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APNs have reported feeling greatly distressed when it comes to having to make end-of-life decisions because of a lack of support in this area. In conclusion, more effort needs to be put into making the lines less blurry for APNs so that they can make end-of-life decisions with more confidence and support.
Ahrens, T., & Kolleff, M. (2003). Improving family communications at the end of life:
implications for length of stay in the intensive care unit and resource use. Am J. Crit
Beckstrand, .L., & Kirchhoff, K.T. (2005). Providing end-of-life care to patients: critical care nurses' perceived obstacles and supportive behaviors. Am J. Crit Care,14: 395-403.
Daly, B.J. (2006a). End-of life decision making, organ donation, and critical care nurses. Crit Care Nurse,26(2): 78-86.
Daly, B.J. (2006b). The ethics of end of life care. Pgs. 16-17. The Frances Payne Bolton School
of Nursing. Case Western eserve University. Accessed…… [Read More]
End-of-life care provided by nurses in palliative settings necessitates conscious awareness of several factors that contribute to the effectiveness of care. Factors that are significantly important components of nursing in end-of-life care include communication skills, advance care planning, sensitivity to contextual and cultural factors, support from the healthcare team, and continuing education.
The importance of communication skills in end-of-life care was acknowledged by Clayton et al. (2007), who developed a set of communication guidelines that nurses could adhere to in the deliverance of end-of-life care. These guidelines were represented by the acronym PEPAED, and they included: to prepare for discussion, relate to patients and their families, elicit preferences held by patients and families, present information, acknowledgement of emotions and concerns, realistic hope, encourage questions, and documentation of information and documents (Clayton et al., 2007). Specific factors regarding the details of information communicated to patients are important in discussions…… [Read More]
End-of-Life Health Care
Imagine this scenario: a patient has end stage heart failure, coronary artery disease, peripheral artery disease, chronic obstructive pulmonary disease and sleep apnea. She has refused any invasive treatments for many years, ignoring potential consequences, and has opted for medical management. She has an advance directive stating her preference for no cardiopulmonary resuscitation, no artificial hydration or nutrition, and only desires comfort measures to allow for a pain-free and natural death. This patient has developed shortness of breath, leg edema, and chest pain, and is rushed to the emergency room. Upon admission, she is diagnosed with pulmonary edema and renal failure. Medications are administered to treat pulmonary edema, but she is not responding to the medications and starts to decompensate. The patient mentions that she does not want to have dialysis or a respirator. Her family is informed of the critical status of the patient and that…… [Read More]
Grief is not something that goes away on its own. If grief is not dealt with properly it can result in psychological problems for the sufferer as well as for the patient. A "positive coping style may be characterized by a spirit of inner strength. A negative coping style may be identified by helplessness or hopelessness, which may lead to more negative outcomes in dealing with life circumstances" (Guido 2010: 138). Grief that is not appropriately channeled can assert itself in unexpected ways: a husband may take out his anger at the loss of his mother on his wife, for example. Positive grief resolution can help the survivors have a more realistic and resilient outlook when confronted with future life events. Ideally, they can learn to honor the person who has passed without being overly regretful about what they cannot change. Grief that is dealt with in an unproductive fashion…… [Read More]
Life Dilemmas in Nursing
End of life
End of Life Dilemmas in Nursing: Issues with Euthanasia and How to Approach Them
A friend of mine had the unfortunate experience of having to make a decision about withdrawing health care from his terminally ill wife. Even without revealing too much detail about the case the description of this incident is rather disturbing. His wife had been treated for breast cancer, but several months later it was found that the cancer had spread to her lungs and brain. Upon returning from treatment one evening she began to experience hallucinations and became very confused. He took her to a local E, where she was combative, confused, and delirious. He was immediately asked by the E physician if he wanted her put on life support as her condition was terminal, and he asked that she be put on life support until he could discuss…… [Read More]
ethical hospice care is that it must be founded upon honesty. "Frank discussions about death and dying, clarifying knowledge of the underlying illness and knowledge of the dying process" is essential (Guido 2010: 35). However, this must be balanced with the patient's desire for confidentiality and his right to die in a way which honors his wishes. In this instance, a private and confidential discussion with Mr. West is essential. The nurse should explain why candor is preferable when dealing with his wife. By communicating the message that it will be less upsetting if Mrs. West is kept aware of his medical condition, Mr. West will be more willing to allow his wife to understand the likely trajectory of his condition. Then, the nurse should have a meeting with the couple and discuss what will occur. However, the hospice principles of honesty vs. autonomy would be in conflict if Mr.…… [Read More]
End-of-life cae may be one of the most difficult aspects of healthcae sevices. Afte all, the goal of most healthcae povides is to heal, and poviding end-of-life equies a shift in pespective. One of the challenges in planning end-of-life cae is that many healthcae povides ae simply not comfotable discussing end-of-life (Deteing et al. 2014). Fotunately, when povides take tageted classes with the goal of impoving thei ability to engage in end-of-life discussions, they self-epot feeling moe comfotable having these convesations (Deteing et al. 2014). As a esult, pio to eve woking with a patient to help plan end of life cae, any pofessional should make sue and take the classes necessay to help them with those decisions, including classes that ae specific to acial, cultual, o social issues that might be linked to a specific goup. This is impotant because diffeent cultues appoach death and dying in…… [Read More]
Ethics and the End of Life
Sometimes, when a human life is coming to an end, the most crucial aspect of providing holistic ethical health care is not maintaining life, but maintaining a semblance of familiarity and routine for the individual in question, and creating an equitable solution that satisfies the broad range of beliefs present amongst the members of all of the dying individual's loved ones. The recent case of Terri Shaivo, one must remember, came to the forefront of the national consciousness not because Terri Shaivo was unique in having her feeding tube removed -- as her husband Michael Shaivo reminded the media and the courts quite frequently, such a medical event transpires every day in hospices and hospitals where critically ill patients are being treated. hat was so unusual about the Shaivo case was the level of disagreement amongst the woman's loved ones, about what the woman…… [Read More]
The history of C.G. is that he is a former smoker, 69-year-old male with cancer in the head and neck (a radical neck dissection was performed in 2012), which has recently metastasized in the liver and lungs, as indicated by PET scan which shows metabolic activity. The patient suffers from moderately-severe depression with a PHQ-9 score of 15 (Kroenke, Spitzer, Williams, 2001) and refuses anymore chemotherapy. He is at a point now where he wants to know his options for what remains of the rest of his life, indicating that he is not willing to undergo any further treatment for the his cancer or its spread.
