Administration of medicines is a key element of nursing

Administration of medicines is a key element of nursing Drug administration forms a major part of the clinical nurses role. Medicines are prescribed by the doctor and dispensed by the pharmacist but responsibility for correct administration rests with the registered nurse (OShea 1999). So as a student nurse this became our duty and something that we practiced and become competent in carry out as explained in figure 1, we were also faced with the challenges of administering medication. Each registered nurse is accountable for his/her practice. This practice includes preparing, checking and administering medications, updating knowledge of medications, monitoring the effectiveness of treatment, reporting adverse drug reactions and teaching patients about the drugs that they receive (NMC 2008). Accountability also goes for students, if at any point I felt I wasnt competent enough to dispensing a certain drug it would be in my responsibility to speak up and let the registered nurses know, so that I could shadow them and have the opportunity to learn and then in future be able to practice and administer. The reflective model I have chosen to use is Gibbs model (Gibbs 1988). Gibbs model of reflection incorporates the following: description, feelings, evaluation, and conclusion. (Gibbs 1988). The model will be applied to the essay to facilitate critical thought, relating theory to practice where the model allows. Discussion will include the knowledge underpinning practice and the evidence base for the clinical skill, that I have learnt and supporting this with current literature. The first stage of Gibbs (1988) model of reflection requires a description of events. I was asked to administer a drug to a patient. I had observed this clinical skill on a variety of occasions and had previously administered medication under supervision. On this occasion I was being observed by two qualified nurses, one of which was my mentor. The drug had been dispensed and was ready to be administered and the patient consented to have a student administer the medication. My mentor was talking me through the procedure step by step, and informed me that they have struggled with this patient and her compliance with medication before so I should keep an out and ensure that she swallows her medication and that she not keeping it her mouth. The Medication that this patient is on is Clozapine. Clozapine is indicated for patients with treatment resistant schizophrenia, or those who are unable to benefit from other antipsychotic medicine, as they cannot tolerate the side effects. The decision to use clozapine is not taken lightly because of the potentially life threatening side effect of neutropaenia, which requires regular blood tests to ensure its safe use. In addition, there is the risk of developing paralytic ileus and some cardiac abnormalities. (WLMT). In addition to that statement if a patient on clozapine white blood cells count falls below accepted lower limit are classified as Red alerts medication must be withdrawn, and any other prescriber in the future wishing to restart medication are aware of the patients haemotological history. Adverse drug reactions are the main limiting factor on using anti-psychotics, for this reason prescribers should keep dosages to a minimum required for efficacy starting at a low dose with gradual upward titration. An awareness of side effects is important to primary care practitioners because they have most contact with the patients, patients with long term monitoring falls within their remit. Clozapine is an atypical antipsychotic, and atypical anti-psychotics are considered of choice both accurately and for maintenance in schizophrenia. Clozapine holds a unique position among the atypical due to its ability to improve negative as well as positive symptoms (delusions, hallucinations). (Morris, D) . During the process of administering anti-psychotics I learnt that using anti-psychotics is just a component of a holistic approach to the patient with psychotic illness and that care should also include psychological treatments and social care. The patient at such does not have any issue with the drug it self but with the staff, as she is in a very psychotic state she is very paranoid and non compliant with medication this is closely monitored by staff and as stated in figure 1 I have to prompt her to ensure that medication is complied with. Service users have requested strategies from services providers to manage the risk of using psychiatric medication to inform their choice about which psychiatric medication to use. (DOH 1999). However evidence suggests that, there is choice, but generally by practitioner experience. (Hamann et al. 2005). In non compliance of medication I had to encourage the patient to make their choice to take the medications and that it was in their care plan a nd apart of their treatment. A nurse who has built a good relationship with a patient by informing and empowering them will be in a strong position to have a non judgmental conversation with them about the importance of adherence. (Mc Lellan. A 2009). I am now going to enter into the second stage of Gibbs (1988) model of reflection, which is a discussion about my thoughts and feelings. I was aware of being under the supervision of two qualified nurses and this made me feel very nervous and self conscious and I had to ensure that I was doing everything correctly and that I made no errors. Once my mentor questioned my practice, concerning if I knew the side effects of the drug I was about to administer, I became even more aware of feeling nervous and under pressure. The patient was present and I did not want the patient to feel that I did not know what I was doing. So I had to ensure before administering that I was giving the medication to the right patient and at the correct dose that it was at the right time and route. All of these had to be done to guarantee that I am competent in my ability to administer medication under the supervision of a registered nurse. This also gave me the opportunity to carry out this task in order to a chieve this so I could get it signed off by my mentor in my essentials skills cluster. The nurse patient relationship is by many considered the core of nursing; this can be done to build a good relationship and rapport with patients. (Framer.J.Kramer.S, 2001). When I was first orientated to the ward, I took it upon myself to read the patients notes so that I had little insight to the patients and their illness and index offences if any. After this I went and introduced myself to the patients because its vital that the patients are aware of who I am and my status if I am to provide nursing care for them. (Berlo 1960) puts great emphasis on dyadic communication, therefore stressing the role of the relationship between the source and the receiver as an important variable in the communication process. So to provide patients with adequate care its important that there is effective communication, that the patients is aware of everything, and that the nurse provides care and compassion in the delivery of care. There is evidence that our ability to use language actually affect s the thoughts themselves, the words we can command, and the way that we put them together affects: what we think how we think whether we are thinking So as a student nurse I was made aware that words can have an impact on care provided and the way in which these words are delivered can have an even greater impact. As explained in figure 1, when I was admitting a patient on to the ward I had to make certain that I was communicating effectively, making certain that I was delivering information in ways that were easy to understand refraining from uses of jargon, and that I was showing compassion to the patient as this could be a time of high anxiety for them, reassuring them that they are in great hands and offering them tea were among the things I did to exercise my care and compassion skill. so my main aim was to make the care of people your first concern, treating them as individuals and respecting their dignity, and working with others to protect and promote the health and well being of those in my care, their families and careers, and the wider community. (NMC 2008). However I tried to use different forms of communication to con vey information from my patients, for instance as stated in figure 1, when I had my 1-1 personal time with my patient I would use (Bein and Miller 1992) the use of open and ended questions and active listening, so that I could comprehend everything I was being told so that when I came round to me providing comprehensive and accurate written report based they would reflect everything that was being. Studies show that during interpersonal communication only 7% of the message is verbally communicated by the words used. Â  Of the 93% non-verbal communication: As a result I learnt to pick up non verbal signals Even if someone decides to say nothing they are still communicating (effective communication skills). All of which skills I can adopt to engage with patients and to help with my development in nursing. Evaluation is the third stage of Gibbs (1988 ), here I will the explain the importance of administering medication and how this combined with care, compassion and communication forms the bases of a holistic approach to care, and with the knowledge I got from supporting literature formed the foundation of my learning and practice. Burnard (2002) suggests that a learner is a passive recipient of received knowledge, and that learning through activity engages all of our senses.

