Sunday, January 19, 2020

Essay on Human Nature and The Canterbury Tales -- Canterbury Tales Ess

Human Nature and The Canterbury Tales  Ã‚     Ã‚  Ã‚   When Geoffrey Chaucer undertook the writing of The Canterbury Tales, he had a long road ahead of him. He intended to tell two stories from each of thirty pilgrims on the way to Canterbury, and then two more from each pilgrim on the way back from Canterbury. Of these, he completed only twenty-four. However, in these tales, Chaucer depicts both the pilgrims and their stories with striking realism. In "The Nun's Priest's Tale," "The Canon's Yeoman's Tale," "The Friar's Tale," "The Reeve's Tale," and "The Cleric's Tale," Chaucer demonstrates his remarkable insight into human nature. By comparing and contrasting these tales, one can see the universality of human nature as shown by Chaucer. One human trait apparent in these selections is greed. Avarice drives the hearts of many men, whether they may be a common miller or a summoner or a supposedly religious canon, and Chaucer was aware of this. In the tales which contain these three characters, Chaucer depicts the greed of these characters. The Reeve tells his fellow pilgrims in his tale of a miller who "was a thief ... of corn and meal, and sly at that; his habit was to steal" (Chaucer 125). The summoner in "The Friar's Tale" "drew large profits to himself thereby," and as the devil observes of him in this tale, "You're out for wealth, acquired no matter how" (Chaucer 312, 315). The canon in Part 1 of "The Canon's Yeoman's Tale," as well as the Yeoman himself, had been driven by the goal of converting base metals into gold, and "though we never realized the wished conclusion we still went on raving in our illusion" (Chaucer 478). The second canon of which the Yeoman speaks is many times worse than his own canon and mas ter, using h... .... Works Cited Balliet, Gay L. "The Wife in Chaucer's Reeves's Tale: Siren of Sweet Vengeance." English Language Notes 28.1 (1990): 1-5. Baylor, Jeffrey. "The Failure of the Intellect in Chaucer's Reeve's Tale." English Language Notes 28.1 (1990): 17-19. Chaucer, Geoffrey. The Canterbury Tales. Trans. Nevill Coghill. Baltimore: Penguin Books, 1960. Dictionary of Literary Biography: Old and Middle English. Ed. Jeffrey Helteman and Jerome Mitchell. Detroit: Sale Research, Inc., 1994. Edden, Valerie. "Sacred and Secular in the Clerk's Tale." The Chaucer Review 26.4 (1992): 369-376. Fehrenbacher, Richard W. "'A Yeerd Enclosed Al About': Literature and History in the Nun's Priest's Tale." The Chaucer Review 29.2 (1994): 134-148. Whittock, Trevor. A Reading of The Canterbury Tales. Cambridge: University of Cambridge Press, 1970.      

