Nurses On A Palliative Care Unit Nursing Essay

Nurses On A Palliative Care Unit Nursing Essay According to Olade (2004), nursing practice using observed phenomena and evidences is an example of education which refers to formalized experiences designed to enlarge the knowledge or skills of nursing educators or practitioners. Through experiences and evidences, the ability to learn actual clinical practice and the orientation in health care protocols and policies in handling patients needs will be achieved. This method is also termed as Evidence-based practice. Evidence-based practice involves a combination of many disciplines, including aspects of multidisciplinary sciences to promote the restoration and maintenance of health in our clients (Davies, 2005). Much literature has been published on this topic in recent years, an evolving subject and concept for specific practices that promote more effective, safer and more efficient ways of caring (Drenkard Cohen, 2004). Maintaining and improving high satisfaction among nurses is an important area to discover (Ebell, 2008). To achieve this, we need a workforce to continually strive for excellence, specifically in caring for clients experiencing loss and bereavement be responsible and flexible enough, have the confidence to face the challenges, and inspire everyone with a shared vision. These are strengths needed by nursing staff to motivate others health care provider to fulfill their potential and achieve goals (Littlefield, 2005). Researches, studies and articles were utilized and analyzed in gathering the necessary information needed. Clinical education, skills and practices are the key concepts used in this paper. Possession of knowledge and competency in performing skills and interventions for clients experiencing grief and bereavement which can be acquired in hands on training are essential in practicing the profession especially in the palliative care unit of NHS hospital is important. As a nursing professional, tangible skills and knowledge in a hospital setting is very important in managing clients and supervising clients (Burns Foley, 2005). Evidences were identified through thorough assessment and research. The challenges discussed below were identified through gathering of recent information in the palliative care unit and data that focuses on this subject. Decisional Teachings and Interventions As a nurse, you need to ensure that the client is treated with dignity, that is, with honor and respect. Dying clients often feel they have lost control over their lives and over life itself. Helping patient die with dignity involves maintaining their humanity, consistent with their values, beliefs, and culture. By introducing available options to the client and significant others, you can restore and support feelings of control. Some choices that clientss family can make are location of care (home, hospital or hospice), time of appointments with health professionals, activity schedule, use of health resources, and times of visit (Matzo and Sherman, 2004). The family of dying patient wants `to be able to manage the events preceding death so she can die peacefully. You can help client to determine her own physical, psychological, and social priorities. Dying people often strive for self fulfillment more than for self preservation, and may need to find meaning in continuing to live whi le suffering. Part of the nurses challenge is to support the clients hope and will (Smeltzer, 2009). Nevertheless, the communication between clients families may not solve all decisional differences, her mother insist on interventions that health care professionals consider inadvisable. In case like this, the initial step is for all parties to focus on having clear goals of care. Hospice Support to facilitate proper bereavement The decision of clients family for home care with hospice support focuses on symptoms control and pain management. Hospice care is always provided by a team of both health professionals and nonprofessionals to ensure a full range of care services. In the case of many patients, palliative care will be the option. This care may be given to meet their physiological need (Matzo, 2005). Ventilatory support for patient can improve her respiratory functioning and relieve symptoms of respiratory distress using mechanical ventilation. While the decisions made by the family wanting their family member to be vented are often reached by consensus with the patient and her family, patient does have an opportunity to designate a family member as a healthcare proxy. Family Teachings and Interventions The reaction of any person to another persons impending death depends on all factors regarding loss and the development of the concept of death. In spite of the individual variations in persons view about the cause of death, spiritual beliefs, availability of support systems, or other factor, responses tend to cluster in the process. To help the family, spiritual support is of great importance in dealing with death. Although not all clients identify with specific religious faith or belief, most have a need for meaning in their lives, particularly as they experience a terminal illness. Establish a communication relationship that shows concern for and commitment to the family and client. There are also communication strategies that let client and her family knows that you are available to talk about death (Smeltzer, 2009). Caring for clients family members is an important intervention in caring for the terminally ill patient. Family-centered interventions and care is focused on the goal, needs and values of the family and patient including their understanding of the treatment options, illness, prognosis and their preferences and expectations for decision making and treatment (Matzo and Sherman, 2004). Specific interventions appropriate for clients family includes providing hope within parameters of individual situations without giving false reassurance. Listening to their expressions regarding their perceptions of the situation is also important to determine how they handle the situation (Zerwekh, 2006). Giving honest answers to their questions and giving correct information will assist the family in dealing with the situation. Encouraging strength, promoting support systems and referring to other resources such as pastoral care, counseling and organized support groups will promote wellness and facilitate long term action (Smeltzer, 2009). Communicating effectively at all levels is a common barrier in the implementation of change among health care in various settings (Kleinman, 2004). As a member of the hospital workforce, a nurse must have the capability to communicate effectively in a non-judgmental way and stimulate other colleagues to think critically. They must also arouse enthusiasm and develop quick thinking and imagination. Moreover, they must also demonstrate resourcefulness and professionalism with infinite patience, understanding, confidence and perseverance are also challenges (Bryar et al, 200). Emotional and Physical Support The skills most relevant to this situation of the family are attentive listening, silence, open and close questioning, clarifying and reflecting feeling. Less helpful to family members are responses that give advice and evaluation, those that interpret and analyze, and those that give unwarranted reassurance. To ensure effective communication, the nurse must make an accurate assessment of what is appropriate for the client. Communication with the family needs to be relevant to their feeling and situation. Whether the