Crimminal justice Essay Example | Topics and Well Written Essays - 500 words

Crimminal justice - Essay Example And, Article III ensures both federalism and separation of powers by providing a mechanism for the Supreme Court to put forward guidelines for the lower courts. It is pointed out that â€Å"the Constitution clearly does limit in important ways congressional power to shift ultimate judicial power from federal to state courts† (Amar 271). Additionally, there are mechanisms such as â€Å"the case or controversy requirement, also called the â€Å"justiciability† doctrine, includes more specialised notions of ripeness, mooteness, and standing to sue, and prohibits consideration of constitutional issues except as a necessary incident to the resolution of a concrete â€Å"case† or â€Å"controversy† (Brilmayer 297). Also, judicial precedent is one of the constitutional provisions for ensuring coherence in the praxis of criminal justice in the United States. The doctrine of judicial precedent in America is closely linked to other constitutional provisions such as the hierarchy of courts, separation of powers, judicial supremacy and the ideology of judicial adjudication. The interpretative nature of judica precedent is based on the fact that â€Å"judicial outcomes are fundamentally indeterminate† (Shapiro and Sweet 122). However, judicial precedent functions in all direction as all courts have to refer at each other decisions on criminal justice of similar type irrespective of the court hierarchy. It means that judicial precedents, in practice, â€Å"help judicial law-making -an intrinsically decentralized mode of governance- achieve a semblance of centralization and systematic coherence† (Shapiro and Sweet 121). American federalism is deep and substantial as it allows an inherently heterogeneous legal system wherein state laws exist in competition with what is legal in the federal realm and other states. American criminal justice system too is highly influenced by the

Judgement and decision making Essay Example | Topics and Well Written Essays - 500 words

Judgement and decision making - Essay Example This tool is also essential, non-egocentric social propriety; thus, Madoff should use this tool to win investors’ trust on their $50 billion. Notably, Bernie Madoff might have capitalized on this tool to influence that belief and trust of investors that he could manage the $50 billion economically and profitably (Kramer, 1998). On this note, Madoff should use the Cialdini’s principle that includes the mode of dress, education, physical characteristics (age, posture), and level of education and experience in handling the entire investment persuasions. Additionally, Madoff could have removed the self-interest from the investment (Connolly, Hammond, and Arkes, 1999). The principle of removal of self-interest from the persuasion often increases the perception of other interested parties in the discussion. However, there are chances that Madoff can fail to convince the investors to entrust him with $50 billion. This might happen if he lacks the expertise or rather the miss-entitlement to allocate incentives. Notably, the decision can only be taken in the self-interest of Madoff but not that of the business (Connolly, Hammond, and Arkes, 1999). In such a case, some of the investors may suspect his own judgment in the persuasion deal and fail to follow his authority’s instructions. Therefore, if Madoff remain faithful and persuades the investors at the interest of the business, there are high chances that the investors may entrust him with their $50 billion worth of investment. In addition, Madoff should apply the liking or the affect as a persuasion mechanism to note that the things that make people feel valued are things that are equally beneficial to those people. The approach also has a strong motivating power, love, anger, pride, and attraction among others. Well articulation of this principle shall overwhelm reason that eventually become extraordinarily difficult to change

Ethical Decision making by School Principals Essay Example for Free

Ethical Decision making by School Principals Essay Principals are faced with the challenge of managing schools and there is need for them to be ethical, respectful, inspiring, creative and knowledgeable about methods of instruction and the culture of the school and curriculum. These principals are also faced with the challenge of knowing and identifying areas of support that is able to enhance the school’s mission and also manage the areas that impede the achievement of a stated mission of the school. Since the needs of students are ever changing, they should also be in a position to make both smaller and larger adjustments that could be beneficial to the school and easily manageable by the organization in the management of these decisions. (Sousa, 2003, pp. 195-198). A decision is termed as ethical when it is able to bring about positive results and does not harm other people or the third party. These decisions are able to bring forth respect, trust, fairness and caring, responsibility and demonstrate good citizenship. When a decision accomplishes the needs of people together with their purposes, it is then termed as an effective decision. Ethically sound decisions are mostly advanced by two critical aspects namely discernment and discipline. For a decision to poses the aspect of discernment, it requires judgment and knowledge. The strength of character on the other hand, makes up a good decision and this takes moral change and