Childrens Functional Health Pattern Assessment Essay Example for Free

Childrens Functional Health Pattern Assessment Essay The U.S. health care delivery system has gone through enormous and transformational changes in the past two decades. The traditional hospital-centered health care delivery is no longer able to support the expanded demands of health care services, especially outside hospitals. In the same token, the traditional role of a nurse as bedside direct caregiver is insufficient to meet the accelerating needs of nurses in other areas, such as health promotion and disease prevention, case management, leadership and research. As a result of that, preparation of the entry-level of professional nurses requires a broader competencies so that nurses are educationally prepared to function with more independence in delivering diversified care. The American Association of Colleges of Nursing (AACN) recognized the Bachelor of Science degree in nursing as the minimum educational requirement for professional nursing practice (AACN, 2000). There are significant differences between associate degree nursing programs and baccalaureate degree nursing programs. The baccalaureate program not only include all of curriculum in the associate degree programs, but also provides in-depth study in physical and social sciences, nursing research, leadership and management, community and public health nursing, patient education, and the humanities (Johnston, 2009). The broader and more in-depth education enhance professional development and critical thinking. The baccalaureate graduate is prepared to better understand many issues in culture, society, economy and politics. Such skills are essential for todays nursing professionals. In clinical practice, associate degree nurses provide bedside care in less complex situation while baccalaureate degree nurses design and manage a comprehensive plan of care. They understand more in patients signs and symptoms, supervise other nursing personnel, support staff, and guide patients through the complicated health care resources in a community, and educate patients on health care options and advanced directives . Over the past several years, researchers and policymakers have identified that educational preparation does make a huge difference in how nurses practice. Johnsons (1988) meta-analysis indicated that there were  significant differences between professional (baccalaureate degree) and technical (associate degree and diploma) nurses on measures of nurse performance. Measures included communication skills, knowledge, problem-solving, and professional role. Pardue (1987) investigated the differences in critical thinking ability and decision-making skills among 121 associate degree, diploma, baccalaureate, and masters prepared nurses. Results indicated that nurses with masters and baccalaureate degrees had the highest scores in critical thinking ability. In my hospital the ICU nurses are BSNs, and they are responsible for patient education in addition to providing bedside care. An example of a patient care situation that was positively affected by having a BSN nurse available, recently occurred at the department where I work. A 37 year-old lady who is a post-liver transplant patient was admitted to the ICU for organ rejection and severe anemia. The medication compliance issue was brought up by the resident doctors. The ICU nurse provided medication reconciliation and discovered that patient often missed Prednisone. The nurse therefore spent more time on educating post-transplant immunosuppressant medications and reinforcing the importance to be compliant with medication regimen. The patient finally confessed that Prednisone made her gain lots of weight, which was the main reason why she did not take this medication. The nurse researched clinical evidence based on patients primary diagnosis and corresponded medical treatment options. She realized that patient has a diagnosis of recurrent autoimmune hepatitis and Prednisone is one of medications that treat autoimmune disease. The ICU nurse called out a meeting with the multidisciplinary team included the transplant social worker, pharmacist, nutritionist, nurse practitioners and surgeons. Patient and her care giver husband were also invited to the discussion of the plan for her care. Because of the shared decision making, the transplant team agreed to lower her Prednisone dose to the minimum and add a small dose of diuretic to avoid water retention caused by Prednisone. Through social workers help, patient agreed to take Prednisone every day and her husband promised to remind her to take the medication. Nutritionist provided consultation in fluid and salt restriction. This example demonstrated that the baccalaureate degree nurse was well prepared to understand the pathophysiology and disease process. She conducted research study and obtained the best available evidence in reference to patients care. Finally she used her coordination and collaboration skills and gathered a meeting of the multidisciplinary team and patients family. She also demonstrated a strong leadership skill in case management. She placed patient at the center of the care and approached to a shared decision-making. Without any doubt, her performance is a result of the educational preparation she received from the baccalaureate nursing program. If this case was handled by an associated degree nurse, her educational skill sets might not have prepare her to fulfill the task. References - American Association of College of Nursing (2000). The baccalaureate degree in nursing as minimal preparation for professional practice. Retrieved from http://www.aacn.nche.edu/publications/position/bacc-degree-prep - Johnson, J. H. (1988). Differences in the performance of baccalaureate, associate degree, and diploma nurses: A meta-analysis. Research in Nursing Health, 11, 183 197. DOI: 10.1002/nur.4770110307 - Johnston, K. A. (2009). The importance of the baccalaureate degree in nursing education. Retrieved from http://www.peoriamagazines.com/ibi/2009/apr/importance-baccalaureate-degree-nursing-education - Pardue, S. F. (1987). Decision-making skills and critical thinking ability among associate degree, diploma, baccalaureate, and masters-prepared nurses. Journal of Nursing Education, 26, 354-61.

