My Hospice Volunteer Experience Essay -- Contribution to My Community S

My first encounter with hospice was on the receiving end and I remember asking the hospice nurse that first day, â€Å"How can you do this every day?† I will never forget her answer, â€Å"Hospice is not about dying, it’s about affirming life, helping people live their last days to the fullest.† During the next several months, I began to understand how true her words were. Today, as a volunteer, those words echo in my mind each time I’m about to meet a new patient. I was so excited to get my first assignment; I had taken all the volunteer classes, listened to countless stories from other volunteers. I was trained and eager †¦until I received my assignment. Anna was a 92 years old lady with colon cancer given only a few days to live. Anna was bedridden and mute. Mute†¦none of the stories I had heard ever mentioned their patients being mute. A thousand questions came to mind along with a mild panic attack. How would I ever know what she needed? Would I know the right words? How would I give her support and companionship if she couldn’t tell me what she needed? Would I be enough? I was a nervous wreck! Getting ready to walk into Anna’s hospice room, my anxiety level was escalating. Saying a quick prayer, I asked God to help me find the right words to comfort Anna and her family. Upon knocking on her door, a young lady in her middle 20’s answered the door. Opening the door for me, she informed me Anna was her grandmother and she would like me just to sit with her and that she would return after work. And she left. No get to know you introduction here, very formal, matter of fact, serious kind of girl. No one was going to invade her space. Oh well, I thought, I’m here to help Anna, hopefully Julie will open up later. Turning my attenti... ...slightly. The disease seemed to loosen its grip on her body with each stroke. I was rejoicing when Anna’s head finally rested on her pillow, something that hadn’t happened since I had gotten there. By the time Julie returned her grandmother was ever so lightly snoring. The look of gratification and appreciation of Julie’s previously stern face melted my heart and again my eyes welled with tears. The fence Julie had built around her heart slowly disintegrated as she observed the bond I had developed with her â€Å"mom†. With a quivering voice, Julie revealed the stress and emotional turmoil of watching this devastating disease imprison the only mother she had ever known. Volunteering for hospice has been one of the most gratifying things I have done. Every patient is different and sometimes you’re just there to support the family, but every family is so appreciative.

Theories of perception

Perception is a combination of both the physiological processes involved within the senses and the way in which the brain integrates and interprets the sensory information that it takes in. The two main explanations of perception prioritise the role of one or other of these different aspects. The bottom-up theory emphasises the importance of stimulus features in perception. The visual information that reaches the eye is thought to contain sufficient unambiguous information about an object for ffective perception to take place with little further processing.Gibson suggested that light reaching the eye does so in an optic array. This provides information about such things as distance, movement and meaning. Interpretation is achieved through analysis of the information in the optic array by means of various cues such as texture gradient and horizon ratio. The former refers to the fact that the texture of an object becomes less clear the further it is away. By picking up this information an observer is able to perceive some aspects of depth. Gibson rejected the view that we erceive a meaningful environment because of the involvement of stored knowledge and experience.He claimed that the meaning of a stimulus is determined by the object's affordance, ie: the physical structure of an object gives clues as to what its' potential use. Eysenck and Keane (1990) suggest that the concept of affordances is central to Gibson's theory as otherwise he would be forced to admit that the meaning of objects is something we store in long-term memory. Gibson's theory has provided a good explanation of the generally fast and accurate perception of the environment ut it does struggle to explain why we do sometimes make mistakes, as with illusions.An alternative explanation of perception is that of the top-down approach suggested by Gregory. This sees the eventual product of perception being ‘constructed', that is, built up from a combination of stimulus information, expectations and hypotheses. The process involves making sense of all the various bits of information provided by the senses. A key aspect of this view of perception is that because of the role of the hypotheses and expectation, perception will be frequently prone to error.

