious differences, and similarities from religions located around the world. These questions ask such things as, is it possible to be a multi-religion person? Are all religions different? How are some religions the same? Life of Pi was written in 2002 and is a fascinating story of how a young man, Pi Patel, makes it in a world with his own personal beliefs. He adopts the three major religions of the world being Hinduism, Christianity, and Islam.Life of Pi is a very questioning book at times and has the capability of persuading nonbelievers to re-evaluate their religious thought process and beliefs. After reading this book you will be comfortable in the knowledge that you will have on other religions, and just may judge them differently. One of the questions that surfaces in this book is â€Å"can a person believe in more than one religion? † The author uses the Christian, Islam, and Hindu religions all in one character to represent the different struggles that Pi Patel is facing within him self, just as animals were used as symbolic representation for people in the first story. As for the question itself, a person cannot believe in more than one religion at a time. This is shown when the three holy men meet Pi in the park and they argue over his religious practices. While arguing Pi’s father reminds the three holy men that â€Å"there is freedom for practice of whatever religion in this country†[2]. The holy men screamed in unison, â€Å"Yes! Practice-singular†[3]. This point supports how even the three major holy religions of the world believe that you can only have one. However, it is possible for people to change religions throughout their lives. As religions are faith based through personal convictions that come from within, you have purpose in what you believe, and therefore are only able to believe in one at a time. To say you believe in Christianity and Hinduism would be like saying you are both a communist and a progressive conservative, which are different philosophies. You have to choose one religion or another, just as in this story you need to believe the first story or the second story, and you cannot believe that both of these events occurred. A person cannot believe two tales of the same legend. The second story with people resembles culture within North America and how everything in the North American world is looked at as bare facts. Most people only believe things that they can see with there own eyes, or feel with there own hands. Starting from our education as children, to jobs in adulthood, knowledge of bare facts measures how much we are capable of doing. In math you add numbers that have relevance to our society, in science pre-determined experiments with actions or re-actions occur, as well as predictions and conclusions. Everything MUST have an answer. If there is a topic to which we do not have an answer we dig for scientific answers, and refuse to accept folk tales or stories from higher powers. In an area of the world with steadily declining religious numbers[4], we need to exercise our faith and imaginations. We all need to have an open and searching mind like that of a younger child. Pi Patel shows just how blunt and â€Å"factual†[5] North America people are by telling the second story, including the murder of people on a lifeboat. Murder is something we can all relate to, thus making the second story â€Å"the right story†[6] to most people. After the second story of realism, many people feel the first story to be a waste of time, showing again just how North American people struggle to explore the imaginative or symbolic side of things. Everybody justifies their respective view by saying, â€Å"that’s not even possible†[7] or â€Å"I’d have to see it to believe it†[8]. The first and second story connects in a way of showing resemblances between the two major religions of the world, Christianity and Islam. The purpose of this is to show how alike Islam followers are to Christian followers. They share most of the same religious views, with very minor differences in stories of interpretations. They also share many of the same characters, such as Jesus, who is God’s son. Jesus sends messages from God and heals people in Christianity, and in Islam a prophet shares the word of God. These two parts in the story show just how different the two religions are, yet are so similar. The first story also shows how, in the eastern world, the people are much more imaginative, by using Hindu and its animals to add a twist to create the first story. It uses the animals to also describe the real people that were on the boat such as the Orangutan, Pi’s mother. In Hindu a person who is caring and involved in religious studies has the possibility of becoming a monkey after death[9]. Pi’s mom was a very caring person who was against the eating of the zebra, or the young sailor. A zebra is looked at as an honest, friendly, and creative person because of his stripes[10]. By using these animals he is trying to show just how North American culture is so bare factual. This story parallels our own personal internal struggles as well as the struggles of different cultures and religions in the world. We begin to understand we have to ultimately face and deal with our own struggles, allowing us to come to terms with our own beliefs, where we are at in our own lives and how we fit into our culture. This story could be interpreted with different meanings by different people, but ultimately causes the kind of thought that moves us forward in terms of who we will become. The purpose of this story is to show the similarities of some religions, and also to show that the things that are different, are not so different after all. This is a book attempting to change minds on religious discrimination and indifferences.Reference http://www.religioustolerance.org/chr_prac2.htm