clients are angry or depressed affects how the client hears messages and how the nurse interprets the clients statement (Matzo, 2005). In facilitating nursing interventions, the nurse must explore and respect the familys ethnic, cultural, religious and personal values inn their expressions of feelings. Teach the family what to expect in the process, such as certain thought and feelings and that labile emotions, feeling of sadness, anger, guilt, loneliness and fear will lessen or stabilize over time. Knowing what to expect may lessen the intensity of some reactions. Encourage her family to express their thoughts and feelings, not to push the family to move on or enforce their own expectations of inappropriate reactions. Encourage the family to resume normal activities after death on schedule that promotes psychological and physical health. Some family member may also try to return to normal activities too quickly. However, a prolonged delay in return may indicate dysfunctional grieving (Matzo and Sherman, 2004). Physiological and other specific end-life care Support Nursing management of the client experiencing a loss is important. Physiological need must be addressed first including palliative care such as pain management and life support. Weakness and paresis are common symptoms that may affect muscle groups. With the loss of muscle innervations the muscles athrophy, paralysis and progressive fatigue result. Dysphagia, dysathria, fasciculations, hyperreflexia, immobility, respiratory failure and aspiration will likely occur. Emotional effects such as lability, loss of control and depression are also common. The goal of management in end-of-life care for every client is the prevention or alleviation of these symptoms. Hygiene and psychological support is also important factor to consider (Zerwekh, 2006). To gather a complete database that allows accurate analysis and identification of appropriate nursing diagnoses for dying client and their family, the nurse first needs to recognize the states of awareness manifested by the client and the famil y members (Smeltzer, 2009). In case of many patients, the state of awareness shared by the dying person and the family affects the nurse ability to communicate freely with clients and other health care team members and to assist in the grieving process. The nurse must also need to be knowledgeable about the clients death related rituals such as last rites, chanting at the bedside and other rituals. The nurse must also recognize the states of awareness manifested by the client and family members. As nurses, we also need to maintain physiologic and psychological comfort and achieving a peaceful and dignified death, which includes maintaining personal control and accepting declining health status (Matzo and Sherman, 2004). The roles of health care team in care management of dying patient are very important. This implies the vital responsibilities of nurse to do the best and competent care to achieve the peaceful death of the patient. The primary role is to ensure that the patient recei ved the highest possible intervention best suited for her. Nurses must include the family of the patient in the care management, emphasizing nurses role as essential factor to maintain dignity of dying client (Matzo, 2005). Conclusions Knowledge and competitiveness is a product of excellent nursing practice. In caring for patient experiencing grief and bereavement, experience and effective learning are essential processes in actual clinical practice of the nursing profession. To be an effective nurse, one should begin with the individual appraisal of ones self competency and enhanced education based on practices and trainings taken previously during undergraduate and graduate studies, workshops, trainings, continuing education, and preparation for teaching seminars or modules including the conceptual, academic and clinical orientation (Foster, 2007). Competitiveness is largely based on innate potentials and motivations afforded by the familiarity of a learning environment. Accordingly, the primary responsibility of the nurse to the patient is to give him/her the kind of care the patient condition needs regardless of race, creed, color, nationality or status (Salsberg, 2008). Advocate the rights and serve as facilit ator of patients well being (Foster, 2007). In doing so, the patients care shall be based on subjective and objective evidence, needs, the physicians order and the ailment; shall involve the patient and the family. It promotes understanding of the differing values held by people in other cultures (Henderson, 2009). For example, it helps client to understand why other people in one culture may regard with approval of their practices of exposing their elderly members to the harmful elements, while people in other cultures may abhor such practice. The strength this critical thinking and decision making is its recognition of the relationship between personal values and a choice of action and it equates personal values and wrong action, it also recognize limits of personal experience and perspective and it implies that a persons moral judgments are infallible. I believe the richness or intensity of the inculcation of knowledge, positive values and skills of a person is not simply based on the innate capacity of one to evaluate, think, reason and interact in a learning situation. It also equally depends on the quality of the nursing experiences which are either limited by the nurses ability and will to choose or by what is desirable to her which is readily accessible in the environment. Nursing education, concepts and programs for improving the knowledge in health facility should also be provided to maintain theoretical and clinical competence of health setting and facilities. From what I have learned in my own area of practice, the key to successful knowledge development is competent learning and effective communication during the practice to achieve the goal of competency. This will determine the path of being an effective and competent nursing professional. In general, the main role of nurses in palliative care unit is focused on providing effective, quality care. Hence, more advanced and competent means of preparing nurses to supervise and manage their patient is important (Briggs et al., 2004). These challenges must be addressed properly by the implementation of appropriate approach and programs to increase the knowledge and experience. Skill development for nursing educators must constantly be framed within the context of individualized patients. Nursing educators should make themselves aware of every situation happening in the field and make it a motivational means to improve the profession by proper preparation and education (Welk, 2007). Therefore, the need for implementing evidenced-based approach to nursing practice is essential in addressing these issues. As nursing profession enter a new era not knowing what to expect. Yes, patient care is the same everywhere, but they must be comfortable with the environment they are placed in. Adaptation is crucial in the clinical arena (Kleinman (2004). Evidenced-based practice and clinical experience may become a highly useful and effective strategy in clinical practice. The nurse becomes less apprehensive about the clinical environment and becomes more client-focused, therefore increasing the effectiveness of care. This also provides the nurse an opportunity for role modeling as the client and family maintains and develops standards of practice and competent care in a familiar environment (Foster, 2007).

