The Battle Of The Civil War - 1840 Words

The American civil war was fought from April 1861 through to May 1865 to determine the existence of the Union or freedom for the Confederacy. January 1861, 7 of the southern slave states declared their withdrawal from the U.S and began to form their own allied states of America. The South from then on produced and included in total 11 states, however, the north did not declare secession and stayed â€Å"loyal† to the US. Who really was to blame for the 1861 American civil war? It’s hard to find a clear conclusion as to why, whom or what was to blame for the outbreak of the civil war. Historian J.R Randall believes that the cause of the American Civil War was caused by the â€Å"Blundering generation of politicians†, the â€Å"blundering generation† was†¦show more content†¦Moreover, as well as the economic and slavery division between the Southern and Northern states, there was also the division between the radical politicians. When Abraham Lincoln stood up at Fort Sumter, there is much agreement that Lincoln can be blamed for making the first initial decision on imposing the American Civil War. The ideological viewpoint and historian John Spicer both agree that the main reason that caused the American Civil war was in fact Slavery. Back in 1619 the first ever African slaves were brought to the North of America (Virgina) to help with the important production of cotton, sugar and tobacco. However, the following year in 1860, with more than 60% of the electorate not voting for, Abraham Lincoln was elected as president. Lincoln’s anti-slavery became well established in the North; â€Å"Republican politicians quite consciously seized on the slavery and sectional issue in order to build a new party† (Holt, F.M, 1978) this quite clearly highlights that the republicans pushed for slavery, however, Lincoln did not in fact want slavery abolished completely. Lincoln agreed that slaves were allowed in the states that already had slaves, yet, he was to abolish slavery in states that had not yet emerged. Lincoln did not want slavery to expand but to only keep slaves where s lavery was already established. In 1861, 1 year after Lincoln was elected, 6 more

I’m Proud to be Lefthanded Essay - 596 Words

One in 10 people reading this is left-handed. There are nearly 34 million of us living in the United States, and about 500 million in the world. Throughout history, though, lefties have been looked down upon. nbsp; Centuries ago, the Catholic Church declared that left-handed people were servants of the devil. The word left comes from the Old English word meaning weak and worthless. In the 1600s in Europe, lefties were burned at the stake for alleged witchcraft and sorcery. nbsp; Just a generation ago, American parents tried to change their childrens left-handedness, even going to the extreme of tying their childs left hand behind his back to keep him from using it. Teachers also forced their students to use†¦show more content†¦nbsp; Famous leftie artists include Leonardo da Vinci, Michelangelo, Pablo Picasso and Lewis Caroll. nbsp; And, although they have trouble with a backward guitar, many musicians are also among us: Beethoven, Paul McCartney, Ringo Starr, Jimi Hendrix, Paul Simon, Kurt Cobain and Billy Corgan. nbsp; Southpaw athletes, mainly baseball stars, include Babe Ruth, Barry Bonds, Reggie Jackson, Ken Griffey Jr. and Larry Bird. (Sportswriter Charles Seymour invented the term southpaw when he noticed that lefty pitchers throw from the south side of the mound.) nbsp; Furthermore, geniuses and icons like Albert Einstein, Aristotle, Isaac Newton, Joan of Arc, Ben Franklin, Mark Twain, Julius Caesar, Napoleon and Henry Ford were lefties. Of 42 American presidents, seven have been lefties. nbsp; But, some of the superstitions may be true, since lefties also include Billy the Kid, the Boston Strangler and Jack the Ripper. nbsp; Studies have shown that a child with two right-handed parents has only a 2 percent chance of being left-handed. A child with one right-handed parent and one lefty has a 17 percent chance, and with two lefties for parents, the child has a 42 percent chance of being a lefty. Also, men are three times as likely to be lefties as women. One more fun fact: left-handedness is twice as common among twins as single births. nbsp; As only 10 percent of the population,

Reflective Practice Free Essays

string(67) " interview with minimal interruption while I listened attentively\." In this essay, I will reflect upon my practice placements and discuss my development in relation to professional/ethical practice, care delivery, care management and personal/professional development. These are the four domains related to the learning outcomes required by the Nursing and Midwifery Council (NMC, 2004)) for entry in to the professional register. They are all concerned with promoting high standards of professional practice and good quality of patient’s care. We will write a custom essay sample on Reflective Practice or any similar topic only for you Order Now I will also reflect upon the Enquiry Based Learning (EBL) activities and discuss how these have contributed to my development in practice.I have changed all the names used in this essay for confidential reasons (NMC, 2004). Nurses and other health care