the will power to be able to do what needs to be done (Hoy Tarter 2004, pp. 56-60). Ethical decision making calls for good leadership from principals. Leadership may be described as the authority or ability of an individual or individuals to lead others towards the achievement of a goal. It involves directing and influencing others towards the accomplishment of the stated common objectives and involves responsibility and accountability for the group. There are various leadership styles that are used today in many organizations and institutions. The autocratic type of leaders apply unilateralist while dominating their team-members in order to achieve a particular objective. However, this method often results to resistance from the team- members, as this style generally requires constant pressure and a lot of direction to get things done. On the other hand, this style could be more effective in urgent situations requiring urgent action (Schiminke, 1998, pp. 107-110). In the Laissez-Faire leadership, little control is exercised by managers over their groups. This allows the team-members to sort out their duties and obligations but the manager is not in any way involved with them. This style of leadership however is ineffective at certain circumstances since the team is left floundering with limited motivation and direction. Laissez- faire is effective in cases whereby a manager leads a team that is highly skilled and motivated and these people have in the past produced excellent work. The Democratic leader on other hand often uses participation and the groups’ teamwork towards attaining a collaborative decision. This style focuses on communication between the leader and the team and hence a positive climate for achieving results is created. The leaders consult their teams before making a decision while still in control of the team. These leaders allow the team to make decisions on how certain duties will be carried out and by whom (Schiminke, 1998, pp. 107-110). In addition, a good democratic leader is one who approves participation by team members and delegation of duties or tasks is done wisely. This kind of a leader values the points put forward from them and also encourages any group discussion. He also empowers the team through motivation. On leadership styles include a coercive leader, authoritative. Leader, affiliative leader, pace setting and a coaching leader. A coercive leader demands obedience, which should be instantaneous and applies initiative, achievement and self-control. In times of crisis or company turn around, this style is considered to be more effective but it mostly creates a negative climate for the performance in an organization. The authoritative leader on the other hand is considered to be one of the most effective as this leader inspires employees to follow a vision, facilitate change and creates a strong organizational climate that results in positive performance. The affiliative leadership values people, their emotions and their needs and relies on friendship and trust to promote flexibility, innovation and risk taking. A pacesetting leader can create a negative climate because of the high standards he or she sets. This style works best in attaining quick results from highly motivated individuals who value achievement and take the initiative. Lastly, the coaching leader builds a positive climate by developing skills that will foster long-term success. This type of leader also delegates responsibly, and is skillful in issuing assignments that are quite challenging. Leadership entails organizing people in a bid to achieve the stated goals of the group. It is therefore essential that leaders should posses certain basic qualities that will enable them to be effective leaders in whatever situation or task they undertake (Guy, 1990 pp. 105-107). Leaders should display a good work ethic that will enable other employees to emulate. A good work ethic includes: being on time, being organized giving praise to employees, being well prepared for meetings and having good communication within the venture that will go a long way towards achieving emotional and financial success. Therefore a leader should set an example with an ethical set of values for other managers and employees. For a leader to be effective, he/she should be willing to constantly learn at the same time integrate the knowledge they have acquired through learning into their leadership style. They must also develop skills that will promote them into being good leaders. Another quality of a good leader is that they should constantly keep up with the current trends in leadership and be aware that the leadership styles are constantly changing. In other words these leaders should be open to change. A good leader should also be able to mobilize people and acquire their trust in the process. Good leaders should also have the ability to communicate effectively with their subordinates communication is an essential aspect since it involves both listening and sending messages or telling others what needs to be done. Moral leaders are in a position to produce good moral leadership. They mostly apply restraint and power in their leadership. They are willing to accept any results without imposing control on other people. This is stewardship. It enables leaders to accept their faults which are human instead of shielding themselves under their authority and status. Ethics can be described as the codes of conduct that guide on how one should behave regarding moral duties and virtues. These moral