Code of Ethics Essay Example for Free

Code of Ethics Essay The primary purpose of a code of ethics is to safeguard the welfare of clients by providing what is in their best interest. It is also designed to safeguard the public and to guide professionals in their work so that they can provide the best service possible. All professional counselors are obligated to perform by a code of ethics. The American Counseling Association (ACA) provides guidance in resolving moral problems that professionals may encounter, whereas Christian counselors not only abide by the ACA Code of Ethics but also by the American Association of Christian Counselors AACC code, which promotes excellence and brings unity to Christian counselors, and gives honor to Jesus Christ. This paper will address the broad similarities and differences between the two codes, as well as comparisons in the specific areas of Confidentiality, Sexual Intimacies and Discrimination. Codes of Ethics Comparison A code of ethics is a systematic statement of ethical standards that represent the moral convictions and guide the practice behavior of a group (Clinton and Ohlschlager, 2002). † With that in mind, every counseling discipline has an ethics code which is continuously revised and updated to stay current with emerging issue, and to promote elevated clarity and direction to the profession. Thus, the ACA and AACC codes of ethics were both created to assist their members to better serve their clients. They also define values and behavioral standards necessary for ethical counseling. Yet while they are similar in intent, they are distinct in their foundational premise. General Similarities and Differences Both codes stress the importance of â€Å"promoting the welfare of consumers, practicing within the scope of one’s competence, doing no harm to the client, protecting client’s confidentiality and privacy, acting ethically and responsibly, avoiding exploitation, and upholding the integrity of the profession by striving for aspirational practice †(Corey, p. 6). However, the biggest difference between the two codes rests in the streams of influence, whereas the AACC code is rooted in a biblical worldview. In other words, the primary goal of the AACC is â€Å"to bring honor to Jesus Christ and his church, promote excellence in Christian counseling and bring unity to Christian counselors† (AACC, 2004). However, the ACA’s goals are educational, scientific, and professional. It strives to enhance the quality of life in society by promoting the development of professional counselors, advancing the counseling profession, and using the profession and practice of counseling to promote respect for human dignity and diversity (ACA, 2005). The primary goal of the AACC is â€Å"to bring honor to Jesus Christ and is church, promote excellence in Christian counseling and bring unity to Christian counselors† (AACC, 2004) Specific Comparisons Both codes express a high priority on client confidentiality. Also, they express the value of discussing and securing written consent from the client. They also both discuss the importance of client disclosure in that protecting confidential communication is always the first response of the counselor. The counselor is mandated to disclose information in life threaten or abusive situations. However, the distinct difference between the AACC and the ACA is in the area of privileged communication. While both associations require that counselors do not disclose client information as it relates to training, research or publication, the AACC adds that â€Å"Christian counselors do not disclose confidential client communications in any supervisory, consultation, teaching, preaching, publishing, or other activity without written or other legal authorization by the client† (AACC, 2004). The ACA and the AACC codes differ greatly in the concept of sexual Intimacies. In fact, The ACA (2005) used the term â€Å"sexual or romantic interactions or relationship†. In other words The ACA (2005) does not forbid, but sets guidelines pertaining to any participation of sexual or romantic interaction with any current or formal clients for a period of 5 years following the last professional contact. However, the AACC declared that all forms of sexual interactions or relationships outside of marriage are unethical. The only exception to this rule is marriage, which the AACC (2004) declared as â€Å"honorable before God†. Thus, guidelines have been appropriated to allow for such a case. In addition, Christian counselors are also forbidden to counsel current or former sexual partners and or marital partners. (AACC, 2004 )Discrimination can result in serious problems for both the people that hold them and the people that they are prejudiced against. Both associations agree that non-discrimination is the best practice, for clients should not be denied service based on age, religion, sexual orientation etc. However, the AACC maintains its biblical perspective in that counselors are to encourage biblical principles. While Christian counselors must not discriminate, they also cannot condone certain practices that conflict with biblical principles. For instance, in the area of sexual orientation, Christian counselors will not deny service. However they will â€Å"encourage sexual celibacy or biblically prescribed sexual behavior while such issues are being addressed† (AACC, 2004). Conclusion There are many similarities and differences relating to the code of ethics for the American Association of Christian Counselors (AACC) and the American Counseling Association (ACA). Through these areas we realize that the code of ethics sets boundaries and regulations for all professional counselors and without them, counselors could not be effective or productive in their true calling.