Saturday, January 11, 2020

Wound Care

Program Evaluation: Wound Care Center The Methodist Hospital offers a Wound Care & Hyperbaric Medicine Program which works closely with patients and specially trained physicians (2010). The program focuses on monitoring, management, and treatment of chronic and non-healing wounds (TMHS, 2010). Non healing wounds affect a large number of the populace and prevent people from leading an active life. Researchers report new technologies are altering the process in which chronic wounds are treated. More options for wound treatment are available today than previously available. Bio-engineered skin substitutes, specialized dressings and the latest compression wraps are a few of the more recent methods for wound treatment. The Methodist Hospital's Wound Care & Hyperbaric Medicine Program offers state-of-the-art technologies and advanced wound care techniques to effectively care for non-healing wounds. Evidence depicts that a wound that has not healed in over a month should not be overlooked (CDC, 2009). The TMHWC program uses a team approach to promote advanced wound healing. The first step of healing for patients enrolled in the wound care program is a methodical evaluation by a wound care physician. There is a huge need for quality wound centers. Non healing wounds and excessive management cost health care centers a substantial amount of money each year. According to Pompeo (2010) health care organizations want well-organized and precise figures to decide which cost effective wound care services to propose. The difficulty with chronic wounds is that it is very demanding on staff within a hospital’s organization (Shai & Halevy, 2005). The burden of chronic wound management is constant and an evaluation is necessary in an effort to prove the importance of maintaining The Methodist Hospital Wound Center. The purpose of this evaluation is to examine the wound care program at The Methodist Hospital in Houston Texas. This evaluation will provide the history and overview of the root source for chronic wounds and the effectiveness of treatment of those wounds. This evaluation will also comprise a review of the programs patient population, chronic wound diagnoses, primary diseases, treatment devices, as well as costs associated with the health care organization. The assessment will expand the findings of the previously submitted needs analysis for the healthcare organization expansion of services. The components of the proposal are consistent with the organizational mission, values and vision. Background The Methodist Hospital's wound care Treatment Center came to exist from a meeting between several surgeons at a wound care clinic in Southeast Texas. The physicians were discussing a patient who had suffered with wounds for a number of years. The physicians were interested in increasing improving the credentialing and recognition of wound care services. The Wound Care Center was founded and incorporated in 1990 as an extension of The Methodist Hospital. The Methodist Wound Care Center is dedicated to the multidisciplinary team approach in promoting the science of prevention, care, and treatment of acute and chronic wounds. Today the Methodist Wound Center continues to offer treatment and intervention for chronic wounds. The Methodist Wound Center is an independent center staffed and funded by The Methodist Hospital. A chronic wound has an appearance of one or more underlying conditions which become evident on the skin. Chronic wounds are reported to have the following etiologies (Krasner, 2001): pressure, venous, arterial, diabetic, ischemic, cancer, and end-of-life. A chronic wound entails intervention by numerous health care authorities to address the many conditions and co-morbidities that impact future prognosis and healing. Mission The mission of The Methodist Hospital's Wound Care Center is to provide a full range of the highest quality, outcome oriented physical therapy services for a variety of patients with wounds. The Methodist Hospital Wound Care Clinic team of specialists works together for improved healing rates and fewer amputations in chronic wound cases. In the course of treatment, the clinics aim is to prevent prolonged or permanent disability and reduce hospitalizations. Vision Statement Where people want to work, where physicians want to practice, and most important, where registered patients want to go when they need healthcare services. The vision statement sets specific goals in objective terms, and a time frame for the goals to be met (Pelland, 2009). Literature Review Webster's New Riverside University Dictionary (2010) defines an ulcer as an inflammatory, often suppurating lesion on the skin or an internal mucosal surface of the body, as in the duodenum, resulting in necrosis of the tissue. Dorland's Medical Dictionary (2010) describes an ulcer as a local defect or excavation on the surface of an organ or tissue which is produced by sloughing of inflammatory necrotic tissue. Wounds that do not respond within the expected time frame are defined as chronic wounds or ulcers (Wollina, Hansel, Kronert, & Heinig, 2010). Chronic wounds are contributed to primary diagnoses which slow down the healing process and may sometimes result in death (CDC, 2007). The first step in conducting a needs analysis for the Wound Care Center is to identify the services most in need of support. A review of the number of referrals for different services could direct an initial effort. Networking with practices that have already implemented similar services may be of assistance. Performance measures must be in place for monitoring program success. Performance measures should assess for method reimbursement and sustainability, patient and provider satisfaction, treatment outcomes, and areas for improvement (Lockamy & Smith, 2009). Development of standards makes ease of operation with other systems a reality and are necessary for efficient operations (Spivack, 2005). Principles to be considered in selection, implementation, and evaluation are patient satisfaction, strategic alignments, process management, performance measurement, and project management (Lockamy & Smith). Developing community and governing commission liaisons will strengthen the chance of program implementation success (Dick, Manson, Hansen, Huggins, & Trullinger, 2007). The CDC (2009) reported that over 25 billion dollars is spent annually to govern the management of non-healing wounds. Each year seven million Americans are diagnosed with at least one type of chronic wound. The incidence rate of chronic wounds ranges about ten percent annually and is contributed to the current increase in age of the populace. Stages of Wound Healing There are three phases of wound healing (Fishman, 2008). First, there's phase one-the inflammatory phase, which immediately begins and is active for the first five days of injury. The inflammatory phase generates coagulate from vaso-constriction, platelet aggregation, and thromboplastin formation. The proliferative phase is the second stage of wound healing. This phase transpires up to three weeks after injury. Granulation, contraction and epithelialization draw the ulcerated edges together in an effort to reduce the deficiency (Fishman, 2008). Stage three of wound healing is sometimes defined as the remodeling phase. The modification stage last up to two years. Collagen is formed, which increases the overall vigor of the wound (Fishman, 2008). There are three types of cost analyses. They are cost-effective analysis, cost-benefit analysis, cost-utility analysis and cost-utility analysis. They are aimed at reducing the wastage of resources in invalid methods by getting the advantages of use of a particular activity with the value in terms of cost. People with diabetes are more prone to developing ulcers on their feet. Decreased sensation and a lack of circulation lead to this problem. The best way to prevent ulcers from forming is by performing a daily foot inspection. The three are not mutually exclusive in their use and can be used in any one particular situation though in different stages of the pyramid. An example is the use of exercise as a cost-effective means of tackling diabetes. In one of its many advantages, the exercise does not only help manage the diabetes but other conditions are catered for in the primary stage. This includes, stress reduction and hypertension which may be additions to the disease. There are many benefits of using exercise to various diseases like the cardiovascular types. The use of exercise is implemented in the third stage, tertiary stage that will include the treatment or management of the disease. It helps in burning down the excess calories in the body. (Hatziandreu, E. , 2003) Wound Center Protocol Patients undergo an inclusive physical upon admission to the wound care center. The work up plan for wound care consists of physical evaluations, blood work, Xrays and wound assessments. Medical staff meets daily to discuss the best plan of care for the patients. The treatment protocol Centers which practice systematic ways to develop wound treatment provide excellent care, including evidence based treatment protocols which lead to superior clinical outcomes (Fishman, 2008). The Methodist Hospital's Wound Care Center treats and takes care of the wounds at any part of the body including sacral, abdominal and even in the lower extremities. The center treats all types of wounds caused by burns and pressure, diabetes, radiation and vascular diseases. The centers protocol is to treat all chronic wounds until they heal as well as prevents recurrence and preserve limbs. The center’s staff does not only treat but also monitors wounds teaches prevention ways such as eating proper nutrition among other specialties. Program Objectives The American Physiological Society (2010) website indicated the evaluation provides formative feedback that helps guide a program as it is being implemented. It also provides summative data that clearly demonstrates that the program is accomplishing its stated goals and objectives. Without an efficient evaluation, the program personnel may be unsuccessful with regard to documentation of impactful program issues. The Wound Care Center employs five full time registered nurses, certified in wound care. The center also employs three administrative personnel, including the clinic administrator. The wound care center employees several medical staff physicians, including a podiatrist, 2 general surgeons and one plastic and internal medicine. The treatment of chronic wounds and research on the pathogen has been going on for many years now. Despite the effort, a large number of people still face the problem when it comes to wound care. A number of people have named lack of integrative perspective in research methodology as a critical issue facing wound care centers (Singhal, Reis, and Kerstein, 2001). Researchers do not view treatment of wounds holistically but have focused on efficacy and safety of specific therapies. The Methodist Hospital's Wound Care Center objectives are to continue with single treatment investigation in addition to pursuing an integrated approach to the mechanisms of wound healing. Integrated approach deals with the physiological activities that make a wound heal or not heal based on the fundamental activities. Study design This study design is pertinent to an evaluation of the wound care center and the subsequent hospital visits from patients subsequent to discharge. The study design for this research is quantitative and the population will be those patients who required treatment at the Wound Center within the last 24 months. The study will use data from Method admissions data base to calculate the number of patients. The system will also track the number of patients returned to the center. Quantitative designs require a prearranged selection of variables. Quantitative designs clarify the result of an experiment, a correlation testing, and often involve the acceptance or the failure to rejection the null hypothesis (Sproull, 2004) using statistical formulas and hypothesis testing with a significant randomly selected sample that represents the population (Creswell, 2004). Sample Patients who are currently admitted in the wound care center and scheduled for discharge within the next 30 days will be the population for this study. The population will be reviewed and counted from the Method’s computer system. We will aggregate the data of all patients admitted and discharged from the last 24 months. The selection process can be described as systematic sampling. The specificity of the items in the database is controlled by change. The series of items is compiled from the medical record number and is tracked over the last 24 months. The advantage of systematic sampling is that, unlike simple random sampling, a designated number does not need to be assigned to every item. Most patients have been discharged from the program because the wounds have healed or they have transferred to other wound care facilities. Recruitment of Participants. This evaluation will not require an excessive amount of contact with participants. There will be no questions or surveys provided to the participants. An option for this evaluation is to review the data in Method and analyze the discharge and monitoring of each wound care patient. MethoD is the computer admitting database which reports on all admitted patients to any program within the institution. Methods