principles guide a person in determining what is wrong or right. Morality by principals can be termed as personal ethics. This is because personal ethics reflect the expectations of people of all works in the society. Ethics has got two aspects: the ability to determine right from wrong, propriety from impropriety and good from evil. The second perspective concerns the commitment to perform an action that is proper, right and good. The principles of personal ethics include: trustworthiness and honesty, concern for the well being of others preventing harm refusing to take unfair advantage, respect for the autonomy of others and basic justice. Ethics as displayed by principals in schools or any other leaders could be classified as under written and unwritten codes of ethics: codes of ethics are the efforts which are systematic in nature and are used in defining the right conduct. They also provide guidance and help in the installation of confidence in various aspects of life from the government and all organizations. The main guidance is reflected in the decision making process especially where values seem to conflict. Written codes of ethics can be made known by an organization, professional or jurisdiction. On the other hand unwritten codes that exist and that help us in our lives are more effective than the written ones. Un written codes of ethics include rules such as honesty, security, loyalty among others. These unwritten codes of ethics mostly arise from family and cultural tradition and can also be found in workplace. These written and unwritten codes of ethics mostly arise from family and cultural tradition and can also be found in workplace. These written and unwritten codes of ethics are found in the society and they help one in establishing their personal belief system. Ethical behaviors should be a part and parcel of an individual’s daily routine (Murphy McMurty, 2000. pp. 110-115). I believe that Principals need to make strategic decisions since society and environment are dynamic and this provides them with a means that is strategic in nature that could enable them consider the external environment by focusing on the strength of the school organization, reducing weaknesses in school and also identify all the available opportunities that could put the school at a better position to be able to gain a competitive advantage. School principals are able to make an ethically defensible decision when the decision is well thought considering all the formal possible angels meaning that everybody takes part in decision making. In addition, ethically sound decisions in corporate all the possible solutions regarding the positive and negative outcomes of the decision. The decisions made by school principles need to involve a consultative process, team or group process or delegated duties to the staff members. This will help principals to come up with an ethically sound decision that will have a positive impact to all the members of the society which includes the students. Today, school leaders are the people who are accountable ethically, legally and morally for any decisions that they make in schools. Dempster and Parry (1999) note that the schools pressure mainly arise from four sources that is pressure of involving non-educationalists in the decision making in schools; changes in the growth of knowledge and applying the new advanced technology in learning processes; increased social problems such as suicide, violence and unemployment. This means that school leaders are constantly faced with ethical dilemmas while making decisions in schools hence resulting in conflicting ethical principles. Therefore how ethics/morals impact on decision-making is profound as this could easily change the way society operates. Foster (1986) also notes that it is the actions by the officials of the school that will strongly determine personal codes of ethics and values (Shapiro, 2000, pp. 120-125). On the ethical decision making by principals in schools, Denig and Quinn (2001) proposed a philosophical model with two moral principles namely; care and justice. They argue that most of the decisions that are made by school leaders, are mainly based on formalism which is policy and law and this is aimed at bringing about the greatest good to all (utilitarianism). In other words, this approach clearly views decision making as a rational approach that involves the use of universal principles. The decision maker performs what is right that could result in good deeds to all rather than individualism hence equity becomes the desirable outcome. They also point out that it is only through making decisions by collaborative means that these leaders can be able to analyze the dilemmas and get prepared to encompass the principle of working together with the school system and this eventually results in making decisions that are ethical (Sousa, 2003, pp. 195-198). Greenfield (19991) on the other hand argues that school leaders experience distinct sets of demands concerning ethics. He notes that schools being moral institutions are designed to bring for the social norms and other principles. They should be able to make decisions that are morally acceptable. He further notes that although schools are charged with the responsibility of creating moral values and making moral decisions by dedicating themselves to promote the well-being of their students, it is surprising that the same students have virtually no right to express themselves to what goes on in their schools and it is for these