A Review of Cadburys Supply Chain

A Review of Cadbury’s Supply Chain: Literature Review: ‘Man of Dairy Milk and Money’. Elaine Watson Article Summary: * This article begins by highlighting how Cadbury’s have had their fair share of problems: * Salmonella outbreak in 2006 * Decision to close Somerdale factory and switch production to Poland. * Factory issues in Sheffield: river quite literally flowing through the factory. * But as the article highlights, the firm has a strong and strategically placed supply chain. Areas of Competitive Advantage: * Factory Network: They recently built a new factory in Poland.They have an established network with two other factories there, and a gum plant. * Cost effective Supply Chain: By strategically placing the factories in Poland they were able to achieved cost savings in two key areas: * Cheaper wages (despite the fact that they are increasing). * A reduction in labour by 15%, which resulted in boosting operating margins from 10% to the mid-teens. * Alig nment of Supply Chain: Cadbury’s treat the supply chain as a whole; â€Å"It is very easy to think in terms of manufacturing, logistics, sales, purchasing and so on. But their objective must all be aligned†.They ensure that work groups are formed compiling of resources from across the different functional teams. This ensures that every project/group is focused on achieving their main goal of customer satisfaction, and are able to consider this from every part of the manufacturing process. * Global Benchmarking: â€Å"We’ve got lots of key performance indicators in terms of quality, safety, service level, and the environment, but for manufacturing we use OEE†. Cadbury’s highlight the importance of waste management owing to the fact that raw materials have dramatically increased in prices over recent years (Cocoa for example has increased from ? ,000/t to ? 1,600/t. * Environmental responsibilities: Cadbury’s aim to reduce their carbon footpri nt by 50% by 2020. * Manufacturing Ownership: Manufacturing is a core competency for Cadbury’s. There are arguments in favour of keeping this in house in terms of economic and intellectual ones. Bournville is the core plant; here they have 1,000-1,200 staff as well as sophisticated machinery producing 100,000t of chocolate products a year. This factory further produces 1m creme eggs a day. * Outsourcing: Cadbury’s outsource two of their products: * Snaps: this involves unusual technology. * Green & Blacks.Literature Review: ‘Ethical Supply Chains – ‘The New Black’? ’ Lisa Brown. Article Summary: * This article highlights the importance of sustainable supply chain management, and likens the rate of take up to ‘The New Black’. Therefore this article is centered around how Cadbury’s manage a sustainable supply chain in order to gain a competitive advantage. * Cadbury’s are an example of a firm who have succes sfully implemented such ethical considerations into their supply chain. In 2009 they announced that the cocoa drinks and dairy milk chocolate would be fair-trade certified in British and Irish markets.This mark ensures that the farmers are paid a fair price, and that crops are farmed under sustainable conditions (putting a halt to child labour). * Advantages of Sustainable Supply Chain Management (SSCM): * Changing consumer attitudes: The article paints a picture of a consumer who is no longer concerned by product quality and other tangible aspects, but rather is concerned with the integrity of supply chains (and will often spend more money on those products that appeal to their moral code). This view is personified through Brown’s comment that â€Å"†¦pressure to donate, volunteer, buy green†¦ by organic, recycle, reduce carbon emissions†.Brown further states, â€Å"Customers often feel a sense of intrinsic commitment and emotional attachment to the product s they purchase * The price of not acting sustainably: the article compares Cadbury’s success to a clothing retailer who has received criticism for their use of sweatshops in Asia. * Competitive Advantage: â€Å"Supply chains have become the new black, a trendy way of connecting with the consciousness of consumers (particularly generation Y) and achieving differentiation from those companies/products not willing or able to keep up†. * How is this hanging consumer attitude affecting the industry? * Competitive Advantage: Transparency of supply chains: in a society where publicly accessible information is just a click away and a good reputation is priceless, ensuring integrity of supply chains is on way to create a competitive advantage. * Product differentiation: Products are no longer differentiated by rudimentary characteristics such as colour and price. Values are a key part of the customer decision. * Declaration of interests: Companies must ensure that companies th ey are partnering with are also keeping within the guidelines. Ethics ahead of profits: Customers nowadays will pay more money for items that appeal to their moral consciousness. Thus, firms