The research study objectives is to identify chronic wound services that need most support, to review the number of referrals and to determine the favorable ways of treating, preventing and controlling chronic wounds. The study uses quantitative data from The Methodist Hospital's Wound Care Center computer records. The study will use a systematic sampling of all the patients that have been treated for wound in the last 24 months. The study will record all the patients who have visited the hospital with wounds, it will determine their age, sex and the type of wound they were treated on. The study will also record how many times the patient has been treated and when the wound healed and if it did not heal the preventive advice given to the patient. The methods of data collection will be observation and investigations of medical records. The prearranged selection of variables includes age, sex, type of the wound and the duration it takes for the wound to heal. The correlation testing will be used to find out if there is a relationship between persons age and time the wound takes to heal or the type of the wound and the sex of a person. The study will apply statistical model of wound healing rates because it predicts the actual healing of the wound. The statistical model does not impose a fixed methodological structure on the healing structure such as time but monitors the progress and actual behavior of the wound (Kumar, 2007). Data Analysis The results obtained from the centers medical records and analyzed by Method’s computer system showed that the center had received quite a number of wounded patients. The computer software showed that 3-4 people out of a hundred people who visited the hospital were wounded. An estimate of 20-30% of the hospital beds were occupied by patients with wounds a big percentage being patients whom had acquired wounds during hospitalization. Pressure ulcers obtained during the period of medication is the major cause of chronic wound affecting an estimate of five inpatients. The results also showed that 5% of patients died after contracting surgical wound infection during the period. The result statistics indicated through tables and graphs drawn using method computer programs showed that chronic wound were caused by a number of factors such as immobility which usually affected patients on hospital bed causing bed sores and pressure ulcers. The other factors included diabetes, trauma, poor circulation and vascular disease (Stillman, 2010). Diabetes was the major cause of developing a chronic would as statistics showed as 20-50% of people with diabetes had the risk of contracting . Wounds can also be caused by other causes namely unhealthy nutrition, ill-fitting shoes, hygiene and lack of exercises. A big number of people obtained wounds after falling. The research study used a new statistical model that combines both the wound’s size wand the time of closure. This was because it was not easy to determine the actual time that most patients would heal after they were released from the hospital. Methodist Wound Care Center just like other hospital and clinical centers released their patients after their wounds closed after giving them advice on proper preventive measures. The model analyzed the wound size against time. A graph drawn should exhibit negative correlation, that is, as time goes the size of the wound reduces in order to indicate healing. Implications Meta-analytic review of wound healing processes showed that the duration a wound took to heal depended on the type of treatment given and the size of the wound. A large number of wounds do not heal completely but only undergo a process called closure. It is therefore not easy to calculate the correlation between the size of the wound and the duration it takes to heal completely. The statistical approach therefore calculated the time of closure as the healing of the wound. Studies have shown that there are four major stages of healing. A normal would heal even before stage IV but a chronic wound that progresses to stage IV may have serious implication that may lead to amputation (Columbia University Medical Center, 2007). Stage IV is usual the wound closure as it involves formation of a new skin and scarring but it does not mean the wound is completely healed. The data analyzed showed there was a negative correlation between the time of closure and the size of the wound. The size of the wound decreased as time the patient undertook treatment increased. This was a measure that healing process was taking place. While 45% of the patients admitted in the hospital for the given period showed a healing trend, some patient’s wounds did not heal regardless of the time frame. In fact some small wounds grew in size as time progressed. The study results did not indicate a linear relationship since some wounds grew in size as time progressed while others became smaller as time increased. The study results showed a non-exponential Gompertz-type model that shows specific differences and variations in individual wound behavior. Monitoring The modified Gompertz-type model was the best for monitoring and evaluating the healing process of the wound as it applied to all types of wound (both the ones that healed and the ones that did not heal). The model has advantage over other models as it could predict the rate of healing based on the treatment and similarity of wound type. Healing involves tissue healing and wound closure. The study model monitored all the patients that had visited the hospital in the last 30 days to determine which stage of healing process they were in. Generally the healing process involved four phases namely inflammatory phase, proliferative phase, remodeling phase and epithelialization(Hess, 2005). All the wounded patients for the last 30 days were monitored and the phase they were in recorded. The wounded patients that had already visited the hospital in last 24 months were expected to be at various phases depending on the size and type of the wound. A table was thereafter recorded and graphs drawn to analyze the data in order to gain conclusive results of the study. A normal wound requires 3-4 days to be at the epithelialization phase where another layer of skin form leading to scarring (Sussman and Bates-Jensen, 2007). Some wounds take more than that depending on the size of the wound. The research study was given 30 days period in which to monitor the phases of patients wound in order to get conclusive results. A table was set up for all the wounded patients, the time they were admitted and the time they underwent all the four phases. At the end of the one month period a time table was prepared that showed the time period and the number of patients at a particular phase.