How do You Spell High School? †S-T-R-E-S-S :: Personal Narrative Writing

How do You Spell High School? – S-T-R-E-S-S When I ask people what their most memorable times are, most tell me that their most memorable times occurred in high school. I entered high school a year ago, and it has been fun, but very, very stressful. I try to organize and make time for everything that I am assigned to do, but still everything seems to bunch up and become overwhelming. Sometimes I just want to give up and stop trying so hard. I don’t just feel pressure from school, but from my family and society as well. Since I am Hispanic, I am expected to defy all those stereotypes that people might have of Hispanics. Some examples of these stereotypes are that Hispanics are not well educated, that they are always loud and that pregnancy occurs at a young age. I might be loud sometimes, but I am very educated and I am not considering having a baby any time soon. But still my parents expect me to exceed all expectations and be the very best, which is pretty hard. Since second grade I was in the Gifted and Talented Program, which is a program for students who are a bit more advanced than their grade level. I was in that program until fourth grade and then I entered the Delta Program at Booker T. Washington M.S. 54. The Delta Program is also for students that are a bit more advanced than their grade level, and in that course I found it very hard to be the best. For the four years that I was in that school, the most I could do was get in the Honor Roll, and for the last two years it wasn’t very easy. My parents always told me that I had to have good grades and get a scholarship to a good college and that was how it was going to be. Before, it didn’t bother me and I would just do everything I was told to do, but now, it is getting very stressful because the work is getting harder and I find myself with more responsibilities. Some studies show that many Hispanics either drop out of high school or don’t ever get to college. Because of this, I am expected to do very well in school and make it into a good college. I am not saying that it isn’t something I want, but this goal seems very difficult, because the stress I am experiencing is working against me and slowing me down instead of pepping me up and encouraging me to keep moving ahead.