reasons that the conduct of these school leaders need to be moral (Kowalski, 2001, pp. 5-98). Robert Starratt (1991) also talks of equality in social arrangement benefits by arguing that today’s social arrangement results to unequal benefits among people. He argues that school principles should not only behave ethically but also be responsible individuals. Lastly, Green field argues that the authority of the principal is moral and teachers should be convinced that the decisions make by the principal reflects all the values that they support (Nutt, 2002, pp. 50-54). Kidder (1995) defines an ethical dilemma as the responsibilities that people face in making choices between two rights cherished values that conflict are the principle cause of dilemmas. For instance a principal is bound to be faced with a dilemma if at all he/she cherishes both the teacher and student and the teacher decides to enact a policy that will result in low expectations. Some philosophers and thinkers have come up with a number of guidelines that could help to solve these dilemmas faced by school leaders. They argue that leaders should be able and willing to act along the set standards of ethics. They could also address and also should be caring and conscious reflection whenever they lead other people (Nutt, 2002, pp. 50-54). School leaders could also form ethics committees to help them solve ethical dilemmas as these committees could prove helpful in raising the awareness concerning ethical issues, advising educators and also in the formulation of codes of ethics. A quality decision that is made by a school principal will depend on a number of factors made, extent to which others are able to generate a quality solution, how the problem is structured and the degree of commitment. Moreover, decisions made in schools require a lot of staff decision and support. School principals also need to understand the culture of their schools while attempting to make any decisions as this will establish whether the decision made is appropriate for the school. Therefore, these head teachers need to analyze and comprehend any relevant and comprehend any relevant information presented to them together with data. They also need to gather and measure evidence, issue judgments and finally make the necessary decisions. Creativity is essential as these will help in solving any anticipating problems hence development of opportunities for the school. Finally, school principals should be in a position to demonstrate quality judgment. This will enable them to know how and when they need to make any decisions among others. Decisions made by school principals could be autocratic, consultative, Group or Delegated decisions. An autocratic decision is that which the school principal makes it himself / herself by use of the available information or gathered from other groups or people. This therefore requires these school leaders to make appropriate and quick decisions when expected to do them at a particular point in time consultation on the other hand means that a problem has to be shared amongst individuals in order to obtain collective views or ideas but the school principal has to make the final decision afterwards.

Case Studies On The Importance Of Oral Care

Case Studies On The Importance Of Oral Care This submission is going to focus on the nursing care that I gave in one placement simulation and two consecutive shifts on placement, placing emphasis on oral care, medication management and communication. It will outline the fundamental aspects of clinical nursing skills that have taken place in my setting. This will also highlight the learning process taken place and how it helped me to enhance my knowledge, and ethical values in order to deliver quality and safety of care. Using other sources of current literature, I will use a reflective model to discuss how I have achieved the necessary level of learning outcome. By utilising this model I hope to demonstrate my knowledge and understanding in relation to these skills as well as identifying areas with scope for learning. Reflection is the process of reviewing an experience in order to describe analyse, evaluate and so inform learning about practice (Reid 1993). Gibbs (1988) model of reflection will be used as a framework, because it focuses on different aspects of an experience and allows revisiting the event fully. By contemplating it thus, I am able to appreciate it and guided to where future development work is required. For confidentiality purposes the patients real names will not be used and will be referred to patients as B and R. This is in line with the (NMC, 2008) requirements to maintain confidentiality at all times. A diary is supported in this assignment as an appendix within the time of the process. The reflective model I have chosen to use as guidance is Gibbs (1988). The care of a patients mouth forms an important component of assisting hygiene needs and yet is a nursing skill which is not always afforded the attention it fully deserves (Evans, 2001) Description I was part of a placement simulation group which went to the multi-skills laboratory to practice delivering and receiving oral hygiene. I was assigned a colleague to brush his teeth using a toothbrush and paste. I put on gloves to pre vent contamination (NICE 2003). Seeking his consent, I undertook a brief visual assessment of his mouths health. I then put him in a comfortable position so that he could tolerate the wash. Thereafter, I cleaned all-round the mouth, gums and tongue. I finished