Friday, January 3, 2020

Stopping Teen Pregnancy and STDs - 595 Words

What does it take to stop teen pregnancies and the spread of STD’s? Sex education in school is a major controversial idea around the world. Tolerance is when people deal with or accept something even though they may not agree with it. Sexual education in school is based on what students need to know to be protected. The schools that do not teach sexual education, teach the idea of abstinence. Abstinence is the idea of retaining from any sexual activity to stay â€Å"pure† until marriage. Schools focus on teen pregnancies, STD and HIV prevention, dating violence,body image, and healthy relationships. Sexual education in schools is a occurring problem in society over the years. The early part of the 1912 teachers were being trained to teach sexual education in schools. In 1940 the health and safety department highly advocated sex ed in schools but by the 1960’s the controversy sexual education in had started (Pardini). Sex education slowly started to stop being sex education it was being turned into abstinence only programs. 1998, twenty percent of states retained to teaching abstinence and fifty-one bills were being considered by state legislatures. Congress committed 250 million dollars from federal funds over five years to promote abstinence until marriage in 1996. â€Å"By the 1970’s, legislatures in the 20 states had voted to restrict or abolish sexuality education.† (Donovan). Sex education has slowly progressed to being a problem in society. Sexual education in societyShow MoreRelatedEssay about The Issue of Sexually Active Young Teens713 Words   |  3 Pagesregarding sexually active young teens. It seems that almost every teen is sexually active. They are having sex at such a early age. A question that rings in our minds, is do they truly even know what sex is? Growing up, Catholic teachings instructed myself to wait until marriage. They say premarital sex is a sin. Now, not only are churches teaching abstinence, but, schools as well. Premarital sex is a important growing problem: that usually results in a unwanted pregnancy, in some cases; forced abortionRead MoreSex, Drugs, And Pressure1065 Words   |  5 PagesRelationships are different than they used to be. There not caused by love at first sight at the homecoming game, there caused by getting drunk at a party and ending up making out or worse. Relationships these days are determined by how much they do. If teens are having sex they must be in love. People donà ¢â‚¬â„¢t realize that you don’t have to have sex to be in love. You should love the person to have sex but you don’t need to have sex unless you are married to that person and are dedicated to spend the restRead More Comprehensive Sex Ed. Programs vs. Abstinence Only Programs Essay2818 Words   |  12 Pagesrealized by abstaining from sexual activity; teaches abstinence from sexual activity outside marriage as the expected standard for all school age children; teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems, teaches that sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects; teaches that bearing children out-of-wedlock is likelyRead MoreEssay on The Effects Alcohol Has On Teens1431 Words   |  6 Pages Nearly 25 percent of teens drink alcohol because they think it is fun; however the problems it may bring are not so fun (Hyde 22). There over six times more teen deaths per year from alcohol than any other drug (O’Malley 30). Alcohol affects the body of teens as well as all of the developmental processes. A major issue of teens drinking is that it increases the chance of becoming an alcoholic in the future; which leads to lowered self-control, impaired judgment, and lowered inhibition (Heath 12)Read MoreThe Oldest Profession in the World Essay2135 Words   |  9 Pagesto society in the spreading of sexually transmitted diseases (STD’s). Sexually transmitted diseases are various infectious diseases that are transmitted through sexual intercourse or other intimate sexual contact. Although society has a variety of viewpoints on the practice of prostitution, it an increasing trend that is detrimental to society. Prostitution has issues regarding legal standpoints on the bu siness, the rapid spread of STD’s throughout the human environment, and the morality issues of