The results of the physical show that C.G. suffers from hypertension, hyperlipidemia, stomatitis, anemia, and neutropenia. He is currently receiving 12.5 mg of Carvedilol daily plus 40 mg of Furosemide daily. His BP indicates that he has "isolated systolic hypertension" and it is…… [Read More]
Charles A Corr's model highlights individual empowerment and guidelines for caregivers. Debbie Messer Zlatin's theory makes use of what she terms life themes in the dying process (Kubler-oss and other Approaches, n.d.).
8. The hospice approach to terminal care
The hospice approach minimizes the patients suffering and provides a compassionate environment for those in the terminal stages. It promotes comfort and quality of life without use of life extending measures. It centers on close, collaborative working associations between health care team members and family (Hospice Approach to End of Life Dementia Care, 2009).
9. Establishment of Hospice programs in the U.S.
The modern American hospice movement was started in 1974 with the founding of the Connecticut Hospice in New Haven. It was based on the replica of care best identified with Dame Cicely Saunders, MD. This center became the representation for complete whole person and family care at the end…… [Read More]
Cultural Issues in End of Life Care
In this age of increased social diversity the cultural aspects of end-of-life care have become increasingly important in the nursing profession. This importance is however complicated by technology and the cultural problematics of extended life care through artificial means. In the book Cultural Issues in End-of-Life Decision Making (raun, K, Pietsch, J.H. lanchette, P. 1999) the crucial point is made that "providing cultural and spiritually sensitive care requires that nurses, physicians, social workers and others know and understand the implications of family members' beliefs about life and death, supportive rituals and other activities." (Review: cultural Issues in End-of-Life Decision Making, 2004)
This book underlines the fact that cultural issues in end-of-life care have essential implications for nursing -- especially in that professional nurses should have knowledge or be cognizant of the wider cultural and social context or milieu in which they work. This…… [Read More]
Controversial Cases of End-of-Life Decisions
For this discussion, we consider one the most controversial euthanasia case in the history of America - the case of Terri Schiavo who never regained consciousness after collapsing at her home on February 25, 1990. She died 15 years later at a hospital but her death and the preceding legal battle that the Americans witnessed regarding the removal of her feeding tube created a firestorm of debate around the country about the status of end-of-life decisions (Johnstone, 2011).
There were people, politicians, artists, activists and the medical fraternity who were clearly divided in their opinion about the right to death and right to euthanasia. The debate clearly indicated the deep divide in the America society related to euthanasia and end-of-life care.
The proponents of euthanasia argued that it was needed by terminally ill patients and support their claims by 'the compassion argument'. They claimed that…… [Read More]
nursing research findings into clinical practice.
Nociceptive Pain at the end of life
Conduct a Medline/PubMed & CINAHL search to identify 2 (two) PRIMARY OURCE research articles that were published within the last 5 years that are not cited in the text Oxford Textbook of Palliative Nursing by Ferrell & Coyles chapter 6.
McMillan and mall (2007) conducted research in order to test whether the COPE intervention would help caregivers better manage symptoms and pain that is experienced by patients with incurable cancer. ince the caregiver acts as mediator between the critically ill patient and the hospital staff, the hospital staff, usually, relies on the caregiver for description of the patient's pain and symptoms. Caregivers, however, are frequently unable to adequately describe and recognize the intensity of symptoms as well as the emotional quality of life (QOL) of patient (all of which contributes to the pain). The researchers wondered whether…… [Read More]
Terry Schiavo died, she had been in a persistent vegetative state for more than ten years. Her husband claimed that Terry "wouldn't have wanted to live in her condition," and had legal guardianship over his wife in her condition ("Terry Schiavo Has Died," 2005). Although Terry's parents' feelings are valid and they do matter, it is clear that the courts made the right decision. There are many reasons why the courts made the right decision. The first reason is purely legal. Michael Schiavo, the husband, did have legal guardianship over his wife in this case. The parents of Terry, Bob and Mary Schindler, tried to wrest legal control from their son-in-law to gain control over their daughter's life. While it is understandable the parents would have wanted control, there is a reason why the law offers legal guardianship to the husband. If Michael Schiavo were unfit to be the legal…… [Read More]
The death of elderly individuals takes place in different circumstances and settings such as painless death at home or painful death in a healthcare facility. Social workers have an important role in planning end-of-life care as part of providing essential social support to elderly individuals. The role of social workers in this process is attributable to the significance of their professional practice in a multidisciplinary palliative care team in hospice and hospital settings (Watts, 2013). Since the death of elderly individuals occurs in a variety of conditions and settings, social workers need to plan for end-of-life care. The planning and delivery of end-of-life care helps in helping the elderly cope with serious illness, face mortality or manage the process of dying in an effective manner.
