The Three Dimension of Happiness According to Seligman Essay Example for Free

The Three Dimension of Happiness According to Seligman Essay

Nursing Essays Therapeutic Relationship Patient

Nursing Essays Therapeutic Relationship Patient Introduction Within the context of healthcare one of the most important factors is the establishment of an effective therapeutic relationship between the nurse and patient (Foster Hawkins, 2005). The ways in which nursing staff and patients interact can be influential in terms of information transfer, provision of psychological support, and may also provide some therapeutic benefits in themselves (Welch, 2005). Hence, there has been a renewed focus on the importance of how nurses interact with patients in practice, in order to enhance patient outcomes (Nursing and Midwifery Council, 2008; Sutcliffe, 2011). Understanding the fundamental components of this relationship and how to achieve these components in practice remains a vital aspect of nurse training and continuing professional development (Ramjan, 2004; Perraud et al., 2006). In accordance with the perceived importance of the therapeutic relationship, the aim of this paper is to provide an evidence-based review of how this relationship may be used in nursing practice. This will be supplemented with a reflection on personal observations made by the author, utilising a reflective model (Nielsen et al., 2007). The model in this case will be that devised by Gibbs (1988), which has been validated as a useful tool for personal practice development and goal-setting in the clinical domain (Foster Hawkins, 2005). This model emphasises a step-wise approach to reflection, encompassing: description, feelings, evaluation, analysis, conclusion and action plan formulation (Gibbs, 1988). Therefore, this paper will consider the therapeutic relationship from the perspective of a specified practice context experienced by the author, with a discussion of how practice can be improved based on the best available evidence from the literature. Reflection context The main context of care that will be the focus of this essay is the elderly rehabilitation ward, where the author first encountered a number of issues regarding the need for optimal relationships between practitioners and patients in practice. The goal of this ward is to assist elderly patients in adapting to their functional capacities and lifestyle abilities, in order that they can achieve the maximum possible degree of quality of life in the community setting following discharge (Routasalo et al., 2004). Consequently, numerous health professionals provide an input into the care pathway, including physiotherapists, occupational therapists and physicians, in addition to nursing staff (Hershkovitz et al., 2007). From the perspective of the author, there are several important aspects of this scenario that relate to the therapeutic relationship: the large increase in personal responsibilities in terms of assisting patients with activities, the need to motivate and communicate effectively with patients to ensure that they are able to remain psychologically motivated, and the need to coordinate personal clinical care activities with those of others to ensure the patient journey is smooth (Siegert Taylor, 2004). The remainder of this paper will consider the therapeutic relationship grounded within this practice context, supplemented with personal experiences from this placement, in order to highlight these factors in greater detail. Evidence-based reflection Defining the therapeutic relationship In order to fully appreciate the need for a therapeutic relationship it is important to define this relationship in a practice context. The term is often used within the context of psychiatric or psychological therapy distribution in modern literature, although the aim of this paper is to consider the term as a more general way in which nurses communicate and interact with patients to establish a clear clinical outcome (Bulmer Smith et al., 2009). McKlindon Barnsteiner (1999) suggest that the therapeutic relationship needs to be a two-way, reciprocal relationship at all times, involving nursing staff, the patient and their family, where appropriate. There is a need to emphasise caring in this relationship, with positive communication and clear boundaries of both personal and professional interactions (McCormack, 2004). Hence, the relationship between a nurse and patient should fit into the patient-centred model of care, where patients are not only listened to within a clinical decision-making context, but are actively encouraged to participate in their own care pathway (McCormack McCance, 2006). The therapeutic relationship encompasses three important domains of care: physical, psychological and emotional care (Pelzang, 2010). These elements may be more profoundly encountered by nursing staff on hospital wards due to their prolonged exposure to specific patients and their in-depth interactions in the patient care journey, when compared to other members of staff who may have less face-to-face time with individuals (Pelzang, 2010). Within the setting of the elderly rehabilitation ward, many patients are transitioning from an acute or chronic care scenario to community care and require additional, specialist assistance in doing so (McCormack, 2003). Consequently, nursing staff in this ward are exposed to patients for extended periods of time and need to consider the holistic aspects of care in order to achieve successful rehabilitation (Cott, 2004). Therefore, the therapeutic relationship in this context involves establishing the capabilities of the patient, working with the patient to achieve set goals, and ensuring that the psychological and emotional aspects of chronic illness or disability can be managed effectively in the long term (McCormack McCance, 2006). Communication In light of the definition of the therapeutic relationship within the context of