Death, Dying and Other Ethical Dilemmas

Death, dying and other ethical dilemmas are issues that all Intensive Care Units (ICUs) throughout the world have to face and address. In the Current Opinion in Critical Care, Vol 16, No 6, December 2010, p. 640, Dixon-Woods and Bosk, writing on the topic of â€Å"Death, dying and other ethical dilemmas† under the journal’s section of ‘Ethical, legal and organizational issues in the ICU’, have stated that â€Å"Recent ethnographic work suggests that ethical dilemmas associated with end-of-life care in ICU clearly persist, even if clinicians are now more open about patients’ chances of surviving.An Australian study identified how decisions and actions made outside the ICU—such as proceeding with surgical procedures with very poor prognosis or admitting moribund patients who had sustained severe respiratory or cardiac arrest—led to a higher than expected rate of non-booked admissions. Staff believed these to be the result of futile inter ventions by staff outside the ICU that then resulted in ICU staff having to manage the patient and family through the dying process.ICU staff believed that this practice was detrimental to families by offering false hope of recovery, and that they were left to ‘clear up the unfinished work of medical staff’. Other studies have also documented the problems faced by staff confronted by patients whose potential for recovery is, at best, marginal, or when patients’ ‘significant others’ seek to influence ICU priorities and distribution of resources. Tensions exist between the critical care clinician’s view of the ICU as a place for caring for patients who can be salvaged, and an external view of the ICU as a place appropriate to send desperately ill, dying patients.Patients admitted to ICU despite ICU staff’s belief that they are not candidates for intensive care lead to role conflicts and other dilemmas for staff. The conflict is embedded i n whom ICUs serve, the relative ease with which non-ICU clinicians can ‘turf’ their most critical patients to ICUs, the tensions ICU clinicians experience when delivering what they believe to be futile care, and the despair that family and clinicians share when having to abandon hope. †This administrative ethics paper takes a look at the issues contained in the article of the aforementioned journal, Current Opinion in Critical Care, Vol 16, No 6, December 2010, and applies these issues to the situations faced by ICUs today and in particular, the ICU healthcare personnel at the 6-bedded ICU at the San-Fernando General Hospital (SFGH), a general multi-disciplinary 680-bedded hospital situated in the south of the island of Trinidad and which serves a catchment area of 600,000 people. Trinidad and Tobago is a twin-island republic in the West Indies, south of the archipelago with a population of 1. million people. The SFGH also has a 4-bedded HDU (high-dependency unit) . Brainstem death The future plan for brain-dead patients whose hearts have been resuscitated by doctors in the Emergency Department (ED) of the SFGH following a cardiac and or respiratory arrest at home, poses an ethical dilemma for the healthcare personnel at the SFGH. Should these patients be admitted to the ICU which has only six beds to serve a population of 600,000? Shouldn’t these ICU beds be kept for patients with potentially reversible and salvageable pathology?Emergency physicians at the SFGH defend their decision to resuscitate such patients on the grounds that they cannot predict with any certainty which patients have reversible brain function and which do not. The present practice at the SFGH to provide ventilator support for these patients in the ED instead of the ICU while tests of brainstem function are being carried out, is frequently met with severe criticisms from relatives and loved ones who claim that the best is not being, and cannot be, done for such pa tients in the ED as opposed to the ICU.And to a certain extent, this is true bearing in mind the chronic shortage of doctors and nurses in the ED. Frequently therefore, here in Trinidad, the ICU personnel have no choice but to transfer such patients to the ICU for monitoring and cardio-respiratory support. Passive Euthanasia â€Å"While active euthanasia is illegal, passive euthanasia, or allowing a patient to die naturally, is legal everywhere. Passive euthanasia includes withdrawing basic needs such as hydration and nutritional feeding† (Fremgen, 2009, p. 304).The Ministry of Health, an arm of the Government of Trinidad and Tobago, has issued a written protocol/policy for the discontinuation of life-support from patients on whom the diagnosis of brainstem death is confirmed but, for such discontinuation, written consent is required from the relatives. â€Å"The person should be pronounced dead, and there is no need for the permission of the surrogates to cease treatment, a lthough there are still questions about consent for donation† (Garett, Baillie, McGeehan and Garett, 2010, p. 253).But intensivists here in Trinidad face an ethical dilemma because forty-five percent of the population consists of people of East Indian descent who, because of their religious and cultural background, do not readily agree to the discontinuation of ventilator support from their loved ones who have been pronounced brain-dead. For similar reasons, they do not readily agree to the donation of organs while the heart is still beating, a situation that has stymied the development of transplant programs here in Trinidad and Tobago. The Surrogate’s Obligation Patient-physician relationship is at the heart of patient management. The trend over the recent years has been towards promoting patients’ autonomy. This model falls apart, however, when the patient loses decision-making capacity. Surrogacy is one means of preserving patient autonomy. Several European c ountries have recently developed laws defining the physician’s role, as well as patients’ and surrogates’ rights† (Lautrette, Peigne, Watts, Souweine and Azoulay, 2008, p. 714). â€Å"Each of the principles (the best interests principle and the rational choice principle) entails problems.The best interests principle asks the surrogate to do what is nearly impossible—to judge what is best for another. Furthermore, it does not address the fact that the interests of the patient and the interests of the surrogate may be in conflict. The rational choice principle assumes that we know what the patient would have chosen when competent and after having considered every relevant factor. This is a very broad assumption. We doubt that anyone can know what a person would have done in all circumstances† (Garett, Baillie, McGeehan and Garett, 2010, p. 2). When surrogates refuse to give permission for their brain-dead loved ones to be disconnected from the ventilator, intensivists at the SFGH in Trinidad, well aware of the limitations and constraints of the situation that exists at the SFGH, choose the ethical route and not only discontinue all drug and intravenous fluid therapy but also reduce the settings on, and oxygen therapy going to, the ventilator to as low as is possible, so as to satisfy the family that the patient has not been disconnected from the ventilator.A do-not-resuscitate order (DNR) is not only written, but is also verbally communicated to the nurses by the doctors in the event of a cardiac arrest. The Cost Factor â€Å"Critical care medicine is expensive and its high cost has been a concern for many years. † (Halpern, 2009, p. 591). Canada’s health care system, including its delivery of hospital-based critical care services, is changing due to fiscal pressures. â€Å"Critical care services should be delivered to those who can benefit from them.Limiting therapy in patients with a poor prognosis may he lp redirect resources† (Leasa and Sibald, 1997, p. 320). Trinidad and Tobago, like the rest of the world, is currently facing an economic recession and so the Government of the day has to be very prudent in its fiscal spending. The Ministry of Health which is responsible for providing the financial resources for running the health system in the twin-island republic simply does not have the money required for the provision of quality healthcare at this time.ICUs are expensive and as such all attempts must be made by all stakeholders involved in the ICU to ensure that monies spent in this area of the hospital are spent wisely, ethically, effectively and efficiently. Conclusion This administrative ethics paper took a look at various challenges faced by healthcare personnel in ICUs today as they deal with death, dying and other ethical dilemmas. Particular reference was made to the ICU at the San Fernando General Hospital, Trinidad, West Indies.