Thursday, December 26, 2019

William Shakespeare s Hamlet - Conversation Enabler

Conversation-Enabler In Shakespeare’s Hamlet, Ophelia is one of the most elusive characters of the play and her importance is very hard to pinpoint and has raised eyebrows for centuries. For example, the scene of her death is one that artists have depicted over and over, yet that iconic moment is merely alluded to and happens off stage. This reflects Ophelia’s character very well considering that she is often at the periphery of the action; more talked about then talked to. There are many questions surrounding Ophelia and many interpretations to her character. Is she as virtuous as her father and brother want her to be? Does her madness really drive her to suicide or is her drowning actually an accident? Is she more than a pawn? All of those are at the back of the reader’s mind when Hamlet is concerned and her importance can easily be questioned considering how little is known about her. Yet, despite the lack of information about her and her past, and despite how very small her actua l presence in the play is Ophelia remains essential if not to the audience, then at least to the characters surrounding her. She serves as a conversation-enabler in relation to many of the chore themes of the play. Ophelia might be a very passive character, but by her mere presence she allows themes of suicide, madness, and grief to be pushed further by the protagonists that surround her. Both because of what happens to her and because of the way people around her react to those events, Ophelia

Wednesday, December 18, 2019

Accounting Midterm Essay - 1760 Words

ACCT112 Midterm Assignment – Week 9 Due at the end of week 9. There are 70 marks. This assignment is worth 20 % of the total grade. True or False: (15 Marks) 1. In spite of its weaknesses, the cost principle is most often used because it is the most reliable basis of valuation. TRUE 2. The going concern assumption assumes the company will continue to operate for at least two years. TRUE 3. The economic entity assumption states that economic events can be identified with a particular unit of accountability. FALSE 4. The monetary unit assumption states that transactions that can be measured in terms of money should be recorded in the accounting records. TRUE 5. The drawings account is a subdivision of†¦show more content†¦d. Debit a revenue account for $500. 9. A furniture factorys employees work overtime to finish an order that is sold on February 28. The office sends a statement to the customer in early March and payment is received by mid-March. The overtime wages should be expensed in a. February. b. March. c. the period when the workers receive their cheques. d. either in February or March depending on when the pay period ends. 10. Jacob’s Company has a June 30 year end. On June 28, Jacob’s provided consulting services to Jennings Company. Jacob’s billed Jennings on July 2 for $800 related to these services. On July 5, Jennings paid the invoice in full. Jacob’s only cost related to this sale was $250 in salaries expense. Jacob’s paid the salaries on July 3. Assuming Jacob’s Company has a June 30 year end, the company’s profit for the Jennings’ job on the June 30 financial statements should be a. 0. b. $800. c. $550. d. $250. 11. Under the accrual basis of accounting a. cash must be received before revenue is recognized. b. net income is calculated by matching cash outflows against cash inflows. c. events that change a companys financial statements are recognized in the period they occur rather than in the period in which cash is paid or received. d. the ledger accounts must be adjusted to reflect a cash basis of accounting before financial statements are prepared under generally accepted accountingShow MoreRelatedCost Accounting Midterm2751 Words   |  12 PagesADM 3346A COST ACCOUNTING Solution Fall 2010 Midterm Examination STUDENT NAME: _________________________________________________ STUDENT NUMBER: ________________________________________________ 90 minutes INSTRUCTIONS 1. 2. 3. 4. Books and notes are not permitted, except language dictionaries. Non programmable calculators are permitted. Put all answers in the question booklet Questions concerning possible errors in the exam only will be answered. 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Be sure to put your answers to the multiple choice questions on your ScantronRead MoreAcct 301 Midterm Exam Solution Perfect Score604 Words   |  3 PagesACCT 301 Midterm Exam Solution Perfect Score (TCO 1) Which pair of accounts follows the rules of debit and credit, in relation to increases and decreases, in the same manner? (TCO 2) Which of the following is not part of the recording process? (TCO 3) Two individuals at a retail store work the same cash register. You evaluate this situation as which of the following? (TCO 4) The retained earnings statement shows all of the following except which one? (TCO 5) In the annual report