professionals are faced with challenging and unique situations in practice, by reflecting on these experiences it allows learning to take place and gain flexible ways in which to respond to these situations (Burns and Bulman, 2000). According to Whitehead and Mason (2003, reflection is the process of examining personal thoughts and actions while focusing on your-self interaction as an individual with colleagues and the environment to obtain a clearer picture of their own behaviour.They further describe it as a process within which a practitioner can think about and achieve a better knowledge of their practice. It is therefore a learning tool which provides a basis for changing practice through a systematic procedure that is logically constructed. Two different forms of reflection exist, reflection-on-action and reflection-in-action. Reflection-on-action means re-running and analysing events which have occurred in the past while reflection-in-action entai ls examining individual behaviour and that of others in situations which offer learning opportunities (Maslin-Prothero, 1997).Therefore, by writing and keeping a reflective journal, nurses can identify personal and professional growth to recognize their achievements (Ghaye and Lillyman, 2001). EVIDENCE Professional/ethical practice Ethics is a code of principles governing correct behaviour and in the nursing profession; it includes behaviour towards clients, their families, visitors and colleagues (Fergusson et al, 1998). The professional and ethical obligations for nurses are set out in the new â€Å"code of professional conduct: standards for conduct, performance and ethics† (NMC, 2004).NMC is the body that sets out regulations for registered Nurses and Midwives. The main purpose for these regulations is to inform the profession of the standard of conduct required of them, in terms of their professional accountability and practice (NMC, 2004). It is also to inform the public, other professions and employers, of the standard of conduct expected of a registered Nurse/Midwife (NMC, 2004). To achieve its aims and objectives, the NMC maintains a register of qualified Nurses and Midwives; sets out standard of Nursing and Midwifery education, practice and conduct.It als o provides advice on a professional standard to Nurses/Midwives and considers allegation of misconducts or unfitness to practice due to ill health. If a Nurse or Midwife acts against the code of conduct, he/she may have his/her names removed from the register (NMC, 2004). Care delivery Delivering care to various client groups across different care settings must be orientated towards practice which is responsive to their needs (Hinchcliff et al, 2003). It is reflected through the ability to assess needs, diagnose and plan, implement and evaluate care and empower clients and their carers to participate actively.Care management This is the capacity to accept responsibilities for the efficient and effective management of care provided within a safe environment (Hinhcliff et al, 2003). It involves being accountable in taking responsibilities to delegate aspects of care to other team members and to effectively facilitate/supervise their work. Both the nursing and other wider multidisciplinary team members should be involved in risk management which is the process of identifying risks that have adverse effects on the quality, safety a nd effectiveness of care delivered.They should also posses the ability to assess, evaluate and take positive actions to eliminate/reduce those risks (Hinchliff et al 2003). I will follow Gibbs (1988) reflective cycle, which is an Iterative Model based upon the idea that awareness, increased knowledge and skilfulness arise from the clockwise ‘movements around the reflective cycle’ (Ghaye and Lillyman, 2001). Gibb’s (1988) reflective model is a cyclical process with six stopping points from description of what happened, feelings of the individuals involved, valuation of the situation, analysis or making sense of what happened, conclusion to action plan and then back to description if needs be (Gibbs, 1988; Ghaye and Lillyman, 2001). I have maintained and developed a reflective journal during my clinical placement. The journal comprised of documented reflective accounts based on my own personal experiences which I have either learned from, feel I could have done better in, or times which I personally feel I have acted effectively in and improved on.To meet the requirement of this essay, the four areas of professional/ethical practice, care delivery, care management and personal/professional development will be discussed in a reflective format and the learning experiences will be displayed using the example below. REFLECTION ON LEARNING FROM PRACTICE EXPERIENCE. Description During my clinical placement, I joined Maureen, an Approved Social Worker (ASW) on a home visit to carry out an assessment of Jane, a 48year-old mother of four. Jane was referred to the community mental health team (CMHT) for social needs’ assessment by her Consultant Psychiatrist who had known her for over 2 years. She was receiving treatment for Agoraphobia (a morbid/abnormal fear of open/public places) and depression. I telephoned Jane to remind her of our visit before setting off. On arrival, Jane answered the door and we introduced