Stereotyping in Nursing Care | Reflection

Stereotyping in Nursing Care | Reflection PLACEMENT REFLECTION Introduction Reflection has been defined within healthcare as the active process of reviewing, analysing and evaluating experiences, drawing upon theoretical concepts or previous learning, in order to inform future actions (Reid, 1993). A reflective practitioner often reflects on experience and is capable of reflecting-in-action, continually learning from experience to the benefit of future actions (Schon, 1983). This essay is a reflective account based on the recurrence of an incident that took place during my placements in a forensic and an acute ward as part of my mental health nursing training. This reflection is based on Gibbs (1988) definition of reflection which is shown in his reflective cycle in the diagram below. The model will be used to describe the incident, my feelings following the incident and an evaluation of my experience. An analysis of what sense can be made of the situation and thoughts of what else could have been done under the circumstances. The final stage is an action pl an for what has to be done if the incident eventuates in future during practice (NHS, 2006). In accordance with the NMC code of conduct (2008) on confidentiality, the names used for the patients are pseudonyms. Reflection in nursing is important as it generates practice knowledge, enhances the ability to adapt to new situations, develops self-esteem, leads to satisfaction and improves professional practice (Baird and Winter, 2005, p.156). Similarly, Siviter (2004, p.165) explain that reflection is about gaining self-confidence, identifying when to improve, learning from own mistakes and behaviour, looking at other people’s perspectives, being self-aware and improving the future by learning from the past. Description of the incident During my first week of placement at a forensic ward, I was cautioned to be careful of some patients whom the nurses had labelled as ‘difficult’. This was a perception I carried with me till the end of my placement, unfortunately. At one instance I was with a nurse in the office when Yosef, one of the ‘so-called’ difficult patients came to request for the patients phone to make a call. The nurse appeared to be very busy and ignored the patient. As the patient kept knocking at the window, I asked the nurse if I could facilitate the request, but I was told the patient had to wait because he has a habit of always making requests. Yosef walked away after waiting for a few more minutes without help. He was fuming and very upset. I looked at the nurse in despair as I really could not understand what he had to wait for in the first place since in my view, the request could have easily been facilitated. I felt a sense of guilt because at that moment I felt we had le t down a service user as facilitators of service. I carried this guilt with me to my second placement which was a female acute admissions ward. I found that here too, the labelling of some patients as ‘difficult’ existed. Bridget, a 59 year old patient who presented as isolative, interacting minimally with peers and staff was also labelled as such. During a ‘plan of the day’ meeting which all patients and staff are expected to attend, Bridget was surprisingly very forthright. She spoke about staff negative attitudes towards patients during the ‘any other business session’. After lunch that day, I decided to have a conversation with her. I started by introducing myself and congratulated her for being outspoken at the meeting, empathising with her on some of the concerns she raised at the meeting. This was meant to make the prospect of engaging her more appealing to her. The conversation took off slowly, but I had to adopt emphatic listening whic h according to Wold (2004, p.73) is about the willingness to understand the other person and not just judging the person’s facts. During the conversation, I maintained eye contact in order to express a sense of interest in what she was saying (Caris-Verhallen et al, 1999). To my surprise, Bridget was participative, and very pleasant throughout the conversation, dispelling the earlier impression I had been given about her. At the meeting that morning, she had mentioned nurses’ insensitivity which I wanted her to elaborate on. In her response, she said ‘Nurses must know that mental illness is invisible unlike physical illness. The therapy is not all about medication, but it is also about relationships that show warmth towards us as patients. But some nurses feel so important and insensitive; their attitude sometimes makes me feel slighted and frustrated. This can easily lead me on to kick off and explode