Switches and Routers Essay Example for Free

Switches and Routers Essay This is as far as I have gotten and I’m very confused about routers. Router and Switch Configuration Switches and routers are key components to operating any network. Switches can break up a large area network into smaller segments. This will free up congestion and provide more bandwidth to each port, which will increase network performance. The first step is to plug into a power source, connect the console port to a computer or modem with UTP cabling and an RJ-45 cable, and use the command line interface (CLI) to configure and manage the switch in user exec mode and privilege exec mode. In most cases, the switch will perform a power on self-test. The manual will indicate the particulars of any failure. One must configure a password because the switch arrives without one. This provides security through the console settings menu and the password configuration option while one may also incorporate an encrypted password option. Entering global configuration through the command line option will change passwords, also. To change the IP configuration, one would choose the [I] key and choose the IP address option and set the Subnet mask and Default gateway. Creating a VLAN requires switching to Global Configuration mode and using vlan vlan# name name_of_vlan command. To add more VLAN ports, go to the Interface Configuration Mode and use the vlan-membership static vlan# command (Regan, 2004). To review or configure spanning tree protocol, go to [N] Network Management option and enter [B] bridge-spanning tree option from the Network Management option (Regan, 2004). One can disable or enable each port from here. When installing a router one must ensure proper ventilation, temperature, and distance limitations of wiring.

Registered Nurses Might Develop Appropriate Leadership Skills Nursing Essay

Registered Nurses Might Develop Appropriate Leadership Skills Nursing Essay The purpose of this assignment is to examine how registered nurses develop appropriate leadership skills, and how this can be implemented in improving a patients care requirements. Throughout this discussion I will give a definition of leadership, types of leadership models and theorist. Examine the KSF (Knowledge Skills Framework) and PDP (Personal Development Portfolio) and discuss the skills and knowledge that nurses need in order to succeed and develop the leadership skills that will be used in improving the patients overall care outcomes. I will use tools such as the internet eg. CINHAL, Caledonian University library, Blackboard, various journals and books to ensure the information provided is up to date and current within modern day practices and techniques within the nursing profession. Leadership, according to Grim (2010), is a complex entity, there are many definitions, Benton (2005), described leadership as the art of influencing people to accomplish the mission, another definition by Huczynski and Buchanan (1991), defines leadership as; a social process in which one individual influences the behaviour of others without threats or violence. Cook, (2001),  stated that; Leadership is not merely a series of skills or tasks; rather, it is an attitude that informs behavior. When we think of leaders we think of great people such as Churchill, Kennedy, Florence Nightingale and many more, these people are regarded as leaders because they had a vision to change things for the better, they inspired their fellow men with words of wisdom, they challenged authority and seized on opportunities. There are different styles of leadership; Autocratic, these types of leaders set their own goals; they do this without allowing other team members to participate in the decision making, (Faugier Woolnough, 2002). Bureaucratic, this is where the leadership has no grey areas they stick to the rules, regulations, and policies rigidly. Participative leader, these leaders allow staff to participate in making decisions, they delegate and pick fellow staff to participate in the decision making. The feeling is that this type of leadership would allow members of the team to feel more committed to the goals set out as they would be part of the team that set them out. (Faugier Woolnough, 2002). Laissez faire leadership is a more risky kind of leadership as the staff members are left to their own devices in meeting the goals set out. According to Faugier Woolnough, (2002), Ellis and Abbott (2009), a better and fairer leadership style may be situational leadership, this style allows the leader to switch between all the above styles depending on the situation they are dealing with and the competence of the workforce he or she is working with at that time. There are some theorists who believe that leadership is in-born and that some traits of a leaders personality such as intelligence, initiative and confidence are what creates leaders. (Goffee and Jones, 2000). There are those who disagree, Kouzes and Posner (2002) for example, argue that the skills of a leader are observable and learnable. Ellis and Abbott (2009), agree with, Faugier Woolnough, (2002), when looking at models of leadership see that some theorists believe that people get intrinsic satisfaction when given more control over their work they tend to be more productive and better motivated. The clinical governance and the policy and procedure manuals are all pushing for nurses to be autonomous practitioners, to lead teams, to give patients guidance in looking after their own health. In order to do these nurses have to inspire and motivate their patients and staff. Timmons and McCabe (2009). As a newly qualified registered nurse, leadership will be a daunting thought, being the newest member of staff, the leadership mantle will not rest on easy shoulders, but Knowledge and skills must be kept up to date throughout the practitioners working life,. (NMC 2004) by taking part in learning activities such as the KSF, a learning tool, that develops