Japan and US Relationship in History Essay Example | Topics and Well Written Essays - 1250 words

Japan and US Relationship in History - Essay Example In mid 19th century, America and Japan started their interaction in economic ventures and diplomatic relations. Among the ways these countries interacted included trading. During this time, various things characterized their view of each other. They expressed these feelings and thoughts about each other by diplomatic visits and entering into treaties that were targeted to bring cohesion and reduce any fear between them. During the time of interaction, some form of confusion and misunderstandings were manifested in their way of relations. Also, their initial interactions manifested differences that the two countries noticed about each other. The expression of diplomatic relationship is, however, noted in the way leaders addressed their counterparts through letters they wrote to each other. The kind of pictures that were drawn by both countries manifested their respect and honor for each other . Citizens of both countries manifested different views about each other. These citizens show ed this through their response when a leader from the other country visited; the reception these leaders got gave a lot of information about the citizens’ perception on the interaction between the two nations. The Japanese never thought Americans as equal to their leaders. Although they considered them important people, they still had some restrictions. For example, when Townsend Harris wanted to travel to Yedo, many Japanese were opposed to his view of going there on a horseback. Horses in Japan were a reserve of chosen few who were in royal ranks. It was only the vice-governor of Japan who supported the idea of Townsend going to Yedo by a horse . The views of Japanese about Americans were also characterized by respect for differences. For example, the images that were made to represent Americans manifested that Japanese respected Americans3. The Japanese drew a picture that represented streets of San Francisco with manifestation of well organized building structures. Again, the Japanese perceived Americans as a group of people who distorted their faith. According to them, the people from the west (i.e. the Americans) believed in Christianity which is different from the faiths of people f rom the Far East countries4. Japanese felt that Americans were people worth to be given freedom to live among them. The government of Japan gave Americans a chance to buy products and hire houses in Osaka and Yedo5. Americans tagged value on Japanese. This can be seen from the reception Japanese embassy was given when he visited San Francisco. The embassy was saluted with fifteen gun shots. In addition, residents of Alcatraz were waiting to see the Japanese embassy when he visited California6. Americans represented good pictures of Japanese leaders in the early times of their interaction. The kind of services Japanese received from Americans was a clear manifestation that they valued their relationship with Japanese. For example, the reception ceremony that was conducted by Americans when Japanese embassy visited their country was a colorful one. In the course of interaction between the Americans and Japanese, they continued to discover different things about each other. Their inter action was focused to understanding some things about each other. For instance, Americans wanted to know whether Japanese respected their rights. For example, when the American consul visited Yedo; first, he wanted to see whether he would be allowed to go into that city where none of the foreign embassies had ever entered. When finally he was allowed, he noted that the Japanese were highly regarding American officials who resided in Japan7. Also, the American

Financial management Essay Example | Topics and Well Written Essays - 1500 words - 5

Financial management - Essay Example Spencer PLC has more than 703 branches across UK in retail parks and in high streets in addition to the airports, stations and other places ranging from the flagship store and out of town over square feet of 100,000 to conventional Food Stores of 7 thousand square feet. The operating activities cash flow, the net cash gotten from the operations has been inconsistent from 666.5 M in 2009, 1601.80 M in 2010, 1197.50 M in 2011, 1443.30M in 2012, and 1236Min 2013. There was little impact of the currency movements on the sale and to the operating profit (Focardi & Fabozzi, 2004). Since the increase of the amortization the income tax reduced but this did not have any impact on the operating cash flow. The reduction in the net cash that the company earns means that the firm has less money to invest. This will subsequently lead to reduction in acquiring the assets and thus fewer dividends are declared to the investors. The cash adequacy ratio shows that the firm operating activities produces insufficient funds to meet the needed business obligations. The Spencer business has since reduced over the years which are evident from the reduction trend of the operating cash flows (â€Å"Foundations of Finance The Logic and Practice of Financial Management, Stude nt Value Edition + Myfinancelab Package†. 2010). This means that the subsidiaries are deteriorating over the years. With the above data it is clear that the net cash flow has been reducing over the last three years which is not a good sign for the company. The net investing cash flows from the investing activities have has unfavorable data which are in negative since 2009.. As outlined in the table the figures from 2009 shows a deficit of 251.7 M, 2010 showed a surplus of 253M, a deficit of 253.4 M for 2011, a deficit of 650.8 in 2012, and a deficit of 966.2 was reported in 2013. The company acquired properties, investments, equipment and

Religion and Well-Being Essay Example for Free