Behaviour for Learning

Behaviour for Learning The need to manage behaviour has long been an issue within schools. With the push on raising attainment, the development of SEN provision and the increase in policy, to be inclusive of all learners irrespective of their academic level or their social behaviour, as identified that 20% of all SEN learners have SEBD. Current policy has adapted towards a positive approach focusing on the ability of teachers to create a positive learning environment developing positive relationships in order to promote a positive attitude towards learning, steering away from the once punitive approach and not being re-active to negative behaviour but more pro-active as supported by (EPPI) Behaviour management is often flagged as an area that ITE students feel they would benefit from having greater support in when entering the profession of teaching (Buell et al., 1999 cited in EPPI). This has been met by the expectations set by the TTA via the Qualifying to teach, the new standards and requirements for Qualified Teacher Status (QTS) (TTA,2002). B4L is a concept that has been developed through a review of effective behaviour management strategies. It has been identified that B4L is a result of multitude of influences and not merely the desire of a learner to misbehave and unwillingness to learn. It is important to identify the theoretical principles behind the way in which learners manifest themselves in terms of behaviour, as identified in the rationale for the EPPI systemic review of how theories explain learning behaviour in school context. Behaviour for learning (B4L) identifies the link between students social conduct and behaviour and the way in which they learn. The schools policy clearly states high expectations of students, We expect students to reflect this in their appearance, attitudes and behaviour. We know we are moulding the citizens of the future and will encourage them to care for one another, be open, fair, honest and just. We want them to have a sense of pride in being part of our school community. (School Aims, Staff handbook). Further to this the school s vision is to raise achievement by developing a culture where learning is at the heart of the school community. To achieve this vision the school identifies whole school priorities for 2010/2011 including improving behaviour and attendance. It also stated that the school will focus on incorporating SEAL practice in the classroom, which has been identified as an important key in developing learners emotional intelligence (Coleman, 1996) providing learners with the skill set to monitor and improve their behaviour independently. It was clearly identified in the School Development Plan that Behaviour for learning needed to be addressed (appendix 1). This was further reinforced as a high priority area during staff meetings and subsequent correspondence from the Head Teacher (Appendix 1a), which focused on current issues in lessons and the need to improve B4L. Two key issues that arose were the use of mobile phones within lessons and consistency of sanctions (Appendix 1a). It is interesting to note that these both encompass the teacher and the learner. It is concerning to note that use of mobile phones within lessons is being flagged as a B4L issue and not a sign of disengagement. Understandably there is a close link between the quality of learning, teaching and behaviour, and therefore raises the question can behaviour be improved through improving the quality of learning teaching? The school clearly identifies that there is a need to reinforce their school policies on behaviour for learning. Through initial observation it was interesting to note the level of behavioural issues occurring both in and out of lessons. It poses the question is this a school being pro-active in managing behaviour for learning or re-active to behaviour that had not been managed consistently? This study will focus on the schools current policy on behaviour for learning and how this is implemented on a daily basis. Through a review of the schools current policy and issues this study will hope to suggest future recommendations to improve behaviour for learning. Recent national policy has moved away from a punitive system where students were punished for doing something wrong reactive and are now working towards understanding what causes learners to be off task and display undesirable behaviour pro-active. With the recent development of special educational needs identification and provision it is no longer acceptable to respond in a punitive way. National policy now promotes the inclusion of a greater diversity of learners in schools irrespective of level of achievement or social behaviour (Department for Education Employment (DfEE), 1999). It is important for schools to recognise this and develop strategies to promote B4L as over 20% of SEN provision are learners with social emotional and behavioural disorder (SEBD) (Department for Children, Schools Families, 2008). SEBD learners by nature can display undesirable behaviour unless managed in a positive way, and would it not be deemed unacceptable from an education professionals view for a learner predisposed to display poor behaviour as the result of a recognised disorder, to fall victim to punitive actions. It is therefore important for schools to have a well-structured B4L policy that coincides with the SEN policy. Communication between the SEN department and the rest of the school is also essential. (back up with research) too many lessons lack challenge and do not take sufficient account of students individual capabilities or encourage independent learning. Also, quality of marking and feedback generally varies considerably across the school. However, a small minority of parents expressed views that the schools communication with parents could be better, and also that students behaviour was not always as good as it should be. Inspectors found behaviour to be satisfactory overall, but variable. In general, students have a high regard for their school, enjoy their education and appreciate the variety of opportunities on offer to them, both within the curriculum and beyond. They are developing a good range of personal skills that are preparing them well for their education and employment after school. Ensure that lesson activities consistently challenge students of all ability groups to make better progress and develop their independent learning skills, especially at Key Stage 4. Behaviour in lessons is satisfactory, although someinstances of pupils being too boisterous were seen during the inspection. However, there is generally not enough really challenging teaching across the school to ensure that students make consistently good progress in their learning and therefore develop the confidence and ability to work independently. Where teaching is less effective, planning does not take sufficient account of students different capabilities and starting points, and is too teacher-directed. Teachers do provide some clear, detailed and useful written feedback, but this is inconsistent across the school and does not always give specific advice about what students need to do to improve their work a problem which persists since the last inspection.