Developing nursing standards of practice Essay

These are the process for the developing nursing standards of practice Standard 1: Assessment: The registered nurse collects comprehensive data about patient’s health. Standard 2: Diagnoses: The registered nurses analyze the assessment data to determine the diagnoses or the issues. Standard 3: Outcome identification: The registered nurse identifies the expected outcomes for the patient’s plan of care. Standard 4: Planning: The registered nurse develops the plan that authorizes strategies and a way to obtain the outcomes. Standard 5: Implementation: The registered nurse implements the identified plan. Standard 5A: Coordination of care: The registered nurse coordinates care delivery. Standard 5C: Consultation: The registered nurse provide consultation to control the identified plan and effect change. Standard 5D: Prescriptive authority and power: The registered nurse uses rigid authority, procedures, treatments, and therapy in accordance with state an federal laws and regulations. Standard 6: Evaluation: The registered nurse evaluates progress towards fulfillment of outcomes. Different entities that might be involved in developing the standard practice. American Nurses Association members are the first link in developing sources (American Nurses Association, 2014). The Department of Health Scope of Practice might be involved in the development of standards (â€Å"Scope of Practice,† 2014). State boards of nursing develop standards of  care at the state level and enforce those standards. The American Nurse Credentialing Center (ANCC) work on the national level. Professional specialty nursing organizations, Educational institution, state boards of nursing and other government agencies develop standards of care. The American nurses Association and the Joint Commission on Accreditation of Healthcare Organization (JACHO) recognized standards of care. Federal and state laws, rules and regulation and other professional agencies/organizations help define standards of practice. The ANA and Joint Commission on Accreditation of Healthcare Organization (JCAHO) established nationally recognized standards of care. References American Nurses Association: Professional Standards (2014). Retrieved from http://nursingworld.ord/nursingstandards Scope of practice decision tree (2011). Retrieved from http://www.doh.wa.gov

Did the Indian Mutiny of 1857 Create the British Raj?