rehabilitation, the remaining sections of this paper will evaluate the core aspects involved in maintaining a therapeutic relationship, with this section focusing on communication between nurse and patient. The specific clinical scenario the author has struggled with in the rehabilitation placement is when a patient has higher expectations than they should in terms of their ability to perform tasks or live independently following discharge. Patients are obviously passionate in maintaining independence in the majority of cases and this can cloud their judgement as to their genuine abilities and capabilities in functional tasks (Cott, 2004). While it is important to acknowledge the feelings and ideas of a patient and act accordingly, it can be negligent of nursing duties not to act with the patient’s best interests at heart (McCormack, 2003). Therefore, the nurse needs to maintain that their actions are guided by medical evidence and professional protocols, as well as reflecting the need and desires of the patient (NMC, 2008). Communication encompasses not only verbal communication with the patient, but is also reflected in body language and actions (Yoo Chae, 2011). Having an open body posture, including the avoidance of crossed arms, can help in establishing rapport, while maintaining eye contact and avoiding distractions during conversations with patients can enhance the bond between nurse and patient (Brown Bylund, 2008). Communication is also as much about relaying information as it is about receiving information and therefore, nursing staff should be able to elicit patient concerns specifically and utilise these appropriately without blocking these interactions with a one-sided approach to conversation (Yoo Chae, 2011). The opposite is also true, whereby overly expressive patients may limit the nurse-led component of the communication episode; both parties need to be good at communication for a perfect mutual appreciation of ideas to occur (Sheldon et al., 2006). In practice this may be difficult to achieve, but the obligations of the nurse to facilitate this process are a core component of the therapeutic relationship. Communicating effectively with patients in the elderly rehabilitation setting was a massive responsibility and challenge for the author, as this was their first encounter with such patients in this setting. The expectation of knowledge in this setting was high and it could be frustrating to patients who want answers from a junior or inexperienced practitioner (McCormack, 2003; Leach, 2005). Hence communication needed to focus on establishing information, sharing action plans and building general rapport that would enable the development of trust and a mutually beneficial exchange of ideas (Leach, 2005). The author found this form of communication challenging to achieve on a routine basis within the rehabilitation setting, due to the need to balance a motivational approach with a realistic form of communication regarding expected patient capabilities and outcomes. Hence, the reflective scenario will focus on aspects of this particular communication episode as a component of the therapeutic relationship. Empathy Empathy is a cornerstone of effective communication with patients and is defined as the ability to share or identify with the emotional state of the patient (Brunero et al., 2010). If done effectively an empathic response to patient concerns can yield a sense of shared understanding, reinforcing the notion that the patient’s concerns are being listened to (Kirk, 2007). By establishing an empathic response with a patient, practitioners often remark that they are better able to connect with the experiences of the patient, allowing them greater insight into how they can help the patient (Brunero et al., 2010). Therefore, empathy is a core component of establishing a meaningful therapeutic relationship with patients in all settings. The nurse can develop empathic communication skills in a number of ways, including through specific communication skills training (Webster, 2010). This training often emphasises the role of open-ended questions and body language within the context of empathy, whereby nurses should ask patients specifically about their emotions and feelings during a clinical interaction (Stickley Freshwater, 2006). Often the process of asking a patient how they feel about a particular reaction is sufficient to allow them to relax and become more comfortable conveying these thoughts and feelings. On the part of the nurse, it is important to reflect these responses back to the patient by further exploring these issues and offering an active listening approach, rather than redirecting the focus of the conversation back to more clinical matters (Brunero et al., 2010). Although it has been argued that empathy is an intrinsic quality, which some people possess, the representation of empathy in communication is important in clinical care and should be delivered through verbal, non-verbal and emotional communication skills (Welch, 2005). In the present scenario, the author was able to empathise with patients on the rehabilitation ward to a high degree and many patients were frank and open about their emotional needs and worries regarding the rehabilitation process. Often the patients’ worries were highly emotive and this affected the author such that the patient was regarded as an object of sympathy or pity in some cases due to their hardships. This made the author feel uncomfortable during patient interactions for a number of reasons: firstly, because it was an emotional situation, and secondly because the expectations of the patient with regards to rehabilitation were higher than expected and it was often difficult to address these in a controlled manner. Hence, the reflective experience demonstrates a number of feelings in this situation, which reflect problems with the therapeutic relationship. Trust and respect One of the primary outcomes of the therapeutic