Aziz Troupe Essays (415 words) - Gender, Gender Studies, Identity

Aziz Troupe October 9, 2017 In the United States when people think of a typical American they think of a Caucasian, Christian, straight person. If you don't believe me, look at most television shows and see if the main character fits the description. America was founded by Puritans trying to escape persecution in England but when they arrived they persecuted the Native Americans until they eventually committed mass genocide. Now in the modern era the new Native Americans, to a degree, are Homosexuals and Transgender people. Personally, I have a gay cousin I've been raised around since I was born. I don't have any issues with gay people but a lot of Americans are homophobic. Many people think you should act according to your gender, meaning that boys should play sports, get dirty, and be as macho as they possibly can, while girls should paint their nails, wear dresses and skirts, and put on their makeup. If a gender decides to do what the opposite gender does, they are immediately questioned and labeled. Matt Du ron, a senior police officer and author of "My Son Wears Dresses; Get Over It", has a son who "only likes girl stuff and wants to be treated like a girl". If he mentions his son's behavior to anyone other than his close friends he is faced with responses like "Man, how do you deal with that? I couldn't do it. Not in my house.". Duron is considered crazy by people for allowing his son to be who he truly wants to be, and that is the problem we face in America. If it doesn't conform to our society's definition of "normal", it is considered absurd and should not be tolerated. Sarah Showfety, author of "Field Guide to the Tomboy", described being a "classic tomboy" as breaking the walls of gender conformity by "avoiding pink clothes, lipstick and nail polish". She avoided all things that typical girls do, not to show that she was better or because she wanted to be different, but rather to express who she was. Similarly, Jennifer Finney Boylan, transgender and author of "A Life in Two Gen ders", went against the traditional roles of gender. Boylan transitioned from man to woman and describes it as "Clark Kent turning into Superman." All three authors share the same position on gender role: that roles are simply for acting. People are who they are and society should be fine with it. In short, and in Boylan's words, "it is what it is."

The Book of Hosea essays

The Book of Hosea essays Hosea was the son of Beeri, and author of the book of prophecies bearing his name. He belonged to the kingdom of Israel. His origin is question because of the peculiar, rough, innocent look. People point to the northern part of Palestine because of the intimate acquaintance he has with the localities of Ephraim. The period of his ministry, that extended for about sixty yeats,, is indicated in the superscription. Surprisingly, he is the only prophet of Israel who has left any written prophecy, the Book of Hosea is one of the books of the Minor Prophets in the Old Testament of the Bible. Its name is taken from the prophet Hosea, who lived in the northern kingdom between 755 and 725 B.C. The book is divided into two parts, first part which is chapter one through three, tells the story of Hosea's marriage to an unfaithful wife. Hosea used this personal tragedy as a parable of the relationship between God and Israel. In the second part which is chapter four through 14, the theme of unfaithfulness is developed. The prophet rebukes corrupt leaders and priests and chastises the Israelites for their superstition and idolatry. Hosea was known to be the first biblical writer to use the imagery of marriage as an illustration of the relationship between God and his people. My favorite verse is from the Acts of the Apostles. Hosea said, Yet the number of the children O Israel shall be as the sand of the sea, which cannot be measured nor numbered; and shall it come to pass, that in the place where it was said unto them, Ye are not my people, there it shall be said unto them, ye are son of the living God And Again I will sow her unto Me in the Earth and I will have mercy upon her that had not obtained mercy; and I will say to them which were not my people thou art my people; and shall say, thou art my god. (1:10; 2:23) I like this verse because it took a little time for me t ...

Linguistic and Encylopaedic Information Essay Example | Topics and Well Written Essays - 3000 words

Linguistic and Encylopaedic Information - Essay Example It has been an observation that this distinction has often been very metaphorical due to inter-relation of lexical and non-lexical knowledge, and thus one can come across different viewpoints regarding possibility of distinction of linguistic and encyclopaedic information. On one hand, few linguistics advocate invalidity of any distinction between the two types of knowledge and/or information due to globalization of language and knowledge that has resulted in increment in spread of semantics and enhanced dependence on semiotics that do not facilitate any distinction between lexical and encyclopaedic information. On the other hand, linguistics of other school of thoughts deny this argument and oppose that it is essential to distinguish both information, especially from the perspective of linguistics as it will allow an in-depth understanding of different elements of a language. In this regard, different viewpoints exist; however, this paper will now include a brief description and dis cussion regarding dictionary and its entries that will allow a general understanding of information that is provided in the dictionaries, which will later on be considered for discussion on its distinction with encyclopaedic information. ... 93) Nowadays, it has been an observation that a dictionary entry usually consists of lexical information regarding a particular word. For instance, in the above example also, dictionary entry consisted of form, syntax, and semantic information regarding the word ‘cat’. However, latest versions of dictionaries are now coming with additional information as well, such as semantic relatives and morphologies, pronunciations, as well as alternative spellings (Spencer, 2012). In this regard, one can see distinction between different types of dictionaries as well since one can come across general dictionaries, subject dictionaries, translating dictionaries, special dictionaries, etc, and thus, every dictionary differentiates from one another based on its characteristics. In some dictionaries, dictionary entry will consist of orthographic information that is not a linguistic characteristic of a word according to many linguistic experts and thus will not be present in entries of o ther dictionaries. According to few linguistic experts, various additional factors play a critical role in understanding of words in English language; they do affect meaning, and consequently utilization of the particular word. Thus, it has now become very difficult to separate worldly meaning associated with lexical word meaning since native speakers although begin with lexical understanding of the language; however, they left the former as soon as they increase the volume of their vocabulary. In this regard, although one can distinguish between lexical that is dictionary information and non-lexical that is encyclopaedic information; however, it will require selection of a particular lens and/or perspective that will enable