The Brotherly Connection Of Sonny Blues English Literature Essay

The Brotherly Connection Of Sonny Blues English Literature Essay Both stories show the importance in having that brotherly connection and a desire to be accepted by the one you admire. In Sonnys Blues, it is established that all Sonny wants is for his brother to understand and accept his way of life. Even though the narrator does in fact care for his younger brother, Sonny, he sees it as more of a promise to his mother that I wont let nothing happen to Sonny (Baldwin 218), which gave the narrator more of an incentive to just watch Sonny rather than being there and listening to his brother, when he needed it most, ultimately severely hurting Sonny., Throughout the story Sonny cries out for his brothers attention and acceptance. In the midst of a significant conversation with one another Sonny blatantly says, I hear you. But you never hear anything I say (Baldwin 221) and which could be one of the narrators biggest mistakes. The narrator once gain ignores what Sonny is saying and starts explaining to Sonny how he will live while his brother is away at war. Experiencing the lack of his brothers affection evidently turned Sonny severely against his brother, and turned his attention to an environment where he knew hed be accepted, playing jazz with the good-time people (Baldwin 219). That choice was not made entirely by Sonny; it was formed by his experiences during childhood. Sonny plays music not only to express himself fully but also to replace the drugs that he is trying to escape from. Sonnys choice of music reflects his attitude towards life and his experiences, and if only his brother can take a moment to listen to that, instead of instantly judging Sonny, their relationship could have been a lot less deficient throughout the years. The need for acceptance between brothers is also portrayed in The Red Convertible, at the same time the reason for their separation is not as preventable as in Sonnys Blues. Unlike his brother Lyman, who was lucky when it came to numbers, Henry ws never lucky in the same way (Erdrich, 236) and was picked for the draft shortly after returning from their summer road trip. About three years had passed until theyd met again, only for Lyman to discover that Henry wasnt the same when he returned from the war. Frustrated and upset about what happened to Henry, Lyman desperately tried to find a way to bring back his old brotherly connection. Symbolic to their relaitonship, Lyman went out to the car and ran the piss right out of it (Erdrich 238) in hopes that it would bring back whatever was left of Henry. When Lyman intentionally damaged the car so that Henry would have to fix it, Henry understood what Lyman was trying to do for him. Rather than responding with anger or bitterness, he fixed the car so that Lyman would have it. Henry knew how lonesome the effect of war left himself, and Lyman also noticing just how different the war made him, they both slowly came to reality to the beginning of the end of their relationship. The brothers in Sonnys Blues and The Red Convertible both have a point in time where they grow apart and experience a major life changing occurrence. Despite Sonnys arrest and misfortune it takes the death of the narrators daughter to finally get a better understanding of his brother. It seems that the narrator could better understand Sonny now, and has decided to write to his brother. In The Red Convertible Lyman destroys the car as he views his and Henrys relationship. Henry understands what Lyman is trying to do for him, and shows his brother that he still cares. The capability to put their differences behind them and restore an old connection that was once so significant can be evident in ones want to finally change. Unfortunately some unexpected cases of events are bound to happen, that we either have no control over or as bad as it may seem, are better off. It is not until now tha tLyman realizes that Henry and he will never gain back that tight bond that they once shared. When Henry jumps into the water, in a strange way, he is showing Lyman that he is doing all he can to be the old Henry. You can dryly put it together that Lyman understands his brothers decision to end his life, in his actions following his brothers suicide. The sinking of the red convertible symbolizes the end of Henry and Lymans relationship and creates a very ironic end to what was once a very strong bond among two brothers. On the contrary, these two brothers had another chance to take up again that connection they once had. After finally beginning to understand Sonny for who he truly is, the narrator steps inside of Sonnys atmosphere, so to speak. Upon entering the Jazz club and meeting all of Sonnys acquaintances, the narrator is impressed and seems very fond of how well liked and appreciated his little brother is. The most important and influential person the narrator meets is Creole, upon meeting him the narrator says one of the most significant statements of the whole story. This is the point where the narrator finaly comes to a true appreciation about who Sonny truly is, not only as a person but for the true talent that he expresses in his music. Due to the hardships of separation and neglicence, both brothers understand the certainty of their relationships after drugs and neglecting are incorporated into the situation. Although both stories do not give the same opportunity to find a way to revive the old beat up relationship, both pairs of brothers finally realized the importance of being there for one another. The way the two brothers reuinte through addiciton, memories and strife make their bond seem stronger than ever.