the practitioners competence and performance. Throughout the NHS the ongoing training tool which is most commonly applied is the KSF. This is an effective tool used to show the broad skills and knowledge that a nurse or practitioner needs to be effective in their particular post or position. The framework was introduced alongside the Agenda for Change (AfC) pay system to ensure every NHS nurse receives an annual review to assess the knowledge and skills required to do his or her job. The aims of the KSF were to show clear and consistent development objectives so that practitioners were aware of what skills would be needed for their chosen role, to help and encourage the development of staff in such a way that they can apply the newly gained knowledge and skills to their post and to help identify any knowledge and skills that may support career progression and encourage the need for life long learning. The KSF will ensure that practitioners are fit to practice and continue to provide a framework for good quality care. (Hinchcliff 2009) The KSF also highlighted that a review should take place annually, this would be provided by the practitioners line manager to agree to any personal development plans that the practitioner may have, if the KSF, is implemented correctly, nurses will have the adequate training and skills to carry out their role effectively. Therefore the KSF will help to raise the clinical standard and standardise the abilities of the staff in specific roles throughout the NHS. (Tanton 2009). Health, safety and security are the key aspects of the job which the KSF describes; it makes it clear that it is vital that everyone takes responsibility for the safety, health and security of patients and clients, the public, colleagues and themselves. It shows that as staff move forward in their careers that their roles and responsibilities for health, safety and security also progress and that different levels of competence are required. (DoH 2004) The DoH (2006) is driving a key initiative to facilitate the development of nursing careers across the UK. Four key priority areas have been identified to address this they are; Develop a competent and flexible workforce. Update career pathways and career choices; Prepare nurses to lead, in a changed health care system; Modernise the image of nursing and nursing careers. (DOH, 2006, p.17) Leadership skills are being implemented at the start of the nurse training program, communication, listening, self awareness, empathy, motivation, reflection, critical thinking and problem solving, these skills will be required from every registered nurse from the onset of their career. The knowledge and skills that are obtained are needed for the team to attain clear, shared and attainable goals, which are essential in ensuring patients receive the best possible care. NMC (2004) Todays practitioners increasingly require the skills and knowledge to base care on best evidence, to use critical thinking and demonstrate advance leadership and decision making skills, to develop and enhance services in a more complex and diverse healthcare environment. Casey and Clark (2009) Critical thinking, is a skill that is defined by Wilkinson (1969) as both an attitude and a reasoning process that involves several intellectual skills. Taylor (2006) Described critical thinking as the rational examination of ideas, inferences, principles, arguments, conclusions, issues, statements, beliefs and actions also referred to as clinical reasoning, clinical decision making and clinical judgement. (Toofany, 2008) In todays healthcare environment things are ever changing and so is the information that the medical, clinical and multidisciplinary teams have to analyse. This information has to be critically analysed, weighing up the evidence and arguments that support such information, research suggests, that many newly qualified nurses and students lack the skills acquired to think critically (Shell 2001). According to Luckowski (2003), critical thinking is a skill that all newly registered nurses must have if they are to succeed in nursing. The need to solve problems in clinical practice (Ferrario 2004), is a skill that is necessary for the development of implementing theory to practice. Once qualified the new practitioner will have to think on her feet, critical thinking requires her to make decisions about patient care and to solve problems, these are complex cognitive experiences that nurses have to carry out quickly. There are structured care approaches such as, Integrated care pathways (ICPs) , protocols and algorithms these are effective tools that will help new nurses and students to learn to be critical thinkers. Intuition, according to Smith (2009) has its place in nursing, this is the emotional side of critical thinking, and is an important part of decision making when looking after a patient. There is considerable debate about this skill has been linked to expertise and the knowledge of a good nurse, There have been a plethora of research carried out on this subject without any conclusive evidence to disregard it as a skill. Acknowledging intuition is a challenge for nurses, educators and researches, because it is difficult concept to put into words and measure. Rew and Barrow (2007) Turnbull (1999) called intuition the neglected source of knowledge striving for legitimacy. Benner`s (1984) From Novice to Expert, is a model that is used as the conceptual framework for nursing research on clinical expertise and the use of intuition. ( King and Clark 2002,as cited in Smith 2009) Communication, one of the main skills that a newly qualified nurse can excel in immediately after training, a good handover, passing on messages such as doctors orders, blood results, listening to what patients are saying and also what they are not saying, body language, telephone calls, information appertaining to the patient in her care, this skill may be intrinsic but it can also be a learned skill. There are