THROAT CANCER Essay -- essays research papers

Throat Cancer Each year, smoking kills more people than AIDS, alcohol, drug abuse, car accidents, murder, suicide, and fires---combined! The use of tobacco increases the risk of contracting throat cancer. Throat cancer is one of the most prevalent cancers within the United States. Cancer of the larynx (or voice box) is a disease in which cancer (malignant) cells are found in the tissues of the larynx. The larynx is a short passageway shaped like a triangle that is just below the pharynx in the neck. The pharynx is a hollow tube about 5 inches long that begins behind the nose and goes down to the neck to become part of the esophagus (the tube that goes to the stomach). Air passes through the pharynx and then the larynx on the way to the windpipe (trachea) and into the lungs. Food passes through the pharynx on the way to the esophagus. The larynx has a small piece of tissue over it, called the epiglottis which keeps food from going into it or the air passages. Throat cancer occurs when cells in the pharynx or larynx begin to divide abnormally and out of control. Most throat cancer begins on the vocal cords, later spreading to other parts of the larynx and pharynx. One of the most reliable and earliest symptom of throat cancer is sudden, unexplained hoarseness in the voice. About 10,000 new cases of throat cancer occur in the United States per year, generally affecting older males who use chewing tobacco, or those who have been heavy smokers (cigarettes, cigars and/or pipe smokers), or alcohol abusers. Studies indicate that the incidence of throat cancer in women and young people has increased due to the greater use of tobacco and alcohol products in this bracket. Throat cancer is more common in men, because smoking is a more common habit among males. Only one-fifth of the patients diagnosed with throat cancer will be women. Throat cancer is also closely associated with other cancers. Fifteen percent of throat-cancer patients also are diagnosed with cancer of the mouth, esophagus, or lung. Surprisingly another ten to twenty percent of these patients develop these cancers later on. Other people at risk include those who consume large quantities of alcohol, especially in combination with smoking. The most affective way to prevent throat cancer is to cease the use tobacco products entirely and cut back on alcohol. When throat cancer affects the vocal cords, the ... ...sed back up to produce sound for speech. This is a very difficult procedure to master for the common person. A popular method of speech production following laryngectomy is the voice restoration procedure. A puncture is placed through the back wall of the trachea windpipe into the esophagus and held open with a one-way valved prosthesis. By occluding the opening in the neck (tracheostoma), air is directed through the voice prosthesis into the throat causing vibration of the soft tissue and generating voice. Fluent speech that is usually readily understandable is produced (See picture #3). In conclusion, the evidence of the rise in the number of people being diagnosed with cancers caused by the use of tobacco products should be a sufficient warning to people to avoid the use of these products entirely. It is important to pay attention to symptoms that may indicate a potential problem and to seek medical attention as soon as possible. Family medical histories should be considered as well when reporting the development of unusual symptoms to the physician. As always, a healthy diet and regular exercise are the best preventative measures to take ensure a long and productive life.