Theater Arts

â€Å"Sitting in Limbo† is a play written by Dawn Penso and Judith Hepburn who are both Jamaican nationals living in London, the play was directed by Jo-Ann McCabe. â€Å"Sitting in Limbo† was held at the University of the West Indies Cave Hill Campus, Errol Barrow Centre for Creative Imagination; in the Walcott Warner Theater. The moon reading featured a trio of Barbadian actors: Amanda Cumerbatch as Yvonne Campbell, Philip Eno as the judge and radio announcer and finally Loretta Hackett as Nita George, on Monday 25th February 2013.The theatrical piece starts out with a contrast between two women, one of a fairly wealthy background and the other struggling to make ends meet this portrays a conflict between both women based on their differences which in the end both women overcame. The play about a prison warden, Nita George and prisoner Yvonne Campbell depicts a political disruption in Grenada’s annals which led to the imprisonment of Grenadian Phllis Coard.Immu red along with her husband for assassinating Grenada’s elected Prime Minister, Nita presumes that Yvonne is a greedy woman with a thirst for predominance and that she is the main reason behind all the troubles in Grenada due to her pushing her husband into the overthrow of the Prime Minister. Nita openly affronts Yvonne, while Yvonne demands that she be respected because of her position in society and the â€Å"success† she has brought upon the country.Two years had passed and Nita’s views about Yvonne hadn’t changed but as the years went by for a total of seven years and they both opened up to each other and adapted to each other’s personalities Nita saw Yvonne as a woman with humanity and compassion. Although the play is mainly about the two characters Nita and Yvonne, the radio announcer plays a very important role, he notifies the audience about the amount of years passed and the fate of Grenada, the radio announcer practically gives viewers an idea of what was going on during the play.The trio has done an exceptionally great job on the piece ‘Sitting in Limbo†. The use of accents added a great effect on the nationality of the characters or the origin where the incident was being taken place. The use of costume was also great because one could identify which character was which , when Nita or Loretta wore the khaki shirt and the khaki pants it gave the audience a hint that she was some sort of guard or officer or in this case a prison warden.In Philip’s case the use of headphones gave the audience an idea that he was a Dj or a radio announcer. The use of the projection of bars gave the audience an idea that it was some kind of prison. The bars also reflected on how each woman felt inside, Nita trying to raise a family by herself in the economic struggles felt ‘imprisoned† because she wanted to live a better life, she wanted to reach for her goals but she could not do so because of the curren t situation but eventually ‘broke free â€Å"and decided to accept the offer her sister had given her.Yvonne although imprisoned literally felt† imprisoned† due to the fact that deep down inside she knew what she did was wrong but her arrogance and pride got in the way ,she’ broke free† by refusing to sign a contract which could have literally freed her by denying everything she had actually done. However they were some minor imperfections which were indeed noticeable, such as the backing of the audience, Phillip walking offstage before the fade had actually begun and where Loretta and Amanda had somewhat forgotten a bit of their lines.There were also some technical difficulties where as the fade would begin too early or a little too late but they but did not affect the theatrical piece it self. The play was a unique piece especially because it was my first time viewing a moon read play and because they tied in a fictional crisis into a play which I f ound very creative. The play also impacted the audience and made it an enjoyable play for them.