Personal statement for an MAB for international student

For an MAB for international student - Personal Statement Example With the guidance of the MBA program of your university, I hope could learn how to manage the business, understand the business environment and learn strategies that are considered important in managing a business. From my personal experience as an assistant manager in our own company and proper education that I will learn from your university, I want to establish also a teaching career in King Saudi University right after graduation. I have completed an undergraduate course of Business management at University of Colorado Denver, and I believe pursuing a Masters Degree in Business Administration in Shenandoah University would help me become successful in business and as an educator. Â  I will not stop with an MBA degree because my long term plan includes a higher degree of learning, and I plan to finish post graduate studies in Human Resources Management. My interest in human resources stemmed from my relations with personnel, clients, suppliers and other personal contacts during m y stint as Assistant Manager of the company.

I am studing phd in operatioanal research and applied statistics my Thesis

I am studing phd in operatioanal research and applied statistics my topic is Data Envelopment Analysis in health care - Thesis Example In this case, the medicine commerce is one of the most prominent industries that make use of this envelopment approaches. Efficiency capacity has been a domain of incredible interest as firms have strived to better efficiency. Causes for this focus were best claimed half a century ago by Farrell in his archetypal document on the measurement of dynamic efficiency. Farrell additionally stated that that chief cause that all trials to resolve the issue and failed, was because of a failure to join the measurements of the numerous inputs into whichever reasonable measure of efficiency (Kuah, Wong & Behrouzi, 2010, p. 3). These insufficient methods creating standard proficiency for one input while disregarding all additional inputs, and building an index of efficiency in which a weighted standard of inputs is compared with efficiency. Reacting to these insufficiencies of distinct indices of labor proficiency and capital profitability were suggested by Farrell an operation scrutiny method that can more efficiently tackle the issue (Cook 7 Seiford, 2009, p. 5). His measures were intended to be applicable to whichever productive firm. From a workshop to an entire financial system, Farrell apparently confined his digital cases and discussion to one output situation, even though Farrell was capable of making a multiple output case (Kuah, Wong & Behrouzi, 2010, p. 3). The provision of a reasonable assessment of every DMU could be argued out that in whichever provided criteria ought to be contrasted simply to other units in similar or less-deprived criteria. A DMU under substantial struggle would be unethic ally punished if contrasted to units in importantly more promising modest surroundings. In the nonexistence of renowned multipliers such as Charnes, Cooper and Rhodes and many others, anticipated deriving suitable multipliers for a provided DMU by resolving a specific non-linear software design issue. Particularly, if DMU is being designed under consideration, the CCR