when I shouldn’t’. She was very thankful and said she felt ‘lifted’ after the conversation. My feelings I had mixed feelings after this conversation; a feeling of disappointment and regret. The disappointment was associated with the fact that there appeared to be a thread of a culture of neglect instead of support at the two wards towards patients. My regret was borne out of the fact that I had allowed some nurses to colour my perceptions of some of the patients. It was clear after this conversation that some nurses have failed to understand and respond to the needs of some patients because they failed to form sound therapeutic alliances with patients which is an essential component of all therapeutic interventions through effective communication Stevenson (2008, p.109). It is important in a mental health setting that nurses promote a therapeutic rapport with patients that is underpinned by a sense of trust, respect and mutual understanding. According to Harkreader and Hogan (2004, p. 245) these are ingredients that would raise the patient’s self-esteem and personal growth. Even more important, according to Arnold and Boggs (2007, p.200) is the need for effective therapeutic communication which can improve the patient’s ability to function. In order to establish therapeutic nurse-patient interaction, a nurse must demonstrate caring, empathy and trustworthiness (Kathol, 2003, p.33). These involve the implementation of interpersonal skills which Johnson (2008) defines as the total ability to communicate effectively with patients and all those involved in their care. Communication is the exchange of information, and effective communication must involve both verbal and non-verbal communication through the use of gestures, postures, facial e xpressions, tone and level of volume. I had a feeling that this intervention was a good starting point to develop my communication and interpersonal skills in future. Evaluation I realised that through communication, I got to know how some patients feel about nurses and the kind of interaction that they expect would contribute to their therapy. At least, my intervention had helped to alleviate her stress to some extent, calmed her frustration and anger through the use of effective communication skills which underpins the promotion of therapeutic relationships necessary to handle aggression more effectively (Duxbury 2002). Analysis Caring which consists among other things of the provision of comfort, concern and support, the development of trust and the alleviation of stress (Leninger, 1994) is a primary duty of nurses. But arguably, caring can only be demonstrated when people interact with each other and get to understand their needs. My interaction with Bridget was part of my duty to provide nursing care, and this was achieved by putting her at the centre of the conversation by way of making her: feel listened to; feel that her concerns are being validated and not trivialised; feel emotionally supported; feel understood. A conducive atmosphere for effective communication was created which enabled her to express her feelings. The Department of Health (DH) (2004) and the National Health Service (NHS) Modernisation Agency (2003) lay emphasis on the importance of patient-focused communication between health professionals and patients. This is seen as vital to achieving patient satisfaction, inclusive decision making in caregiving and an efficient health service. Nursing literature also promotes these concepts as indicative of best practice. For example, McCabe and Timmins (2006) and Charlton et al. (2008) found that, by using a person-centred approach in the interaction between nurses and patients, care outcomes were improved in: patient satisfaction; adherence to treatment options; patient health. Effective communication is also essential to practice and improving interpersonal relationships in the workplace between professional groups and peers (Grover, 2005) Conclusion The nurse is seen as the therapeutic agent in the nurse-patient relationship. This involves the application of effective communication and interpersonal skills which can lead to a sense of safety and protection, improved levels of patient satisfaction and greater adherence to treatment options and increased recovery rates. Furthermore, a successful communication through a patient-centred approach also serves to reassure relatives that their loved ones are receiving the necessary treatment. Action Plan My action plan for future clinical practice is to avoid stereotyping of some patients, but to try to understand them as individuals and treat them with the care that ensures recovery. This can only be done by forming