Religion and Well-Being Essay Religion can be defined as a strong belief in the supernatural power that holds the sole authority to control human destiny. It is an institution that helps to express our belief in a heavenly power. Religion is as old as the human civilization and came into existence when the human brain became superior to realize the significance of faith, and worship. Earlier humans lived in small groups, and each group recognized an icon that harmonized the ideologies of different people in the group. Rituals were an essential part of lives and were carried for natural resources icons such as moon, sun, fire, river, etc. since its beginning religion has been very beneficial for humans and it still holds an important place in the lives of people. Religion is a completely personal choice and should be left to the choice of individuals. It is unfair to force a religion on followers of some other religion through offering gifts and cash. Each religion has its own beliefs and ideologies and should be mutually respected by others in the world. Only then this world can become a better place to live. A growing number of studies convincingly demonstrate that people who are more deeply involved in religion tend to enjoy better physical and mental health than individuals who are less involved in religion (Ellison Levin, 1998; Koenig, McCullough, Larson, 2001). As this literature continues to develop, researchers have begun to tackle challenging issues that involve explaining how the salubrious effects of religion on health might arise. A number of potentially important theoretical perspectives have been devised. For example, some investigators argue that involvement in religion exerts a beneficial effect on health because it helps people cope more effectively with the deleterious effects of stress (Pargament, 1997), whereas other researchers maintain that the potentially important health-related effects arise from the sense of meaning in life that many people find through greater involvement in religion (Park, 2005). An explanation that was proposed some time ago forms the focal point of the current study. More specifically, a number of researchers have argued that people who are more involved in religion tend to have better health because they are more likely to adopt beneficial health behaviors than individuals who are less involved in religion (Levin Schiller, 1987). Subsequent research has provided support for this perspective. For example, a number of studies indicate that individuals who attend religious services often are more likely to avoid the use of tobacco and alcohol (Gillum, 2005; Strawbridge, Shema, Cohen, Kaplan, 2001). Moreover, greater involvement in religion has been associated with more frequent exercise, a better diet, better sleep quality, and the regular use of seat belts (Hill, Burdette, Ellison, Musick, 2006; Hill, Ellison, Burdette, Musick, 2007). There is also some evidence that religious individuals are more likely to engage in a range of preventive health practices, such as getting a regular mammography, having a routine cholesterol screening, and obtaining flu shots (Benjamins, 2006; Benjamins Brown, 2004; Benjamins, Trinitapoli, Ellison, 2006). Although there is broad-based empirical support for the notion that religious involvement is associated with beneficial health behaviors there is still a great deal that is not known about this relationship. One area that is in need of further development forms the focal point of the current study. More specifically, researchers have not devised well-articulated models that explain how involvement in religion promotes the practice of better health behaviors (e. g. , Benjamins et al. , 2006; Ellison et al. in press). This information is essential for the development of more effective interventions that are administered in religious institutions. As van Ryn and Heaney (1992) observe, â€Å"Clearly, application of well-defined and carefully tested theories to the program development process holds tremendous advantages for health educators in terms of coherence, effectiveness, and evaluation of interventions† (p. 328). Three potentially important mechanisms have been identified in the research that has been done so far. The first involves the notion that certain religious beliefs encourage people to take better care of their bodies. Included among these beliefs is the notion that the body is the â€Å"temple of God† (Ellison et al. , 2009) as well as the belief that better spiritual health is associated with better physical health (Benjamins et al. , 2006). Second, a number of investigators provide evidence which suggests that some people take better care of themselves if they worship in congregations that provide formal programs that are designed to promote better health behavior (Campbell et al. 2007; DeHaven, Hunter, Wilder, Walton, Berry, 2004). Third, other researchers report that people who attend church on a regular basis are more likely to adopt beneficial health behaviors because they are encouraged to do so by their fellow church members (Ellison et al. , 2009). For more than 100 years, researchers have argued that religion is an inherently social product. For example, James Mark Baldwin, an early president of the American Psychological Association, wrote in 1902: â€Å"The fact is constantly recognized that religion is a social phenomena. No man is religious by himself, nor does he choose his god, nor devise his offering, nor enjoy his blessings alone† (p. 325). Although the early theorists made invaluable contributions to the literature, they did not explore the more pragmatic implications of their insights. The current study was designed to contribute to more recent efforts by a new generation of scholars who have begun to assess health-related effects that appear to arise from deeper involvement in religion. We hope the findings from the current study and the theoretical perspective we have devised encourage further research in this field.