†REFLECTION Monitoring and Ensuring Quality Care

– REFLECTION Monitoring and Ensuring Quality Care Introduction The purpose of this paper is to reflect on a recent personal experience of patient care, which enabled me to achieve a module 9 competency, Actively seeks to extend own knowledge. I will be critically analyzing one nursing practice incident using Boud, et al (1985) model of reflection, (please see appendix 1) which will enable me to monitor and ensure quality patient care in future practice. The nursing incident happened when I was looking after a patient requiring enteral tube feeding (ETF). It is important to note that all confidential information relating to patients, wards, hospitals and professional colleagues has not been included in this paper to ensure ethical practice and adherence to the NMC code of professional conduct, section 5 which affirms that I must guard against breaches of confidentiality (NMC 2008). Reflection is a useful tool for the continuation of professional development among nurses (Somerville and Keeling 2004). The word reflection originates from the verb reflectere which means to bend or turn backwards (Hancock 1998). It is a tool, which unlike text books and videos, does not have a limited shelf-life, it is cost effective, is portable and can be used world wide. Patient Profile The aspect of nursing care I have chosen to reflect on is the care of a patient who required enteral tube feeding (ETF) due to dysphagia a condition in which the action of swallowing is difficult to perform (Unison Health Care 1998). This nursing intervention was essential for a patient in my care, who I shall call John. Please see appendix 2 for Johns past medical history. The Plan of Treatment for John John was admitted to my area of practice six days ago following his CVA. He is receiving ETF via an NG tube as an immediate intervention and is being assessed to see if he is a suitable candidate for a percutaneous endoscopic gastrostomy (PEG) tube which are used as a more permanent form of enteral tube feeding (Holmes 2004). The nasogastric tube is about 22 inches [55.9cm] in length (Holmes 2004) and was inserted into his left nostril down through the pharynx, through the oesophagus and through the cardiac sphincter muscle and into the stomach (Marieb 2001). Food can be administered through the tube directly into the stomach and the swallowing process does not need to take place. The food is administered by a pump that controls the amount of feed given in mls per hour. This description could sound as though ETF is always safe and effective and has no complications. Elia (2001) affirms that ETF is typically safe and easy to administer. However John did experience a number of difficul ties that could have been rectified sooner than they were. On reflection of Johns care it is clear to see (with the benefit of hindsight) that if Johns care was managed differently and if complications were noticed and acted on promptly, his hospital experience could have been very different. 1.) Returning to the experience Problems John faced. John experienced two main complications as a result of ETF. The first was regurgitation of the feed into his throat and mouth and the second was diarrhoea. The rate of the feed had been increased over a period of days to its optimal rate, following the ETF guidelines provided by the NHS trust that I was working in. The infusion was commenced during the night while he was sleeping to allow John greater freedom during the day as he could be disconnected from the pump. The regurgitation happened during the first night that the pump was running at the optimal flow rate. Davis and Shere (1994) report that regurgitation is a common complication of ETF. As a consequence, John had to swallow what had come up into his mouth. The rationale for John to undergo enteral tube feeding was to prevent further weight loss and aspiration which can be caused by dysphagia (DeLegge 1995, Gibbon 2002 and Davies 1999). Aspiration has various meanings, however in this context it refers to the movement of for eign material i.e. fluids or food, into the trachea and further down into the lungs (Unison Health Care 1998). This can occur when the swallowing mechanism is ineffective or impaired. Infection of the lobe of the lung, in which the foreign material has lodged, occurs. This is called aspiration pneumonia (Unison Health Care 1998). Patients suffering from dysphagia are at risk of developing aspiration pneumonia (DeLegge 1995 and Gibbon 2002). ETF was commenced to overcome this risk but now the very intervention that was intended to eliminate the risk has caused an even greater risk of aspiration pneumonia. According to Marieb (2001) there are two stages of deglutition (swallowing). The buccal phase, which is a voluntary action, occurs in the mouth and is the first phase of deglutition. The tongue progressively elevates anteriorly to posteriorly, propelling the bolus through the oral cavity. When the bolus has moved to the base of the tongue, the soft palate is raised, preventing food from being regurgitated via the nasal passage (Davies 1999). The second is the involuntary pharyngeal-oesophageal phase which Davies (1999) describes as a complex sequence of muscular movements. After a CVA the ability to initiate the secondary phase of deglutition can be disrupted resulting in ineffective or complete failure of this phase of deglutition. This short explanation of pathophysiology demonstrates how important it is to know nursing rationales for nursing interventions. Patients suffering from dysphagia can sometimes overcome the problem by eating a pureed diet and drinking thickened fluids, but this depends on the severity of the dysphagia (Stringer 1999). John needs ETF because his dysphagia is too advanced to be overcome by a change in diet. Arrowsmith (1993) recommends that patients who are receiving ETF via a NG tube that are lying in bed, should have their head and shoulders elevated 30-40 degrees during feeding and up to one hour afterwards to minimise gastric pooling and reflux of the feed. This example demonstrates how a simple action can make a substantial impact on the quality of care that they experience. It has the twofold purpose of Impact of the quality of care that they experience. It has twofold purpose of promoting the effectiveness of the intervention and minimises harm to the patient by reducing the risk of aspiration pneumonia. Assessing for signs of aspiration in a patient suffering from dysphagia should always be taken seriously by nursing staff. Stringer (1999) reports that if dysphagia is serious enough it can prevent the victim from swallowing their own saliva. The average person swallows approximately 590 times each day 146 when eating, 394 when awake and not eating and 50 times during sleep (Davies 1999). With the average person swallowing literally hundreds of times each day, patients are at risk of aspirating (on their own saliva) regardless of ETF. Barer (1989) found that over one third of conscious acute stroke patients admitted to hospital had unsafe swallowing. Davies (1999) citing Ellul and Barer (1994) affirms that dysphagia in the first three days after stroke is associated with a five to tenfold increased risk of chest infection during the first week. This is due to varying degrees of aspiration. Aspiration is a potentially fatal complication of ETF. John also experienced three episodes of diarrhoea since starting ETF. John was only provided with a commode which was only dealing with the symptoms rather than treating the cause. No contact was made with the senior house officer or dietician. Furthermore there did not appear to be much concern among the nursing team and there was no discussion or sharing of knowledge between