many theories and models on communication, much has been written about this subject models such as, `The Circular Transactional Model of Communication`, (Bateson 1979), and a `Skill Model of Interpersonal Communication` Hargie Dickson 2004) to name only two of them. (Timmons McCabe 2009) The theories and models may not have a direct influence on how the nurse communicates with her patient, but by reading them it allows discussion and in a nursing context this could illustrate a difference between a task centred approach or a patient centred approach when dealing with her patients. Communication is one of the most important skills a nurse can learn, its one of the first lessons taught at the beginning of her training and carries on for the rest of her nursing profession. According to ( Hinchliff et al 2008pg194) Clear communication is essential to an effective and ethical professional relationship. A nurse uses this skill consciously and unconsciously every day of her professional life. To be an effective communicator and have the patients best interests, the nurse must communicate openly and honestly, this may not only be with the patient and their family, but other members of the multidisciplinary teams. A registered nurse must develop a range of communication skills, styles, and technique to best suit her patients needs. There also needs to be good communication between the multidisciplinary teams, poorly written information about a patient could have an effect on the outcome of a patients care. NMC Guidelines for records and record keeping (2004), state tha t, Good record keeping is a mark of a skilled and safe practitioner, It is also a fundamental part of nursing, which carries a legal responsibility as patients records are part of the key evidence if a case goes to a court of law.(Hinchliff 2008). A professional nurse may on occasions find herself involved in situations where they may be called to give witness under oath; this is when the skill of good accurate record keeping plays a pivotal role. Active listening skills are an important skill, establishing a rapport with a patient just stopping for a moment and giving them eye contact smiling and asking open and closed questions will allow the patient to trust the nurse this in turn may reduce the patients anxiety levels and allow the patient to see that they are not just an illness but an individual, thus a therapeutic relationship may develop. (McCabe 2004: Astedr-Kurki and Haggman-Laitila 1992; Williams 1998) A nurse also has to be patient centred in her approach to planning, implementing and evaluating patient care, showing qualities of empathy warmth, genuineness, all the following skills are also essential; Self Awareness and Assertiveness are skills that the newly qualified nurses have to develop, the need to understand themselves and be aware of their own feelings, actions, values, attitudes, beliefs and how they influence relationships and interactions with others. A nurse cannot understand others until they themselves are self aware. Self-awareness is a lifelong process and requires the individual to look inside themselves and reflect take on board feedback from others. Senge (2006) Assertiveness, another valuable skill in the element of communication Balzer-Riley (2000) suggests that assertiveness is the ability to express thoughts feelings and ideas without undue anxiety or having a negative effect on others. To have leadership skills nurses must be more assertive, it is well documented (McCabeTimmins 2006) that in the past most nurses tended to take a submissive role in communication behaviour, todays nurse with good mentorship and support can be frank, flexible and open-minded and with the right encouragement can motivate and encourage others, without being confrontational or challenging, this can work in the patients best interest to have a confident practitioner. Self- regulation; this is the component of emotional intelligence that enables the individual to be reasonable in the workplace, with appropriate control over feelings and impulses; they are open to change and have the capacity to create environments of trust and fairness. Motivation: driven by not only external incentives such individuals are uniquely internally motivated and will display both innate optimism and organisational commitment. Empathy; this is an essential component, which enables one to understand both the needs of the user of the service and also those of the providers. Social skills; enables the individual to find common ground and manage relationships. (Timmins McCabe 2009) Responsibility is a duty for which one is responsible, while accountability relates to the fact that one can be called to account for ones actions with regard to a duty. Nursing midwifery council, states that a practitioner may be expected to delegate to others who are not registered nurses, they may be health care assistants, (HCAs) or students, but the practititioner still remains accountable for the appropriateness of the delegation. NMC (2004). Delegation is the transfer of selected tasks and responsibility for completion of tasks to another person and retaining supervision and accountability for that activity (Hansten and Jackson 2004). Delegation is a skill that a new nurse may have to use from day one in her job, she may find herself delegating a task to health care assistances (HCAs) or a student, this may seem inappropriate as the HCA probably has much more knowledge of the task than the new nurse. What a new nurse or in fact any nurse has to weigh up when delegating the task to another is, does this person have the right skills and competence to carry out the task delegated to them, has this person had training to carry out the task, who is liable if any harm befalls the patient or the carers, the person who carried out the task? or the person who delegated the task? The law will state that due to professional accountability, only responsibility can be delegated to