Attribution Theory Essay Example for Free

Attribution Theory Essay Attribution Theory Definition The process by which persons interpret and pinpoint causes for their own personal and other’s behaviour is the theory of attribution. 1 In this motivational theory, a person always finds a way to explain things, he make inferences on why things or events occur. After explaining the events a person then predicts future events through his inferences. He wants to understand the reasons or causes behind behaviour of people and why events happen. It was first proposed by Fritz Heider in 1958 and further developed by Harold Kelly and Bernard Weiner. Theories Internal vs. External Attributions Every person observe and analyze things differently thus having different ways of explaining things. The attribution theory proposes that when people observe and analyze things they try to find out whether it is caused internally or externally. 2 Attribution is a three-stage process: (1) Observation of an individual behaviour, (2) Determination whether the behaviour is intentional and (3) Attribution of the observed behaviour to internal or external factors. Those that are believed that can be personally controlled are called internal attributions while those believed to be caused by outside forces are external attributions. 2Â  Example of internal attributions are ability, personality, mood, efforts, attitudes or disposition while external attributions are task, other people and luck. 4 Following is an example of an application of this theory is when an employee failed to perform in a given task, a manager tries to explain why this thing happened. He may attribute this failure to poor efforts made by his subordinate (internal attribute) or he may consider that the given task maybe be too difficult for his employee (external attribute). Consistency, Distinctiveness and Consensus On the other hand, when making a determination between internal and external causes of behaviour, three factors must be considered: (1) consistency, (2) distinctiveness and (3) consensus. 1 Consistency is how frequent a person behaves similarly when faced with the same situations. Distinctiveness is how different a person behaves when faced with different types of situations. Consensus is when a group of people behaves similarly when faced with the same situation. 2 When a person behaves similarly when faced with same situations, we can say that the consistency is high; if he acts differently every time exposed with the same situation, consistency is low. 3 An example of consistency is the following is when an employee consistently has a low performance when he always assigned in a individual task rather when he is assigned in a group task. The observed behaviour of the employee wherein there is a high consistency can be attributed to an internal factor which is attitude. When a person behaves differently during different types of situations distinctiveness is high; if he behaves similarly during different situations, distinctiveness is low. 3 An example of distinctiveness is when an honor student gets high grades (same behaviour) in all of his subjects during three consecutive grading periods (different situations). The observed behaviour of the student wherein there is a low distinctiveness can be attributed to an internal factor which is ability or effort. When the observed behaviour of a group of people is the same in a given situation, consensus is high; if this group behaves differently given a similar situation, consensus is low. 3 An example of distinctiveness is when all students are late in a first period class (consensus is high), the attribution to this behaviour maybe due to an external factor which is traffic caused by a vehicular accident. Figure 1. Summary of the key elements in attribution theory. 2 Errors and Biases in Attribution The difference on how every person thinks, perceive and judge things may lead to some biases. One may consider the greater attributes of certain occurrences to external factors rather than internal factors or the other way around, well on the actual these considerations may not be correct all the time. Fundamental Attribution Error and Self-serving Bias Fundamental attribution error is when people have the tendency to consider the influence of external factors more than considering the influence of internal or personal factors. 2 An example of this is when we attribute the promotion of an officemate to perfect timing or luck rather than to his own efforts and perseverance. Self-serving bias is overestimating the influence of internal factors or personal traits rather than assigning external or situational factors to certain occurrences. When a person attributes his personal success to his own traits or internal and his misfortunes to bad luck or external factors, he is thus committing a self-serving bias. 1 Self-fulfilling Prophecy Perceiver’s expectations for a person will cause the perceiver to treat the person perceived differently and the person perceived will respond in a way that confirms the initial expectations. 1 Example of this is when a teacher thinks that his student will do well during his exam so he spends more time with this student and coaches him well, in return the student will get a high score in the exam. Summary Attribution theory is important to management because managers’ and employees’ actions and opinion can be influenced by how they perceive or see the reasons that cause human behaviour given a certain situation. 3 Different attributions of a manager to an employee’s attitude and performance can affect the standing of the employee in the organization. If a manager attributes the employee’s poor performance to lack of effort in performing the assigned task, he may fail the employee or give the employee a low rating during performance appraisals. On the other hand, if the manager attributes the poor performance to the high level of difficulty of the job, the manager may review and revise the job specifications to lessen the difficulty level of the job. Attribution also affects employee motivation. If an employee attributes the success to external factors, then they may lose motivation since anything that may occur is beyond their control. If an employee attributes success to internal factors like perseverance, then they are expected to have a high motivation for their job.

Nurse patient relationship and first case of death