relationship is to establish a caring and trusting relationship between the nurse and patient (Brown et al., 2006). Trust is a concept based on respect and openness within this relationship and this often takes time to establish, acting as an extension of the professional respect a patient may hold for a nurse and vice versa (Miller, 2006). Within the context of elderly care rehabilitation, nurses need to establish a strong bond of trust as patients will often have to make compromises in terms of assisted living devices and acceptance of their functional limitations when attempting to optimise their quality of life (Schmalenberg et al., 2005). Unless they trust the healthcare professionals involved in their care they are less likely to adhere to recommendations or to accept help, reducing the potential positive impacts of nursing interventions (McCabe, 2004). Establishing trust within a therapeutic relationship requires time and demands that the practitioner is able to manage their communication skills appropriately to ensure the patient feels that they are listened to and involved in their own care (Brown et al., 2006). Both the practitioner and the patient must be receptive to the idea of trust within the relationship in order for this to be achieved, which often involves addressing barriers to trust, including suspiciousness of the intentions of healthcare professionals, poor communication, and mutual respect on a personal level (Miller, 2006). When a trusting relationship is achieved there is a greater chance that patients will be receptive to clinical interventions and nursing input, at least when delivered on a personal level (Wolf Zuzelo, 2006). Equally, nursing staff can trust that patients will make informed decisions about their care and will follow guidance, when appropriate (Schmalenberg et al., 2005). Within the present reflective context, the author felt as though there was a distinct lack of trust in the therapeutic relationship, primarily due to the fact that a patient would often wish for their expectations to be met without heeding specific nursing advice on several occasions. This was likely secondary to the fact that the author found it difficult to convey these ideas in a sensitive manner, while addressing the concerns of the patient in an empathic way. Hence, it can be perceived that the patient and nurse did not enter a trusting relationship, as communication between the two was suboptimal (McCabe, 2004). However, on a more positive note, the relationships formed with patient during the initial days on placement were friendly and demonstrated a degree of mutual respect, which is an important facet of the therapeutic relationship (Stickley Freshwater, 2006). Hence, there were positive and negative aspects to the therapeutic relationships formed in practice during this placement, according to a reflective evaluation. To make sense of this situation, the author analysed these positive and negative factors within this context. What was clear to the author was that the communication skills that had been utilised so far in therapeutic relationship building relied heavily on patient factors, rather than nursing input. Hence, there was an imbalance in the way information was presented and received within this relationship, to the detriment of the therapeutic journey. The reasons for poor communication and trust establishment stemmed from multiple factors, including the younger age of the author compared to patients, relative inexperience on the part of the author, and the highly charged emotional nature of interactions in this setting. Therefore, it was clear that one of the main factors that was missing in the therapeutic relationships was the projection of a strong professional identity, which could guide the patient towards a suitable clinical outcome and would assist in developing the appropriate communication tools for the rehabilitation process. Professional values While it is clear that the need for the therapeutic relationship stems from a desire to form a constructive clinical partnership with a patient in a specific context, there is also a professional responsibility to engage patients in this manner in practice (Chitty Black, 2007). The Nursing and Midwifery Council (2008) advocate communication, trust, dignity and respect during the treatment of all patients as a fundamental aspect of care delivery and therefore establishing a therapeutic relationship can be considered a core aspect of all nursing practice (Fahrenwald et al., 2005). However, within the context of effective nursing practice it is recognised that there is a need to respect the personal boundaries of the patient and to act as a professional rather than a friend in most cases (Rushton, 2006). Professionalism in the context of rehabilitation care includes the need to be realistic with regards to patient expectations, while ensuring appropriate levels of motivation and commitment to a therapeutic plan (Fahrenwald et al., 2005; Rushton, 2006). For some practitioners, an overly empathic response to patients and their condition can lead to sympathy and warped clinical decision making processes, often favouring the opinion of the patient over established guidance (Bulmer Smith et al., 2009). This is likely to have a detrimental impact on the patient in the long term and should be avoided as a result. Within the Gibbs reflective cycle (1988), the author has noted that one of the main conclusions that can be drawn from working within the rehabilitation sphere is that maintenance of professional values and boundaries is essential to avoid becoming overly emotional or inappropriately involved in patient care (Stickley Freshwater, 2006; Baker et al., 2008). The author should try not to become too attached to patients during their care journey in order to make an objective assessment of their capabilities and therapeutic needs, as relying too heavily on the opinions and desires of the patient