off by helping him to rinse his mouth with mouthwash. I treated my partner as though he was physically unable to hold the brush himself to scrub his own teeth, but he was able to communicate with me and was able to assist me in terms of spitting and gargling with water at the end of the procedure. Feelings When first informed that I was expected to undertake this task I felt anxious and concerned. I was aware that I had not brushed anyones teeth outside of my family before and that the mouth is an intimate and personal part of the body which is not usually exposed to anyone other than myself or the dentist. I was concerned about how my partner (whom I did not know well at that stage) would react to me examining his mouth. Writ ers have described such intimate physical assessments as creating a potentially intrusive situation (Lewis 2006, Sturdy 2007) which might cause the patient to feel uncertain and inadequate. I was also concerned that my own anxiety was shared by my partner who also appeared embarrassed and awkward at the time. This anxiety was increased when during the procedure my partner began to cough as though distressed. This caused me to feel hesitant about continuing- a situation recognised by Millon (1994) as a common response for carers to such an experience, although I persevered with his cooperation. When the task was completed I felt comfortable with my performance overall. Evaluation What was good about the experience was that, despite being aware that this role is often delegated to health care assistants (Kelly et al 2010), I was able to deliver a fundamental component of essential nursing care (Essence of Care 2003) quite effectively. The experience helped me to appreciate that oral c are provides any nurse with an ideal opportunity to undertake a thorough physical, emotional and cognitive assessment of a patient (DOH, 2001). I was satisfied delivering this aspect of care without harming the patient as no injuries were sustained (having I checked his mouth prior to and after cleansing). Also, I was pleased to have an opportunity to improve my communication skills through the delivery of this skill and to understand the impact that this might have on the development of a therapeutic relationship with future patients. From my colleagues reaction and feedback, I understood how feedback is an important learning tool. Despite my discomfort during the undertaking of this task, the experience highlighted the potentially complex problems I might have to solve in the provision of care needs to patients for whom I may not have had contact with before. Analysis Administration of this clinical skill involved undertaking an assessment of my colleagues mouth before delivering any care in order to help determine the most appropriate means of delivering oral care. Malkin (2009) asserts that this is a critical component of the procedure and was one I was keen not to overlook. The World Health Organisation (WHO 2010) describes a healthy mouth as being free of chronic mouth and facial pain and in the situation described; this is the condition I found my partners mouth to be in. I was therefore happy to proceed with cleaning his teeth as instructed. I selected to use a soft bristled toothbrush and toothpaste. The use of these adjuncts are described by many writers as being the most appropriate in terms of removing plaque and preventing trauma to the gums (Holman et al 2005,McCauliffe 2007).Despite this it has been identified that they are also most often not selected by nurses who appear uncertain about most effective evidence based practice ( McAuliffe 2007). Conclusion Clearly, mouth care is important and that, nurses have a role in assessing and maintaining it (Malkin, 2009).The task identified the role of the nurse in providing encouragement to the patient whilst delivering oral care. His weakness created a sense of dependency upon me and necessitated the utilisation of good communications skills on my part to complete the task properly. It has raised my awareness the effects of nursing interventions on others within my practice. Action Plan At the moment, I read more books a day than practice. My aim is to be proactive in the future by promptly opening up through total participation and doing more practices by brushing my teeth on regular basis. I would consider brushing others also and allowing them to brush mine in order to become familiar with areas that are often not well attended to. Keeping up to date with evidence based principles of practice will be maintained through the scrutiny of journals that refer to this aspect of care. I will take care to remember my feelings when providing and receiving oral hygiene before deliverin g it to patients in the future. Recognising the potential for embarrassment and awkwardness I will ensure that I treat the patient with sensitivity and discretion at all times. Administration of medicines is a key element of nursing care (Audit commission, 2002,). Therefore, one is accountable for the administration of medicines. Description I shadowed my mentor during the process of dispensing medication and knew that my role as a student nurse, each registered nurse is accountable for his/her practice. As a student it is important to seek consent from the patient before any care is given which I did. I went to the treatment room with my mentor and prepared for medication for morning. During the process of medication there are important nursing protocol steps to follow. Firstly, I checked order, assessing client, label