colleagues accept what came from myself. I told my mentor what I had been reading during my reflection time and pointed out some reasons that have been identified as causing diarrhoea for patients receiving ETF. The attitude of my mentor was apathetic, and commented, Hes bound to pick up a bug, give it time, it will pass. This shocked me as Somerville and Keeling (2004) reports that the nursing profession depends on a culture of mutual support, and this was not what I received from my mentor. I wanted to discuss the temperature of the feed, his current medication and the cleanliness in which the feed was prepared and administered. If the feed is too cold when it is administered it can cause diarrhoea (Arrowsmith 2003). Howell (2002) reports that diarrhoea can be the result of ETF but it can also be due to the side effects of medications. Antibiotics can cause the common side affect of diarrhoea (BMA 2001) but John was not receiving any. Diarrhoea in ETF can also be caused through the introduction of bacteria through poor hygiene standards in the preparation and administration of the feed; however the preparation and administration does not need to be performed aspptically. This is only indicated if the patient is immunocompromised (Arrowsmith 1993). My professional knowledge reminded me that I could not dismiss the diarrhoea as a coincidence. If there were nursing interventions that could be used and I didnt use them, I would be failing to provide quality care for my patient. Nurses are responsible not only for their actions but also for their omissions (NMC 2008). I wanted to refer to each others professional knowledge through discussion, and to the ETF guidelines to see if there was a simple cause to the problem that could be rectified before consultation with the doctor or dietician became necessary. I was able to rule out most factors that can cause diarrhoea. This led me to believe that the infusion rate could be too fast. These are the factors that I wanted to discuss with my mentor so I could contact the dietician to seek help from the multidisciplinary team. Gibbon (2002) asserts that stroke care requires the services of a multi-professional te am, working towards an agreed therapeutic plan hence my reason to collaborate with the dietician. 2.) Attending to feelings What did I feel was Positive? During reflection time I was very interested and pleased to find this research to suggest that there could be something that I could do to put an end to the discomfort, distress and potentially disastrous complications of a patient in my care. Many times as a student I have felt that I personally, am not making a great difference to my patients health and wellbeing as I am not working independently, but under my mentor who in general decides on a course of action for our patients. This time I have found the answer from my own research. All that remains is for me to bring this research to my mentors attention and then put the intervention into practice. The patient will benefit, and I will have a great sense of achievement as I will have, in a small way, improved the quality of someones life, accomplishing one of the reasons why I decided to take a career in nursing. Attending to feelings What did I feel was Negative? In response to the apathy that I encountered, I felt disappointed and powerless and undervalued. My original mentor was off on temporary short term sickness due to a small operation and therefore I was allocated another Junior Ward Sister to take her place for the short period of time in her absence. I felt disappointed because my contribution to the care of my patient was not welcomed and that this mentor was not as patient or interested in my learning and on-going development. I also thought it was unfair because I had evidence to base my suggestions on. It was not a vague idea I had conceived but it was grounded in research. I felt powerless because as a junior and inexperienced member of the team I felt I had little influence over the overwhelming hierarchy. Morris (2004) states that student nurses possess little power because they are viewed as inexperienced. I wanted to make my mentor realise that the patient could be suffering (from diarrhoea and regurgitation) because of our negligence and not from inevitable causes. Why was Cognitive Learning Being Achieved? In this situation I was learning a number of things, mainly relating to communication, team work, assertiveness, accountability and responsibility. I learned that my priority is with the care of my patient and not with my popularity among colleagues, just as the NMC (2008) signifies when it states when facing professional dilemmas, your first consideration in all activities must be in the interests and safety of patients. When I met with my original mentor on her return back to work we discussed this incident of practice and she praised my efforts in extending my knowledge to improve patients care. I therefore achieved the competency, actively seeks to extend own knowledge. Do Any Barriers to Learning Exist? The barriers that existed to my learning were the apathy of the nurses and the limits of my own assertiveness. It was very hard on this ward to feel proud of the care that was being given. The ward was poorly staffed, the ward manager was unanimously unpopular, the ward relied heavily on agency staff that was not familiar with the ward and my temporary mentor wanted to leave nursing because of all of the above (and more). As a new and enthusiastic team member I found my self fighting against the low morale and low motivation of the current staff. Job satisfaction can impact on the care that nurses provide. Brown (1995) believes that when nurses enjoy good job satisfaction they provide a higher standard of care to their patients. Rohrlach (1998) and Govier (1999) cited by Kitson (2003) discovered that nurses who were happy with the care they were giving were more likely to stay within the clinical area which would in turn provide some stability and security within the workplace. Accor ding to this research, the inability to give quality care (due to the problems mentioned) was resulting in low morale. The dilemma I faced was as follows. I had already approached my mentor once regarding Johns problems and detected that there was little interest in what I had to offer and in the nurses willingness to correct any problems. If I addressed the issue again, I risked worsening the relationship between my mentor and myself. Morris (2004) identifies that student nurses often feel nervous about speaking out because they feel the need to conform or do not wish to be viewed in a negative way. Student nurses risk upsetting the status quo by speaking out. If I left the issue my patient may be suffering discomfort unnecessarily, but as a student I will never be held accountable in a way that registered nurses midwives or health visitors are (NMC 2008). Would this justify me leaving the issues and conforming to the apathy and bad practice of my mentor? Morris (2004) disagrees. She says that although students are not legally accountable for their actions and omissions, they are morally responsible for ensuring that patients are receiving good standards of care. The student nurse must be responsible. Semple and Cable (2003) affirm that responsibility is concerned with answering for what you do. Registered nurses, midwifes and health visitors are accountable which, Semple and Cable (2003) defines as being answerable for the consequences of what you do. 3.) Re-evaluating the Experience Drawing Conclusions Drawing conclusions is the most vital part of the process of reflection. It will shape future practice and quality of care. Conclusions that are drawn from reflection must agree with the Nursing