can yield unsatisfactory results in the long term, particularly when these go against recommended practice (Leach, 2005). By applying more rigorous professional boundaries in the future, and focusing on explaining complex situations from a nursing perspective, rather than yielding to the patients’ wishes, the author can improve their contribution to practice in the long term and enhance the patient journey through rehabilitation. Conclusion In summary, this paper has considered the personal experiences of the author within the context of a reflective practice episode in order to appreciate the value and tenets of the therapeutic relationship in practice. The core components of the therapeutic relationship, as they relate to the present scenario, have been discussed with reference to the evidence base in order to develop a constructive reflective episode reflecting a description of events, feeling, evaluation, analysis and conclusion. The process of reflection should yield a suitable action plan and in this case the author feels that they should engage with patients in a more professional manner, ensuring that they maintain an empathic and understanding approach to care while maintaining nursing boundaries. In order to achieve this, communication skills should be enhanced in the future, through attendance at specific communication skills courses, in order to become more comfortable in managing potential conflicts or hostility. This should enhance the therapeutic relationship and ensure that future patients can be managed in a manner that benefits all members of the relationship. Furthermore, it is important that the author is aware of how other colleagues maintain professional boundaries and can direct their relationship accordingly in practice, and consultation with colleagues on this point would be a useful learning tool. On completion of these tasks, the author should therefore feel better prepared to engage with patients in a meaningful way, ensuring that trust is developed and that patients have an effective care process, in all areas of care. References Baker, C., Pulling, C., McGraw, R., Dagnone, J. D., Hopkins†Rosseel, D., Medves, J. (2008). Simulation in interprofessional education for patient†centred collaborative care. Journal of Advanced Nursing, 64(4), 372-379. Brown, D., White, J., Leibbrandt, L. (2006). Collaborative partnerships for nursing faculties and health service providers: what can nursing learn from business literature?. Journal of Nursing Management, 14(3), 170-179. Brown, R. F., Bylund, C. L. (2008). Communication skills training: describing a new conceptual model. Academic Medicine, 83(1), 37-44. Brunero, S., Lamont, S., Coates, M. (2010). A review of empathy education in nursing. Nursing Inquiry, 17(1), 65-74. Bulmer Smith, K., Profetto-McGrath, J., Cummings, G. G. (2009). Emotional intelligence and nursing: An integrative literature review. International Journal of Nursing Studies, 46(12), 1624-1636. Chitty, K. K., Black, B. P. (2007). Professional nursing: concepts challenges. London: WB Saunders Co. Cott, C. (2004). Client-centred rehabilitation: client perspectives. Disability Rehabilitation, 26(24), 1411-1422. Fahrenwald, N. L., Bassett, S. D., Tschetter, L., Carson, P. P., White, L., Winterboer, V. J. (2005). Teaching core nursing values. Journal of Professional Nursing, 21(1), 46-51. Foster, T., Hawkins, J. (2005). The therapeutic relationship: dead or merely impeded by technology?. British Journal of Nursing, 14 (13), 698-702. Gibbs, G. (1988). Learning by doing: a guide to teaching and learning methods. Further Education Unit. Oxford Polytechnic: Oxford Hershkovitz, A., Kalandariov, Z., Hermush, V., Weiss, R., Brill, S. (2007). Factors affecting short-term rehabilitation outcomes of disabled elderly patients with proximal hip fracture. Archives of Physical Medicine and Rehabilitation, 88(7), 916-921. Kirk, T. W. (2007). Beyond empathy: clinical intimacy in nursing practice.Nursing Philosophy, 8(4), 233-243. Leach, M. J. (2005). Rapport: a key to treatment success. Complementary Therapies in Clinical Practice, 11(4), 262-265. McCabe, C. (2004). Nurse–patient communication: an exploration of patients’ experiences. Journal of Clinical Nursing, 13(1), 41-49. McCormack, B. (2003). A conceptual framework for person†centred practice with older people. International Journal of Nursing Practice, 9(3), 202-209. McCormack, B. (2004). Person†centredness in gerontological nursing: an overview of the literature. 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Ramjan, L. M. (2004). Nurses and the ‘therapeutic relationship’: Caring for adolescents with anorexia nervosa. Journal of Advanced Nursing, 45(5), 495-503. Routasalo, P., Arve, S., Lauri, S. (2004). Geriatric rehabilitation nursing: developing a model. International Journal of Nursing Practice, 10(5), 207-215. Rushton, C. H. (2006). Defining and addressing moral distress: tools for critical care nursing leaders. AACN Advanced Critical Care, 17 (2), 161-168. Schmalenberg, C., Kramer, M., King, C. R., Krugman, M., Lund, C., Poduska, D., Rapp, D. (2005). Excellence through evidence: securing collegial/collaborative nurse-physician relationships, part 2. Journal of Nursing Administration, 35(11), 507-514. Sheldon, L. K., Barrett, R., Ellington, L. (2006). Difficult communication in nursing. Journal of Nursing Scholarship, 38(2), 141-147. Siegert, R. J., Taylor, W. J. (2004). Theoretical aspects of goal-setting and motivation in rehabilitation. Disability Rehabilitation, 26(1), 1-8. Stickley, T., Freshwater, D. (2006). The art of listening in the therapeutic relationship: The role of the modern mental health nurse is becoming more technical when, argue Theodore Stickley and Dawn Freshwater, what would really benefit patients is the often misunderstood art of listening. Mental Health Practice, 9(5), 12-18. Sutcliffe, H. (2011). Understanding the NMC code of conduct: a student perspective. Nursing Standard, 25(52), 35-39. Webster, D. (2010). Promoting empathy through a creative reflective teaching strategy: a mixed-method study. The Journal of Nursing Education, 49(2), 87-94. Welch, M. (2005). Pivotal moments in the therapeutic relationship. International Journal of Mental Health Nursing, 14(3), 161-165. Wolf, Z. R., Zuzelo, P. R. (2006). â€Å"Never again† stories of nurses: dilemmas in nursing practice. Qualitative Health Research, 16(9), 1191-1206. Yoo, M. S., Chae, S. M. (2011). Effects of peer review on communication skills and learning motivation among nursing students. The Journal of Nursing Education, 50(4), 230-233.