medication, provide information to the client, check the medication when dispensing and record in the patients prescription chart. Patient R was present and I offere d him a cup of water along with the Clozapine 300mg in another cup. Before I came in contact with the patient, I read their notes and the medication they are on. This gave me the baseline whether the patients comply with medication and the reason why they do not comply. Feelings The routine for prescribing medication may be different in various clinical settings. Although I have participated dispensing medication, I felt nervous and did not want my patient to see this as a weakness. (Butler, 1991,) warns us that when our self-talk is negative, we are carrying around toxic environment for ourselves everywhere we go. My mentor took the role to encourage me by assuring that I was doing fine, talking me throughout the procedures of medication management. I had brief knowledge about medication and this gave the opportunity for my mentor to question my knowledge about the right dose, time, route, right patient and right drug. My role as a Nurse is to record and report deterioration improv ement and takes appropriate action for his treatment to care. Patient R felt that he did not need medication because he is not mentally ill. This was a barrier because he had no insight and it leads him to deteriorate with compliance. Evaluation 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). The (NICE, 2008,) guidelines state principles for the administration of medicines that treatment and care should take into account patients needs and preferences and patients should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals. The staff discussed his presentation to healthcare professionals in the Muti-disciplinary team (MTD) if they could change his medication time and dose as he presents lack of motivatio n and sedation. People with schizophrenia should have the opportunity to make informed decisions, including advance decisions and advance statements, about their care and treatment, in partnership with their healthcare professionals.(NICE, 2008,) This is the importance of communication working as a team within the MDT. Analysis Administrating drug medication is one of the most critical nursing responsibilities for both legal reason and safety patients. Hand washing was important protocol the infection control policy as hands are source of infection and hand washing would break the chain of infection. Patient R is on Clozapine. The use of this atypical antipsychotic licensed to people who are resistant to or intolerant of other antipsychotic drugs due to the potentially the use of adequate dose of two different antipsychotic agent. Clozapine can lower the number of white blood cells that help to fight infection (BNF, 2008,). Before initiating Clozapine, patients should have a history and physical examination. For example, if the patient has a history of cardiac illness, it is important that you have regular blood tests. The reason behind this is because, if 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 haematological history. Once a week I would go with the Patient to the Clozapine clinic to have blood test done and to monitor his potential side effects of psychiatric drug treatment. Patient R was presenting various side effects sedation, drowsiness which makes him less motivated to get out of bed for his medication leaving him to forgetting the mornings. Conclusion Not all non-compliant choose to reject medication; it may be because they forget to take them and this may be cognitive confusion. Intolerance of various side effects is the most common cause of clients discontinuing medication use (Tayl or et al 1997). It is important to remember that the symptoms can fall into a number of different categories, so patient like to be told their diagnosis and what is wrong with them (Blenkiron, 1998,). This area was one of my weaknesses, and I asked my mentor the importance of the Clozapine clinic and how it is associated with regular blood monitoring. I learnt that in order to attend regular visits, all patients must have normal leucocytes and different counts. Action Planà ¢Ã¢â€š ¬Ã‚ ¦ Communication Description On this occasion I was being observed and supervised by my mentor to work with a 45year old Caucasian man, with a diagnosis of paranoid schizophrenia and on section 37/41 of the Mental Health Act 1983. He has previously presented with chaotic behaviour, auditory hallucinations, delusions as well as violent and threatening behaviour. In the morning I would do my observation of the patient and make an assessment of how he presented himself to see if he had attended to his per sonal hygiene and activities of daily living. According to (Greenwood, et al 1999), patients who are in hospital satisfaction with information are found to be lacking. Feelings As a student nurse my role and responsibility by the (NMC, 2008,) is that you must respect and support peoples rights to accept or decline treatment and care. I observed that Patent R found it difficult to wake up and take his medication, which was a problem that staff nurses struggled with time to time. (Watson, 1995,) emphasise that caring communication is holistic, taking into account the entire person and demonstrating respect for the clients ad people. Evaluation Listening is the most important communication skill in nursing. (NICE, 2004), emphasis that communication between healthcare professionals and patients is essential. I learnt that