Did the Indian Mutiny of 1857 create the British Raj? The Indian Rebellion of 1857, which was also called the Indian Mutiny, or the War of Independence was a turning point in the history of Britain in India. However, whether this lead to the formation of the British Raj, will be explicitly explored in this essay. The East India Company traded in cotton, silk, tea and opium. They won over Bengal after gaining victory in the Battle of Plassey in 1757, under Robert Clive.The East India Company functioned as the military authority in growing sections of India, as well. By 1770, heavy taxation and other policies had left millions of Bengalis deprived. While British soldiers and traders made their fortunes, the Indians starved. Between 1770 and 1773, about 1/3 of the population died from famine. At this time, Indians also were barred from high office in their own land, which meant people like Robert Clive had more opportunities and privileges. The British considered them inherently corrupt and untrustworthy.The Company began to vigorously expand its area of control in India, making it easier for young aristocrats from Britain to exploit its potential. The British felt there were two positive economic benefits provided by the India. It was a captive market for British goods and services, and served defence needs by maintaining a large standing army at no cost to the British taxpayer. Amongst these benefits were the large scale capital investments in railways, canals and irrigation works, shipping and mining; the commercialisation of agriculture and the establishment of an education system in English.This emphasised law and order creating suitable conditions for the growth of industry and enterprise; and the integration of India into the world economy. Conversely, the British Raj are criticised for leaving Indians poorer and more prone to devastating famines; exhorting high taxation in cash from penniless people. Also, draining Indian revenues to pay for an army beyond India's own defence needs and servicing a huge debt. This was the result of the economic power left in British hands. In 1784, the Board of Control was established, this gave British Parliament he right to oversee all aspects of the East India Company. The Governor General managed the Board of Control, he was was appointed by the British Government, this meant that the British had control over the east India Company, giving them the power to impose restrictions on certain prospects. There was a great deal of racial distrust between the British and Indians living in India at the time of the British Raj. Moreover, many Indians despised the English, they felt that they were only concerned about their own Industrial Growth this made them uneasy with the new ‘Alien Rule'.Many were unhappy with the rapid cultural changes imposed by the British. They worried that Hindu and Muslim would be ‘Christianized', mainly by the missionaries. There is some truth to these statement, but there were a number of other underlying causes for the rebellion. The Indian soldiers were believed to be under a ‘double rule', both a military and religious rule, which meant the two often came into conflict, causing them vast problems. One of these problem was the cause of The Great Rebellion.The main reason the Indian Sepoys mutinied against their British commanders was because they had heard that the newly issued rifle cartridges were greased with pig and cow fat, making them unacceptable for both Hindu and Muslim soldiers. This led to a monumental outbreak, as the Muslims and Hindus rebelled ceaselessly. What started as a small conflicting group of Indian soldiers from a single regiment, soon expanded to a vast number of Indian Sepoys fighting for their integrity and freedom.Following the Indian Mutiny, the East India Company was abolished by Act of Parliament and the British crown assumed full rule of India. The British used violence and negotiation to put an end to the Uprising, resorting to merciless tactics to restore order. This created resentment, opportunity for revenge and long-term problems. They used fear to breed control, which was very disorderly. The British dispatched more troops to India and eventually succeeded in putting down the mutiny. Many sepoys who had surrendered were executed by British troops.To ensure that British rule could never be threatened in such a way again the Indian Army was reorganised so that it needed its British components to function effectively. Alternatively, the British should have dealt with this issue in a more political and diplomatic way, instead of as an act of vengeance. The conflicts of 1857 and 1858 were brutal and bloody, The bitter legacy of murder and mutilation of atrocities committed by both sides circulated in newspapers and illustrated magazines in Britain, poisoning relationships for decades.The Government of India act 1935 gave Indian provinces more independence. For the first time direct elections were introduced and the right to vote was increased from seven million to thirty-five million. The British government never actually intended to take control of India, but when British interests were threatened the government had to step in. The embodiment of the new British rule in India was the office of the Viceroy. British rule from the time after the mutiny is often called the Raj.During this period small amount of British officials and troops (about 20,000) ruled over 300 million Indians. This was often seen as evidence that most Indians accepted and even approved of British rule. Undoubtedly, Britain could not have controlled India without the co-operation of Indian princes and local leaders, as well as huge numbers of Indian troops and many others. Moreover, British rule of India was maintained by the fact that Indian society was so divided that it could not unite against the British.In fact, the British encouraged these divisions. The British embarked on a furious policy of â€Å"Divide and Rule†, fomenting religious hatred as never before. The better-off classes were educated in English schools. They served in the British army or in the civil service. They effectively joined the British to rule their poorer fellow Indians. For much of the 1800s the average Indian peasant had no more say in the way they were ruled than did the average worker in the United Kingdom.The British view tended to portray British rule as a charitable exercise – they suffered India's environment (climate, diseases) and in return they bought India a good government and economic development (railways, irrigation, medicine). On the other hand, Ruling India brought huge benefits to Britain. India's huge population made it an attractive market for British industry. In the 1880s, about 20% of Britain's total exports went to India. By 1910 these exports were worth ? 137 million.India also exported huge quantities of goods to Britain, especially tea, which was drunk or exported on from Britain to other countries. Then there were the human resources. The Indian army was probably Britain's single greatest resource. Around 40% of India's wealth was spent on the army. This army was used by Britain all over the world, including the First and Second World Wars. It was the backbone of the power of the British empire. In 1901, the British viceroy of India, Lord Curzon, said ‘As long as we rule India, we are the greatest power in the world.If we lose it we shall straight-away drop to a third rate power'. Overall, I have a mixed opinion on whether that Indian Mutiny of 1857 did actually create the British Raj. They used the same tactics the East India Company used, divide and conquer. They broke India up into small kingdoms and put a native Raj in power over that Kingdom. In this way no Raj had enough power to challenge British Rule. Therefore, I have come to the conclusion that the Indian Mutiny did in fact contribute towards strengthening t he British Raj, yet did not ultimately create it.