injection molding :: essays research papers

Wilbert Plastic Services In the early days manufacturers came to us for a specific thermoformed or injection molded part or parts for a product they were making. Over the years we noticed that, more and more, they were coming to us for entire subassemblies and more complex parts that might incorporate both thermoformed and injection molded parts. Based on that experience, and our knowledge of the pressures that manufacturers are under to increase efficiency and reduce cost, it became obvious to us that we needed to provide a wider array of services to help our customers increase their efficiencies, reduce their overall costs and maximize their ROI on each project, part or component. This vision has lead us to add assembly, decorating (in and post mold), reusable packaging, RFID and much more to our capabilities. We believe that Lower Overall Customer Cost comes from an innovative, total solution made up of customer focused, operational excellence. By combining quality production and secondary services with design expertise, supply chain management, and world class logistics WPS has been able to help our customers find new ways to lower their costs and improve profitability. Injection Molding is the process of forcing melted thermo plastic into a mold cavity. Once the plastic has cooled, the part can be ejected. The first injection molding machines were built in the 1930's. There are six major steps in the injection molding process: Clamping An injection molding machine consists of three basic parts; the mold, the clamping unit, and the injection unit or units. The clamping unit holds the halves of the mold under pressure during the injection and cooling. Injection During the injection phase, plastic material, usually in the form of pellets, are pulled from a hopper on top of the injection unit. The pellets feed into the cylinder where they are heated until they reach molten form. Within the heating cylinder there is a motorized screw that mixes the molten pellets and forces them to the end of the cylinder. Once enough material has accumulated in front of the screw, the injection process begins. The molten plastic is inserted into the mold through a sprue, while the pressure and speed are controlled by the screw or in some cases a ram. Dwelling The dwelling phase consists of a pause in the injection process. The molten plastic has been injected into the mold and the pressure is applied to make sure all mold cavities are filled. injection molding :: essays research papers Wilbert Plastic Services In the early days manufacturers came to us for a specific thermoformed or injection molded part or parts for a product they were making. Over the years we noticed that, more and more, they were coming to us for entire subassemblies and more complex parts that might incorporate both thermoformed and injection molded parts. Based on that experience, and our knowledge of the pressures that manufacturers are under to increase efficiency and reduce cost, it became obvious to us that we needed to provide a wider array of services to help our customers increase their efficiencies, reduce their overall costs and maximize their ROI on each project, part or component. This vision has lead us to add assembly, decorating (in and post mold), reusable packaging, RFID and much more to our capabilities. We believe that Lower Overall Customer Cost comes from an innovative, total solution made up of customer focused, operational excellence. By combining quality production and secondary services with design expertise, supply chain management, and world class logistics WPS has been able to help our customers find new ways to lower their costs and improve