therapeutic alliances with them through effective communication and interpersonal skills. REFERENCES Arnold, E. C. and Boggs, K. (2007) Interpersonal Relationship: Professional Communication Skills for Nurses, Copyright  © 2006, Elsevier, London. Baird, M. and Winter, J. (2005) Reflection, practice and clinical education in Philadelphia: ElsevierChurchill Livingstone. Caris-Verhallen, W. M. C. M., Kerkstra, A. and Bensing, J. M. (1999) Non-verbalbehaviour in nurse-elderly patient communication. Journal of Advanced Nursing, 29 (4), 808-818. Charlton, CR, Dearing, KS, Berry, JA and Johnson, MJ (2008) Nurse practitioners’ communication styles and their impact on patient outcomes: an integrated literature review. Journal of the American Academy of Nurse Practitioners, 20: 382–8. Duxbury J.A. (2002) An evaluation of staff and patients’ views of and strategies employed to manage patient aggression and violence on one mental health unit. Journal of Psychiatric and Mental Health Nursing 9, 325–337. Gibbs, G (1988) Learning by doing: a guide to teaching and learning methods. Oxford: Further Education Grover, S. M. (2005). Shaping Effective Communication Skills and Therapeutic Relationships at Work, The foundation of Collaboration. AAOHN Journal, 53(4), 177-182. Harkreader, H. and Hogan, M. A. (2004) Fundamental of Nursing: Caring andClinical Judgment. Johnson, D. (2008) Interpersonal skills [onlinehttp://www.mtsu.edu/~jsanborn/iskills/interpersonal.htm[Accessed on 21 March 2014] Kathol, D. D. (2003) Communication in Kockrow, E. O. and Christen, B. L. (eds) Foundation of Nursing, Missouri: Mosby. Leninger, M. (1994). Evaluation criteria and critique of qualitative evaluation studies. (Ed.), Critical issues in qualitative research methods (pp. 95-115). Thousand Oaks, CA: Sage. McCabe C, Timmins F. (2006) Communication Skills for Nursing Practice, Palgrave MacMillan NHS Modernisation Agency (2003) Available at: http://www.institute.nhs.uk/index.php?option=com_joomcartmain_page=document_product_infoproducts_id=230cPath=67 Accessed on April 2014 Nursing and Midwifery Council. (NMC). (2008). The Code Standards of Conduct, Performance and Ethics for Nurses and Midwives. London: NMC Reid, B. (1993) But we’re already doing it! Exploring a response to the concept of reflective practice in order to improve it’s facilitation. Nurse Education Today. 13 pp. 305-309. Schon, D.A. (1983) The reflective practitioner. New York: Basic Books. Siviter, B. (2004) The Student Nurse Handbook. USA: Baillere Tindall. Stevenson (2008, p.109). Unit, Oxford Polytechnic. Wold, G. H. (2004, p.73) Basic Geriatric Nursing 3rd ed. USA: Mosby https://www.gov.uk/government/publications/amending-the-national-health-service-act-2006

Community Diagnosis Essay

CHAPTER I INTRODUCTION A community is a group of organisms or populations living and interacting with one another in a particular environment. People with common agenda, interest, or cause, who collaborate by sharing ideas, informaton, and other resources. In communty health nursing, community is the client who needs promotion and preservation of the health of the population. Community diagnosis is a means of examining aggregate and social statistics in addition to the knowledge of the local situation, in order to determine the heath needs of the community. It is a tool to disclose the hidden problems that are not visible to the community people but are being affected by them. This tool is important and has helped many communities in improving their health status. The main purpose of community health and nursing services is to improve and sustain the health situation of the community that doesn’t have access to basic health care services and to help individuals who need help to promote quality care for the whole community. This study will mainly benefit the people in Barangay 842, District VI of Manila. The researchers were optimistic that through this study they will be able to assist the community in developing measures that will enable the local residents to identify and manage their own health related problems and be able to achieve good health. Read more:  How to write a diagnostic essay of my self. Rationale This study aims to present the nature of the community of Barangay 842, District VI, Pandaca Manila thus aiding the nursing students to practice their knowledge and skills with discipline accuracy and in logical manner like contributing to the improvement of the condition of the locality. The community as the center of this study provides them to do their role in the field of health care as a responsible health nurse. It can produce data and information that can help to determine and identify