and Midwifery Council code of professional conduct. It is with the NMC that all matters of conduct, practice and attitude are dictated to nurses. The NMC (2008) motto, protecting the public through professional standards can only be achieved if all those on the NMC register are willing to submit to the conditions and regulations that it upholds. Indeed Somerville and Keeling (2004) affirm that in order for nurses to meet the demands of the NMC, they must focus on their knowledge skills and behaviour which can be achieved through reflection. On reflection of the described incident, it was difficult to know what to do. My mentor was not up to date with the knowledge of this area of practice. I cannot, and do not expect her to know everything, however Glover (1999) points out the nurses should be reliant on others for information. The NMC (2008) states that nurses should work cooperatively within teams and respect the skills, expertise and contributions of colleagues, treating them fairly and without discrimination. Therefore I expected my temporary mentor to take more interest in what I had to offer. Indeed Morris (2004) argues that qualified nurses are obliged to listen to other staff regardless of their qualification status. Announcing that practice should be in accordance with the NMC is too simplistic an answer to such a diverse problem. It is correct to say this but how will this be achieved? The ward is in need of good clinical leadership, first of all from the sister in charge. Nadeem (2002) states that the call for good leadership in the NHS has reintroduced the matron figure and also the new role of nurse consultants. Specialist nurses do have a role in ensuring safe practice and quality care but this should be in addition to effective local leadership i.e. leadership from the ward sister. Leadership is perceived as being good if there is good team working and if managers have good relationships with staff (Lipley 2003) which is one area that needs consideration in this scenario. Meeting the staffs needs improves satisfaction, productivity and efficiency (Nadeem 2002) which in this instance principally means the provision of resources, i.e. human resources. Nurses who are happy with the care they give are more likely to stay within their clinical area (Rohrlach 1998 and Govier 1999 cited by Kitson 2003). This would provide some stability and security in the workplace. Clinical governance has also come to play a prominent role in ensuring quality care. The government has defined clinical governance as a framework through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding standards of care, by creating an environment in which excellence in clinical care will flourish (Department of Health 1998). It had been noted that unacceptable variations in clinical practice where becoming common in the NHS (Department of Health 2010). While some patients were receiving excellent health care, e.g. in stroke care, other patients in the country were receiving sub-optimal stroke care due to differences in facilities, funding, education and staff. Each clinical area can improve the quality of care by (1) using modern matrons and nu rse consultants as clinical leaders, (2) by having adequate staff to care effectively and to lift morale among existing staff and (3) by implementing clinical governance which will result in the flourishing of good practices across wards, departments and NHS trusts through the sharing of expertise, research and ideas. The wards problems could also be addressed through annual reviews or by encouraging staff to keep an up-to-date portfolio (Somerville and Keeling 2004). This will allow nurses to identify strengths and opportunities for development. Critically analysing using reflection on this incident has been valuable in maintaining the quality of care as set out in the NMC code of professional conduct. Gallacher (2004) says that she questions different peoples practices in order to provide her patients with first class quality care. Clinical practice will not improve if it remains unquestioned. Hindsight gives the practitioner the opportunity to discriminate between good and bad practices. Safe, legal and quality care can only be given if it is in keeping with the NMC code of professional conduct. Reference list Arrowsmith, H. (1993) Nursing Management of Patients Receiving a Nasogastric Feed. In: British Journal of Nursing. 2 (21) 1053-1058 Barer, D. (1989) The Natural History and Functional Consequences of Dysphagia after Hemispheric Stroke. In: Neurol Neurosurg Psychiatry. 52, 236-241 BMA (2008) New Guide to Medicines and Drugs. London: British Medical Association. Brown, R. (1995) Education for Specialist and Advanced Practice. In: British Journal of Nursing. 4 (5) 266-268 Department of Health (1998) First Class Service: Quality in the New NHS. London: The Stationery Office. Davies, S. (1999) Dysphagia in Acute Strokes. In: Nursing Standard. 13 (30) 49-55 Davis, J. Shere, K. (1994) Applied Nutrition and Diet Therapy for Nurses. 2nd Ed. Philadelphia: PA,WB Saunders. DeLegge, M. (1995) Percutaneous Endoscopic Gastrojejunostomy: A Dual Centre Safety and Efficacy Trial. In: Journal of Parenteral and Enteral Nutrition. 19 (3) 239-243 Gallacher, G. (2004) Gaining a Better Understanding of Reflection to Improve Practice. In: Nursing Times. 100 (23) 39 Gibbon, B. (2002) Rehabilitation Following Stroke. In: Nursing Standard. 16 (29) 47-52 Glover, D. (1999) Accountability. In: Nursing Times Clinical Monograph. 27, 1-11 Elia, M. (2001) Trends in Artificial Nutrition Support in the UK during 1996-2000. Maidenhead: BAPEN. Hancock, P. (1998) Reflective Practice using a Learning Journal. In: Nursing Standard. 13 (17) 36-39 Holmes, S. (2004) Enteral Feeding and Percutaneous Endoscopic Gastrostomy. In: Nursing Standard. 18 (20) 41-43 Howell, M. (2002) Do Nurses know enough about Percutaneous Endoscopic Gastrostomy? In: Nursing times. 98 (17) 40-42 Hutton C (2005) After a stroke: 300 tips for making life easier, London.UK Kitson, J. (2003) Education for High Dependency Nursing. In: Paediatric Nursing. 15 (1) 7-10 Lipley, N. (2003) Research Shows Benefits of Nurse Leadership Training. In: Nursing Management. 10 (2) 4-5 Marieb, E.N. (2001) Human Anatomy and Physiology. 5th Ed. United States of America: Benjamin Cummings. Morris, R. (2004) Speak out or Shut up? Accountability and the Student Nurse. In: Paediatric Nursing. 16 (6) 20-22 Nadeem, M. (2002) Evolution of Leadership in Nursing. In: Nursing Management. 9 (7) 20-5 Nursing and Midwifery Code of Professional Conduct. London: Nursing Council (2008) and Midwifery Council. Nursing and Midwifery An NMC Guide for Student of Nursing and Council (2008) Midwifery. London: Nursing and Midwifery Council. Semple, M. Cable, S. (2008) The new Code of Professional Conduct. In: Nursing Standard. 17 (23) 40-48 Somerville, D. Keeling, J. (2004) A Practical Approach to Promote Reflective Practice within Nursing. In: Nursing Times. 100 (12) 42-45 Stephanie K, Daniels, Maggie Lee Huckabee (2008) Dysphagia following stroke (clinical dysphagia) London. Stringer, S. (1999) Managing Dysphagia in Palliative Care. In: Professional Nurse. 14 (7) 489-492 Appendix 1 Three stages to the process of reflection. Boud, Keough and Walker (1985). a) Returning to experience Observations what happened? What was my reaction? Clarify personal perceptions b) Attending to feelings What did I feel at the time? What did I feel was positive? Why is cognitive learning being achieved? What did I feel was negative? Do any barriers to learning exist? Raise awareness and clarify feelings c) Re-evaluating the experience Draw conclusions and insights together with existing knowledge Identify gaps in knowledge Integrate existing and new knowledge