profitability. Injection Molding is the process of forcing melted thermo plastic into a mold cavity. Once the plastic has cooled, the part can be ejected. The first injection molding machines were built in the 1930's. There are six major steps in the injection molding process: Clamping An injection molding machine consists of three basic parts; the mold, the clamping unit, and the injection unit or units. The clamping unit holds the halves of the mold under pressure during the injection and cooling. Injection During the injection phase, plastic material, usually in the form of pellets, are pulled from a hopper on top of the injection unit. The pellets feed into the cylinder where they are heated until they reach molten form. Within the heating cylinder there is a motorized screw that mixes the molten pellets and forces them to the end of the cylinder. Once enough material has accumulated in front of the screw, the injection process begins. The molten plastic is inserted into the mold through a sprue, while the pressure and speed are controlled by the screw or in some cases a ram. Dwelling The dwelling phase consists of a pause in the injection process. The molten plastic has been injected into the mold and the pressure is applied to make sure all mold cavities are filled.

moralant Morality in Sophocles Antigone :: Antigone essays

Antigone: The Obedience of One's Morality According to the Bible, after Jesus was arrested by religious leaders, the apostles, his closest followers, fled his side. The apostle Peter was later recognized as one of Jesus' companions by the people who helped arrest him. Peter, however, denied even knowing Jesus three times. Peter believed that, should he remain faithful, he would be granted eternal life by God, and he knew that denying Jesus was a grave sin. However, his fear of his accusers caused him to err, and to stray from what he believed to be right. Today, many of us have been told to "do what you believe is right, no matter what the cost." However, human weakness often causes one to falter, as Peter did, in an attempt to protect oneself. While many people advise others with the aforementioned motto, few will use it to the extent that is insisted upon in Antigone, the extent to which the apostle Peter should have applied it.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Antigone is an outstanding example of someone who did what she thought was right, while she was among fools, many hardships, and people who were discouragingly uncourageous. Although we may not defend the self-sacrificial actions of Antigone, or may not have the strength to do something similar, we should follow principle behind her actions. Antigone believed, as did most people of her time, that a dead person's soul could not rest if that person's body was not buried. Creon, the King, ordered that the body of Polyneices, Antigone's brother, be left to rot unburied because he had died attacking the city, a traitor. This presents a huge problem for Antigone; she feels she must obey the laws of the gods and bury her brother, but the penalty would be earthly death. Antigone's moral values were so important to her that she was willing to die in order to uphold them. She reasoned that her reward (or punishment) after death would reflect the nobility of her decision--and the reward would last much longer than her terrestrial life. However, Peter believed the same thing, and had complete faith in his beliefs, but did not act accordingly. He became too overwhelmed by the present, and his possible suffering then. It is human nature to fear death, and this overwhelmed Peter's desire to adhere to all godly laws. Such was not Antigone's case; no doubt ever entered her mind as to what she was to do.