needs, interest and problems of the community through joint efforts and cooperation among students and the people affected. Recognizing their needs, interest and problems of the community will enable them to plan the action needed, offer proposals, alternatives and solution and solve these problems with unity and coherence to have a better community setting. Community diagnosis provides the students exposure to the real-life situations, thus developing their decision-making skill and learn on ho w to deal on different people and situations in a right and ethical manner that we will encounter while conducting this study. It also helps them develop our knowledge, skill, attitude, cooperation, and participation on improving the condition and organizing a community and learn how to deal on a chaotic situation effectively. In addition, nursing practice in the community – The community diagnosis helps raise the level of health dissemination of the community. This will also help students to maximize our potential and to render the potential on preventing diseases, promoting health and organize and participate on the development of health plan that will benefit the community to attain optimum health to individuals, families and communities. STATEMENT OF OBJECTIVES GENERAL OBJECTIVES After two weeks of gathering information at Barangay 842, Pandacan Manila BSN level Group 1 will be able to identify their community’s health concerns and make actions towards acquiring of health resources and services. SPECIFIC OBJECTIVES 1. To assess the health condition and needs of the community and identify existing health programs and resources available. 2. To identify the health conditions that requires the highest priority and needs to be addressed. 3. To plan with the barangay officials and health care personnel a program that will help resolve the health concerns and needs of the barangay. Scope and Limitation The prioritization of the problems observed and stated by our group focused more on the gathered data from the families interviewed residing from Barangay 842. The content of the data gathered from the random sample may not be reliable enough to represent the whole community of Barangay 842. However, the study may post significance in the sense that it may be useful in determining the problems of the community. Methodology/Tools Used There are 110 family respondents which compromises of 496 individuals in Barangay 621 Zone 62, District VI,, Sta. Mesa, Manila for our Community Diagnosis. This family represents the people we interviewed. This survey will serve as the representation of the community. The main method we used to assess the problem of the community is â€Å"survey† by means of survey forms. We assess the community by asking questions through interviewing that is clear and specific that can gather exact and specific answers. In addition, we gathered data through â€Å"observing† to complete the data needed in the survey form. The survey form was adapted from the Municipal Health Department and was modified by Mr. Kenneth Joe Lovely RN, faculty member – College of Nursing of Universidad De Manila. We used a â€Å"spot-map† to locate the area for our community diagnosis. Data Gathering Procedure The community assessment was conducted over the entire Barangay 621 Zone 61, Sta. Mesa, Manila. Only 110 families are surveyed to represent the entire community. All the questions are restricted in the survey form that is made by the Municipal Health Department and modified by Mr. Kenneth Joe Lovely RN, faculty member – College of Nursing of the Universidad De Manila. All the data gathered was according to what the researchers see and hear. The history of the barangay is available at the barangay hall of the community. SETTING OF THE COMMUNITY DESCRIPTION The barangay 621 is one of the Barangay at Sta. Mesa, Manila. It has a total number of populations of six thousands four hundred forty. Juan Philip P. Manabat is the current Barangay Chairman. It is bounded at the Cordillera Street. Tagalog is their medium of communication, but as we observed there are also other languages that present in the community such as Bisaya, Cebuano, Ilocano, etc. the Barangay boundaries are 590 north, 603 east, 611 west, and 630 south. Approximate land area of more or less 6.5 hectares. Covering the streets of Jacinto Zamora Link and Valenzuela Street. The existing facilities in the community are: * Water pumps * Half courts The most common means of transportation in their street are pedicabs but some of the people that live there also use motorcycles and cars. The road of the streets are fully cemented, there are also parts of the roads that are rough roads. HISTORY