Should Embryonic Stem Cell Research Be Federally Funded? Essay

The possibility to cure Alzheimer, Parkinson’s, AIDS, spinal injuries, and many more diseases and conditions is received by many in the medical world with excitement and anticipation. The discoveries of embryonic stem, ES, cells in 1998 by James A. Thomson, a biologist at the University of Wisconsin, Madison, was a great breakthrough for the medical world, showing great promise in the field of stem cell research. This is because they have the capacity to become any type of cell tissue in the body. To the medical world the opportunities seems endless. However, there is a great deal of debate by some who question the moral and ethical use of ES cells, believing that life begins at fertilization. Supporters argue that we have an obligation to help others who are suffering by using ES cells, because they are consider potential life. The question is do we have the right to use ES cells for research purposes when the embryos will be grown specifically for research and destruction? A nd if so, should this research be funded by the government? First of all, what are ES cells and how can they help us? ES cells are non-specialized cells found in the human body and are capable of multiplying and creating all types of specific cells. ES cells are developed in an in vitro fertilization clinic and not in a woman’s womb, as the name seems to indicate. Because these cells have the ability to develop into any type of cell, the research potential for ES cells is very promising. If the correct genes can be turned on they could regenerate tissue cells that are incapable or too damaged to replace themselves. Or they can be used to find and correct genetic defects or degenerative diseases. ES cells offer a promising future to many people even if that f... ... Future of Medicine." The Guardian. The Guardian UK, 1 Mar. 2009. Web. 16 Jan. 2012. . Sansom, Dennis L., P.H.D. "How Much Respect do we Owe the Embryo? Limits to Embryonic Stem Cell Research." Ethics & Medicine 26.3 (2010): 161,173,131. ProQuest Research Library. Web. 13 Jan. 2012. Schechter, Jody. "Promoting Human Embryonic Stem Cell Research: A Comparison of Policies in the United States and the United Kingdom and Factors Encouraging Advancement." Texas International Law Journal 45.3 (2010): 603-29. ProQuest Research Library. Web. 13 Jan. 2012. Simon, Stephanie. "THE NATION; Stem Cell Dissent Roils States; Even Where Voters have Moved to Support the Embryonic Research, Opposition is Fierce." Los Angeles Times: A.12. Los Angeles Times; National Newspapers Core. Aug 01 2007. Web. 13 Jan. 2012

The Age of the Global Interactive Agency Essay -- Business, Technology

It was only a matter of time before the fledgling web design firms and online advertising agencies that were spawned in the late 1990s grew and coalesced into mature national companies. Now, these companies have grown too large for a single country and the age of the global interactive agency is upon us. Led by companies such as 7 Strategy, a combination of design, e-commerce, database management and a host of other marketing and technical skills are combined under one roof to provide companies from around the world with multi-national exposure on the Internet. In a unique twist, 7 Strategy has several main offices. One is dedicated to Europe, one to the Far East and one each for the Eastern and Western halves of the United States. While each office is responsible for a certain section of the world, all of their clients have access to the full breadth and range of 7 Strategy’s marketing experience and technical expertise. When asked about their success, Director of Client Services, Chase Welles, states, matter-of-factly, â€Å"It’s our ability to integrate a uniform, company-wide, back-end database and e-commerce platform with various front end designs customized to regional marketplaces that differentiates us from less well-diversified interactive organizations.† He then pauses to take a breath. This statement is rather sweeping and encompasses quite a broad swathe of technological know how and marketing expertise. Indeed, these abilities that do not seem to be in short supply at 7 Strategy. Founded in 2001, this company has never been a boutique design firm. Instead, they have focused on offering their business clients a full range of interactive marketing products that can achieve real and measurable business growth. Chief ... ...e implementation of 7 Strategy as the company has experienced significant annual growth since its inception. 7 strategy has engineered some remarkable success stories throughout its history. They have created search engine optimizations that have produced results on the first page of the Google search engine. They have also crafted award winning website designs for clients in North America, Europe and Asia. Despite these successes, the management and team at 7 Strategy would argue that, most importantly, they have delivered significant and measurable increases in the business metrics that are most important to their clients. In short, years of focused research and practical strategy testing are combined by 7 Strategy with extremely talented and innovative designers and engineers to produce highly functional and exceptionally attractive interactive experiences.