ourselves before she allowed us in. She was very tearful with increased respiratory rates and pale in colour. She appeared very restless pacing all over the room and had difficulties in speaking at first.Maureen tried to find out what the problem was and she said; â€Å"I have got to do this†¦ I have been lying about it all, I never told anyone the truth†¦Ã¢â‚¬ ¦I was brought up by a lady who taught me to say nothing to no one. I cannot take it any more, you have got to help me†¦ you have got to get me out of here†¦.. † Maureen led the interview with minimal interruption while I listened attentively. You read "Reflective Practice" in category "Papers" Jane expressed her self and we found out that she had been using crack cocaine, cannabis and diazepam (approximately 24-30 tablets a week) for a very long time.Jane said that ‘all hell broke loose and her body and mind fell apart’ when she completely stopped using all the substances 3 days before our visit. Jane developed both physical and psychological symptoms of increased anxiety, panic attacks, insomnia, nightmares, fears of going mad, tight chest and breathless feeling, â€Å"flu-like† symptoms, nausea, diarrhoea, distorted vision, dizziness, shaking and ringing in the ears. She had no suicidal feelings or aggression but she described creeping sensation on her skin and increased sensitivity to light, sound and touch. She lived with her boy-friend who also used and supplied the substances. None of her four children lived at home but two of her sons were said to be frequently in trouble with the police. She continuously begged to be taken out of her flat to get help. She was prescribed Venlafaxine 75mg three times a day which she was not using as she was taking other substances. Maureen attempted to contact Jane’s general practitioner (GP) but the surgery was closed. She also phoned the Home Treatment Team to ask for their services but this was not successful as Jane did not meet the criteria.Eventually, I suggested that we could take Jane to Accident and Emergency (AE) department where she would be checked up by the medical team as well as Liaison psychiatric services. However, Maureen contacted the duty psychiatrist who advised her to change Jane’s prescription of Venlafaxine to 75mg once a day. I told Maureen that according to my training, it was against the guidelines for administration of medicine to give/take prescription over the phone and that in case of any error or adverse reaction; we would be personally accountable regardless of the doctor’s advice (NMC, 2004).Considering Jane’s physical condition, we explained to her the need to attend AE department. She expressed her fear of being judged by other people in the department but following our reassurance, she agreed. We accompanied Jane to the department where she was assessed by both teams. She was commenced on Zoplicone medication and allowed to go home the following morning. We made a follow up visit the following afternoon and Jane had marked improvement in her physical symptoms. Maureen asked if I was able to organise a GP’s appointment for Jane and make a referral to the Community drug team which I did.Jane was started on a gradual reduction dose of diazepam to limit the severity of withdrawal symptoms and her care was then transferred to the Community Drug Team who offered her immediate appointment. Feelings On reflection of the situation, I felt that we acted in the best interests of Jane, to promote and safeguard her well-being. I felt puzzled and speechless at the beginning as Jane had no known record of substance misuse on her file. She was very restless and tearful as she struggled to speak.She appeared very distressed and was breathing very fast. Maureen remained very calm while she encouraged Jane to express her feelings. It felt easier for me to remain silent and listen to Jane attentively as I had very limited knowledge of her difficulties. I also felt that the advice given to Maureen by the duty psychiatrist on phone to change the prescription of Venlafaxine was contrary to the NMC (2004) guides for administration of medicine. Any alteration/cancellation of a patient’s medication must be signed for by the prescribing doctor.Evaluation Section (1. 4) of the NMC code of professional conduct requires nurses to have a duty of care to their patients and clients, who are entitled to receive safe and competent care (NMC, 2004; DOH, 1999). On reflection, our decision to take Jane to AE was beneficial as she needed a careful check to exclude any physical conditions which represent a contraindication to the usual benzodiazepine regime. These include liver disease (cirrhosis) and chronic airway diseases which may develop into respiratory failure. Daily use of even therapeutic doses of benzodiazepines (such as diazepam) for longer than 4 weeks has been reported to result in physical dependence (Clayton and Stock, 2004). Jane reported to have been using diazepam including other substances like cocaine and cannabis for several years. Withdrawal syndrome occurred after she suddenly stopped the regular use. Healthcare professionals including qualified nurses, students and managers should be proactive to ensure that risk and quality management is their priority (DOH, 1999).This means that, we should be able to identify actual and