One of the major functions of social workers in their role in planning for end-of-life care is providing psychosocial and practical support to individuals who…… [Read More]
One of the most important ethical issues in nursing is how to approach end-of-life care. Nurses have a duty to provide compassionate care in ways that respects the individual’s autonomy and dignity. As patients live longer due to advancements in medical care, nurses are increasingly being faced with care options that extend life, versus options that do not extend life but which promote quality of life through a greater acceptance of death. A related issue is physician-assisted suicide. When physician-assisted suicide is legal, nurses may have this option presented to them by patients, creating ethical dilemmas. This paper will examine multiple sides of the end-of-life issue, showing that while there is no easy or “right” solution, individual cases should highlight the means by which nurses can always ascribe to their professional duties and the ethical standards of the profession.
Point of View: Quality of Life Over Quantity
Legal…… [Read More]
It is impossible for science to "overtake" the light but not impossible for humans to experience it. hile light is pleasing, it is not lasting for the poet. hen it is no longer present, what remains is something that is almost opposite to light. The poet describes the experience as a "quality of loss / Affecting our content, / As Trade had suddenly encroached / Upon a Sacrament" (17-20). Here we see the emergence of despair and loss when the light is gone. The light is a severe contrast with the darkness alluded to in the other poems mentioned here but above all, the contrast demonstrates the poet's ability to write about diverse topics.
Death is a source of inspiration for Emily Dickinson and while this make seem creepy to many readers, it is actually brave for the poet because death, even today, seems taboo for many artists. This may…… [Read More]
Life and Death in Shanghai
Nien Cheng, a lady of wealth, culture, and social refinement, was unused to the treatment she would ultimately receive at the hands of Mao Zedung's Red Guards. Viewed as a natural enemy to a Communistic regime - based on a measure of wealth and education - the mostly teenaged "Red Guards" invaded homes and workplaces in search of people disloyal to Zedung and the political environment of the day.
Considered "too aggressive and too independent in mind and spirit for a Chinese woman," Ms. Cheng would be humiliated in "town meetings" where false and unfounded accusations were used to force a confession of subterfuge and espionage, tortured, imprisoned for over 6 years without news of her only daughter, Meiping, who had been murdered by Maoists revolutionaries for refusing to denounce her mother as a spy, and placed under house arrest.
The Red Guard…… [Read More]
Many including Weijer (1999) comment on the futility of the current medical system as established in the United States. There are many doctors making decisions on whether patients need life support with or without just cause. Here lies the problem. With all patients, not just patients with disabilities, the writer feels multiple considerations must come into play. ight to life types may suggest it is the patient's right to live and the physician has an obligation to maintain the life of the patient for as long as feasible (Freeborn, Lynn & Desbiens, 2000). There are others however concerned that certain patients are not given appropriate consideration.
For example, some patients with disabilities may not be given adequate consideration. In cases as these doctors may feel they are better able to understand what is and is not in the patient's best interests compared with the wishes of the patient and/or…… [Read More]
, p. 842)
As our research shows, and as St. Leo's core values demonstrate, a great deal of Personal Development is required to face the difficult decisions that are implied by end-of-life planning. ith this personal development, growth and maturation comes an appreciation for the suffering of others in the wake of one's passing. The result is a concerted effort to ease this process. And as the article by Bunting-Perry (2006) finds, "the lifting of care burden opens a window for formal grieving. Family and friends comfort the bereaved person for a short period of time after the death." (Bunting-Perry, 106)
By showing a sense of the experience of others rather than simply of one's own fear in facing death, one also demonstrates a clear understanding of the Responsible Stewardship implicated by maintaining a living will. Particularly, Furrow et al. tell, "a number of devices have been developed to facilitate…… [Read More]
However...generally a vast difference exists between what healthcare providers understand and what laypersons are able to comprehend. This immeasurability of knowledge was evident in the participants' narratives and was exacerbated by the conveying of "false hope" or "false optimism" to patients and patients' family members.
Seconding Robichaux's argument is ackstrand's (2006) findings that hospital-based EOL programs are not the "ideal" form of healthcare that elderly patients should receive, according to a survey of nurses. For the nurses, "no patient should face death alone," which ultimately happens when patients are confined in a hospital facility receiving palliative care. Comparing ICU EOL care against the hospice and nursing home care programs, 'dying with dignity' is remote in this kind of program, since "[t]he ICU is no place to die. It would be nice to have a comfortable, quiet, spacious room for those who are dying. Let everyone in and let the rest…… [Read More]
The objective is to impede rumination. 3. In the third stage -- relapse prevention or rehabilitation -- Mr. Thomas will be encouraged to participate in activities (such as hobbies that he enjoys, listening to music, socializing, his work and so forth) and to move towards increased interest in his work, and other components of his life outside of his depressing domestic situation. The whole model would focus around prevention and intervention where prevention aims at reducing the individual's psychobiological vulnerability (via for instance reducing the stress facing Mr. Thomas by enlisting the aid, for instance, of his children and coworkers) whilst intervention seeks to strengthen that same vulnerability (via for instance cognitive-behavioral techniques or other depression-reducing interventions).