Nurse patient relationship and first case of death Introduction The purpose of this essay is to discuss, analyse and reflect upon an acute event which took place when caring for a patient in practice. The writer has chosen to discuss the diagnosis, care and death of an 82 year old gentleman, named James Green (hereafter referred to as James). The writer will discuss the nurse-patient relationship experienced with James, and how his death affected the writer. Due to and to ensure confidentiality, the chosen patients name has been edited, which follows the guidelines of the Department of Health Code of Practice on Confidentiality (2003), NMC Code of Conduct [Confidentiality] (2008) and the Use of Patient Information (DH 2006). The essay will begin with a discussion on reflection including definitions, its purpose, and the advantages and disadvantages of reflection in nursing and education. The essay will then describe the acute care event of his diagnosis and death and reflect upon this. The essay will be structured using Gibbs Reflective Cycle (1988) to enable the writer to consciously analyse what happened and why. In certain areas of this essay, it will be appropriate to write in the first person, when describing the incident and discussing the thoughts and feelings experienced at the time (Webb 1992). It is not usually academically appropriate to use the first person, however, in reflective essays, personal thoughts and emotions are required in some areas and therefore Webb argued that it was certainly more appropriate to refer to oneself as I in those sections. From the section subtitled Evaluation, the writer will revert back to writing in the third person, as this is considered more academically appropriate for analysis and evaluation. Reflection was appropriately described by Boud (2001) as turning experience into learning however, it has been considered an important tool in learning and development for many years. Reflection was first documented in 1933, by the philosopher, John Dewey, in his studies on psychology and the way one thinks and learns. Dewey thought of reflection as a form of problem solving, by relating ones experiences to earlier similar ones to explore any commonalities. Another concept of reflection is that it enables the nurse to solve problems or learn from actions through thinking consciously about an activity which would then enable one to learn from any task undertaken. This was argued by Mantzoukas and Jasper (2004) in their studies on reflection and ward activity. However, in nursing, one of the most significant studies on reflection was carried out by Donald Schà ¶n (1983; 1987) in his works on The Reflective Practitioner. Much of the nursing literature regarding and surrounding reflecti on refers to Schà ¶n, which indicates that his work is widely accepted in nursing and nursing education. It is also from Schà ¶n that the term reflective practice was born. Schà ¶n advised that reflection, is a form of story telling, that leads the nurse into selecting particular actions and details of an activity one would normally or abnormally carry out. This in turn allows the nurse to solve details of their actions and learn exactly what in fact they had carried out. In nursing, reflection is used as an aid in recognition and development of knowledge and skills of chronic and acute illness, accidents and the care and treatment of a patient. Reflection following an experience in practice allows a nurse to revisit, explore and learn from an incident and gives an opportunity to relate the incident to theory. According to Maggs and Biley (2000) there are advantages to learning and evaluating practice through reflection. By allowing one to challenge opinions and theories in relation to an incident and relating these back to practice, the nurse can spend time discovering what happened and why. Reflection can be used to evaluate any clinical incident, positive or negative to attempt to better understand and contemplate the events which have taken place, and the behaviour, emotions and actions of not only the nurse, but the patient and others involved at that time Reflection allows time for one to think deeply about a situation and increase knowledge sur rounding that situation (Hannigan 2001). These advantages were mirrored by Gustaffson and Fagerberg (2004). Reflection in nursing is guided by various models of reflection, such as Gibbs Model of Reflection (1988), Johns model (1994), Kolbs Learning Cycle (1984) and Atkins and Murphys model of reflection (1994). This essay will focus upon and use Gibbs Model as the structure for reflecting upon the acute care event witnessed in practice. Gibbs model is considered a useful framework by students for structuring reflection as it is clearly separated into smaller sections titled, description, thoughts and feelings, evaluation, analysis, conclusion, and an action plan, in the style of an ongoing cycle of learning and reflecting. Gibbs unlike most other models of reflection encourages the learner to think through emotions and feelings experienced (Jones and Alinier 2006). However, Rolfe et al (2001), and Jones and Alinier (2006) argued that the six sections in the cycle were unspecific and too general and that it assumes that all learners have the same needs. Despite this, for the purpose of thi s essay, Gibbs model is considered the most appropriate. It would appear from the literature read, that there are many more advantages than disadvantages, for the use of reflection in nursing and nurse education. However a strong example which was found when searching for disadvantages was that some writers believe that not all those using reflection would feel comfortable writing openly and honestly about a situation, if they thought someone were to read it. This may be due to a lack of trust or a fear of humiliation or simply being unable to or not wanting to revisit uncomfortable situations or memories (Boud 2001; Tate and Sills 2004). Sumner (2010) discussed success in reflection in terms of moral maturity and found that nurses with little experience, as well as younger nurses, fail to have the experience and maturity to allow them to be comfortable and successful in reflection. Also, Dewey (1933) wrote that reflection only begins when an individual identifies a problem or a need to learn from an activity. If an individual is not to th ink of a problem or activity then reflection may not take place. The structure of Gibbs reflective cycle will begin here with the first section of the cycle, detailing what happened in the Acute Care Event. For the purpose of structuring this essay, each section will be subtitled in accordance with the headings used in Gibbs Cycle. Description As discussed in the introduction, the writer will here describe the illness and death of a patient being cared for in practice. The acute care event which will be focussed on is his diagnosis and death and the emotions felt by the writer following the loss of this patient. James had presented in AE after a fall at home and apart from a previous medical history of a myocardial infarction in 2007 and tachycardia, James was in good health. This was his first fall, however he had trouble recalling if he had tripped, or alternatively collapsed. Following his fall, it was reported he was having mobility problems and was notably short of breath and therefore he was admitted onto the ward, originally for overnight observation. He was being cared for on the ward with regular observations, medication and was prescribed 2litres of oxygen through a nasal cannula for his shortness of breath and lower oxygen saturation (SpO2). He was scoring 0 on most occasions on his Early Warning Score (Morgan et al 1997), which indicated that he was quite well other than his noted shortness of breath. Within 4 days of being admitted to the ward however, James health had not improved and rather, had begun to deteriorate and he was being monitored regularly. He complained of pain in his lower abdomen and advised he had been suffering from constipation intermittently for several weeks. He was prescribed senna to