Nurses Role In Communicating Effectively In Clinical Practice

Nurses Role In Communicating Effectively In Clinical Practice The purpose of this essay is to discuss and analyse the nurses role, in relation to communicating effectively in clinical practice. To explore this area fully an example taken from a clinical practice will be outlined, in accordance to the NMC (2008) confidentiality guide lines. To follow after will be how we learn to communicate, what communication is and the potential barriers that prevent effective communication. A nursing module by the name of Egan (SOLER) that has been especially designed to help nurses develop communication skills will be discussed in relation to the clinical practice example. Another nursing module from Roper, Logan and Tierney has also been briefly examined and related back to the clinical practice example. Suitable conclusions will be drawn up to bring this topic to a closure. In accordance to the Nursing and Midwifery Council (NMC) 2008, the patients name has been changed in order to protect their identity. Alex is a male patient, in his late forties and is currently being treated for on a mental health ward. To communicate with Alex a trusted relationship had to build up first, as he suffers from paranoia schizophrenia. His average day would consist of being huddled into a ball in a small arm chair anxiously aware of everyone and everything around him. I aimed to make sure that I approached Alex in the same manor every shift in order to build up a trust between us, so that i could offer assistance to him if needed. Over the placement period the trusted bond between Alex and I had started to form and he now trusted me enough to help assist him to the dining room to feed him, where as normally the food was brought to him because of his nervousness and anxiety around large groups . In order to communicate effectively you need to understand the aspects involved with communication. The basics start off with oral and written communication skills taught to us from a young age, in order to achieve in life. Oral communication is a constant learning skill throughout life, by observing and practising. The same can be said for written communication. Both communication aspects should equally complement one another, as weak or poor oral/written skills can lead to disagreements between individuals, poor documentation, and waste of time for resources. Whilst mastering the art of effective oral communication other factors now come into play such as, using open and closed questions to enhance a conversation and also the facilitators/barriers to communication. As well as being able to speak and write correctly, other learning functions are also taught from a young age by observing others, and are also included in our constant learning curve through life, these include listenin g, understanding, becoming self aware and to the ability to maintain confidentiality . Without these important extra factors no further improvement personally or professionally would be able to happen. If unable to listen and understand oral communication/commands catastrophic consequences could occur, especially in the field of nursing. Effective communication is needed in order to understand the individuals viewpoint on their illness and to strive for empathy. The nurses job does not only involve looking after the physical demands of the patient, but also to try and build up a therapeutic relationship between them. Oral communication consists mainly of two divisions called verbal and non verbal, from which they both strand off and explore the various different characteristics between them. Verbal communication pays close attention to the accents, pitch, tone, volume, speed and context. (Arnold, 2001, p.41) Referring back to the clinical example above, before I started to communicate with Alex I politely asked him what language he spoke or preferred to use, Alex stated that English was his only language. The Nursing and Midwifery Council (2008) states that, You must make arrangements to meet peoples language and communication needs. (NMC code 2008, p.3) Communication was one of the barriers that affected Alex so therefore effective verbal communication was extremely important to my patient in order for him to maintain his social interaction skills and memory processing (Mason and Whitehead 2003) By approaching Alex frequently throughout each shift I tried to maintain as much social interaction as possible to help him overcome his timid social skills and to keep some sort of normality to his daily living on the ward. Communicating with Alex would often be a one way conversation due to the lack of response when communicating with him; some qualified health care professionals would spend less time with him, for the feeling of being ignored. When actually socialising with the patients is a therapeutic activity and can help with the healing process. Mason and Whitehead states that, Thus, nursing can be viewed as a social action and also as a form of therapy in itself. I tried to speak to Alex in a way that I hoped would reassure to him that I brought no harm, by slowing down my speech and speaking quieter and softer than normal. The purpose in doing so was that speaking in a lower tone to Alex proved to be more effective and calming for him, which overall provided a better response in conversation. If you were to suddenly ask Alex a question, without thinking about your self-awareness and interpersonal skills first, it would startle him and sometimes cause an outburst of unsettlement. Whilst trying to keep sentences short and simple for easier understanding, to further the conversion I made a conscious effort to ask open questions that would prompt more of an answer other than yes or no. The reason in doing so was to try and assist with Alexs social skills and build up his autonomy confidence. Questions such as what visitors have you had today or who got you out of bed this morning would help to establish a small conversion whilst trying to set up building blocks to further the conversation. To start a conversation off with one of the following words who, what, when, where, why and how, help to approach an open ended question and to also address specific symptoms. (Sheldon L.K, 2009.) While non verbal communication looks more at the paralinguistics such as, body language and movements, facial expressions, proximity, eye contact and posture. (Arnold, 2001, p.41) Referring back to the clinical example above, non verbal communication needed just as much attention because Alex would sit with his knees pulled in tightly to his chest, with his arms wrapped around them and his head bowed down. By displaying these closed gestures, Alex was indicating his need