oemtiems, conflicts in commucantion occur inthis type sof stiaution when ethical condudresm are invoeld such as a perosn wishing to die whislt eveyroen else wants her to live on, or the gnawing unceratiny…… [Read More]
Lives Artists: Volume 2 Giorgio Vasari, Peter Murray, George Bull, Book Review -The audience read book, give
Essentially, the author of the work of literature entitled Lives of the Artist, Volume 2, created this work in order to immortalize artists who painted approximately during the time of the Renaissance. Some of these individuals who are depicted in this book are famous and are known by posterity without this piece of literature; others, however, are decidedly less so. In the latter case Vasari's work serves to preserve some of the memorable facets of the character behind the artist. In all cases, he helps to build the legend of these devoted artists while also portraying them as regular humans. To the end that Vasari is simply issuing a collection of remembrances and overviews of a plethora of different artists, this manuscript does not explicitly have a thesis. Additionally, the author is not…… [Read More]
What's more embarrassing is that I had to sit in the front row so I ended up like a superstar being watched by the whole class. It was not fun. It really wasn't. But in the end I think it is better to be looked over than to be overlooked. And if my classmates would talk about me, well, I would say, "there is only one thing in life worse than being talked about, and that is not being talked about." I am glad I am at the better side.
When I was younger, my mother would always tell me, "Son, honesty is the best policy. If you are honest, people may cheat you, but be honest anyway." George Washington once said "it is better to offer no excuse than a bad one." I believe that's true, very true actually. But a voice keeps telling me to remain silent and…… [Read More]
Life of the Buddha:
What was the Buddha's name? How else do Buddhists refer to him?
His name is Siddhartha Gautama and he is often referred to as the 'awakened' or 'enlightened' one.
What are the circumstances in which the Buddha grew up?
Siddhartha was born in 563 B.C. He lived in a place called Lumbini and then was raised in Kapilavashtha, Sakya Kingdom's capital. During this time, Northern India was made up of various small and independent states. It is during this period, people came to challenge and question Vedic philosophy through a number of new religious and philosophical schools. There was a strong moral vacuum present.
What are the "four passing sights"?
The first is an old man that reminded Buddha of aging. The second was a sick person that reminded Buddha of pain and disease. The third was a corpse that reminded Buddha of…… [Read More]
However, the social perceptions that could have gained her an easier entry into low-class work also could have kept her there, and prevented her from entering a management position. Gender in the absence of race seems to be the cutting divide at the Maids, while the individual who is in charge of the franchise is male, and a male voice guides the Hispanic demonstrator on the tape. But in more diverse Minnesota at the al-Mart, Ehrenreich is recruited as "management material," a status not extended to her nonwhite colleagues. (Ehrenreich, p.109) "Much of our interaction with others consists of subtle negotiation over just how much deference, honor, respect, and awe we are to extend and receive." (Kroehler & Hughes, p. 178) Divisions of respect are not exclusive to race, but race seems to predominate, with class, language, and gender stepping in only afterwards, in the absence of clear racial markers.…… [Read More]
This is a very important concept that has not been touched upon in the book but can actually serve as an impetus for good in one's life.
Religious counseling is an important field and one that works on the same principles as general counseling but integrates religion into it. When a Christian counselor works on the mind of his patient/client, the key objective is to align them to the teachings in the scripture without intimidating the client. In other words, it is the job of the counselor to learn as much as he/she can about the behavior, values and attitude including mindset of the client by providing a trustworthy and comfortable environment. Focus is placed on facilitation of communication where the client talks feeling completely safe in the presence of the counselor. He is given the maximum opportunity to express his views on various things in order to seek his…… [Read More]
According to the United States' Government's Medicare program, coverage of nursing home care is offered only on a limited basis. In order to be eligible, the Medicare must only receive services from a Medicare-approved facility, and must have a "qualifying hospital stay" just before entering the nursing home; this stay is generally three days or longer ("Nursing Homes: Paying for Care").
In light of these potential medical costs, one must be careful when advising this couple. The goal of retirement is to allow them to maintain their quality of life, but their quality of life is not maintained if they are constantly sick or worrying about their health. The father's skepticism about taking out a policy that would cover nursing homes or home nursing services is warranted. First of all, no one wants to think about the time when they will no longer be able to take care of him…… [Read More]
All of these scenes indicate that there might be little more than nothing after life. This poem allows us to see that Dickinson was not happy with accepting the traditional attitudes toward death and dying.
Another poem that examines death is "The Bustle in the House." Again, we see death is uneventful. Elizabeth Piedmont-Marton claims that in Dickinson's poetry, "the moment of death seems often less momentous than ordinary" (Piedmont-Marton) and it is "one of the most disturbing and powerful characteristics of Dickinson's poems" (Piedmont-Marton). "The Bustle in the House," demonstrates this assertion very well with its idea of humanity continuing to get along with the "industries" (the Bustle in the House 3) of life after a loved one dies. The heart of the dead is swept up (4), making it seem like the process of death needs a clean sweep and that is it. Mourning is nothing more than…… [Read More]
Every special needs student has different strengths and weaknesses. Under IDEA, the IEP is forms the educational standard for all special needs students. The IEP determines the course of their education, goals, and method of teaching. The standards are adjusted to the needs of the student. This differs from the nationalized standards that dictate the educational needs of the general population.
Quantitative assessment is the rule of assessment of the general population. However, assessment of the special needs population is largely qualitative. The problem in assessing the success of life skills classrooms must consider whether the individual goals of the students are being met. However, there are many variables that can impact this success. For instance, a student may develop unexpected medical conditions during the course of the year that impact the ability to meet IEP goals. These factors must be considered in order to make a fair assessment of…… [Read More]
In the late winter as our root cellars begin to empty and the food begins to spoil our daily meals became quite meager but we live with the knowledge that matters will soon improve as the weather becomes warmer.