others, accountability and liability cannot be delegated. (Cornock 2008) This means that even though the individual took the task on, they may state, that they lacked the authority, knowledge and experience to carry out the task, even though the stud ent/ HCA have took responsibility for the task. The nurse who delegated must from a legal perspective remain nearby to monitor the task, and to offer advice if needed. In America, The National Council of State Boards of Nursing (1995), brought about the `five rights of delegation` these are The right task, The right circumstances, From the right person, With the right communication, With the right supervision. The NMC (2007b) also reflect on this advice with regards to delegation, as delegation is a skill that will develop over time with the right mentorship and guidance. (Hinchcliff 2009) As the new practitioners confidence in her experiences, abilities and competence in the field she has chosen, grows, mentoring will be the next stage of her development. Mentoring whether its formal or informal is one of the important roles that every nurse has to take part in. The NMC (2006) states that, nurses who take the role of mentors must be registered with the NMC and be on the same part of the register as the students they assess, the mentor must be on the register for at least 12 months and have completed an NMC approved mentor preparation course, (PA, Panther 2008). The NMC (2004 4.3) states that the practitioner must communicate effectively to others and share knowledge, skill and expertise with other members of the team as required for the benefit of patients. The course is a ten day program following the publication of the NMC, Standards to Support Learning and assessment in Practice (NMC 2006) Reflection, just like clinical skills reflection needs to be learned, it is an activities that is central to a nurses professional practice. Johns (2000) stated; Reflection is a window that the nurse can view and concentrate on herself within the context of her lived experience, this will help her to confront and understand the problem and work towards resolving it within her practice of what she has done and what she would like to do better. When carrying out tasks with the patient although the nurse does her best, using reflective practice she can look back and see how she could have made this event better for the patient, it may identify a lack of knowledge or a skill that needs to be practiced for the future care of a patient. There are several models of reflection (e.g. Gibbs 1988, Johns 2000, Taylor 2006,) these models help the practitioner by asking structured questions about their experiences in clinical practice which prompt the practitioner to remember certain aspects of th e event e.g. who, what, where and when, these questions are a catalyst for the practitioner. When reflection forms part of a structured learning experience then theory and practice become more integrated and theory informs practice and practice informs theory. (Clark et al, 2001), (Fowler, 2006). The purpose of this assignment was to examine how registered nurses develop appropriate leadership skills, and how this can be implemented in improving a patients care requirements. The NMC states that as a practitioner you must keep your knowledge and skills up to date throughout your working life, this will be helped by carrying out Personal Development Portfolios and following the Knowledge and Skills Framework, as this can benefit the practitioner by highlighting abilities, achievements and experiences. Also the portfolio can show the development of analytical skills through reflective study. The practitioner will need to acquire and develop the skills and attributes required to deal with a range of new and emerging nursing responsibilities in todays healthcare. Nurses who are competent in the skills of leadership will be able to plan and design the way care is delivered in the future, this will achieve the goals of the health service providers and improve patient care outcomes. REFERENCES LEADERSHIP 2010 Astedt-Kurki, P Haggman-Laitila, A (1992) Good Nursing Practice as Perceived by Clients: A starting point for the development of professional nursing. Journal of Advance Nursing, 17 (10), 1195-9 Balzer Riley J. (2000) Communication in Nursing, 4th edn. Mosby, St. Louis. Bateson G. (1979) Mind and Nature. Dutton New York. Benner P. (1984) From Novice to Expert: Excellence and Power in Clinical Nursing Practice. Addison-Wesley, Menio Park Ca. as cited in; Smith A (2009) Exploring the legitimacy of intuition as a form of nursing knowledge. Nursing Standard 6 vol 23 no 40 pg 35-39 Benton T. 2005) Airforce Officers Guide. 34th ed. Mechanicburg, PA: Stackpole Books. As Cited in Grimm JW. (2010) Effective Leadership: Making The Difference. Journal of Emergency Nursing. Vol 36 (1) pg 74-77. Casey D, Clark, L. (2009) Professional development for registered nurses. Nursing Standard vol 24 No 15-17 pg, 35-38. Clark A. Dooher J. Fowler J. (2001) The Handbook of Practice and Development. Dinton: Quay Books. Cook, M. (2001).   The renaissance of clinical leadership.   International Nursing as cited in Cornock M. (2008) Where the buck stops. Nursing Standard 12, 17 vol 23 no 15-17 Department of Health (DoH) (2004) The NHS Knowledge and Skills Framework. London Department of Health Ellis P. Abbot J. (2009) How to succeed as a new renal nurse manager. Journal of Renal Nursing 1 (2): 93-96. Faugier, J. and Woolnough, H. (2002).   National nursing leadership programme.   Mental Health Practice, 6 (3): 28-34. Ferrario CG. (2004) Developing clinical reasoning stratergies: cognitive shortcuts. Journal for Nurses in Staff development 20, 5, pg 229-235. Fowler J. (2006) The impotance of reflective practicefor nurses and prescibers. Nurse Prescribing. 4. 103-6. Gibbs G. (1988) Learning by Doing: A Guid to Teaching and Learning Methods. Oxford; Further Education Unit, Oxford Polytechnic. Goffee R. Jones G. (2000) Why should anyone be led by you? Havard Buisness Review. 