George Orwells Nineteen Eighty-Four 1984 :: Free Essays on 1984

The Orwell’s perception of an ideal government is pretty much the same as Montesqueue describes in â€Å"Persian letters†. They both seem to think that the best government would be one in which power was balanced among three groups of officials. As opposed to totalitarian regime of the Party, Montesque’s ideal government would be the government elected by people and not a product of a despotic ruler’s ideas. He, as well as the Orwell believed that the success of democracy- a government in which the people have the power - depended upon maintaining the right balance of power. Moreover, the only way of achieving this would be dividing power onto three branches: an authority that enforced laws (like a king), Parliament, which made laws, and the judges in courts who interpreted laws. According to Montesqueue it is called ‘separation of powers’. Avoiding placing too much power on one individual or group of individuals would certainly prevent total itarian governments of coming into existence. Therefore, no branch of the government could threaten the freedom of the people. Orwell’s society displays a threatening projection of a totalitarian system into the future. Indeed it is a regime very similar to the tyrannies of the 20th century and strongly echoes Stalin Russia or Nazi Germany. The dominant mood inside this repressive system is one of threat and suppression due to the systematic persecution and oppression of non-conformists. As Goldstein explains in his ‘Oligarchical Collectivism’ there have always been three classes: the high, the middle and the low with the middle and the high constantly changing their respective position. Eventually this movement was identified by historians as being cyclical. In an attempt to interrupt this recurring pattern the Party is essentially focusing on the problem of Stability. Indeed Stability becomes principal in Oceania as well as in the other two superpowers Eastasia and Eurasia. In short it is the problem of how to keep things the way they are and maintain a hierarchical society without risk ing an overthrow of the established system. Several devices and attitudes have been conceived to achieve this aim. First of all the Party constantly controls and monitors its subjects. A crucial device in this scheme is the telescreen which, by being able to send as well as to receive information, allows a constant surveillance of all Party members. In addition other institutions such as the Thought Police or the Spies have been contrived to guarantee a maximum of surveillance.

Script for Emceeing

Pleasantries†¦. After 41 years of dedicated service to the people of Dagupan City, it is just and right to give honor to someone we call mentor and mother. Mentor of every budding teacher who wanted to follow her footsteps and mother who gives worthwhile lessons in life and motherly advices to teachers like me. Ladies and gentlemen, we are all gathered here for one common purpose†¦to celebrate, give due recognition and reminisce the unforgettable moments we had with our beloved†¦the one and only, Madam Aurora Tiu Domingo or simply Madam Oying! ******************************************************************************* Before everything else, let us all first seek for the Divine providence of our mighty creator with a prayer to be led by Angeline Liwag. ******************************************************************************** Music has always been part of every person’s life. Through its expressive lyrics, they make us smile when we are in our sad mome nts, or even uplift us when we feel so down†¦Folks, Let’s give it up for the Chalk and Eraser Band as they serenade sentimental songs for our beloved Madam Oying. Let’s give them a big hand. ) ******************************************************************************* 41 years is quite long public service. This 41 years is for sure full of accolades from humble beginnings. Though an audio-visual presentation, let’s all see some of the highlights of 41 dedicated years of Madam Oying in Dagupan City Division. ******************************************************************************* Besides being an achiever, Friendly and always at her foot are most of the descriptions given to Madam Oying.It’s time for us to hear testimonies and presentations from the people deem important and influenced by our honoree. (Refer to the program â€Å"Testimonies and Presentations†) ************************************************************************** ******* Let’s now give the floor to Madam Oying for the Response to the testimonies and Presentation ********************************************************************************** Part II-Fellowship