Tuesday, December 10, 2019

Nursing Staff Perceptions Regard Physician -Myassignmenthelp.Com

Question: Discuss About The Nursing Staff Perceptions Regard Physician? Answer: Introduction Communication skills are crucial in the process of implementing effective nursing practices. A transparent and effective course of communication helps in understanding the patient dilemma. Additionally, some of the therapeutic communication approaches provides the patient with sufficient autonomy in invoicing their individual opinions regarding the care services (Gausvik et al. 2015). It is one of the pivotal aspects of establishment of patient care approach where the patients are placed at the centre of the support and care services. The assignment explores the affectivity of communication skills in delivery of enhanced care and support services. In this respect, Mrs. Forks is a lady admitted to the hospital with hypertension and has received normal reports for most of her medical tests conducted. However, during my interaction with Forks I found her muttering to herself. She has overheard the conversations between me and a fellow nurse and that we were wishing that she leaves soon as there is more number of patients than hospital beds. In order to meet Ms. Forks needs I should have in the first place consulted the general physician attending to her. Therefore, in case if any future discrepancy in relating to Ms. Forks condition I will consult the healthcare professional and the attending to her as well as the staff nurse in charge of her care so that they could help me understand the treatment plans used with her so far. Yes, I think I should taken initiatives to clear the misunderstanding of Ms. Forks by explaining it to her that we were only discussing the conditions of the ward as felt equally responsible and committed towards her care need. I think I need to excel my time management skill as I provided too little time in my interactions with Ms. Forks. Some of my interactions could have been more detailed. As commented by Lum et al. (2015), maintaining transparency in communication can provide the patient with more autonomy in decision making. I dont think I did not reflect much on the information collected for taking supportive sessions of Ms. Forks as I totally missed that Ms. Forks has movement disabilities and could not drive herself to the attending physician for routine check up two times a week. Yes, I think I respond to cues from Ms. Forks appropriately. During my interaction with Ms. Fork I found that she is an 82 year old woman living on own without any family and children. However, she had been admitted to the hospital with complain of hypertension. Though, she has received nil or no abnormality in most of her medical records. However, she needs to be under constant treatment and supervision. During my interaction with her I have found that though she is deaf. However she lacks sufficient amount of consciousness with regards to the medications. The major issue though highlighted by her over here is difficulty in walking which could make visiting the chamber of the general physician two times a week difficult for her. A very simple consultation method has been used by me for dealing with the case scenario of Ms. Forks that is by simply taking down notes. As a nurse attending to the support care of Ms. Forks I have been actively using health information related to Ms. Forks for important health decisions. Effective team negotiation and networking is required in order to collect important cues regarding the patient (Brand et al. 2015). In this respect, I was mainly dependent upon the datasheets provided to me. However, in order to extend after discharge care services to the patient I would need to negotiate with the home care organization as well as her doctor for scheduling future appointments. I think I was quick in negotiating with Ms. Forks, though I should have put more effort into knowing the medications subscribed to the patient. This is because it would have otherwise lead to serious health implications as Ms. Forks was provided with wrong medications. In order to prioritise the care regimen of Ms. Forks I need to reflect upon her present health condition in details. I also need to consult with a number other channels such as doctors and home care organizations. Thus, conducting a comprehensive assessment will help me reflect upon the loopholes in Ms. Forks. Additionally, use evidence based communication tools such as SBAR (Situation, Background, Assessment, Recommendation) for understanding the problem situation faced by the patient could also be an effective measure (O'hagan et al. 2014). It will also facilitate the handover process. For effectively managing my time for the care of Ms. Forks I need to divide my task into top priority and mid priority basis. This will help me in looking after the care concerns of the patient. I think I should have done my research well before I could interact with Ms. Forks. I felt in certain areas I could have been more proactive while dealing with the patient. For instance, the wrong medications being provided to Ms. Forks would have totally missed my mind had she not pointed it. Therefore, I will need to be more careful from next time onwards. I think insufficient communication between the members of the care team employed to look after Ms. Forks would have resulted in falsification of the identification of the patient. Nursing entry in the progress notes PROGRESS NOTES Date Nursing Entry: APIE framework Assessment (A)- the patient showed normal reports which were all marked NAD (no abnormally detected) Planning (P)- the patient was supposed to attend routine check up two times a week Implementation (I)- the home care organization professional was supposed to drive the patient to the doctors chamber provided here movement difficulties Evaluation (E) - the patient would need to undergo a blood test for doing her lipid profile which will help in understanding her recovery rates Conclusion The current assignment focuses on the aspect of implementation of effective communication approaches within a healthcare setup for understanding the problem situation of the patient. In this respect, the patient though on her discharge was providing with wrong medications. Therefore, such as negligence on the part of the healthcare providers could have serious consequence. Therefore, implementation of effective evidence based communication tools such as SBAR could help in the addressing the different health parameters. References Brand, S.I., Slee, K.M., Chang, Y.H., Cheng, M.R., Lipinski, C.A., Arnold, R.R. and Traub, S.J., 2015. Team strategies and tools to enhance performance and patient safety training: The effect of training on both nursing staff perceptions regarding physician behaviors and patient satisfaction scores in the ED.Journal of Hospital Administration,4(2), p.48. Gausvik, C., Lautar, A., Miller, L., Pallerla, H. and Schlaudecker, J., 2015. Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction.Journal of multidisciplinary healthcare,8, p.33. Lum, L., Dowedoff, P., Bradley, P., Kerekes, J. and Valeo, A., 2015. Challenges in oral communication for internationally educated nurses.Journal of Transcultural Nursing,26(1), pp.83-91. O'hagan, S., Manias, E., Elder, C., Pill, J., Woodward?Kron, R., McNamara, T., Webb, G. and McColl, G., 2014. What counts as effective communication in nursing? Evidence from nurse educators' and clinicians' feedback on nurse interactions with simulated patients.Journal of advanced nursing,70(6), pp.1344-1355