78(5) 63-70 Grimm JW. (2010) Effective Leadership: Making The Difference. Journal of Emergency Nursing. Vol 36 (1) pg 74-77. Hansten R, Jackson M. (2004). Clinical delegation skills: A Handbook for Professional Practice, 3rd edn. Aspen Publication, New York, as cited in Timmins F. McCabe C. (2009) Day Surgery Contemporary Approaches to Nursing Care Wiley-Blackwell UK.pg. 112. Hargie O. Dickson D. (2004) Skilled Interpersonal Communication: Research Theory and Practice. Routlege. Sussex. Hczynski A. Buchanan D. (1991) Organisational Behaviour: An Introductory Text 2nd edn. Prentice Hall. London. Hinchliff, S. Norman S, Schober, J. (2008) Nursing Practice and Health Care. A Foundation Text 5th ed Hodder Arnold. London. Johns C. (2000) Becoming a Reflective Practitioner: A Reflective Holistic Approach to Clinical Nursing Practice Development and Clinical Supervision. Oxford; Blackwell Science King L. Clark JM. (2002) Intuition and development of expertise in surgical ward and intensive care nurses. Journal of Advanced Nursing. 37, 4. 322-29 Kouzes JM. Posner BZ. (2002) The leadership challenge; How to keep getting things done in organisations. Jossy-Bass. San Francisco. Luckowski A. (2003) Concept Mapping as a critical thinking tool for nurse educators. Journal for Nurses in Staff Development. 195. 225-230 McCabe C. (2004) Nurse-Patient communication: An exploration of Patients experiences, Journal of Clinical Nursing 13,41-9 Nursing Midwifery Council NMC (2004) Guidelines for records and record keeping. Nursing and Midwifery Council Nursing Midwifery Council NMC (2006). The PREP Handbook. London: Nursing and Midwifery Council. Nursing Midwifery Council (NMC), (2006). Standards to Support Learning and assessment in Practice London: Nursing and Midwifery Council Nursing Midwifery Council NMC (2007b). Advice on Delegation for NMC Registrants: A-Z Advice Sheet, London: Nursing and Midwifery Council. Pa, A. Panther, W. (2008) Professional development and the role of mentorship. Nursing Standared. 6, 25, 22, pg 35- Rew L, Barrow EM. (2007) State of the science: intuition in nursing, a generation of studying the phenomenon. Advances in Nursing Science. 30, 1. E15-25 Senge PM. (2006) The Fifth Discipline: The Art and Practice of the Learning Organisation. Random House Business, London. Shell R. (2001). Percieved barriers to teaching for critical thinking skill by BSN Nursing Faculty. Nursing Health Care Perspective . 22. 6. pg286-89 Smith A (2009) Exploring the legitimacy of intuition as a form of nursing knowledge. Nursing Standard 6 vol 23 no 40 pg 35-39 Taylor BJ. (2006) Reflective Practice: A Guide for Nurses and Midwives. Open University Press. Maidenhead. Timmins F. McCabe C. (2009) Day Surgery Contemporary Approaches to Nursing Care Wiley-Blackwell UK. Toofany S. (2008) Critical thinking among nurses. Nursing Management vol 14 No9 Feb (2008) pg28-31 Turnbull J. (1999) Intuition in nursing relationships: the result of skills or qualities? British Journal of Nursing 8,5, 302-306 Williams, A.M. (1998) The delivery of quality nursing care:A grounded theory study of the nurses perspective. Journal of Advanced Nursing, 27, 808-16

Essay on Toms Escape in The Glass Menagerie -- Glass Menagerie essays

Tom's Escape in The Glass Menagerie      Ã‚   In Tennessee Williams' play, The Glass Menagerie, each member of the Wingfield family has their own fantasy world in which they indulge themselves. Tom escaped temporarily from the fantasy world of Amanda and Laura by hanging out on the fire escape. Suffocating both emotionally and spiritually, Tom eventually sought a more permanent form of escape.    Tom supports his family despite his unhappiness of his world.   He tries to please Amanda by   being the sole supporter, but only gets rewarded by Amanda's constant nagging and suspicion.   Eventually Tom finds himself more like his father as he seeks adventure in the movies and hangs out on the fire escape he avoids suffocation, and desperately seeks the life he always desired; the life of adventure.        Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   By hanging out on the fire escape, Tom finds a temporary safe haven from Amanda.   With Amanda nagging Tom about every minute action, like mastication, Tom needed to find somewhere to escape.   Perhaps, even more, the fire escape shows various things about Tom's personality.   Since Amanda and Laura have their illusionary worlds inside, Tom can easily escape these worlds by going out on the firescape.   He does not desire to be part of an imaginary world, which only proves to be the downfall of Amanda and Laura.   He realizes that the world is not what Amanda has made it seem inside the house.   Also, during his reflections on the firescape he is not really separating himself from the imaginary world because that metal frame is still anchored to the apartment wall.   This shows that no matter how hard Tom tries to escape he will always be 'bounded' to the apartment.   His emotional attachments to Laura would permantly k... ...s and it will be impossible for him to not disturb the nails.   He is suffocating in his own figurative coffin, but knows his escape will upset Amanda and Laura.        Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Tom escaped from the fantasy world of Amanda and Laura by hanging out on the fire escape, even though he could never fully escape.   Unfortunately for Tom, his life was cramped like the coffin and he was slowly suffocating emotionally and spiritually.   Unhappy with the lifestyle he followed in the footsteps of his father, he searched for adventure, escaping the nagging of Amanda.      Works Cited and Consulted Bloom, Harold Ed. Modern Critical Views: Tennessee Williams. New York: Chelsea House Publishers, 1987. Williams, Tennessee.   "The Glass Menagerie." The Bedford Introduction to Literature. Ed. Michael Meyer.   5th ed.   Boston:   Bedford/St. Martin's. 1999. pp.1865-1908.