relieve this, however his symptoms persisted. James was then sent by the medical team for an abdominal CT and X-ray, which diagnosed colorectal cancer, with large malignancies in both his colon and rectum, and metastatic cancer of the liver. Consultants sadly diagnosed this as terminal as all 8 segments of the liver were cancerous and the disease was too severe for him to benefit from active treatment and so they recommended he be managed conservatively, ensuring he was comfortable and pain free. The decision was made by the medical staff following discussion with James that resuscitation would not take place in the event of an arrest as doctors decided this would allow James a dignified and peaceful death, given his diagnosis and illness. This is the decision made in most cases with terminal illness or with the very elderly (Jevon 1999). Despite this, staff predicted he would be discharged as he was still well and self-caring. Over the 2 weeks after his diagnosis, James weight decreased and his BMI dropped from19 to 16. His appetite lessened, and he became frail and unable to walk around the ward. On the fourteenth day following his diagnosis, James passed away around 7pm. I was caring for a patient at the bed next to him, when his family discovered he had passed away, and informed me. I closed the curtains around his bed and then reported his death to the nursing staff and my mentor, leaving James family to spend time with him and grieve. James was pain free at the time of his death and appeared settled and comfortable in the short time before his death that evening. Thoughts and Feelings This was my first experience of death, and James and I, along with other staff, had developed a strong Nurse-Patient relationship and rapport. He was a well liked patient on the ward and his diagnosis and death were sudden and relatively unexpected. The nursing staff allowed me to sit away from the ward as I was noticeably distressed, upset and unable to disguise my emotions. The break enabled me to compose myself away from the ward, James and his family and reflect upon what I had just experienced. I felt extremely sad that James had died and also felt as though I was unaware of how to cope or react having never seen a dead body and not experiencing death before. I found it difficult not to cry, knowing that some may find it inappropriate but informed the nursing staff of the fact that this was the first experience of death in an acute setting and that I felt inexperienced in how to deal with the emotions I was experiencing. Over the course of the evening, when speaking to my colleagues, his family, and when at home after my shift, I experienced phases of sadness, powerlessness as a student nurse and guilt. I felt it was appropriate to discuss my experience with my family in order to share my feelings and receive comfort and support from others. Some writers argue that the feeling of guilt and powerlessness is because many feel that somehow they should have done more to prevent the death occurring, despite death in many cases being unavoidable (Kirchhoff et al 2002). Dakin (2003) discussed that the emotions felt by the nurse are more for the impact the loss has on the family, and will begin when observing the emotions of the family. Gerow et al (2010) argue that the way a nurse copes during and after a first death, and whether they are supported by colleagues during this time, will affect their behaviour and emotions in future deaths. I feel I was well supported by my mentor at the time, in that she allowed me to take some time to compose myself after his death, and gave me the opportunity to decide whether or not I carried out last offices. My personal thoughts are that at the time of the incident, I was experiencing a similar grief to that of the loss of a loved one or friend, as James and I had developed a strong nurse-patient relationship and he was an extremely popular patient with all the nursing staff during his time on the ward, although he was always aware of professional boundaries. I feel that in reflection of this event, I was not prepared for experiencing my first death and was unaware of how to cope during the incident and therefore perhaps, I was fearful and displayed too much emotion. Kà ¼bler-Ross (1969, 1973), discussed grief as a five stage model, containing denial, anger, bargaining, depression and acceptance. When comparing the emotions felt during this time, it is quite possible that the feelings only cover the depression and acceptance stage of this five stage model. Her theory of grief was originally designed to incorporate the feelings of terminally ill patients into an understandable and recognisable model or cycle, however, the theory also includes a broader theory that those involved in a dying persons care may experience comparable stages of adjustment. Some have argued that this theory is not relevant to many patient or others experiences surrounding death or illness and that since the publication of her book, there has been no further research or evidence to support the five stage model (Bonanno 2001). Lange et al (2009), compared nurses attitudes and emotions when dealing with death regularly, to various attitude scales, such as The  Frommelt Attitude Toward Care of the Dying (FATCOD) Scale (1991), in which it gives a range of potential thoughts and feelings a nurse may encounter and asks the nurse to compare their feelings to these suggestions and gives a total score. Their findings showed that the more experience a nurse had with death and care of the dying, the more positive their feelings and emotions were, and those with little or less experience, showed more negative emotions, such as fear. The study also showed that those with less experience would benefit from education and exposure to ensure they cope effectively with end-of-life care and death, which mirrors other literature on nurses emotions and coping (Lange et al 2009; Hegedus et al 2008; Dunn et al 2005). The writer has read articles on the emotions experienced by students when coping with difficult situations and death which has allowed me to compare the way I felt, to the way other nurses feel in similar situations and literature has confirmed that the emotions felt by myself at the time of the incident are in fact quite common among nurses and in particular nurses with less experience in coping with death (Redinbaugh et al 2003; Lange et al 2009; Dakin 2003). Evaluation Prior to and after James death, following his diagnosis of terminal colorectal cancer, he was well supported by all health professionals involved in his care. He was notably low in mood and quite tearful at times in the 2 weeks before his death. He spoke at length about his feelings and asked a number of questions about his condition and about death. He would often inform the nursing staff of his gratefulness and ability to open up to them about his illness and discuss the shock he was suffering following his diagnosis. He would often advise us that he felt a comfort from knowing someone was there to listen and talk to him. James care was well managed by staff, including the acute care incident of his death where dignity and respect remained a positive element of his care as a whole. As previously documented, he was a popular