Essay --

Elie Wiesel was born in Sighet, Transylvania (later known as Romania) on September 30, 1928. Elie focused on Jewish religious studies before being relocated to Nazi death camps in WWII. Wiesel survived; he eventually began to write about his experiences in his memoir Night. He became an activist, orator and teacher. He spoke out against persecution and injustice. People should look at what Elie Wiesel and many other Jews went through just to be able to live in this world. The people living now should be appreciative of everything that is given and more. No one understands such a dreadful experience as the Holocaust without shifting in the way you were before. In Night, a memoir by Elie Wiesel, the author defines his suffering at the hands of Nazis. Taken with his family in 1944, they were directed to Auschwitz to come before the dishonorable selection. There, Elie parted from his mom and sister leaving him with his father who was too busy to spend any time with his son before the camp. Being under the Nazis' control, Elie and his father moved to several camps. The Nazi command â€Å"deprived Elie...of the desire to live..., which murdered his God and soul and turned my dreams to dust† (32). Preceding to the war, Elie lived an extremely spiritual and blameless life. Elie controlled a very strong curiosity in Jewish beliefs. At such a young age, Elie followed the Jewish faith with a vigor unusual for his age; his father kept him grounded in a world of reason. Even as Elie's freedoms vanished, he still maintained a sense of faith as a crutch. This also shows how Elie still was a child at the time, not aware that the Germans could try to eradicate an entire race. Ellie did not have an inkling of the horrors that lay before him and how they... ...ce out of the camp he "Spent his days in a total idleness. And I had but one desire to eat. [He] no longer thought of his father or mother"(107). The war left him crushed for life without any attachments to reality or sympathy for his family; he had cried his last tears. Following the camp, Elie only existed as a body wanting basic necessities without a soul or passion. The Holocaust changed Elie from a religious child to a mindless body who lost all innocence at age when he "Was fifteen years old"(96). The flames of the furnaces and the noose on the necks of fellow prisoners stole that desire from him and all the prisoners leaving empty bodies to work for the Nazi regime. Such horrors forced any man to abandon his passions if he wished to survive to the next day. The effect the war had on the Jews makes the claims of Holocaust deniers incredibly ignorant and cruel.

Rugby is Better than Sex :: Personal Narrative Sports Athletics Papers

Rugby is Better than Sex An imitation of â€Å"Surfing is better than sex† I USED TO LOOK AT THE SENIOR BOYS PLAYING ‘THAT ROUGH’ GAME rugby and just wonder at the courage that they possessed. Never in my mind did I see myself as a rugby player. It is true I was bigger than many of the people on the team but that did not mean I had half the courage. That was way back in my first years at Budo high school. Then one day, a rugger by the name of Yustus reached out to me. â€Å"KESA†, he called out my nickname. â€Å"You should try out rugby with us one of these days†, he added. Rugby is a very small club sport at Lafayette and has a lot of challenges. During orientation, I accidentally met up with a team member called Mike who told me about Lafayette rugby. He told me that the team did not have a coach and â€Å"we are trying to get in as many freshmen as possible†. I replied that I had a lot of experience, having played rugby for about 5 years, and I would love to join. When we had our first rugby meet, it was on a small quad in front of one of the nine fraternities. This quad was the antithesis of the real big fields I was used to; one could hardly run a forty-yard dash on it. Well, after a couple of weeks playing on the quad, we were able to head out to Metzgar fields. These are a set of fields for lacrosse, soccer, baseball, and football practice and there is also provision for rugby. In the middle of all other sports grounds, our rugby team found a somewhat full size field. The first engagement we had for the season was a home match against Lehigh University and this was one of best games for the entire season. We went into this game as the underdogs, but that did not inhibit my team from maneuvering well. We were not expected to win, so all we did is have fun giving Lehigh a decent challenge. On many occasions, I would run with the ball and stop just a couple of yards away from the goal line. My teammates were always there to support me whenever I went with the ball. I remember one time when a Lehigh player broke through the scrum and was heading towards our goal.