OF THE COMMUNITY The Barangay 621, Zone 62, District VI of Manila was created around 1970’s through the effort of their ancestors. Their Barangay Patron is Saint Labrado which is the Patron Saint of Farmers which they celebrate every 3rd week of May in commemoration of their ancestors. COMMUNITY PROFILE The Barangay 621, Zone 62, District VI of Manila is the 2nd Barangay that can be seen when entering the Bacood Area. The best landmark of this Barangay is the Bacood Park which is within the jurisdiction of this Barangay. Barangay 621 has an estimated land area of more or less than 6.5 hectares. Covering the streets of Jacinto Zamora Link and Valenzuela Street. The boundary of the community is a river at the south near the Pandacan Bridge (Zamora Bridge). The certain spots of the Barangay started from a house near the river. Consequently, the houses were mostly were wood type houses and some are concretes. A lot of stray dogs and cats can be seen in the streets. During anytime, its an extreme hotness while as nighttime approaches, a little bit breeze of coldness can be felt. Polluted air can be inhaled due to the cars passing by. The nearest schools in the Barangay are Regina Apostolorum Academy, Tzu Chi Great Love Campus which is near some basketball courts and near the Pandacan Bridge (Zamora Bridge). Some children go to the Bacood Elementary School which is in the other Barangay near Barangay 621. Utilization of their own resources was one of the main factors in their livelihood. Sari-sari stores are the primary livelihood in the Barangay. Others also exists such as junk shops, karinderyas, pedicabs are rented for transportation purposes. The Barangay hall is just near the houses and there are Barangay tanods in yhe community, which provides safety and security. SPOT MAP * Chapter II The Community and Population Group Population of the Barangay6440 Total Families Surveyed:110 Families Total Population of Individuals Surveyed:496 Sex Ratio: (SR) Sex Ratio:= MaleX 100 Female = 251 Males / 245 Females X 100 = 102 Males per 100 Females The Families surveyed in Old Sta. Mesa St. Brgy. 621 zone 62 accounts for 110 families in whom individuals are 496, there are 251 Males and 245 Females. Using the above formula, the computed sex ratio is 102 Males per 100 Females. The sex ratio of individuals who is

Lena Baker vs Annette Lyes

The Lena Baker and Anjette Lyles are two-court cases that are very questionable in court decision. Lena Baker shot and kill Ernest B. Knight who had remove her from her home and locked in a the gristmill. Baker was sentenced to Death. Anjette Lyles was a woman who murder four people Ben F. Lyles Jr who was her first husband, Joe Neal Gabbert who was her second husband, Julia Lyles who was her former mother in law and Marcia her daughter. She was sentenced to the State Hospital for the Insane in Milledgeville. Georgia's In Lena Case, the Judge put to gun on the stand to intimidate the court to give him the verdict.Her trail lasted less than day. Even with the right to fast and speedy trail in my opinion that was to fast for the defense to cast enough doubt in any juror mind. The Judge gun influenced the jury to give him the verdict he wants. Those two alone is enough for a mistrial. The Governor granted Lena a sixty-day reprieve so that the Board of Pardons and Parole could review the case. In January 1945, the board denied clemency. Baker's execution date was rescheduled for March 5, 1945. She was taken to Reidsville State Prison on February 23, 1945.Sixty years later the state of Georgia accounted that it had made a mistake and that Lena Baker should have been sentenced to a lesser serious crime. I think that the death should be removed from the books because innocent people are sentenced to death each year. The Death pleanty here was unreasonable everyone knew what was happening was wrong but still happened. In the Anjette case, her poison four people . Anjette plan these murder out and commit them. She had her trail and was sentenced to death. She would have been the first white woman sentenced to death and people were not happy about that.The governor step in and appointed a sanity commission consisting of a psychiatrist, psychologist, and medical doctor to examine Lyles. The conclusion the team presented to the Board of Pardons and Paroles was that the pri soner was insane. The Board commuted her death sentence, and Lyles was sent to the State Hospital for the Insane in Milledgevillethe Insanity plea in this case was unreasonable everyone knew what was happening was wrong but still happened. took form Document by Mr. Sutton Word for Word. 2005 took form Document by Mr. Sutton Word for Word.