Thanksgiving Day Essay examples -- Descriptive Writing Examples, Observ

Thanksgiving Day I stepped out of the chilly November air and into the warmth of my home. The first snowfall of the year had hit early in the morning, and the soft, powdery snow provided entertainment for hours. As I laid my furry mittens and warm hat on the bench to dry, I was immediately greeted with the rich scent of sweet apple pie, pumpkin pie, mashed potatoes, and the twenty-pound turkey my mother was preparing for our Thanksgiving feast. As I walked into the family room, I could feel the gentle heat of the crackling fire begin to sooth my frostbitten cheeks. I plopped myself down on the sofa. The soft cushions felt like heaven to my muscles, sore from building snowmen, riding sleds, and throwing snowballs from behind the impenetrable fort. As I lay there resting, I closed my eyes and just soaked in the joyous sounds of the holiday. I could hear my father chatting with my grandmother, reminiscing of childhood memories and the joy of raising kids. Soft acoustic guitar melodies from the stereo sounded above the snapping and crackling of the fire. The ...

Making Good Choices

James Anderson Making good choices Making right choices is crucial for the direction that you want to go in in life, but sometimes it can be very hard to choose the right thing. Sometimes you do not make the right choice and there are consequences for those actions. Before you make a decision about doing something ask yourself a couple of questions. Would I tell my closest friend or relative about it? Will it have consequences? Will it cause harm? Think about what you are doing, before you do it. Whether it is about a relationship, personal issues with family, or even what you are going to have for lunch today.Do not do anything rash without thinking about the results, and planning how you will deal with the results. Some consequences can be severe, but sometimes it's worth it, that's what you have to decide for yourself. Avoid rash decisions. Don't do something out of feelings in the moment, take some time to be sure about what you want, and wait to calm down and relax before you ma ke the final decision and do something about it. It's a good idea to confide in someone and get some opinions on what you could do (ex. Your brother/sister, your bestfriend). Do not over-think everything.Don't get nervous at small things, that requires small decisions, that will not affect your life further. You should know what is important enough to be thinking well about it. Over-thinking everything can cause stress, which is very bad for you Trust yourself. Go with your gut, but always think any big and Hucrucial decision through. Have faith in yourself and in your instincts. After all, the only person you can trust to want the best for you is yourself. The choices we make throughout our lives determine our futures but the problem is, that we are not always wise enough now to make the choices we should for the people we want to become.When we are young and need to make important choices for our financial future, such as which subjects we should study and how to get good grades, we are not sufficiently wise to realise that a little pain now gives great gain in the future. We also want the pleasure that comes from eating forbidden fruit, from pigging out on confectionery or trying the adult pleasures that can ruin our health for life. We see adults smoking or consuming alcohol and saying that they enjoy it or get pleasure from it or need it to overcome the stress of the day.We are not wise enough to know that what adults say gives them pleasure also causes future ill health problems or that advertising is not reminding us to make healthy choices but trying to put money in other people's pockets. When we become adults, we will know what choices we should have made and will wish that we had made them long ago, when we were young. But the only way in which we will then be able to make good choices, will be to help and educate our own children to make the choices that we wish we had made when we were their age. Why good choices? Why not?Haven’t you ever h eard that if you’re going to do something, you might as well do it right? Well, it’s the same thing with choices. We’re not talking about preparing a meal or making a dress. This is your LIFE! You have the right to make your own choices, but you don’t have the right to choose the consequences. You may decide to stick your hand in the fire, but you’re probably going to get burned. We’ve all had the opportunity to make choices. Some of them were not so good. We’ve allowed other people to influence our lives, and sometimes what seemed like a good idea in the moment, turned out to be a huge mistake.As a teenager did you ever borrow the family car without permission? What did your parents do? They probably took the keys away from you and sent you to your room. Maybe you were grounded. Maybe that meant missing the prom or something else that was important to you. If so, you probably learned a lesson that has stuck with you. Other choices tu rn out to be much more serious. In fact, they may be serious enough that they will affect you for the rest of your life. What if you’re that teenager who borrowed the family car and wrecked it? Were you drinking? Texting? Talking on the phone?Just simply not paying attention? Was anyone else harmed, or even killed? If so, then that changes everything. Instead of being sent to your room, you were judged according to the laws of the land. You were probably taken to jail, and maybe even sent to prison, but even that won’t take away the consequences of knowing you injured or ended a life. People get married without a guide book and children don’t come with directions. Parents do the best they can but sometimes they just don’t provide the guidance a child needs. It’s not generally that they’re bad people.It’s just that they really