Computer Communications :: essays research papers

Computer Communications Communications. I could barely spell the word, much less comprehend its meaning. Yet when Mrs. Rubin made the announcement about the new club she was starting at the junior high school, it triggered something in my mind. Two weeks later, during the last month of my eighth grade year, I figured it out. I was rummaging through the basement, and I ran across the little blue box that my dad had brought home from work a year earlier. Could this be a modem? I asked Mrs. Rubin about it the next day at school, and when she verified my expectations, I became the first member of Teleport 2000, the only organization in the city dedicated to introducing students to the information highway. This was when 2400-baud was considered state-of-the-art, and telecommunications was still distant from everyday life. But as I incessantly logged onto Cleveland Freenet that summer, sending e-mail and posting usenet news messages until my fingers bled, I began to notice the little things. Electronic mail addresses started popping up on business cards. Those otherwise-incomprehensible computer magazines that my dad brought home from work ran monthly stories on communications-program this, and Internet-system that. Cleveland Freenet's Freeport software began appearing on systems all over the world, in places as far away as Finland and Germany - with free telnet access! I didn't live life as a normal twelve-year-old kid that summer. I sat in front of the monitor twenty-four hours a day, eating my meals from a plate set next to the keyboard, stopping only to sleep. When I went back to school in the fall, I was elected the first president of Teleport 2000, partially because I was the only student in-the school with a freenet account, but mostly because my enthusiasm for this new, exciting world was contagious. Today, as the business world is becoming more aware of the advantages of telecommunications, and the younger generation is becoming more aware of the opportunities, it is successfully being integrated into all aspects of our society. Companies are organizing Local Area Networks and tapping into information resources through internal networking and file sharing, and children of all ages are entertained by the GUI-based commercial systems and amazed by the worldwide system of gopher and search services. As a result, a million more people join the 'net every month, according to a 1994 article by Vic Sussman in U.S. News & World Report. They say that the worldwide community used to double its knowledge every century. Right now, that rate has been reduced to seven years, and is constantly decreasing. I've learned more since I started traveling the information highway

Policies issues Essay

By watching the video for this assignment I agree that these children are getting abuse and by the environment they come from they will grow up and may follow the steps of their parents. The mother had put a restraining order on the boyfriend. Until she had to call the police cause he kept coming to her house. Her small son was scare and child protector services (CPS) had to get on involve and replace him in a foster home. There are different factors. Some kids are taking drugs because they grew up around their parents or friends doing drugs. There some kids that physical abuse is involve in the family. In the video also addresses Policy implications or recommendations of the crime. Ità ¢Ã¢â€š ¬Ã¢â€ž ¢s also a personal crime. The abuse come from the family itself or someone known by the family. I believe that the abuse effects all young kids. These abuse kids will show depression, anti-social, anger, rebellious, and will lead them to take drugs. Before its misinterpreted wrong it is very important to understand the various kinds of child abuse that does occur. Child abuse is not just rigorously a bodily problem, but it is more than just that. This is what child abuse is; physical violence, verbal abuse, emotional, rape and psychological torment, sexual molestation, and abandonment. It important to see the background of these crimes and see if there is a pattern that were the abuse is coming from. Child abuse is an inexplicable subject to so many people like the courts and child protective service. There is a few children that are found murdered every day from child abuse and nearly millions reports are made every year. REFERENCES: www.futureunlimited.org/pdf/DVintervention.pdf https://www.ncjrs.gov/works/wholedoc.htm

Jean Watson’s Theory of Caring