for self protection, and that he was feeling vulnerable. In order to open up his body language and communicate with Alex small and gestures had to be used such as, trying to maintain eye contact throughout lets you establish a connection and initiates communication whether it be verbal or non verbal, it also helps to engage with your patient and help with attentiveness. (Gupta, 2008) Before I sat down or made an approach, I made sure that I informed Alex what I was going to do. Uys and Middleton suggest, When moving towards the patient, inform him/her verbally of what your actions mean. By pulling up a chair to sit next to Alex decreasing the proximity between us i tried to show warmth, care and understanding, by placing my arm slowly and gently on his arm of the chair, instead of standing over him and coming across as superior. (Boyer,J.M 1992) Proximity between Alex and I would differ from day to day, sitting close to him in a chair may be ok some days and on others you would need to allow significant body space. By judging his non verbal communication such as facial expressions and eye contact, you consciously knew the distance he would appreciate. (Uys and Middleton, 2004) To offer assistance to Alex and prepare him for moving off his security setting and into the dining room for food, I would verbally and non-verbally explain to Alex what the plan was and how we were going to get to the dining room. I would point to specific points in the day room and explain it would only take three steps or five steps to the next point, to try and encourage movement. Whilst pointing around the room I would show my palms instead of pointing my index finger. The reason for showing my palms was that pointing at something can be misinterpreted as an attack, whereas a palm is more open and patient, ready for encouraging small movement at a time. Showing points in the room to where we would walk to first, would make the journey to the dining room seem less intimidating and also not to cause any additional anxiety for him, as some restless and panicky patients need reassurance about the availability of support (Uys and Middleton, 2004) Other days small gestures would be all it took for Alex to open up his body language, such as keeping a happy, wide eyed expression around him, showing that i was still available if he wanted some reassurance. The work of Egan (1986) has been drawn upon extensively by nurses as the basis for active listening, as this skill is a fundamental aspect required by nurses to provide adequate care, and by suggesting that non verbal skills can demonstrate to the patients that you are listening to what he or she is saying. The frame work is labelled by the name of SOLER, and is an acronym from the word squarely. It encourages the nurse to sit squarely facing your patient so that you may engage them fully; this was especially helpful when talking to Alex as it showed I was willing to communicate with him. It also mentions about adopting an open posture to show encouraging and facilitates patient expression. Alex displayed closed off gestures, by implying openness I tried to facilitate effective communication whilst also being aware of my own body language, posture and movement. To lean slightly forward showing attention and interest was not always a good position to hold, as being so close to Alex wo uld slightly unnerve him and make him feel intimidated. Soler also suggests maintaining good eye contact, which again shows interest. In relation to Alex maintaining good eye contact was vital for encouragement and progress when assisting to the dining room, by showing a wide eye, happy expression I aimed for encouragement and reassurance. The last part of Soler, Egan argues that it is imperative not to fidget and to feel at ease and relaxed (Stretch, 2007) again this part played an important factor when assisting Alex to the dining room. There are also many barriers that prevent effective communication between the nurse and patients such as, stereotyping. Nurses must try and refrain from culturally stereotyping patients, and should consult patients regarding values, beliefs, preferences and cultural identification first. (Boyer.J,M, 1992) Other barriers include perceptions, prejudgements, environmental factors and nurses avoiding subjects or rapidly changing the subject if the nurse feels uncomfortable within a nurse/patient situation. The reason for distancing themselves was to avoid exploring an area that could actually do more harm than good to the patient. Over time this procedure has been reviewed and communication is now seen as a vital aspect for improved better care and a more therapeutic nurse-patient relationship. (Walsh and Crumbie, 2007) Roper, Logan and Tierney collaborated to refine the Roper models (1980) as a way of introducing beginning students to think about nursing practice. It has been used extensively within the United Kingdom as a frame work for nursing care, practice, teaching and learning. The module is divided up into two sections, the module of living including the sixteen activities of living (ALS) and the module for nursing including twelve further activities of living that came into action after a lengthy debate in 1996. Starting off with the module of living Roper et al categorized this section into three groups, essential looks at the physical demands of daily living, increase quality of living pays close attention to the social aspect of daily living, and mortality looks at the dying stage of life. The next twelve activities of living are related to particular human needs and have biological basis to them, whereas the sixteen activities of daily living have social and cultural determinants. (Aggleton and Chalmers, 1986) (Holland et al, 2003) The focus of the theory model is aimed at efficient nurse/patient communication in order to achieve a positive living outcome for the patient. It shows empathy, non judgement and respect to the patients needs by recognising that, people require nursing episodically and that minimal disruption to a persons lifestyle should be maintained. As mentioned previously with Alex, communication with him on the ward was to try and keep some sort of normality to his daily living, whilst being looked after. Roper, Logan and Tierney states that, Alternative strategies should be carried out on an informed basis and not simply in accordance with past precedent. (Aggleton and Chalmers, 1986, P.31) One of the new strategies tried with Alex was to assist him to the dining room for food, rather than bringing the food to him where he felt secure in his chair. The purpose in doing so was to encourage and seek responsibility for self-care, to promote dignity and to raise Alexs self esteem. Conclusion