just don’t know what a particular child needs. Sometimes parents have enough problems of their own and just simply don’t have what it takes to be good role models. As an example, I had parents who were good people. Charming, attractive, full of charisma. My birth was the event of the century for our family. I was the first child, and the first grandchild for my father’s parents. I remember everyone thinking I was pretty wonderful. When I look back at this time in my early childhood, I seem to settle on the happiness and security I felt at about age three.After that, things started going haywire. Alcohol played a huge part in the unhappiness of my parents and they decided they just couldn’t stay married. They still loved each other, but pride had gotten in the way and neither of them were willing (or able) to make the necessary changes to keep us all together. By the time I was seven, my parents officially divorced, and my sister and I, along with our father, went to live with our paternal grandparents. Thank goodness for grandparents who are willing to step in wh en there is a need. They became the parents to all three of us! Life was good with our grandparents.In fact, I’m sure my sister would agree that the three years with them were the most secure years of our childhood. At the end of those three years, our father remarried and expected a new â€Å"mother† to raise us. Our own mother had moved away, believing that we would be better off without her. Had she asked me what I thought about that, I would have begged her to stay. Things weren’t better without her. This new woman we now lived with didn’t want to raise someone else’s children and she made that pretty clear. For me, reading was a way to escape. I was a good student and didn’t do anything to cause problems.Being the peacemaker, I smiled on the outside, but inside, I was terribly unhappy. I dreamed about running away and never coming back. When I was seventeen, that’s just what I did. I got married, graduated from high school, and h ad my first baby in the same year. Did I know what I was doing? Heck no! Do I wish I’d have made better choices? Absolutely! That marriage was short-lived and only added to my trials. Not only do I have regrets, but I’ve also suffered with the â€Å"what might have been. † The best thing about it is the daughter who came from it all. She was always my strength and my reason for living.The worst thing is what I went through to get to where I am today. On the outside, I look like a pretty normal person. There are scars on the inside but they’re barely visible anymore. They say time heals all wounds, but without love and forgiveness, they will just continue to fester and bleed. You can apply bandages but until you heal the wound from the inside, it will only continue to cause pain. A few things have helped me on my road to freedom. 1. Good friends. If you only have one person you can count on in life, consider yourself blessed. Two childhood friends appeared when I needed them most and I credit them ith my ability to live through the worst time of my life. 2. Learning the meaning of the Atonement of Jesus Christ in my life. He suffered not only for my sins (and my lack of good choices) but He also suffered my pain. Too many times I think we think only of the crucifixion and not the precious gift He offered in the Garden of Gesthemane. When times get hard, I realize that He truly understands my pain because He has suffered it not only for all mankind, but just for ME. 3. Making the decision to forgive. I haven’t forgotten, but I have forgiven. The memories help me remember how important it is to make the right choices in life.If I didn’t have them, what would stop me from continuing to make them? Forgiveness helps remove the pain. It’s part of the Atonement of Jesus Christ. He forgave. If I am unwilling to forgive those who have hurt me, then I am bringing my own condemnation. Christ will be the one, in the end, to judge. 3. Journaling. Early on, I knew I had to write my story. The process of recording it had a few benefits. Therapy for me. A record for mchildren It’s the story of a young girl with a good heart who got sucked into a life that forced her to grow up faster than she wanted.She learned she couldn’t trust the people who were supposed to love her. You just have to read it to learn more about her and determine for yourself whether or not she succeeded. I don’t know what lead you to this website, but I do know that everyone on this beautiful planet we call Mother Earth has made some choices they regret. You don’t have to live with a life of pain. The past does not determine who you are today. When you make good choices and decisions, you reap the rewards. When you make poor choices and decisions, you suffer the consequences. In high school, you have more freedom and more independence than you’ve ever had before.Of course, with this greater freedom an d independence comes greater responsibility. Learning to accept responsibility for your actions and for the choices that you make is an important part of growing up. You will have many decisions to make in high school. It is therefore important that you have good decisions-making skills. Try following these steps whenever you have a decision to make: -determine your options write down the positive and negative aspects of each option make sure that you have all the information you need to make an informed decision carefully consider the positive and negative aspects of each option make your decionRemember that whatever you do, it's not the end of the world, there's always a solution for everything. Make your own decisions, it's okay to know someone's opinion, but the decision is yours to make. Always consider the good things and the bad things about your decision, and the results of it. It's natural to take the wrong decision sometimes. We learn from our mistakes, don't get too upset about it.