Our lives here are quite difficult. We are often cold and there is little to eat. We work extremely hard and what free time we do have we spend in pray being thankful for what we do have. We do, however, have our family and fellow congregation members and together we are free to honor our God in our own way. This has not always been the case and we are grateful for this opportunity. Our first days here were particularly difficult but things have improved as we have learned to adjust to the harsh weather conditions, improved our hunting skills, and gradually cleared the forests to build our farmlands. In…… [Read More]
On an individual level, however, such safeguards can be interpreted as learning how to survive in a non-technological world. In other words, it is important that we ensure that a technologically run world does not end up creating a complacent and physiologically inept human society.
Human ingenuity has resulted in computer technology and the Internet creating untold opportunities for improving the quality of life. The same human ingenuity must also now ensure that the use of Information Technology and the Internet is responsibly done and placed in the right perspective.
CNN.com (1999, June 24). Internet Alert: FTC warns against false health claims.
etrieved Dec.1, 2004: http://www.cnn.com/HEALTH/9906/24/internet.health.02/
Home Office. (2004). Crime & Policing: Internet Crime. etrieved Dec. 1, 2004:
Jackson, W. (2004, February 4). Senator calls for mandatory reporting of viruses.
TeCrime International, Inc. etrieved Dec. 1, 2004: http://www.tecrime.com/llartV22.htm
Joshi, V. (2003, Oct. 12). Cell phones now debit cards…… [Read More]
life of a non-Profit employee course number & name: Human esources Management (BAL1127A)
The research paper will be exploring 'How new learning dimensions of human resource studies can be applied for expanding the H role in optimizing and shaping organizational and employee behavior in non-profit organization'. This is the thesis statement upon which the whole research will be build upon using number of authors review, recommendations, journals, academic reading and statistical data on the subject matter concerned.
Today, organizations are faced with number of human resource challenges among which some of them are developing leaders for the next generation along with fundamental staff required, succession planning, motivating volunteers and staff with the diversified work and managing work style and work environment in nonprofit organizations. Due to the growing need of nonprofit institutions in an economy, universities have started nonprofit courses and programs, yet it doesn't guarantee to establish a link…… [Read More]
God created the dispensations and guides humanity differently during each period. C.I Scofield outlines the dispensations including Innocence, Conscience, Human Government, Promise, Law, Church, and Kingdom ("End Times" 4). Dispensationalism is based on a literal and unequivocal interpretation of the Bible ("End Times" 4). Efird, for instance, describes dispenstionalism a historically accurate and nearly scientific method of discerning Biblical prophecy based on a close reading of the sacred text. Efird claims that dispensationalism prevents the "disappointment and embarrassment" that has plagued believers in the apocalypse (7). Dispensationalism is a relatively new type of Christian eschatology and has the unique hallmarks of American Protestantism. The Catholic Church does not embrace a strict interpretation of millennialism. On the contrary, Catholics prefer a more symbolic interpretation of the Book of Revelations ("End Times" 4).
Regardless of the denomination of Christianity, the end times is central to the religion's teachings, its cosmology, its theology,…… [Read More]
Other limitations which further hindered the analytical strength of the study, was the fact it was conducted only in one hospital.
The suggestions provided by the researchers in the conclusion of the study are both enlightening and appropriate to further study and methodology of care giving within hospice. The designers of this research propose the idea that hospice care should include attention towards a patient's physical symptoms, but also their psychological symptoms which are bound to be prevalent within the atmosphere of a hospice. Attention geared towards the patient's psychological wellness will greatly improve the quality of life which the patient must endure while awaiting the inevitable inside the hospice walls. These conclusions and suggestions, although somewhat of a transgression from the primary focus of the study, are important for the truth they hold within them.
McMillan, Susan C., Dunbar, Sandra, B., Zhang, Weihua. (2007). The prevalence of symptoms…… [Read More]
Life sucks and then you die, is a popular saying among Gen-Xers to describe the futility of it all. The phrase may be original, but the sentiment certainly is not. Long before Generation X came on the scene, Ernest Hemingway was writing about heroes who faced the harsh unfairness of finite life with dignity and grace. This "grace under pressure" became known as the Hemingway Code.
Hemingway scholar Philip Young explains that the code "is made of the controls of honor and courage which in a life of tension and pain make a man..." (63). Feminist scholars have suggested that this definition of the code is sexist and that women in Hemingway's work, too, display honor and courage (Tyler 29).
Rovit and Brenner agree with Young's basic definition and add an additional component. Hemingway's code, they say, also has to do with "learning how to make one's passive vulnerability (to…… [Read More]
Also, the workers are overcharging us for the work! It is like highway robbery! It is unbelievable!
I am trying to work here and there, making a little, not a lot to help the family. I am sewing little things like ripped clothes, cleaning for others, cooking, and baking but other people in the village are tight on money, too. We want to move but that will require a lot of money but we want to move where Frank may find a better job. We will see. Sometimes Frank will take the eldest, Lorenzo to the city when he finds work. He hopes the bosses will see he has child and will give him a job but that has not happened. Frank is too picky. He will not travel too far for work but he won't work if he has to get his hands too dirty. He won't work if…… [Read More]
He notes that at the time of the novel's publication, there was growing concern and distrust for unregulated scientific experimentation. He claims that these beliefs "so successfully dominated the cultural sphere that the word "Frankenstein" was soon used to refer to the creature created by the scientist rather than the scientist himself. Frankenstein, therefore, became the monstrous and supernatural offspring of the practices of science" (illis 236). Mellor suggests that Frankenstein was the first creature that was created by a single man and Shelley created her myth "single-handedly" (Mellor 38). Victor teaches us some valuable lessons and the most important might be to never forget the law of unintended consequences. Victor never considered that his creation would be hideous and that oversight ruined everything for him and the creature. Victor's desire to know more lead to more destruction than he could have ever imagined.