patient on the ward and all health professionals enjoyed working with him. By deeming James popular, the writer has reflected upon this, and on the nurses attitudes towards other patients on the ward and whether care given to less popular patients was the same. Stockwell (1972) discussed the care given from nursing staff and attitudes, to popular and unpopular patients. This study challenged the opinion that nurses treat all patients the same in a non-judgmental manner and the conclusions found that those patients deemed unpopular were in fact treated less well than those deemed more popular. Reflecting on James and the other patients, this conclusion is fairly true of some, not all, nursing staff on the ward, in that there were similar patients whom were deemed more difficult to care for, and they were often not given as much time or support from staff. This theory has been revisited a number of times with different studies and reviews, man y of which reaching the same conclusions as Stockwell (English and Morse, 1988; Carveth 1995; Conway 2000). There are positive and negative elements to this, in that James was given excellent care and support during his time on the ward, and there is doubt whether the nursing and medical staff could have done more to reassure James or make him comfortable, however, it has made the writer realise that perhaps other patients were not cared for in the same way. At the time of the incident, immediately after being informed of James death; the writer feels as though they coped well, giving the family time and privacy to come to terms with his death, away from nursing staff and other patients. The writer was strong enough to not show any outward emotion at the time, and it was only when informing the other staff, that sadness and distress occurred. The writer feels the way they coped around his family was a positive experience, as they could see sadness from a nursing point of view, but other emotions were appropriately fairly hidden until away from them. Some may argue that perhaps at the time there was too much emotion exposed overall, however, again, these emotions did not show in front of James family (Bolton 2000). However, one cannot say that a tear was not shed when speaking to them, but the writer believes this to be an appropriate way of empathising with the relatives of patients following the death of their loved one, and for that, t he relatives are most grateful (Redinbaugh et al 2003). Dakin (2003), on a study of emotions of nursing students, found that most, if not all, have experienced a sense of loss and grief and have become emotional at the loss of a patient at some point, but mainly in the earlier stages of training and on the first experience of death. Redinbaugh et al (2003) again, discussed the emotions of Doctors and in particular medical students, following the death of a patient. Their findings showed that the more time that is spent with a patient; the more vulnerable the doctor is to feelings of loss when the patient dies. Although this paper refers to Medical staff and students, this is true for all health professionals, and can relate very strongly to nurses. As described above, the nursing staff allowed the writer to take some time away from the ward to stop crying and reflect upon what had and what was being experienced. One of the nursing staff came to discuss the writers feelings following his death and made sure the writer wasnt experiencing too much shock or distress. The support from nursing staff given during that time, was a very positive experience and extremely beneficial to learning. This was the writers first experience of Clinical Supervision, giving the writer time to discuss what had happened and the feelings being experienced (Cutliffe et al 2010). Clinical supervision was described by the NMC (1993) as à ¢Ã¢â€š ¬Ã‚ ¦professional support and learning which enables individual practitioners to develop knowledge and competenceà ¢Ã¢â€š ¬Ã‚ ¦. This best describes the support the writer was given during this time and Bonanno et al (2001) argue that talking, rather than writing, about ones emotions following trauma or loss is highly beneficial to learning. Analysis In this section, the writer will discuss how James was cared for during his time on the ward, and select key themes from the incident which will enable the writer to discuss and analyse certain elements of the incident. The key themes which have been identified from the description and on reflection are the nurse-patient relationship, grief, and coping with the first experience of death. Prior to James death, following his diagnosis of terminal colorectal cancer, he was well supported by all Health professionals involved in his care. As previously documented, he was a popular patient on the ward and had a strong positive professional relationship with all staff involved in his care. The writer feels as though this was a positive element of James care and that effective communication took place between staff and patient in this instance. James appeared happy on the ward and would often praise nursing staff for their ability to talk to him and offer comfort in a distressing time. The nurse-patient relationship was described as a therapeutic relationship between a nurse and a client built on a series of interactions and developing over time in Mosbys Medical Dictionary (2009), which the writer believes to be a positive description and true to that of the relationship with James. The nurse patient-relationship in this instance is a factor of this acute care event that the writer has chosen to reflect upon. The nurse-patient relationship was documented by Peplau (1952) in the Interpersonal Relationship Model, where Peplau wrote of this being an essential element of nursing to enhance a patients well-being. This was an essential part of James care and an element that he himself was grateful for during a difficult and emotional time. Pullen and Mathias (2010) wrote that the key to the patient feeling a sense of peace and well-being was based on effective communication and building a therapeutic relationship. Nicholson et al (2010) also discussed effective communication and relationships as a positive promoter of dignity. Sumner (2010) wrote that effective nurse-patient relationships are only present when the nurse is competent, mature and experienced enough to manage themselves in the interaction. This could be seen as a disadvantage in nursing as a whole as many nurses are young and less socially mature or experienced. Also those fitting this category may believe this to be a false claim of younger nurses which the writer can also relate to. She also wrote that in caring as a nurse, there are two players involved, the patient and the nurse, who both have feelings and needs which need to be addressed in the interaction. With relation to the connection with dying patients, many nurses find it difficult to approach a patient and build a positive nurse-patient relationship due to fear, or the fear of losing that patient. This however can frustrate the nurse as they may feel a duty to connect with that person as well as comforting the patient when they are in distress or are frightened (Moore, 1997). Mok and Chiu (2004) found that the nurse-patient relationship