if patients are encouraged to have treatment choice, they need to have information about the recommendation given before committing themselves. This is why it is impor tant that patients must be central to and include in their care. For the patients to be able to do this, it requires the nurse to use communication skills effectively, to develop therapeutic nurse-patient relationship in which the patient feels safe enough to disclose and discuss issues they find central to them and from jargon. Analysis During the shift I communicated with other members of the team on any significant events or any concerns with the patient. At the end of the shift I recorded what the patient had done for that day and I gave handover to the staff who were taking over the next shift. This was very important because it would ensure continuity of care and reduces any errors or omissions. A good example of effective communication links to medication is to give instructions and provide training involving analysis and synthesis of the learners experience. In reference to my patient (Gamble, 2004), illustrates when a person has mental health problem it can affect the indiv idual cognitive process, their beliefs, perception and outward behavior. If Patient R discontinues Clozapine he will become psychotic again and create a turmoil leaving the community and his family members in distress. Conclusionà ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦. I developed my knowledge by providing leaflets about Clozapine, encourage to attend to the clinic centre which they will explain the pros and cons of Clozapine. Action Planà ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦.. General Conclusion I identified that some patients felt uncomfortable with direct question so it was important to use (Bein and Miller 1992), Open ended question. The outcome if the client-nurse interaction depends on the nurses ability to engage the client in decision making and share the control and power in the relationship (Roberts, et al 1995,). I felt that their were barrier to communication as I felt that some of the staffs attitudes made me feel as if I was not part of the team and sometimes lead to me no being able t o give my views on issues regarding patients. Although I am aware that all nurses do not use evidence in the same way and may use different methods in clinical settings. I felt that working in partnership with the patient and other health professionals can enable time to build supportive and empathetic relationship as an essential part of care. (NICE, 2008,). The process of learning I went through is more complex than Gibbs suggests. It is not as cyclical as this model implies and I found myself jumping or combining some stages, before coming back. However, it has taken me out of my comfort zone, challenging my thinking.

Reflective Essay: Alice in Wonderland -- Charles Lutwidge Dodgson Lewi

There and back again with Alice I gasp my hands on my knees, bent over, out of breath. I can feel my lungs compressing and pushing hard against my chest in an effort to fit just a little more air. My palms are wet, beads of sweat trickle down my forehead, making my hair feel wet and sticky. My shirt is drenched in sweat. I stare at the ground and see the stalks of grass, standing tall like trees to the tiny ants that scurry among them. What I must look like to those minuscule creatures, like a giant, so big that I block the blazing sun and give them shade. I wonder if they are afraid of me? I lift my eyes and glance ahead. I’m almost there, only a couple more meters. I hear footsteps behind me, they’re catching up quickly. It’s now or never. I push off with my back foot and go into a sprint. My heart speeds up, almost as fast as I’m running and I can hear its pounding in my head, like a prisoner beating on locked doors, wanting to be free. If it had feet of it’s own it might run alongside me and race me to the fort, but that’s silly, hearts don’t have feet. I swing my arms back and forth to help me run faster and I try to take longer strides. I’m running so fast now, I feel like everything around me is standing still, as if I’m the only thing in the world that is moving. I don’t want to stop running, I want to keep going, faster and faster, forever. Now I understand why my heart pounds so hard, why it tries to push out of my chest and run on its little feet and never stop, never look back. But I canno t keep on running forever, I have to stop. My legs finally give in and I plop onto the stiff ground. The dust sticks to my sweaty clothes and turns into mud. I take big, loud breaths but I cannot hear myself because my heart is sti... ...in a scientific experiment. Everything is set to provide you with the perfect living conditions, the right amount of food, water, the right temperature, etc. And while you’re in that perfect, controlled environment you feel safe, you feel happy and yet, somewhere lingering in the depths of your mind is the gnawing sensation that at any given moment someone will unscrew the lid on your jar and let in the wrong air, that you will be forced to wake up from your perfect world and dragged, kicking and screaming into the world that everyone else lives in. That is my fear. That I will wake up one day and not be able to return to the world in my dreams but that I will have to learn to survive in the real world. Much like the adventuresome Alice, my wish is to live somewhere between the non fiction and fantasy of daily life, to allow the lines to be blurry. But how blurry?