potential risks to clients, their carers, others and ourselves to promote and maintain health and safety at all times (NMC, 2004). Jane was at risk of developing withdrawal seizure or fit as a result of â€Å"cold turkey†. Stopping all at once overwhelmed Jane with severe withdrawal symptoms and as the pain and distress was unbearable; Jane would have started taking diazepam again, which can result in a sense of failure, or a fear of going through withdrawal again. Analysis Jane was very brave to seek help after so many failed attempts in the past.She thought that the information she had given us would be used to put her and her boyfriend in trouble. It is acknowledged that to trust another person with private and personal information about your-self is a significant matter. However according to the NMC (2004), if the person to whom the information is given to is a nurse, midwife, or a specialist community public health nurse, the patient or client has a right to believe that this information, given in confidence, will only be used for the purposes for which it was given and not be released to others without his/her permission.In contrast, I explained to Jane that the information she gave us would only be used for the purpose of her treatment and would not be released to others without her permission (NMC, 2004). As part of the shared values for all health care professionals caring for patients and clients in the United Kingdom, all nurses mus t: â€Å"respect the patient or client as an individual obtain consent before giving any treatment or care,†¦Ã¢â‚¬ ¦ to maintain confidentiality of patient’s record†¦ co-operate with others in the team, †¦Ã¢â‚¬ ¦act to identify and minimise risk to patients and clients† (NMC, 2004).This requires nurses to work co-operatively within teams and to respect the skills, expertise and contributions of their colleagues. My suggestion that Jane should be taken to AE was valued by Maureen and this increased my confidence in inter-professional practice. Conclusion Risk factors in any situation, habit, environment or physiological conditions such as those experienced by Jane, increase the vulnerability of an individual to other illnesses. If Jane’s habit of substance use was uncovered earlier during assessment, she would have received some help before stopping the diazepam use abruptly.Rather, a gradual reduction of the dose would have been carried out to limit the severity of the withdrawal (Clayton and Stock, 2004). Action plan In future if I come across a similar situation, I would probably make the same decision to refer the patient to hospital where he/she would be clinically assessed by qualified professionals and an appropriate plan of care drawn. To maximise compliance, it is important that the rate of dose reduction is negotiated with the patient. The patient will need to see a speciali st at least once a week for supervision of the withdrawal. This provides them with an opportunity to monitor the dose to the severity of any symptoms. Most of the patients will require observation as their withdrawal symptoms do not follow a linear reduction but tend to exhibit occasional peaks. I will also remember that where an aspect of care is beyond my competency, I will seek supervision to ensure safe and effective practice. I will try to work according to the guidelines laid down for any procedure. PROFESSIONAL/PERSONAL DEVELOPMENT, According to the NMC (2004), one must identify his/her own professional development needs though reflection.Since starting the Diploma in nursing, the key areas I feel I have developed greatly in include self awareness, assertiveness and communication. Communication is an important aspect of nursing, effective communication is central to providing sensitive and individualised care. Patient centred care involves respect for and responsiveness to patient preferences, needs and values. Achieving patient centred care requires complete and effective communication between healthcare workers and patients (Riley, 2000). When I first begun my nurse training, I was a quiet person who did not communicate much with others.I found it difficult to mix with people I did not know and I was quite happy to sit on the side lines and allow everyone else to do the talking for me. However I feel that the lectures and experiences I have had through out the course of my training regarding communication were extremely helpful. This allowed me to see how I could improve within myself and strengthen my communication skills and the important non-verbal communication. By reflecting on these lectures and paying more attention to how I portrayed myself, I discovered that I rarely made eye contact when speaking to people I did not know and I frequently stood with my arms folded. According to Riley (2000) we disclose ourselves in many ways, through what we say and do. This includes facial expressions, gestures and other forms on non-verbal communication. Non-verbal communication does not involve words and is used unconsciously as we interact with other people (Riley, 2000). I learnt that my posture and standing with my arms folded could actually portray lack of interested in the other people (including clients) and to others; I may come across as hostile.Riley (2000) believes that if a non verbal message contradicts