Whitman College Acceptance Rate, SAT/ACT Scores, GPA

Whitman College is a private liberal arts college with an acceptance rate of 50%. Located in the small town of Walla Walla, Washington, Whitman offers 49 majors, small classes, and a 9-to-1  student / faculty ratio. For its strengths in the liberal arts and sciences, Whitman was awarded a chapter of the prestigious  Phi Beta Kappa  honor society. Students interested in the sciences, engineering, or law can can take advantage of collaborations with top schools like  Caltech,  Columbia,  Duke  and  Washington University. Whitman also offers a wide range of options for study abroad with programs in 45 countries. In athletics, Whitman competes in the NCAA Division III Northwest Conference. Considering applying to Whitman College? Here are the admissions statistics you should know, including average SAT/ACT scores and GPAs of admitted students. Acceptance Rate During the 2017-18 admissions cycle, Whitman College had an acceptance rate of 50%. This means that for every 100 students who applied, 50 students were admitted, making Whitmans admissions process competitive. Admissions Statistics (2017-18) Number of Applicants 5,226 Percent Admitted 50% Percent Admitted Who Enrolled (Yield) 16% SAT Scores and Requirements Whitman College has a test-optional standardized testing policy. Applicants to Whitman may submit SAT or ACT scores to the school, but they are not required.  During the 2017-18 admissions cycle, 37% of admitted students submitted SAT scores. SAT Range (Admitted Students) Section 25th Percentile 75th Percentile ERW 610 710 Math 620 740 ERW=Evidence-Based Reading and Writing This admissions data tells us that of those students who submitted scores during the 2017-18 admissions cycle, most of Whitman Colleges admitted students fall within the top 20% nationally on the SAT. For the evidence-based reading and writing section, 50% of students admitted to Whitman scored between 610 and 710, while 25% scored below 610 and 25% scored above 710. On the math section, 50% of admitted students scored between 620 and 740, while 25% scored below 620 and 25% scored above 740. While the SAT is not required, this data tells us that a composite SAT score of 1450 or higher is competitive for Whitman College. Requirements Whitman College does not require SAT scores for admission. For students who choose to submit scores, note that Whitman participates in the scorechoice program, meaning that the admissions office will consider your highest score from each individual section across all SAT test dates. Whitman does not require the essay section of the SAT. ACT Scores and Requirements Whitman College has a test-optional standardized testing policy. Applicants may submit SAT or ACT scores to the school, but they are not required.  During the 2017-18 admissions cycle, 54% of admitted students submitted ACT scores. ACT Range (Admitted Students) Section 25th Percentile 75th Percentile English 26 35 Math 25 31 Composite 27 32 This admissions data tells us that of those who submitted scores during the 2017-18 admissions cycle, most of Whitman Colleges admitted students fall within the  top 14% nationally  on the ACT. The middle 50% of students admitted to Whitman received a composite ACT score between 27 and 32, while 25% scored above 32 and 25% scored below 27. Requirements Note that Whitman does not require ACT scores for admission. For students who choose to submit scores, Whitman participates in the scorechoice program, meaning that the admissions office will consider your highest score from each individual section across all ACT test dates. Whitman does not require the ACT writing section. GPA In 2018, the average high school GPA for Whitman Colleges incoming freshmen class was 3.66, and over 75% had average GPAs of 3.5 and above. These results suggest that most successful applicants to Whitman College have primarily A and B grades. Self-Reported GPA/SAT/ACT Graph Whitman College Applicants Self-Reported GPA/SAT/ACT Graph. Data courtesy of Cappex. The admissions data in the graph is self-reported by applicants to Whitman College. GPAs are unweighted. Find out how you compare to accepted students, see the real-time graph, and calculate your chances of getting in with a free Cappex account. Admissions Chances Whitman College, which accepts half of applicants, has a competitive admissions pool. However, Whitman also has a  holistic admissions  process and is test-optional, and admissions decisions are based on much more than numbers. A strong  application essay  and  glowing letters of recommendation  can strengthen your application, as can participation in meaningful  extracurricular activities  and a  rigorous course schedule. The college is looking for students who will contribute to the campus community in meaningful ways, not just students who show promise in the classroom. While not required, Whitman strongly recommends  interviews  for interested applicants. Students with particularly compelling stories or achievements can still receive serious consideration even if their grades and scores are outside of Whitmans average range. In the graph above, the green and blue dots represent accepted students. As you can see, the majority of students who got in had GPAs in the A range, SAT scores (ERWM) above 1200, and ACT composite scores of 27 or higher. Many admitted students had 4.0 averages. If You Like Whitman College, You May Also Like These Schools Stanford UniversityPitzer CollegeUniversity of WashingtonCarleton CollegeBowdoin CollegeGrinnell CollegeMiddlebury CollegeReed CollegePomona College All admissions data has been sourced from the National Center for Education Statistics and Whitman College Undergraduate Admissions Office.