Berry Laura. The Child,…… [Read More]
I have experienced the fairytale love story and girl or young woman can dream of. Yet I am now well aware of the fact that not everybody has this luxury and that many people in the world must struggle to find a proper source of income or they have to leave their families and go to far away countries to find a better life. After this course, I think that it is our duty to help these people, to be active and responsive to their needs.
As a result of my experience with the Vietnamese immigration issue I realized that in most cases foreigners tend to work more and better than the regular American. This is because we value or time and our efforts and because we can afford to do that. Others can't. Others must struggle to find food, to find shelter. And it is our duty to make…… [Read More]
Williams...consistently denied killing Owens.
March 11, 1979 --...three of Williams' friends -- all with criminal histories and motivation to lie, Williams says -- testify that he confessed to the killings. A ballistics expert links a shotgun shell at the motel to Williams' gun. Williams has also steadfastly maintained his innocence in the Yang killings.
1981 -- Williams is tried and convicted in Los Angeles Superior Court of all four murders, plus...sentenced to death. He arrives at San Quentin's death row on April 20.
1987 -- Williams is placed in solitary confinement for 6 1/2 years after committing a string of violent incidents behind bars, including assaults on guards and other inmates.
1988 -- the California Supreme Court affirms Williams' death sentence, and he files his first federal appeal to the U.S. District Court.
1996 -- Williams, with co-author Barbara Cottman Becnel, publishes the first of a series of anti-gang books…… [Read More]
At the same time, a series of interrelated events occur between the communication partners over time and space.
The active sender is comprised of encoder / interpretation / decoder. The passive-recipient, on the other hand, constitutes decoder / interpreter / encoder. Similar to the Shannon & eaver theory, each encodes and decodes the message according to her own interpretation of content.
Ultimately, communication is made up of signs. It is we who invest it with meaning and who provide those signs (or symbols) with a referent. The person on the other end (the decoder) cannot always understand the referent, or, if of a different culture, may have no knowledge of that referent altogether. Language is also diachronic, meaning that is constantly in flux from situation to situation. Thinking of the gap in the middle as well as the attendant 'noise' and the fact that the recipient always changes helps us…… [Read More]
Choice # 2: I also made the decision to make citical thinking a pat of this couse, instead of meely focusing on the histoy o technical aspects. I want students to be able to fom thei own opinions about folk medicine based on what they have leaned.
Name and descibe one of you pojects stengths.
One of the main stengths of this poject is that it combines fun with fact. In othe wods, it is not just a dy look at the histoy of folk medicine, but it will include inteesting anecdotes and some bizae and funny ituals and pactices as well. I went this diection because I want to keep things inteesting and keep the students engaged.
Name and descibe one of my pojects weaknesses.
The main weakness of this poject is that it may be difficult to include all of the many aspects of folk medicine in detail…… [Read More]
Paradoxically, states with harsher criminal statutes and higher conviction rates tend to maintain fewer inmate developmental programs because high-volume prisons tend to be run on a for-profit basis that discourages "unnecessary" spending. The most cynical suggestion is that decreasing recidivism is against the financial interests of private prisons and (although to a lesser extent,) those of government-run prisons as well (Schmalleger, 2008).
Other aspects of many types of contemporary criminal trends may also significantly undermine any strategy of deterrence through awareness of strict prosecution and sentencing. In that regard, law enforcement authorities across the nation have catalogued volumes of information about criminal subcultures in general and of the street gang mentality in particular (Pinizzotto, Davis, & Miller, 2007). Urban street gangs in particular have given rise to a culture of remorseless violence and disregard for the consequences of even the most violent crime that largely precludes any real deterrent value…… [Read More]
life [...] legal and ethical issues of the beginning and ending of life. Legal and ethical issues abound surrounding how we begin and end our lives. Abortion and euthanasia are two of the most controversial subjects facing Americans today, and how we resolve them indicates what type of society we will perpetrate and uphold.
Abortion has been legal in this country since 1972 when the Supreme Court ruled on oe vs. Wade, but the decision has remained contentious for a number of reasons, and anti-abortionists continue to fight for an abortion ban. The ethics of abortion for each side are quite clear. Pro-choice proponents of abortion believe it is a woman's right to choose what happens to her body and her unborn child, while anti-abortion proponents feel it is the right of the unborn child to live. One expert writes, "Throughout the history of the United States, religious revival has…… [Read More]
ight to Life
For all human beings death is one of the most intricate truths to cope with. In spite of this, people take decisions to finish their lives, which in turn result in ending their pain and suffering. This practice is known as euthanasia, or even commonly called as assisted suicide by those who are against the practice completely.
However, whatever term we may use to label it, it is an issue that society should become more familiar with. For instance few countries like Switzerland have legalized the practice and extend great support to those who want to end their lives so as to get away from the detriment of their disorders. However, this practice is only legal and offered only to those who are going through terminal illnesses or vegetative states. Although there are many controversies that surrounds euthanasia, there are numerous religious activists and humanitarian groups that…… [Read More]
Mortality and Life eview
For most of us, a sense of impending mortality prompts a need to find closure, conduct a full life review and reconciliation (Clarke, 2007). The reality that death is a natural process -- leading towards an inescapable final destination -- seems implausible at first glance. For a variety of reasons, death has become a taboo subject that no longer represents an accepted progression of life, but something unnatural to be wrestled against. Coming to terms with impending mortality is challenging and calls forth a range of deep emotions that need to be expressed. Expressing these intense feelings and reviewing one's life is essential to finding peace and allowing true healing on an emotional and spiritual level (Sand et al., 2009).