a friendly verbal one most people will believe the non verbal message. Eye contact is a powerful non verbal cue used as a method of regulating the flow of conversations for example, looking at someone normally means we would like to start a conversation with them (Riley, 2000). I have realised that by not making eye contact with new people, I was probably halting any chances I could have had to acquaint my-self with them. However, I am now more aware and conscious of my non verbal cues.I rarely stand with my arms folded and when speaking to people, I maintain eye-contact with them whether I know them or not. Riley (2000) argues that many of the unconscious judgements we make in regards to other people are based on the amount and type of eye-contact we make. In other words, communication is essential to our development as social beings. The ability to relate and communicate with others enables the development of either short or long-term relationships (Miller, 2002). ENQUIRY BASED LEARNING (EBL):Through the use of enquiry based I have developed the following Intellectual skills; Demonstrate a commitment to continuing professional development and lifelong learning through the development of skills in relation to self directed and independent study; use problem solving skills and decision making strategies to support sound clinical judgement, use skills of reflection, evaluation and critical thinking to support the delivery of care to people with mental health and their families / carers.I use scenarios to develop an understanding of practice theory links and inter-professional learning, which I can apply in my professional role in the future and the wider context of Health and Social care. I used a variety of learning methods such as lectures, student led seminars, small group work, skills based practice sessions, self directed studies including internet resources and through practice to promote the ethos of lifelong learning and take the responsibility for my own learning (Glenn and Wilkie, 2000).Summary The reflective learning has allowed me to enhance my personal learning, which has improved the way I will care for my patients in future and it has improved my confidence and ability to critically think and act while being self aware of the situation. More importantly, however, it reminded me to be more aware of patients’ right to make a personal, informed choice about their nursing care and treatment. I know that failure to obtain informed choice and consent is a serious breach of conduct. NMC (2004: clause 1. ) In conclusion therefore, through reflective practice, I have heightened my awareness and increased my understanding of the true essence and value of nursing. It has also contributed to my professional development by helping me to recognise, understand and value my abilities, strengths, achievement and experiences. It also created opportunities for me to identify areas for improvement and self-development. Reflective practice therefore, should involve thinking consciously and systematically about professional actions and experiences in order to learn from and maintain/improve high standard of practice (Hinchliff et al, 2003). How to cite Reflective Practice, Essays

Rheumatic Heart Disease Samples for Students †MyAssignmenthelp.com

Question: Discuss about the Rheumatic Heart Disease. Answer: Rheumatic heart disease (RHD) is the condition in which the individual suffers damage to the heart valves after an episode of acute rhematic fever (ARF). The condition is caused by episode or recurrent episode of ARF due to which inflammation occurs in the heart, impairing normal blood flow through the damaged valves. If left untreated, RHD leads to heart failure, stroke and endocarditis (Stewart, 2016). Two important social determinants of health that might have been responsibe for making Shakira more vulnerable to RHD are social exclusion and a lower rate of education. Being socially excluded and living in the remote rural community has been the cause of insufficient access to healthcare for Shakira. In addition, a lower rate of education restricts the care giving approach of parents from the indigenous community. The decision making around care for Shakira demonstrated by her family had been guided by low education is a negative manner (Watkins et al., 2017). Standard treatment fo r RHD is antibiotics for infection and blood thinning medicines. Chances of aboriginal population to suffer rheumatic heart disease is 64 times more than non-Aboriginal population (rhdaustralia.org.au, 2017). Cultural awareness involves the ability of the nurse to become aware of the cultural perceptions, beliefs and values of the patient that is different from his own. Cultural awareness is central to interaction carried out with people from other cultures. A nurse is to respect the patients cultural values and beliefs of Shakira whilecommunciating with her. Cultural sensitivity is the understanding of a nurse about the cultural similarities and differences between people without conferring them a value- right or wrong, positive or negative. When Shakira puts forward her perceptions in relation to cultural beliefs, the nurse must not undermine it (Black, 2016). The Aboriginal and Torres Strait Islander Act 2005 concerns self-reliance and self-government of