need to walk the walk rather than just talking the walk. Literature Review: ‘Reconfiguring Three Companies Under one Umbrella’. Alan Robinson. Article Summary: * This article identifies how the Cadbury’s supply chain ensures that network benefits are realized and capitals costs are reduced. In essence it portrays how Cadbury’s creates a competitive advantage through three of their products: Schweppes, Motts and Snapple. Competitive Advantages: Integrated Supply Chain: The three companies have an integrated supply chain, which provides the following benefits: * Continual realignment and readjustment of products means that they never duplicate efforts. * Owing to constant changes in product lines (with them acquiring other lines and products), they continually review the ir locations and distribution channels. They ensure that they are always maximizing efficiency (hence their move from Somerdale to join their other factories in Poland). * Synergies between brands: Brands work together.For example a group with a mature manufacturing knowledge, Motts, was paired with a new manufacturing company, Snapple. Mott’s ran the Snapple manufacturing activities. * Analytical Tools: They use advanced supply chain analytical tools such as VA-basis Insight and its SAILS. This is supply chain network modeling software (similar to those shown in the picture below). Source: Ernst & Young Power and utilities Network Modeling Overview. This provides them with the following benefits: * Ability to strategically set up plants and locations (network modeling). They are able to constantly reevaluate their market in order to reduce duplication and reduce carbon emissions (which saves costs and promotes their sustainable supply chain management image). * Ability t o analyse demand seasonality to ensure that their brans have the capacity to meet customer demand throughout the year (their products are highly seasonal – e. g. Cadbury’s creme eggs). * Mature stock and inventory level management systems gives an idea as to where they should invest additional capabilities. * Reduces capital costs Products are sold to market at varying stages in supply chain: * Motts and Snapple sell ready to go products that can be sold to the end customer. * Whilst Dr. pepper and Carbonated drinks just sell the ingredients. * Range of outlets: Cadbury’ sell their products in a range of outlets in order to meet their customer base. For example, Convenience stores, supermarkets and drug chains etc. * Variety of Production Methods: * Outsourcing: Cadbury’s Schweppes brand is outsourced to Hershey’s in America. * Franchise: Cadbury’s franchise Dr Pepper and 7Up.Those who buy the franchise get rights to the product, the concent ration and the packaging. * Use of distributors: Snapples Beverages use distributors to reach their market. Synthesis: The assimilation of each of the articles that I have researched demonstrate that Cadbury’s see their Supply Chain as being a key area in which they can create a competitive advantage. Their main advantages are achieved in the following areas: * Make-buy/Outsourcing Decision: Cadbury’s assess the market and their areas of strength to ensure that what they are producing satisfies the customers needs.This is both cost effective and logical in terms of fulfilling the customer requirements. * Factory/Distribution Outlets Networking: Intelligent network software is used to ensure the network that supports their supply chain is cost efficient and reduces duplication. This can be seen from their move to Poland, thus creating synergies. This also increased their operating margin. * Integrated Supply Chain: Owing to the number of product lines that Cadburyâ€⠄¢s own (often through M&S activities), the Cadbury’s supply chain is configured to enhance brand cooperation and coordination.This can be seen through a number of examples listed in the examples above: * E. g. 1. For example a group with a mature manufacturing knowledge, Motts, was paired with a new manufacturing company, Snapple. Mott’s ran the Snapple manufacturing activities. * E. g. 2. Different departments are bought together a matrix manner in order to ensure that projects and work takes into account the view of the whole manufacturing process. This ensures that their objective is always in the forefront of projects and is accounted for through all different functions views. Sustainable Supply Chain Management (SSCM): They are able to differ from competitors in a number of ways. The benefits achieved through their morally appealing supply chain activities are: * Competitive Advantage * Product differentiation * Declaration of interests * Ethics ahead of prof its * Manufacturing Ownership: Manufacturing is a core competency for Cadbury’s. There are arguments in favour of keeping this in house in terms of economic and intellectual ones.Bournville is the core plant; here they have 1,000-1,200 staff as well as sophisticated machinery producing 100,000t of chocolate products a year. This factory further produces 1m creme eggs a day. * Global Benchmarking: â€Å"We’ve got lots of key performance indicators in terms of quality, safety, service level, and the environment, but for manufacturing we use OEE†. Cadbury’s highlight the importance of waste management owing to the fact that raw materials have dramatically increased in prices over recent years (Cocoa for example has increased from ? 1,000/t to ? 1,600/t.