in palliative care often developed into more of a friendship, as a nurse would spend more time with the families and much more time listening to the fears of patients and attending to their needs. The relationship being seen as a friendship was due to the depth of intensity of the relationship. This is due to the patient discussing extremely personal and emotional aspects of their life which would not normally occur, however this is a one-sided intimacy (Spross 1996). This theory was true of the relationship the writer and other health profession als had with James. For this reason, it can be understood why nurses sometimes feel a great sense of loss after the death of a patient they have cared for, as a close relationship may have formed, particularly with long term patients. Another key point recovered from this reflection, is that of the sadness and grief experienced, following the death of this patient. As documented in the section subtitled feelings, the writer feels as though they experienced a sense of loss which can be related to grief which may be similar to that experienced following the death of a friend. This is due to the positive nurse-patient relationship with James and as previously written, the fact that he was a popular and well thought of patient on the ward. Because his death was sudden following the diagnosis of colorectal cancer, the writer believes that none of the health professionals involved were prepared for his rapid deterioration and death. Again, Kà ¼bler-Ross (1969; 1973), describes grief and loss as a 5 stage model, commonly known as the five stages of grief. In it, the stages described are, denial, anger, bargaining, depression and acceptance, however an individual may not experience these stages in the order Kà ¼bler-Ross described, nor may they experience all of the five stages. When comparing the emotions felt during this time to this model, it is quite possible that the feelings experienced only cover the depression and acceptance stage of this five stage model. However, in Kà ¼bler-Rosss description of these stages, she writes that depression involves a person becoming detached from emotion, non-acceptant of affection or acceptant of efforts to improve emotion. When comparing this description to the emotions felt during this time, it may be possible that one did not experience depression in the form that is described and may only have experienced the acceptance stage of her five stage model. In this stage Kà ƒ ¼bler-Ross describes the acceptance as coming to terms with the loss (Kà ¼bler-Ross 1969). Bonanno (2002, 2004, and 2009) is a popular critic of the work of Kà ¼bler-Ross and other theorists. In his studies, and his book titled The Other Side of Sadness: What the New Science of Bereavement Tells Us About Life After a Loss, Bonanno states that grief does not necessarily occur in stages, as has previously been argued, rather that it contains four common sections (trajectories) which different people facing loss will experience. The four trajectories, as detailed by Bonanno are resilience, recovery, chronic dysfunction and delayed grief. Bonanno has been highly acclaimed by many psychologists and his peers however he is criticised also for his argument that humans can be resilient, or hardy in the face of trauma, which overturns the theories we have become accustomed to such as Kà ¼bler-Ross stages of grief and Freuds theory of repressed memories and coping. Matzo et al (2003) argued that the loss of a patient can affect all involved, including the patient, the family and the nurse themselves and that a nurse will experience a personal feeling of grief and confront it with their own coping skills. In terms of the sadness felt by the writer at the time of the death, as previously discussed, some may argue that from a professional perspective, expressing emotion in such way is not appropriate , however studies carried out have shown expression of emotion to be a healing power and can help with coping with distress in future incidents (Kennedy-Moore and Watson 1999, 2001; Pennebaker, 1997). In relation to this, Consedine et al, (2002), argue that inexpressiveness can be harmful and can cause delayed distress on the body, however some have argued that in terms of coping professionally, not expressing emotion or a lack of association with an emotional event, may be beneficial (Bonnano 2001). In nurse education, the theory surrounding death and dying is taught in terms of definition, assessment and intervention, and all student nurses are aware of these from an early stage; however, little or no teaching is given on death, emotion, grief and the feeling of loss experienced by the nurse (Matzo 2003). This in turn can affect the way a student experiencing a death for the first time can behave and can affect the emotions experienced and displayed, as it did for the writer on the death of James. As discussed earlier Dakin (2003), found that most nursing students when asked to discuss an experience of death, have shared a sense of loss and grief and have become emotional at the loss of a patient at some point which has argued that the sense of emotion felt by the writer is in fact relatively normal, particularly when less experienced with emotion situations. Conclusion Following the incident, when reflecting upon what happened and the feelings of the writer, it could be confirmed by the writer that James was given excellent care and support during his time on the ward and in death, and there is doubt whether the nursing and medical staff could have done more to reassure James or make him comfortable. James was pain free at the time of his death and appeared settled and comfortable. The writer feels this incident, although sad and emotional, to be overall quite positive, in that it has enabled the writer to learn from the emotions experienced and build strengths in dealing with similar situations. This incident and the chance the writer has had to reflect upon what happened at the time, has allowed the writer to discover the thoughts and feelings of the incident and relate them to literature. As this was the writers first experience of death and dying, there is no other previous clinical incident to relate these feelings and behaviour to, although a similar incident which has recently taken place, will be discussed in the next section. From speaking with doctors and nursing staff on the subject of coping with the death of a patient and coping with the sudden diagnosis of terminal illness, the author has learned more about the topic and how to approach it. The writer has also found it positive to learn that the emotions experienced are common, particularly among nurses and that emotion is a natural human response that in some cases cannot be avoided (Dakin 2003; Matzo 2003; Redinbaugh et al 2003). Working with and meeting James was a very heart warming and at the same time educational experience for the writer, in that his death, although emotional, has enabled the writer to learn from what happened and from the emotions experienced and build upon strengths in dealing with similar distressing experiences in their future training and career. The writer feels happy that had the opportunity to work with James, and happy, and thankful that it was him