Contrasting Imagery with Symbolism Essay

The story The Cathedral by Raymond Carver is a story of transformation of a human character’s life from depression and carelessness to belief and diversity. A cathedral is a symbol of faith, conversion, creativity and strength and is therefore a substantial component of Carver’s story. The process of drawing it becomes the climax of the story when the author uses intense imagery to describe the workings of the drawing that the husband is creating. Imagery and symbolism are greatly used in this story, but in very different ways to provide very different effects. Moreover, the cathedral is connected to the representation of the blind man as a preacher and a teacher. The symbolism of the cathedral in the story makes one believe in the future and optimism. A cathedral symbolizes religion, and the TV show that the two men watch leads to an important question. The blind man asks the husband to describe to him the image of a cathedral. The husband is unable to successfully compose an accurate description because he doesn’t understand the meaning and the symbolism of the building. He is not a man of religion, and he is watching the show only because he has nothing else to do. â€Å"Don’t ask me why this is,†(245) he says. Compelled to think about the purpose of cathedrals, the narrator begins to realize that they symbolize the struggle that people endeavored to build those structures. What would make people do such a thing? Belief and religion sometimes give direction and meaning to peoples’ lives. The effort required to build a cathedral becomes an outburst of creativity. The inability of the husband to understand the purpose of cathedrals shows that he lacks creativity, and his life is meaningless and not fulf illing. By making the husband draw a cathedral together with him, the blind man teaches him about the importance of the cathedrals and the significance of believing in something. The husband experiences something that he has never thought would happen to him, and it makes him aware of the diversity of life. Before Robert came, the husband was alone, and his wife says that he didn’t have other friends. â€Å"Never thought anything like this could happen in  your lifetime, did you, bub?† asks Robert and there is no answer. The narrator’s loneliness caused by urban life has become his style of living, and when he has to communicate with others and to share ideas he becomes anxious. The detachment makes him pessimistic and closed-minded. The narrator’s anxiety disappears as the story progresses, and when he begins to draw he is more relaxed and in a creative mood. The first thing that he thinks of is his house: â€Å"I drew a box that looked like my house†(247). The transformation of the house into a cathedral is a very powerful image. His home and himself derive the symbolism of a cathedral. And â€Å"What’s a cathedral without people?†(247). Characterized as a social place where people meet, the cathedral becomes symbol of the husband’s ability to overcome his loneliness and his inability to communicate. The author uses suddenly uses intense imagery in the story that he hasn’t used before, this is to emphasize the importance of the moment. â€Å"His fingers rode my fingers as my hand flowed over the paper. It was like nothing that I have ever felt before.†(247) This marks the climax of the story as well as the turning point in the thoughts and beliefs of the husband. Nevertheless, the husband doesn’t change his life by himself. It seems that the blind man is showing the husband how to draw and not the opposite. Robert is in control, but the narrator does not oppose that experience. He has been waiting for something like this to happen, and he is happy that it happened. The process of drawing a cathedral together with the blind man creates the symbolism of a cathedral and becomes a religious experience, which symbolizes the husbands conversion – his spiritual epiphany from good to bad. He is taught the meaning of value and virtue; he is happy that he encoun tered Robert. The symbolism of the cathedral is also directly connected to the blind man. His question if the husband is a religious person is almost rhetorical because he already knows that he isn’t. The blind man is a very powerful person because his blindness has made his other senses different than ours in a wonderful way. He sees things from a special perspective, and becomes a person who can share a different angle toward wisdom, a different entrance  toward knowledge. For the husband, Robert comes as nobody, and he becomes somebody. He is like a preacher who opens your mind and gives a meaning to life. The blind man is a teacher, and his image is connected to the spiritual image of a cathedral. The image of a cathedral is an image of something enormously strong, stable and at the same time beautiful and creatively artistic. The author uses imagery not only to create a mental portrait of the physical surroundings of the story, but also to breath life into the symbolism of the images that are created. The small amount of imagery that is used is very significant in that the imagery that is used, brings across very strong and clear pictures of meaning and thought. The symbolism that is in this story is enormous. It can be found everywhere. It is used in contrast with imagery to give greater meaning to the story that otherwise wouldn’t have been clear.