The definition of the life review process is described as a "naturally occurring, universal mental process" (Butler, 1963). In other words, it is a normal developmental…… [Read More]
The quality of life was another issue addressed in research of the use of feeding tubes with patients who have dementia (Finucane, 2001).
obert MCCann, MD reports that the everyday imagery of food and its pleasant addition to life cannot be ignored in the discussion of removing natural nutrition and using a feeding tube.
McCann reminds the medical community that the image of a family gathered around the Thanksgiving table, interacting and nurturing each other through the meal presents an entirely different image than an elderly person suffering from dementia alone in a bed in a nursing home with a tube inserted into their stomach. The imagery of food and its measurable impact on a person's life must be accurately envisioned for the decision to be made according to McCann (Finucane, 2001).
McCann studied Hospice cancer patients who were in the end stage of life. According to his research it…… [Read More]
Negotiating Cross-Cultural Issues at the End of Life
The clinical problem and dearth of research which led to the study was directly connected to the fact that there was a clear understanding that not enough clinicians had cultural competency, particularly with patients receiving end of life care, but there wasn't a clear sense of how to fix this. The fundamental issue at stake was how cultural competency could improve end of life care and the services which needed to be available to clinicians in order to improve healthcare delivery and patient outcomes. As the researchers assert, "Thus the risk for cross-cultural misunderstandings surrounding care at the end of life is also increasing. Studies have shown cultural differences in attitudes toward truth telling, life-prolonging technology, and decision-making styles at the end of life" (Kagawa-Singer & Blackhall, 2001). These notions illuminate clearly the need for the study and the relevancy of the…… [Read More]
ationale for the use of life cycle Management at Glazers
LCM (Life Cycle Management) is a framework which manages and scrutinises the performance and sustainability of services and goods. This framework aims to achieve the long-term objectives of the business, and gives less stress on the short-term objectives. For getting a more sustainable value chain, organizations are making use of this framework, which would in turn improve their economic and social performance. Businesses throughout the world are making use of this framework for many purposes, like to improve their standing within the market, to strengthen the relationships with the stakeholders and to produce more environment friendly goods.
LCM urges the companies to look away from their own processes, and focus on activities which are not under the direct control of the company. Such activities include the upstream and the downstream operations that become a part of value chain. In…… [Read More]
Living With Incurable Cancer at the End of Life-Patients' Perceptions on Quality of Life
Johansson, Christina Melin RN, Phd-student; Axelsson, Bertil MD, PhD; Danielson, Ella RN, PhD
This article is either a qualitative or a quantitative research study. Identify which, and then complete the table below where applicable. Write no more than three sentences in each cell of the table. The study may not contain all of the elements listed, or the element may be necessary and is not addressed. If the study does not address one of these elements and it is not necessary, simply indicate as N/A in the appropriate box. If the element is not adequately discussed, explain based on your readings and your understanding of the research study.
How do patients describe their perceptions of the quality of life (QoL) in incurable cancer at the end of life?
Patients with…… [Read More]
Beauty and Life of the Monarch Butterfly
This is a paper about the Monarch Butterfly. What animal kingdom is it from? Listed is the life cycle of the butterfly. What are the adaptations of the Monarch Butterfly?
THE BEAUTY OF THE MONACH BUTTEFLY
Many people think butterflies live in a carefree environment, but they are wrong. They seem so peaceful visiting flowers, but they are bound by social conventions and instincts of their own. Although their lives appear to be so simple, yet their lives are quite demanding (Farrand 1990). The beauty of the Monarch is found delighting in most butterfly lovers. The life of a Monarch Butterfly is quite complicated as it meets the instincts that it is bound with. A butterfly's life depends on finding enough food, where to lay its eggs safely, the intricate demands of courtships, and on finding the right spot of transformation from a…… [Read More]
On this matter, House Democratic Leader Nancy Pelosi stated, "Congressional leaders have no business substituting their judgment for that of multiple state courts that have extensively considered the issues in this intensely personal family matter." (Euthansia and Terri Schiavo b). Federal Judge James Whittemore heard the Schiavo case and ruled on March 22, 2005 that the Schindlers had not established a "substantial likelihood of success" at trial and refused to order the reinsertion of Terri Schiavo's feeding tube. Two days later, the United States Supreme Court would deny the Schindler's request to hear the case. Terri died on March 31, 2005.
This paper has presented only the most noted court rulings and proceedings regarding the Schiavo case. "Nineteen different judges at various times considered the Schindler's request on appeal in six state courts. All have sided with Michael Schiavo" (Euthanasia and Terri Schiavo b). In the absence of a living…… [Read More]
The Singer debate 'are there some lives not worth living:'
The sanctity of life and utilitarianism
Professor Peter Singer is a well-known utilitarian who advocates the right of parents to commit infanticide based upon utilitarian premises: he argues that the resources expended by keeping such children alive are too great and it would make more sense to allow families to adopt instead healthy children with a greater chance at happiness. Disability activist Harriet McBryde Johnson, who says that she would not be alive if this type of calculus had been employed notes: "But like the protagonist in a classical drama, Singer has his flaw. It is his unexamined assumption that disabled people are inherently 'worse off,' that we 'suffer,' that we have lesser 'prospects of a happy life'" (Johnson 2003: 12). However, Johnson also argues against assisted suicide entirely, even with the consent of the person who feels…… [Read More]
Ethics to Practice: Analysis of 'end of life' decision making
The foregoing discussion is an incursion into nursing ethics. Implication(s) to 'omission' of information as a customary practice within our healthcare institution is reviewed in relation to best practices pertaining to 'informed consent,' and hospital policy is not definitive. Directed at the evolution of ethical decision making, the general query to the study focuses on the parameters of informed consent where individual practice is concerned.