Cultural Quotient Essay Example | Topics and Well Written Essays - 1750 words

Cultural Quotient - Essay Example Moreover, the ultimate behavior that defines a fine line between the successful managers and the other managers is the Cultural Quotient also known as Cultural Intelligence Quotient. Like IQ and EQ, Cultural Quotient (CQ) is a set of expertise that has been proved to give the organizations a superior authority to survive in this competitive world. CQ could be defined as an individual’s capability to understand and function in an effective manner through the national and the organizational cultures (Livermore, 2010). Changes that occurred in the global business environment over last 20 years Everything in this world is changing, except for change itself. The rate at which the world has witnessed change over the past few decades is dramatic and amazing, both at the same time. The world has transformed into a global village in which everything is interrelated. Every walk of life has been influenced by these changes. The business world is mostly affected by change, in both positiv e and negative way. Factors that served as a catalyst for change are uncountable. They are numerous. However, two of the most important factors that initiated changes are globalization and technology. As Sultan and Chan (2000) have mentioned, over the last 20 years many of the changes in organization have been predominantly driven by two factors: globalization and technology. These two factors changed the entire course on how businesses operated. Globalization is somehow linked with demographic changes. These changes did affect the business world. Globalization and technology have made the customer more educated, more informed and more aware than ever before. Rapidly increasing urban societies are not only changing the whole coarse of societies, but the business within them as a whole. The increased interaction and interdependent relationship between the public sector and the private sector is also changing the whole nature of the businesses today. Technology means, innovation, new things, new designs, creativity - all these terms are synonyms for change. Businesses no longer rely on the trademark and classic products they started off with. They are continuously looking for new things that will help them to achieve competitive advantage. No longer experienced is preferred over youth. Now businesses seek fresh blood and fresh ideas. Hodgkinson (2007) holds the belief that all these changes have also altered the paradigm which businesses used to operate in. Advanced technology has brought information at the finger tips of everyone. May it be an employee or a consumer, everyone has access to information all the time. This information has served as a blessing as well as a curse for the businesses. More information means more variety and more choices. This has certainly brought a great threat to businesses who need to revise all their existing products, policies, practices according the non stopping trends of the world. The shifts of local workforce to the global w orkforce have also brought many challenges. The management practices have been altered. They are much more in consideration with the global culture than one particular culture. The world has now become a huge market where there are customers and stakeholders stretching from one corner of the world to the other. The cutthroat competition has pressured the business immensely. Business struggle is all the time to get a

What role does technology play in development Essay

What role does technology play in development - Essay Example Knowledge and technology should be considered together otherwise development is hampered. Nowadays information and communication technologies are the potential for the development. Therefore it is necessary to pay attention to distribution and application of these technologies in order to give equal rights to developed and developing countries (Wehelive, 2005, p. 39). This research paper considers technology and development with regard to information society. The works by Bell, Schumacher, Smith, Ovitt, Steinberg, Castells and others are focused on thee discussion of connection between technology and development. The majority of researchers claim that technology and development are closely connected and technology is considered to be a crucial factor in a modern society. On the other hand, inequity of technology distribution between developed and developing countries may be a drawback of development. Moreover, technological progress may be an obstacle to development. Thus it is relevant to discuss not technology, but intermediate or appropriate technology as it is suggested by Schumacher and Ovitt. Daniel Bell is focused on the study of the information society. His writings are mainly focused on three main issues: post-industrial information and workforce; the second one is about information flows; the third is focused on the discussion of connection between computers and the information revolution. Bell has always connected the society first with goods and then with services. Furthermore, Bell draws parallels between information and knowledge (Duff, 1998, p. 373). He emphasizes the significance of theoretical knowledge and its importance for a modern society. Thus Bell’s claim about the post-industrial society concerns theoretical knowledge as the only way to successful development. He suggests knowledge to be codified into symbols and be applied