Monday, December 2, 2019

Zoos, Do We Really Need Them Essays - Zoos, Animal Welfare, Zoo

Zoos, Do We Really Need Them? Do Zoos Positively Affect the Welfare and Conservation of Animals What are Zoos: A Zoo is a place where animals are put in captivity and display, where people can view the animals. The Zoo, which is short for Zoological Park or Zoological Garden, houses a wide range of animals. Most of these animals are native to certain parts of the world. Zoos also habit endangered animals, which the zoo takes in to help with the conservation of the most endangered animals around the world. [1] Against Zoos: Captivity often makes animals crazy --- When animals, especially animals not born in the zoo and captured from the wild, are introduced to Zoos (especially Zoos with a low budget) with small enclosures, cramped spaces, and virtually no privacy, they have very little opportunity to exercise and keep their minds active. For example, In the wild, elephants are known to travel up to 50km a day while migrating, bears are active for up to 18 hours at a time every day by exploring their home ranges for up to hundreds of kilometers , and tigers and lions often run, climb and roam throughout their environments and travel many kilometers to hunt. Animals imprisoned in enclosures may suffer from a condition known as zoochosis , a condition similar human madness, where the animal act strangely and even injure themselves over frustration and boredom. This behaviour is mainly observed in animals that have close-knit communities, such as Gorillas or Elephants. [2] One of the main problem with Zoos is that animals that are usually in the travel thousands of kilometres to migrate and move around a lot. When they are brought into an enclosed space, it would take a long time to adjust to the new environment they are placed in, and they would be extremely stressed out from the adjusting experience. An example of this would be Elephants. Elephants travel thousands of kilometres when migrating and they more around a lot to find water and food etc.They are very social creatures living in very large families of up to 100 other elephants. When held in captivity, the limited space and only one or two other elephants, which they might not even be compatible with, causes them huge stresses and anxiety, which shortens their lifespan. Elephants in the wild are expected to live for up to double the years that an elephant in captivity or natural wildlife preserves would be expected to live for. African Elephants living in Amboseli Natural Park o f Kenya has an average lifespan of around 36 years, compared to African Elephants in Zoos which live up to 17 years old. [4] Other huge problems with Zoos are the high costs, not only to buy them and bring them into the zoo but also for maintenance of the already residing animals in the zoo. Zoos may close down as the lesser income from visits by customers and other funds may not be able to pay for the high maintenance costs or make a profit from the income of the zoo. This leads to animals getting divided to be sent off and accommodated by other Zoos, animal rescues, or getting sold off to cover any debt the affected zoo may have. What's worse, the animals do not always go to people with the animal's best interests in mind, and for this reason, Zoos are not only harming the lives and welfare of the animal, but also the livelihoods of the staff working in the zoo. [3] For Zoos: In the wild some animals, especially on the IUCN Red List of Threatened species, have a very low survival rate in their environment. Animals in the wild are subjected to predation, not only by other predators but poachers. These poachers hunt tens of thousands of endangered animals for their very valuable skin, bones, meat and other by-products. Some animals may find other problems such as pollution, destruction of habitats, high level of competition for food, over-predation, diseases and other reasons. Zoos help these animals by taking them in and looking after them. In Zoos, these animals are protected from all sorts of dangers which they might find out in the wild such as