I Don’t Know What I Want to Do, but I Know that it has Nothing to Do wi

I Don’t Know What I Want to Do, but I Know that it has Nothing to Do with Medical School Ihave had three majors since I have been in college. Chemistry was my entering major, which I kept all of one semester. The one I kept the longest is math, which I had for three semesters. Now I am an anthropology major. This is my first semester with this major. In fact, I haven’t officially changed the major yet. In order to understand where I am in my life now, you must realize where I have been. In high school I was in the National Honors Society, I took AP classes, and was completely controlled by my family. They had put the idea in my head that money made people happy. I had to make a lot of it. I was pushed to decide what I wanted to do with my life early. To my family the obvious choice was for me to be a doctor. I went with it. All I wanted was for them to approve of me. My senior year I was taking AP physics and a chemistry course. I decided I liked chemistry, there was my major. It really didn’t matter what it was, I was pre-med., any science would do. Science? What was I thinking? I got to college and realized chemistry was not for me. I hated lab, the professors, for the most part, were mean, and I just didn’t want to be a doctor anymore. The slight separation that I had from my family made me realize I didn’t know what I wanted to do, but I knew that it was not medical school. Then came the freak out. What am I going to do with myself? Professional student sounded good to me. All I needed was something I could get good grades in without trying. Obviously math, since I never had to study for a math class in my life. I wasn’t just good at math, I WAS math. So I changed my major, thinking it was the best move ever. It... ...es, I want to travel, and I hate the nine to five lifestyle. My plan is to get my Ph.D. in archaeology and then become a college professor. I will dig in the summer and maybe teach a few field schools later on. Being a teacher is something I would like to do too. Now that I am in college I realize the best teachers are the ones that are a little bit crazy. I think that is so fitting for me. One of my professors now, Elise Brenner, is my idol. She is an archaeologist and a college professor. I learn so much in her class because she doesn’t do a straight lecture format, and she makes class enjoyable and memorable. I want to be to someone what she is to me, a role model. I may not have everything figured out yet, but I am on my way. I might not be rich a famous, but I will be happy. Someday you can visit me in my apartment in the city. That is, if I’m not in Africa. I Don’t Know What I Want to Do, but I Know that it has Nothing to Do wi I Don’t Know What I Want to Do, but I Know that it has Nothing to Do with Medical School Ihave had three majors since I have been in college. Chemistry was my entering major, which I kept all of one semester. The one I kept the longest is math, which I had for three semesters. Now I am an anthropology major. This is my first semester with this major. In fact, I haven’t officially changed the major yet. In order to understand where I am in my life now, you must realize where I have been. In high school I was in the National Honors Society, I took AP classes, and was completely controlled by my family. They had put the idea in my head that money made people happy. I had to make a lot of it. I was pushed to decide what I wanted to do with my life early. To my family the obvious choice was for me to be a doctor. I went with it. All I wanted was for them to approve of me. My senior year I was taking AP physics and a chemistry course. I decided I liked chemistry, there was my major. It really didn’t matter what it was, I was pre-med., any science would do. Science? What was I thinking? I got to college and realized chemistry was not for me. I hated lab, the professors, for the most part, were mean, and I just didn’t want to be a doctor anymore. The slight separation that I had from my family made me realize I didn’t know what I wanted to do, but I knew that it was not medical school. Then came the freak out. What am I going to do with myself? Professional student sounded good to me. All I needed was something I could get good grades in without trying. Obviously math, since I never had to study for a math class in my life. I wasn’t just good at math, I WAS math. So I changed my major, thinking it was the best move ever. It... ...es, I want to travel, and I hate the nine to five lifestyle. My plan is to get my Ph.D. in archaeology and then become a college professor. I will dig in the summer and maybe teach a few field schools later on. Being a teacher is something I would like to do too. Now that I am in college I realize the best teachers are the ones that are a little bit crazy. I think that is so fitting for me. One of my professors now, Elise Brenner, is my idol. She is an archaeologist and a college professor. I learn so much in her class because she doesn’t do a straight lecture format, and she makes class enjoyable and memorable. I want to be to someone what she is to me, a role model. I may not have everything figured out yet, but I am on my way. I might not be rich a famous, but I will be happy. Someday you can visit me in my apartment in the city. That is, if I’m not in Africa.