Jean Watson's Theory of Caring Jean Watson's Theory of Caring Dr. Jean Watson developed a theory of human caring that has become essential in nursing. Caring is at the core of nursing and is vital in providing positive patient outcomes. Watson’s theory of caring can be applied to patient situation and his or her environment. She based her theory upon human caring relationships and experiences of human life. She acknowledges a caring relationship and a caring environment preserve human dignity, wholeness, and integrity and to restore the person’s harmony it is the nurse’s responsibility to assist an individual to establish meaning in illness and suffering (Cara, 2003). Nurses have a responsibility to evaluate the patient’s physical, mental, and emotional well-being. Watson developed her theory in 1979 and revised it in 1985 and 1988. The majority of the revisions was made to her carative factors that she believes is the concept for the core of nursing (Cara, 2003, p. 52). According to Sulimann, Welmann, Omer, and Thomas, (2009), Watson’s theory suggests that, â€Å"Caring is a different way of being human, present, attentive, conscious, and intentional. Nursing is centered on helping the patient achieve a higher degree of harmony within mind, body, and soul, and this harmony is achieved through caring transactions involving a transpersonal caring relationship† (p. 294). The major parts of Watson’s theory are the carative factors, the transpersonal caring relationship, and the caring occasion caring moment (Cara, 2003, p. 51). Watson has 10 carative factors, and she uses the word carative to contrast the word curative used in conventional medicine (Cara, 2003, p. 52). Watson believed that caring and curing were independent of each other (Bailey, 2009, p. 18). Cara (2003) indicates carative factors attempt to, â€Å"Honor the human dimensions of nursing’s work and the inner life world and subjective experiences of the people we serve (p. 2). The 10 carative factors are the formation of a humanistic-altruistic value system, instillation of faith and hope, cultivation of sensitivity to self and others, development of helping-trusting relationships, expression of positive and negative feelings, creative problem-solving caring process, promotion of transpersonal teaching and learning, supportive, protective, and corrective mental, physical, societal, and spiritual environment, assistance with human needs, and allowance for existential-phenomenological-spiritual forces (Cohen, 1991, p. 906). Looking at these carative factors, I can see how Watson sought to address aspects of the patient to make it more of a holistic approach with the concept of caring at the core. These carative factors was used by Watson to develop her transpersonal caring relationship, this relationship describes how the nurse goes beyond an objective assessment, showing concern toward the person’s subjective and deeper meaning regarding his or her own health care situation (Cara, 2003, p. 53). The nurse’s caring consciousness becomes essential to connect and establish a relationship with the cared-for to promote health and healing. The nurse has a moral commitment to the patient to protect and enhance his or her human dignity as well as his or her deeper self. One of the carative factors of developing a trusting relationship has to be in a place for a transpersonal relationship to occur. In the transpersonal relationship, a mutual instilling of faith and hope are present as described in one of Watson’s carative factors. Developing a transpersonal relationship with the patient’s has to involve a cultivation of sensitivity toward the patient’s and being able to support and protect him or her in the environment is essential for this kind of relationship to occur. I do not believe in the ability with patient care to have a transpersonal relationship with patients if the nurse cannot first use the carative factors with patients. Watson developed seven assumptions in her caring model to incorporate the humanistic value system with scientific knowledge. Watson believed that practice and knowledge are essential for building a caring-healing framework (Bailey, 2009, p. 18). If we just do one without the other, I personally do not think we will obtain the same results. We need to be caring toward our patients and show them we care; but we also need to do medical interventions that will bring the caring and healing together, Watson’s seven basic assumptions of the science of caring as follows: 1) Caring can only be effectively demonstrated and practiced interpersonally. 2) Caring consists of carative factors that lead to the satisfaction of certain human needs. 3) Effective caring health and growth for the individual and family. 4) Caring responses accept a person the way he or she is no matter how he or she may change in the future. ) A caring environment allows the patient to choose the best action for him that offers the development of potential at any time. 6) Caring is more healthogenic than curing. Caring is complimentary to the science of curing. 7) The practice of nursing is central to nursing (Bailey, 2009, p. 18). The last assumption that Watson made is that nursing is central to nursing (Bailey, 2009, p. 18). To understand what she meant by this, it is important to see how Watson views nursing. She views the focus of nursing as the interaction between nurse and patient. She views the goal of nursing as a science where the health and illness experiences are mediated by different transactions such as professional, personal, scientific, and ethical. Last she views the uniqueness of nursing as the spiritual growth of people within these interactions. They can release feelings, and help gain self-healing (Cohen, 1991, p. 906). I have seen how she viewed different aspects of nursing and how they convert over to caring moments with our patients. I recently had a caring moment with