Annie’s Homegrown Video case questions and answers Essay

1) Annie knew what she wanted and had the willingness and determination to see it through. a) Annie’s person characteristics of being health conscious, willing to take chances and focusing on no only her wants and needs, but also the wants and needs of others has helped shape the success of her business. 2) The company evolved into a multimillion dollar leader in the natural organic food industry by identifying the markets and then focused on the top ten markets. In those markets Annie’s company focused on the products attributes, being realistic and willing to take chances while maintaining a high loyalty to its existing customers. In 1998 capital infusion from Consorzio and Fantastic Foods help fuel growth in Annie’s business. Consumer satisfaction and brand awareness helped get the attention of another investor Solara Capital LLC in 2002. These investors where looking to enter into the organic food market and by investing in Annie’s company they helped the growth of Annie’s business as well. So with the help from loyal customers and investors Annie’s business was able to grow. a) I think that the only growth strategies would be focusing on what the consumer wants and finding ways to provide that. The only other thing that I can see would be trying to get more product placement in stores that they are currently not in. 3) The web site has many unique feature like: a) Spreading the goodness – finding out what’s new at Annie’s. b) Taste Our Products – give a list of products with descriptions and pictures. c) Recipes and fun tab – recipes and a kids club and a way to get free stuff d) The website its self is very unique and lively, a pleasant site to visit. 4) The web site promote Annie’s mission by having it right on the home screen of the web site. It also promotes her mission be everything that is on each page of the web site, from products to articles to recipes.

A Look into the Assassination of JFK - 981 Words

John Fitzgerald Kennedy was born on May 29th, 1917 in Brooklyn, Massachusetts. He was named after his grandfather, John Francis Fitzgerald, who happened to also have a career in politics as the mayor of Boston, Massachusetts. He had 8 siblings, three brothers and five sisters. His parents were Patrick Joseph Kennedy and Rose Kennedy. His early life in Massachusetts helped shape him into one of the greatest presidents America has ever had. Kennedy was an especially bright young man with many talents, in 1940 he graduated from Harvard University, where he also played football like his brother Jack, in 1940. As an Irish Catholic in Boston he suffered from prejudice, but he was determined not to let that affect his future and set the goal to†¦show more content†¦Before Lee Oswald could be tried and convicted he was shot two days after the assassination by Jack Rudy while in transport to a new location. Oswald died two hours later. Because of the fact there was never someone convicted of the assassination various conspiracies arose, these are known as the JFK conspiracy theories. There’s many conspiracy theories surrounded this topic, but the most believed conspiracies are, The CIA had him killed, the Mafia had him killed , Lyndon Johnson had him killed so he would become president. Johnson did in some ways benefit from Kennedy’s death because he became the President, but many historians have discredited any allegations against Johnson claiming he set up a hit against Kennedy to become president, but since Johnson was viewed as ruthless politician that not many Americans liked, a lot of Americans were quick to put the blame on him, even though he had an air tight alibi for the evening the so called â€Å"hit† was placed on Kennedy’s head. The next theory that the mob did has also been disproven since three different mobs at the time claimed to be responsible without any solid evidenc e to support that they in fact did kill Kennedy, so this is just a hearsay based conspiracy theory with not a single piece of evidence to back it up. Lastly, the most widely believed theory, the CIA had Kennedy killed. This theory unlike many of the otherShow MoreRelatedThe Assassination of John F. Kennedy1076 Words   |  4 Pages The assassination of John F. Kennedy is one of the most controversial and debated topics in American History. JFK was one of the most beloved presidents of our time. It was November 22, 1963 when JFK was assassinated. Unlike previous presidential assassinations, the JFK assassination is the most conspiracies of all time. The theories are the Government cover up, Mafia influence and Cuban President Fidel Castro. Imagine one person can do all this planning which Lee Harvey Oswald. 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Kennedy1743 Words   |  7 Pagesout more than others. The first being the JFK conspiracy theory, second is the moon landing conspiracy, and last the Illuminati. The John F. Kennedy assassination is and always will be one of the most controversial topics of all time. Perhaps the world will never know what was behind the fateful events of John F. Kennedy’s assassination on November 22, 1961. Many different groups have generated various theories as to the culprits behind the JFK assassination. Each grouping would claim to have the