Homer, Alaska :: essays research papers

Where the land ends and the sea begins Homer is the hub of the lower Kenai Peninsula of Alaska, an area incomparably rich in natural wonders and recreational possibilities. The Kenai Peninsula is an Alaska in miniature, a combination of mountain and meadow, coastline and island. The backbone of the peninsula is the Kenai Mountain Range, which separates the rolling hills and salmon streams from the Gulf of Alaska and cradles the 1,000 square mile Harding Icefield, a trackless inland ocean of 3 million-year-old ice. Around Homer, rolling hills and ridges overlook Kachemak Bay and Cook Inlet. Bears, wolves and moose roam the uplands; dozens of species of birds gather each spring to feed on the mudflats at the head of the bay. Until the early 1950s, Homer was accessible only by boat, airplane or driving the stony beach from Kenai. Paved road now strings together the coastal towns of Ninilchik, Anchor Point and Homer, affording impressive views of volcanic Mount Iliamna, rising more than 10,000 feet above the sea, and Mount Redoubt, which became active again in 1989 after a couple decades of slumber. Across Kachemak Bay, fabulously rich in marine life, mountains, glaciers and steep-walled fjords dramatically drop into the ocean. When wrapped in mist, the thick stands of spruce and hemlock lend an ethereal air to the secluded coves and bays. Seldovia, Nanwalek and Port Graham are ensconced in such sheltered recesses at the tip of the peninsula. The Southern Peninsula offers visitors an unparalleled blend of the wild and the picturesque, of vigorous life amid immemorial beauty, where glimpses of an eagle soaring, a salmon charging the rapids, or a sunset burnishing the mountain crests leave impressions that can never fade. Homer's population has grown to nearly 5,000 people, and the city serves as a trading and service center for nearly 10,000. It has a modern hospital, newspapers, public and commercial radio stations, a movie theater, thriving commercial and sport fishing fleets, and a high school that was honored in 1989 as one of the best in the nation. The Kachemak Bay area is the arts capital of South-central Alaska. An impressive group of professional and amateur artists provide residents with art shows, dance, music and drama throughout the year. The Homer Council on the Arts also regularly brings nationally- and internationally known performers to Homer. The area's major industry is commercial fishing, which pumps nearly $30 million a year into the local economy.

Working with Medicaid

Working with Medicaid The Medicaid program is for low-income people. The Medicaid program is financed by the federal government and the states. The Medicaid program is the nation’s largest non-employer-sponsored health insurance program. In order for a person so be eligible for Medicaid benefits, the must meet the minimum federal requirements and any additional requirements of the state in which they live. Medicaid rules vary from state to state and are frequently changing. Due to the variations in Medicaid rules from state to state, a person would need to contact their local social services department to find out what procedures and services are covered and not covered. Depending on what state a person lives in, those enrolled in the Medicaid program may be treated by a provider of their choice or it may restrict patients to a network physicians. Enrollees may have to receive all services through their primary care provider that is responsible for coordinating and monitoring their care. Those that need to see a specialist may need to obtain a referral from their PCP or Medicaid will not pay for the services. If a Medicaid enrollee wants to receive a service that is non-covered, the enrollee must pay for the non-covered services prior to the services being rendered. Medicaid recipients can also be billed if the physician informed the patient before the service was performed that the procedure/service would not be covered by Medicaid, the physician has an established written policy for billing non-covered services that applies to all patients, the patient is informed in advance of the estimated charge for the procedure and agrees in writing to pay the charge. If the physician has reason to believe that a service will not be covered, the patient must be informed in advance and given a form to sign acknowledging this. However, some states may require the enrollee to pay a small co-pay for covered services. Implications of simultaneous federal and state involvement in the insurance process could cause conflict between state regulations with federal regulations. The cost of compliance is more likely to be greater because there are two regulating bodies. Complexity is increased due to satisfying the requirements of two regulatory bodies. Regulatory goals of the states may be different than the federal goals which in turn lead to a duplication of effort.