a patient who contributed to my own self-actualization. My patient was a 78-year-old male admitted to the hospital with pneumonia and a collapsed lung. Two chest tubes was placed in his left lung and chest x-rays was obtained showing the presence of a cancerous tumor. Upon hearing the results he and his family was devastated. He was afraid of dying and what was going to happen to his wife of 60 years. I had a caring moment with him as I sat and listened to him express his feelings about death and dying, and he shared how he was feeling. I allowed him to discuss his beliefs of the dying process and how he viewed them. He said he felt much better having someone listen to him express his feelings. He believed he could face death and that he needed to look deep into himself and trust that his wife would be all right. This was a caring moment with this elderly gentleman in which I showed my patient he was worth my time. He could go very deep because of the trust we had been building. Watson defines the person as a being in the world comprised of body, mind, and spirit. These are influenced by the concept that oneself is unique and free to make choices. She sees a person as one that needs to be accepted for whom he or she is and who he or she may become (Cara, 2003, p. 55). With my patient, I operated in this view of the person as I demonstrated several of the carative factors of Watson’s theory with my patient. I could help him find a sense of faith and hope that his wife would be taken care of after his death. I allowed him to express his positive and negative feelings about dying. I used transpersonal teaching and learning with him as I taught him some of the details of what happens as he dies as well as I learned much about him as a person and how he sees life and death. I met his physical needs by keeping him comfortable and I offered support for his mental, physical, and spiritual environment. With his permission, I arranged a visit with the chaplain, to offer more spiritual support for him. Watson’s definition of health is a person’s subjective experience, and one of her assumptions about health is that caring will promote health with the patient or the family (Cara, 2003, p. 56). I believe that each individual person has his or her own idea of what health means to him or her. We need to discover how each patient defines health for his or her own situation. In this moment with my patient, I worked with him to promote health. This was not the health that immediately comes to one’s mind. This was not health as an absence of illness. This patient was not going to get better in his physical health. I tried to promote health with him in the spiritual and emotional parts of the patient. He began to release the worries about his wife and find a more healthful attitude to continue in after our conservation. The caring environment that Watson describes is her assumption allows the person to choose the best actions for him at any time, and the nurse can help facilitate the environment that the patient desires. My patient wanted some time alone with his wife in the room and did not want to offend his other family members. I told him not to worry about it that I would take care of that for him, and he could focus on having some time with his wife. This was important for him and I could facilitate this change in environment for my patient. He made the decision, but I helped to facilitate it. Watson’s caring theory really affected me and the area of nursing that I am currently working. I am working on an intensive care unit where my patients come in near death situations daily. These patients need a nurse who understands what it means to care and develop a transpersonal relationship. These patients are coming to grips with the facts that they are about to lose their lives and what happens when they die. They begin questioning everything about this life and what happens to them when they die. These patients really need to be seen as unique individuals with specific needs of their own. My caring moment with my patient who seems like his life was greatly fulfilled prior to death leads me to believe that it is very possible to implement Watson’s theory in day-to- day nursing practice. Through the research on Watson’s theory of caring, it provided me with the ability to learn the essential elements of her theory and apply them to clinical situation in the work environment. References Bailey, D. (2009). Caring defined: a comparison and analysis. International Journal for Human Caring, 13(1), 16-31. Retrieves from CINTAHL Plus with Full Text database. Cara, C. (2003). A pragmatic view of Jean Watson’s caring theory. International Journal for Human Caring, 7(3), 51-61. Retrieved from CINAHL Plus with Full Text. Cohen, J. (1991). Two portraits of caring: a comparison of theorists, Leininger and Watson. Journal of Advanced Nursing, 16(8), 899-909. Retrieved from CINAHL Plus with Full Text. Suliman,W. , Welmann, E. , Omer, T. , & Thomas, L. (2009). Applying Watson’s Nursing Theory to Assess Patient Perceptions of Being Cared for in a Multicultural Environment. Journal of Nursing Research (Taiwan Nurses Association). 17 (4), 293-300. Retrieved from Academic Search Complete database