Ethical Computing

Ethical Computing QBA 362 w/ Burke Ltelatk H. Fritz FRITZ, LTELATK Ethical Computing QBA 362-Spring 2010 E T H I C AL C O MP UT I NG 1. Find a code of ethics from a firm of your choosing (other than the CPSR or the ACM). What do you think are the best five guiding principles from all the tips that you found? http://www. buzzle. com/articles/computer-ethics-code-of-ethics-in-computing. html Code of Ethics ? Information stored on the computer should be treated as seriously as written or spoken word. ? Privacy should not be violated. In case of academic use, it is known plagiarism. ? ? ? Information for public viewing should not be modified or deleted or inaccessible since these are considered as destructive acts. Intrusive software such as â€Å"worms† and â€Å"viruses† which are destructive to the computer system is also illegal. Congesting somebody’s system with a lot of unwanted information is also unethical. Sending obscene and crude messages through mail or c hat is also forbidden. ? Sending sexually explicit content, message or pictures is also forbidden †¡ I felt the top five codes under Buzzle ®Ã¢â‚¬â„¢s Code of Ethics were the best. Because in general it covers a broad area of things. Treating information stored on computers as if they were written or spoken words, is like asking users to respect the rights of others, as well as their responsibility towards other people’s work. (Individual Responsibility) Leaving other people’s work in tact as they are—without modification or deletion, is important because it preserves the other person’s integrity. It’s kind of the same as walking into (or breaking into ) someone’s home and rearranging their furniture without their knowledge. Preserving Integrity) †¡ 2 FRITZ, LTELATK Ethical Computing QBA 362-Spring 2010 2. Is forwarding e-mail jokes good or bad? Summarize the opposing arguments you found. †¡ I personally forward e-mail that I think is appropriate for the individual I am sending the message to. However, congesting someone’s space is considered unethical according to the Buzzle ® Code of Ethics. †¡ Another factor I was totally oblivious of was the fact that all these people’s names and address are forwarded with the mail. My current method of forwarding the message is just to cut the message content and then forward it to friends. Sometimes I insert their address in the blind carbon copy (bcc) area to keep their address private. It is all about respecting someone’s privacy and integrity. 3. How does anonymous e-mail work and why would you use it? †¡ There are so many sites where you can set up anonymous e-mails, i. e. http://www. sendanonymousemail. net/ or http://www. hidemyass. com/anonymous-email/. But you can just as well set up a bogus account and use it to send anonymous e-mails. There were so many given reasons to use such websites like, â€Å"catching a spouse/partner cheating,† whistle-blowing, reporting illegal activities to the authorities. But I say, if you can’t say it in person, write it in a letter and sign it with your name. Be account for what you believe. It takes guts, but sometimes we just gotta. †¡ 4. What are five ways e-mail use can be unethical? Which do you think is most common? Why? †¡ †¡ †¡ †¡ †¡ †¡ Using e-mail to steal company information. Using e-mail to scam people out of money. Using e-mail to conduct illegal activities, like money laundering, human trafficking, etc†¦ Using e-mail to ruin someone’s reputation or â€Å"blasting† stuff about a foe. Using e-mail in push/mass marketing. (Free Viagra or stuff like that) The most common I used to get is push/mass marketing. I once got my Inbox filled with 10,000 messages in less than a month. 5. Why is deliberate spreading of viruses unethical? Name five reasons. ? ? Intrusive software such as â€Å"worms† and â€Å"viruses† which are destructive to the computer system is also illegal. (Buzzle  ®) Congesting somebody’s system with a lot of unwanted information is also unethical. Buzzle  ®) ? 1) Thou shalt not use a computer to harm other people: If it is unethical to harm people by making a bomb, for example, it is equally bad to write a program that handles the timing of the bomb. Or, to put it more simply, if it is bad to steal and destroy other people’s books and notebooks, it is equally bad to access and destroy their files. (CEI) 3 FRITZ, LTELATK Ethical Computing QBA 362-Spring 2010 ? 2) Thou shalt not interfere with other people's computer work: Computer viruses are small programs that disrupt other people’s computer work by estroying their files, taking huge amounts of computer time or memory, or by simply displaying annoying messages. Generating and consciously spreading computer viruses is unethical (CEI) ? 7) Thou shalt not use other people's computer resources without authorization: Multiuser systems use user id’s and passwords to enforce their memory and time allocations, and to safeguard information. You should not try to bypass this authorization system. Hacking a system to break and bypass the authorization is unethical 4