whom the writers first experience of death was with. Action Plan From writing this reflective essay, the writer has learned valuable theory and skills in dealing with death and dying patients and how emotion is quite normal in the experience of death. From reading literature, it has helped me understand more about death, grief and about how nurses cope and develop coping skills when dealing with emotional situations. I felt it necessary to review literature, to compare my feelings and to discover if others experience similar a similar sense of loss. On discovering that the emotions felt following a first death experience are common, it gave the writer assurance and confidence that they would cope better the next time a death occurred in practice. Coincidently, after reading this literature, recently, another elderly patient passed away whilst the writer was in practice. Similarly to James, she was a well liked patient on the ward and her death was relatively unexpected, although she was frail and elderly. From reflecting now upon how the writer coped with James death and how they coped with the death of the second patient, an 90 year old lady, the writer can see a substantial difference in the emotions felt during each incident. This confirms that the writer has gained confidence, knowledge and skills in dealing with death and dying patients. The writer learned how to shed a tear without becoming overly emotional, and how to offer sympathy and support to the family of the deceased without showing too much sadness. The writer believes this is due to not only the literature read for this essay, but also the support received from the nursing staff following James death, and the clinical supervision received on the ward by nursing staff at the time. This mirrors Bonannos (2001) argument that talking about an incident and ones emotions is highly beneficial and potentially more beneficial that writing or reflecting about it. The writer does feel however that student nurses should be given more ed

Deborah Tannens Cant We Talk Essay examples -- Deborah Tannen Cant

Deborah Tannen's Can't We Talk Deborah Tannen’s case study entitled â€Å"Can’t We Talk?† is the most relevant reading that I have ever done for any class. It relates to a problem that every person regardless of age, race or sex, will have to face many times in his or her lifetime. The problem is that men and women communicate differently and these differences can often lead to conflict. This case study is very informative because it helps to clarify the thought process of each sex. That said this reading leaves the reader somewhat unfulfilled because Tannen does not offer a solution to the problem. In Tannen’s first section, status vs. support, Tannen states that women view talking as a way to receive support, whereas men are always trying to gain the upper hand while talking. Tannen and her husband had jobs in different cities. When people would comment on her situation Tannen would accept their support of her difficult situation. Her husband, on the other hand, would feel threatened and felt compelled to refuse their support and point out the good in the situation. Due to societal influences men are often expected to be tough and therefore they feel threatened more easily. Because they feel threatened more easily they tend to go on the offensive more during conversation. Women are expected to be more sensitive and therefore they seek support. The section entitled advice vs. understanding is very closely related to status vs. support. In this section a woman has a deformed breast, due to a previous bout with cancer, and expresses her distress to her husband. H er husband responds that she could have plastic surgery to correct the deformity. She became quite upset at the thought of another surgery. Because of t... ...roblems of inter sex communication. She does a superb job of pointing out how each sex reacts to each situation and why, but does not even propose a solution. Now that I have read this case study I feel as though I am prepared to offer a solution although I am not sure how viable it is. The recurring themes of Tannen’s case study are that men are expected to be tough and women are expected to seek support. These themes seem to be the root of the conflict between the sexes, so I would propose that each sex should do their best to break away from these expectations. Men should strive to be more open and less concerned about preserving a macho image whereas women should strive to be less dependent on the approval of others. While my proposed solution would not completely abolish miscommunication between the sexes, it would be a large step in the right direction.

The Origin of Gender Roles Essay -- Essays Papers

The Origin of Gender Roles The root of all gender issues which presently exist in society may be traced back to The Creation Story in Genesis. This crucial chapter of the Bible provides evidence supporting that God intended for man and woman to exist as equals, yet he assigned gender roles once Adam and Eve disobeyed him by eating the fruit from the forbidden tree of good and evil. Thus, men have been characterized as the â€Å"breadwinners† and women as â€Å"child bearers and housekeepers† since the beginning of humanity. The story of Lilith as Adam’s supposed first wife suggests Adam took on a patriarchal role from the beginning, yet Lilith refused to accept his assumed superiority. She initially challenges him, and then leaves him; she represents a rebellious, yet independent woman. Although these two stories on the first man and woman are significantly different, the two convey that men and women have been trapped in certain roles since the beginning of time, and have always had a power struggle between them. Gender issues have not evolved over time; they have always existed. â€Å"Then the Lord God made a woman from the rib he had taken out of the man, and he brought her to the man† (Gen. 2:22). The order of human creation in Genesis calls into question whether it was intended for a hierarchy to exist between genders. Since Eve is created from Adam’s rib, and as his helper, it is argued she is created merely to support him, and that she derives from him. These claims have connotations of inferiority. However, other evidence in the Bible proves God did not intend for man to be put above woman. He created both in his image, from the earth, and with the intention they would come together to form one flesh. Therefore, sinc... ... patriarchal text. It argues for women’s presence in the Bible, and deeply explores the stories of prominent female biblical characters. Swidler, Leonard. Biblical Affirmations of Woman. Philadelphia, Pennsylvania: The Westminster Press, 1979. Swidler compares the status of women from the biblical period to that of women from the post-biblical period. The author also evaluates the positive and negative aspects of Jewish and Christian biblical traditions, yet puts more effort into exploring the positive elements of the biblical tradition as far as women are concerned. The Bible. This is the King James Version which is most commonly used and analyzed. It is the core to many religions, and narrates the stories of all prominent biblical figures from the Old Testament to the New Testament.