In the nation of Canada where I am a nurse the number of situations where patient informed consent decisions might be subject to our national code of nursing ethics is many. e face critical ethical dilemmas every day, as emergency procedures and critical care interventions are standard practice. Complexity in decision making is furthered in the conduct and approaches made by international colleagues on contract in our institution by way of exchange.
The primacy of…… [Read More]
Marriage in Literature: "The Secret Life of Walter Mitty" and "The Story of an Hour"
On the surface, it would not seem as though Thurber's "The Secret Life of Walter Mitty" and Kate Chopin's "The Story of an Hour" would be comparable because of their varying tones, the former is comedic and the latter is more serious, and themes, escapism vs. reality. However, at the heart of both stories is a marriage that is unhappy. In both stories, the protagonist has been slowly suffocated by their husband or wife. They both are extremely unhappy in their unions and use their imagination to escape their realities. The stories differ in how the protagonist deals with the intrusion of reality into their happy fantasy; one continues on in the fantasy world, making it less and less likely that he can survive within reality and one admits that she cannot return to reality…… [Read More]
puritan life was heavily contaminated by death. Half of the original 102 pilgrims that settled in America died during the first winter and it was not uncommon for children to perish before they reached adolescence. Funerals were a common occurrence in everyday life and the air of towns was often littered with the sounds of church bells. From the early stages of learning, children were educated on the grim reality that they faced and if they were fortunate enough to grow up, their demise still followed them wherever they ventured to. Puritan religion explains that a person is unable to control their destiny. Their ascendance to heaven or hell is pre-determined before the time of their birth and their actions in life have no influence on their final destination.
Although her lifetime took place more than two centuries after their arrival, Emily Dickinson presented poetry that offered views on death…… [Read More]
Suicide," an act of suicide is defined as an event when "an otherwise healthy victim has, without any outside pressure, willfully arranged the circumstance that brought around his or her death." The process of clearly defining circumstance and actions that constitute suicide is essential to medical providers, mental health workers and many social service and public providers who are charged with caring for the health and safety of other individuals. Without a clear definition of suicide it can be difficult, if not impossible for these providers to fulfill their ethical and professional obligations to care for sick individuals or prevent crisis or emergency situations that may result from that which is truly suicidal behavior.
Doctors, nurses, social workers, and psychologists in health clinics, hospitals, and outpatient settings are expected to care for their patients and make efforts to safeguard their health and wellness. These providers are often required to protect…… [Read More]
NURSING CRITIQUE ON LAW: LIFE, LIERTY AND THE PURSUIT OF PALLIATION: RE-EVALUATING RONALD LINDSAY'S EVALUATION OF THE OREGON DEATH WITH DIGNITY ACT Y DURANTE (2009)
The objective of this study is to critique the work of Durante (2009) entitled "Life, Liberty, and the Pursuit of Palliation: Re-Evaluating Ronald Lindsay's Evaluation of the Oregon Death with Dignity Act." The Death with Dignity Act was enacted by the state of Oregon on October 27, 1997. This act enables patients who are terminally ill to end their lives by use of self-administration of medications that are lethal in nature and that the physician has prescribed to the patient for this express purpose. The work of Durante (2009) examines the claims of Lindsay on this subject and reports that the evaluation of the experience of Oregon with physician-assisted suicide of Ronald Lindsay is "a much needed counterpart to moral speculation." (p. 28) According to…… [Read More]
This mass floats through space "unseen and undetected through space. It takes a very long time for a white dwarf to cool enough to become a black dwarf, and many astronomers suspect the galaxy hasn't aged enough for any to have yet formed. If any have formed, it will not be easy to find them" (McGrath). hile space may look like it is not changing from Earth, we can know that it is - even in death. Red dwarf stars are the result of a dying star that is very small - anywhere from 65% to 3% of our Sun's size. Red dwarfs are cool and very faint; however, there are many of them sprinkled throughout the universe. Stars can also die and become brown dwarfs, which are actually pseudostars or "failed stars" (NASA) with not enough gas to fuel the "hydrogen-fusion reaction that powers true stars" (Heckert). Brown dwarfs…… [Read More]
Maximize Quality of Life in Old Age
As an individual advances in age, his/her risk of acquiring aging-related conditions increases. Understanding that such conditions (i.e., arthritis, memory loss, hip fractures, etc.) don't form a part of normal aging is essential. They will likely develop at a particular age; however, one mustn't perceive them as an expected and unavoidable component of the aging process. How a person ages is determined by three elements: genetics, lifestyle and environment. Individuals have no control over their genes, but they can regulate their lifestyle and environment, and it is these elements that contribute the most to how well an individual ages. Jones (2014) states ten tips for maximizing quality of life for the elderly, and longevity:
Keep stress in check. Stress, in particular chronic stress, is one among the very few factors contributing to premature aging. While everybody faces stress in life, and a small…… [Read More]