Aboriginal and Torres Strait Islander population. The aim of the Act it focused on developing the cultural and economic condition of this population. The Act institutes the Torres Strait Regional Authority (TSRA), the Indigenous Land Corporation and a corporation called Indigenous Business Australia that formulate and implement programs for the betterment of the population. Aboriginal and Torres Strait Islander people are known to suffer from shortened life expectancy and significant health concerns as compared to their counterparts. The underlying cause of this is the historical disturbance and suffering associated with the bequest of colonisation that have led to many unresolved issues from different domains such as poor economic development, self-determination and identity and land rights. As a result of the trauma of colonisation, these people suffer loss, powerlessness, grief and sense of hopelessness and disconnection (Andersen et al., 2017). Community participation in decision making for indigenous population is a key approach to be taken by a nurse for improving communication and building rapport with the patient. Delivery of care to this population with advanced healthcare models undermines the indigenous individuals preferences for their treatment. Their own values and health beliefs are a reflection of their care practices that might not be aligned with those of non-indigenous population. Giving a chance to the patients to put forward their ideas and preferences for care plan fosters a trusting and credulous relationship between the patient and the care giver (Cherry Jacob, 2016). For communicating with Shakira and her family, it is imperative to acknowledge the cultural beliefs and perceptions about treatment for a chronic disease such as RHD. Being sensitive to the cultural differences holds much importance. Any differences between the traditional treatment options and modernised concepts are to be explained to them that there are chances of conflicts. In addition, the language barrier between the nurse and patient and her family is to be addressed. In case they are not conversant with English, an interpreter would be helpful in two-way exchange of information (Giger, 2016). Ensuring culturally and linguistically diverse staff is maintained in the healthcare organisation would be beneficial for Shakira and her family as they would feel secure accessing care services. The diverse staff would be better able to establish an effective strong relationship with the patient as they might be upholding the same social and cultural beliefs influencing healthcare (Truong et al., 2014). I understand that the indigenous Australian history and culture shapes their interaction with non-indigenous society. The culture places them in a position that isolates and excluded them from the mainstream population. The orthodox beliefs and staunch traditions are often not accepted by the non-indigenous population, leading to discrimination and prejudice exhibited towards this group. While the non-indigenous lives mostly in urban areas, the indigenous population live in remote rural areas. As a result of locational isolation, the interaction between the two population is restricted (Duckett Willcox, 2015). Denial of suggestions that there is a problem- A healthcare professional might be denying that the indigenous patient is faced with health complications and other challenges, compelling the patient to think that the denial is due to cultural differences Low utilization of available services-An indigenous patient might not be presented with comprehensive services, and the utilisation might not be optimal (Douglas et al., 2014). References Andersen, C., Edwards, A., Wolfe, B. (2017). Finding Space and Place: Using Narrative and Imagery to Support Successful Outcomes for Aboriginal and Torres Strait Islander People in Enabling Programs.The Australian Journal of Indigenous Education,46(1), 1-11. Black, B. (2016).Professional Nursing-E-Book: Concepts Challenges. Elsevier Health Sciences. Burden of Disease. (2017).Rheumatic Heart Disease Australia. Retrieved 19 October 2017, from https://www.rhdaustralia.org.au/burden-disease Cherry, B., Jacob, S. R. (2016). Contemporary nursing: Issues, trends, management. Elsevier Health Sciences. Douglas, M. K., Rosenkoetter, M., Pacquiao, D. F., Callister, L. C., Hattar-Pollara, M., Lauderdale, J., ... Purnell, L. (2014). Guidelines for implementing culturally competent nursing care.Journal of Transcultural Nursing,25(2), 109-121. Duckett, S., Willcox, S. (2015).The Australian health care system(No. Ed. 5). Oxford University Press. Giger, J. N. (2016).Transcultural Nursing-E-Book: Assessment and Intervention. Elsevier Health Sciences. Stewart, S., Carrington, M. J., Sliwa, K. (2016). Rheumatic heart disease.The Heart of Africa: Clinical Profile of an Evolving Burden of Heart Disease in Africa, 121-135. Truong, M., Paradies, Y., Priest, N. (2014). Interventions to improve cultural competency in healthcare: a systematic review of reviews.BMC health services research,14(1), 99. Watkins, D. A., Johnson, C. O., Colquhoun, S. M., Karthikeyan, G., Beaton, A., Bukhman, G., ... Nascimento, B. R. (2017). Global, regional, and national burden of rheumatic heart disease, 19902015.New England Journal of Medicine,377(8), 713-722.