Chanel Essay -- essays research papers

CHANEL  Ã‚  Ã‚  Ã‚  Ã‚  Gabrielle ‘Coco’ Chanel was born in Saumur, France in 1884. Vogue Magazine referred to her as â€Å"the couturier who takes no account of fashion, who pursues her own faultlessly elegant line in the quiet confidence that fashion will come back to her - and sure enough it always does.†   Ã‚  Ã‚  Ã‚  Ã‚  Chanel began designing heavily during the 1920s. Her first outfits were wool jerseys, and were very simple. She became famous for the simple look of her extremely classy outfits. Chanel stayed away from the vivid colors of many of the other designers of the time. Instead, she used blacks, navy, and tan almost exclusively. Unlike many designers who primarily made dresses and suits, Chanel also designed jackets, hats, and costume jewelry. When presenting a show, she did not have to accessorize her models with designs from other houses. Chanel designed well into the 1930s, but was forced to close her house during the years of World War Two. In 1954, she was able to reopen, and she designed until she died in 1971.   Ã‚  Ã‚  Ã‚  Ã‚  Chanel was one of the most influential designers of the twentieth century with a non-conformist and classical streak. Coco designed the definitive women’s suit, wore masculine clothes, sported a cropped haircut and flaunted a suntan when it was considered to be an symbol of the working class. In 1916, she outraged the fashion industry by using jersey at a time when it was strictly associated with... Chanel Essay -- essays research papers CHANEL  Ã‚  Ã‚  Ã‚  Ã‚  Gabrielle ‘Coco’ Chanel was born in Saumur, France in 1884. Vogue Magazine referred to her as â€Å"the couturier who takes no account of fashion, who pursues her own faultlessly elegant line in the quiet confidence that fashion will come back to her - and sure enough it always does.†   Ã‚  Ã‚  Ã‚  Ã‚  Chanel began designing heavily during the 1920s. Her first outfits were wool jerseys, and were very simple. She became famous for the simple look of her extremely classy outfits. Chanel stayed away from the vivid colors of many of the other designers of the time. Instead, she used blacks, navy, and tan almost exclusively. Unlike many designers who primarily made dresses and suits, Chanel also designed jackets, hats, and costume jewelry. When presenting a show, she did not have to accessorize her models with designs from other houses. Chanel designed well into the 1930s, but was forced to close her house during the years of World War Two. In 1954, she was able to reopen, and she designed until she died in 1971.   Ã‚  Ã‚  Ã‚  Ã‚  Chanel was one of the most influential designers of the twentieth century with a non-conformist and classical streak. Coco designed the definitive women’s suit, wore masculine clothes, sported a cropped haircut and flaunted a suntan when it was considered to be an symbol of the working class. In 1916, she outraged the fashion industry by using jersey at a time when it was strictly associated with...

Fenway Park

Some things on this earth are just magical. To some it may be the beach at sunset, to others it may be as simple as the drive to work in the morning. For me that place is Fenway Park in Boston Massachusetts. Going to a game in Fenway is a smorgasbord of delightful feelings. Even the walk up to the ballpark is some thing to behold. Walking with hundreds of passionate fans, all decked out in their red sox T-shirts, jerseys, and of coarse that iconic navy hat with the red B on it. I feel like I belong there with this organized group of strangers.There is such a since of family as I see people from the â€Å"T† car I was on and chatted with. A few hundred yards ahead I could hear a â€Å"Lets Go Red Sox† chant as people around me began to join in it became more enticing to do so myself. After all this was my team, our team, and this was our year! That was the constant attitude of a Sox fan. Just as the team would look like they were primed to make a push for the World Serie s they would lose in heartbreaking fashion and mostly to the hands of the damn Yankees. As me, my uncle, and my dad approach the park down Yawkey Way, the air is filled with a combination of smells.As you pass the sports bars the smell of beer and cigar smoke is thick in the air. As you pass a different vendors the smells of nachos and pretzels tempt you, and finally the smell of †Fenway Franks† (the ball parks signature hot dogs) hit you like a baseball. I’m not just a sports nut but a food fan too, so I enjoy the aromas as they tempt me. The robust scents of sausage and onions fill the air along with smoke from near by grills. As you walk closer and closer to the stadium you are barraged with people shouting â€Å"programs.Get you programs, three dollars out side five inside the park† and scalpers try to sell you â€Å"amazing† or â€Å"best in the park† tickets. As we near the gates I begin to shuffle in my pocket for my ticket. As I get it out I notice the cracks and pops between my Nikes and the asphalt. The sound of boiled peanut shells, plastic spoons, and the occasional lighter or beer can. The slick pavement and lunatic drivers keep me from daydreaming too much but still my mind races as I see the team’s championship banners and I think back to where I was when we won those years. I look down a gated lley that reads â€Å"players and coaches only† and I think If I was just there twenty minutes earlier I would have gotten a glimpse or even a word in with one of my favorite players. As I drift back in to reality I see several long lines at gate A this was unusual but my spirits were to high to be broken. As I slide into what looks like the shortest line my Uncle Geno grabs me and says, â€Å"let’s go† so my dad and I follow him. I was curious where we could be going and I really didn’t want to have to step out of line but I knew geno had something up his sleeve for us.Geno leads us around the perimeter of the park and to gate D. There was almost no line at this gate so we slide in easily. Geno had done it again, always the go to guy on street knowledge and somehow he knew everyone. When we make our way past countless vendor to the tunnel the crowd roars. As I step through the tunnel into the light the glare of the setting July sun hits me. When my eyes finally readjust to the light I look around and almost have trouble with my depth perception because of how big and crowded Fenway is.As we begin our treck to our seats we pass countless passionate fans I look to the scoreboard, the giant Budweiser neon sign, and to the enormous coke bottle and marvel at their size. Then there it is the† Green Monstah† the 39 foot tall left field wall and the luxurious monster seats. The crowd roars again and the home team comes out of the dugout and takes the field. I could feel the excitement as it rose to a fever pitch as my anticipation exploded and I joined i n the Let’s Go Red Sox chant. ~BPM