The Chinese New Year essays

The Chinese New Year essays Whizzzzzzzzzz...BANG! Yes, its that time of year again. A time where streets are lit up with bright flamboyant lights, sounds of crackling fireworks can be heard a mile away, smells of freshly baked moon cakes play with our nostrils, and the laughter of jovial people fill the air. No, its not Christmas, New Years Eve, Thanksgiving, or Labor Day. Its the Chinese New Year! This is a time where all worries and sorrows are left behind and the only rule is to be merry and celebrate. Each year represents a different animal of the Chinese Zodiac and this New Year is the year of the horse. Why is the Chinese New Year so awesome? Three reasons: 1) It tells of an amazing origin of the Chinese culture, 2) It is when Chinese cooking and cuisine goes all out, and 3) We celebrate it with our own style and flare. Chinese New Year one of the most amazing holidays known to man and thats a fact. When we celebrate the Chinese New Year, we are celebrating Chinas rich, fascinating, and prosperous history and culture. Back in the days of the Dynasties, the year revolved around the lunar cycle and when the new year came, the emperors would hold gargantuan feasts in honor of the gods who would in turn bring forth a new year filled with prosperity, fortune, and happiness. Each of the lesser peoples would have their own parties and invite their families and friends. Once gathered around the table, many dishes would be brought out and together they would dine. After the feast, the families would have moon cakes in honor of the gods and bring good luck into their future. Then at night, a festive and jovial parade would tread across town where reenactments of legendary stories would be shown. Also, dragons and lions would line the streets and dance about while fireworks filled the night sky with their multitudes of color and thunderous drums of sound scared away the evil spiri ts. It wa...

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German Loan Words in the English Language English has borrowed many words from German. Some of those words have become a natural part of everyday English vocabulary (angst,  kindergarten,  sauerkraut), while others are primarily intellectual, literary, scientific (Waldsterben,  Weltanschauung,  Zeitgeist), or used in special areas, such as  gestalt  in psychology, or  aufeis  and  loess  in geology. Some of these German words are used in English because there is no true English equivalent: gemà ¼tlich,  schadenfreude. 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German citation: Venzke, J.-F. (1988): Beobachtungen zum Aufeis-Phnomen im subarktisch-ozeanischen Island. - Geokodynamik 9 (1/2), S. 207-220; Bensheim. autobahn e Autobahn freeway - The GermanAutobahn has almost mythical status. automat r Automat a (New York City) restaurant that dispenses food from coin-operated compartments Bildungsroman*pl. Bildungeromane r BildungsromanBildungsromane pl. formation novel - a novel that focuses on the maturation of, and the intellectual, psychological, or spiritual development of the main character blitz r Blitz lightning - a sudden, overwhelming attack; a charge in football; the Nazi attack on England in WWII (see below) blitzkrieg r Blitzkrieg lightning war - a rapid-strike war; Hitlers attack on England in WWII bratwurst e Bratwurst grilled or fried sausage made of spiced pork or veal cobalt s Kobalt cobalt, Co; see Chemical Elements coffee klatsch (klatch)Kaffeeklatsch r Kaffeeklatsch a friendly get-together over coffee and cake concertmasterconcertmeister r Konzertmeister the leader of the first violin section of an orchestra, who often also serves as assistant conductor Creutzfeldt-Jakob diseaseCJD e Creutzfeldt-Jakob-Krankheit mad cow disease or BSE is a variant of CJD, a brain disease named for the German neurologists Hans Gerhardt Creutzfeldt (1883-1964) and Alfons Maria Jakob (1884-1931) dachshund r Dachshund dachshund, a dog (der Hund) originally trained to hunt badger (der Dachs); the wiener dog nickname comes from its hot-dog shape (see wiener) degauss s Gau to demagnetize, neutralize a magnetic field; the gauss is a unit of measurement of magnetic induction (symbol G orGs, replaced by the Tesla), named for German mathematician and astronomerCarl Friedrich Gauss (1777-1855). delidelicatessen s Delikatessen prepared cooked meats, relishes, cheeses, etc.; a shop selling such foods diesel r Dieselmotor The diesel engine is named for its German inventor, Rudolf Diesel(1858-1913). dirndl s Dirndls Dirndlkleid Dirndl is a southern German dialect word for girl. A dirndl (DIRN-del) is a traditional womans dress still worn in Bavaria and Austria. Doberman pinscherDobermann F.L. Dobermannr Pinscher dog breed named for the German Friedrich Louis Dobermann (1834-1894); the Pinscher breed has several variations, including the Dobermann, although technically the Dobermann is not a true pinscher doppelgngerdoppelganger r Doppelgnger double goer - a ghostly double, look-alike, or clone of a person Doppler effectDoppler radar C.J. Doppler(1803-1853) apparent change in the frequency of light or sound waves, caused by rapid movement; named for the Austrian physicist who discovered the effect dreckdrek r Dreck dirt, filth - in English, trash, rubbish (from Yiddish/German) edelweiss* s Edelwei a small flowering Alpine plant (Leontopodium alpinum), literally noble white ersatz* r Ersatz a replacement or substitute, usually implying inferiority to the original, such as ersatz coffee Fahrenheit D.G. Fahrenheit The Fahrenheit temperature scale is named for its German inventor, Daniel Gabriel Fahrenheit (1686-1736), who invented the alcohol thermometer in 1709. Fahrvergngen s Fahrvergngen driving pleasure - word made famous by a VW ad campaign fest s Fest celebration - as in film fest or beer fest flak/flack die Flakdas Flakfeuer anti-aircraft gun (FLiegerAbwehrKanone) - used in English more like das Flakfeuer(flak fire) for heavy criticism (Hes taking a lot of flak.) frankfurter Frankfurter Wurst hot dog, orig. a type of German sausage (Wurst) from Frankfurt; see wiener Fhrer r Fhrer leader, guide - a term that still has Hitler/Nazi connections in English, more than 70 years after it first came into use *Words used in various rounds of the Scripps National Spelling Bee held annually in Washington, D.C. Also see:  The Denglisch Dictionary  - English words used in German

What was the significance of the Lawrence, Massachusetts Strike of Essay

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