Beryllium :: Research Papers Essays

Beryllium Beryllium is a highly toxic metal and if exposed to it, at or above the threshold values, it can lead to a chronic beryllium disease (CBD) (i.e. berylliosis) or an acute beryllium disease. Toxic exposure to beryllium is most often thru an inhalation pathway. Beryllium has a variety of effects. Some beryllium combines with a protein and is deposited in the liver, spleen and kidneys, but the beryllium when bound with a biological protein, a hapten, can result in the chronic form of the disease which is believed to be a delayed hypersensitivity immune response. The major toxicological effects of beryllium are on the respiratory tract,specifically the lungs and their alveoli. Beryllium and its unique characteristic led to it being used widely in a variety of industries prior to is know toxic effects. Today it is know that beryllium is a highly toxic material which results in devastating toxic effects on the lungs. There has been drastic increases in the regulation in beryllium use so as to protect those that directly handle and work with the metal. With theses regulations, beryllium is fairly safe to work with and use in a variety of products and industries. In the following text, there will be a description of beryllium confusing history and toxic effects on the respiratory system of man. Beryllium has the symbol Be. In the older chemical literature, beryllium is called glucinium after the Greek word glykys meaning sweet, because of Vauquelin's initial description and observation of Beryllium. Beryllium's atomic number is 4, its atomic weight is 9.01 and in its pure metal form it melts at 1278 degrees Celsius. The Beryllium element, an alkaline earth metal which belongs to group II of the periodic table, was first discovered in 1798 by L.M. Vauquelin. Vauquelin,a French chemist, was doing work with aluminum and noticed a white powder that was nothing like that of aluminum or any of its derivatives. Vauquelin named this mystery powder, gluinium because of its sweet taste was like that of glucose. In 1828, Wohler, a German metallurgist reduced it to its metallic form and renamed it beryllium.(figure 2) There was no commercial application of beryllium until 1918 when Cooper patented a beryllium-aluminum alloy, which turn into the 'jump-start', into extending beryllium's application. Following Cooper's patent of the beryllium alloy, Charles II in 1921, was intrigued by beryllium's light weight, extreme stiffness, high heat absorption and interesting nuclear cross section.

Child Pornography: Canada vs. Japan Essay

â€Å"We think that child pornography, in any form, promotes values and sends the message that it is OK to sexually abuse children. It helps paedophiles to justify their ideas or behaviour and it desensitizes society as a whole.† ( 1995. John Carr, a United Kingdom government adviser. ) The classification of sexual exploration , the governments laws, and landmark cases all play a part in how the people perceive child pornography. â€Å"Japan is one of the world’s biggest suppliers of child pornography and the second biggest consumer after the U.S.† (Justin McCurry, Japan to Outlaw Possession of Child Porn, GUARDIAN, Mar. 10,2008) In Japan they have a very lose definition of child pornography where as in Canada it is firm and unbending. There are many different types of sexual exploitation in Japan involving minors, some are considered illegal and wrong but most comply with the country’s laws. Adult anime or Hentai is one of the most popular forms of pornography in Japan. It is in a cartoon format and can therefore show graphic sexual activities without being subject to the same laws as live films. They feature mainly young school girls or boys and are not considered child porn. Since it is not classified as illegal anime pushes many boundaries that movies could not. Hentai commonly involves rape(Goukan Purei â€Å"Rape play†) , bondage( Broken Dolls), and Lolicon with involves sexual encounters with prepubescent girls. There are video games based on these fantasies called â€Å"bishÃ… jo games† or â€Å" pretty girl games†. Many Asian cultures have an obsession with child like women. Women show in all media are small and frail, helpless and have very high voices. This shows a value message in Japan, that women are meant to seem young and child like and innocent . In Canada there is a rigid definition of pornography written in the Code. It includes all material computer generated or actors. It can be defined depicting or promoting sexual abuse of a child, a sexual act or the genital organs of children. It exists in three main forms, visual, audio and text. Canada is very intolerant of it and has strict laws in place to prevent the production, distribution, and possession of child pornographic materials. Under article 175 in the Criminal Code , Japanese laws states that it is illegal to sell, display to the public, and distribute child pornographic material. Child pornography was banned in Japan in 1998 by the Act on Punishment of Activities Relating to Child Prostitution and Child Pornography. The enforcement of this act began in 1999 and it was first amended in 2003. Films and pictures depicting sexual organs are against the law but company’s have found ways around it that are perfectly legal and just as inappropriate. The body parts are merely made fuzzy and according to the law may be sold to the public. Many of the Japanese politicians appear to be indifferent to this issue unfortunately. They believe that it would contravene with the fundamental freedom of speech and expression. The Japanese have historically be lax on this subject in 1996 it was brought before the UN conference in Sweden. The public began to put heavy pressure on Japan to reform their laws and the government was forced to act. Despite the law stating that the sale, display, and distribution of the pornography is illegal the possession of it is not. In 2008 the government begin a campaign to amend the act to pronounce the possession of child pornographic items illegal as well. This change was spearheaded by former American ambassador to Japan, J. Thomas Schieffer and the bill is waiting at the Japanese parliament ( Diet) since 2009. While the government in Japan struggles to control the controversial media with new bills and enforcement of the laws Canada is very sure of its position in this matter. The Canadian Criminal Code includes child pornographic material under Part 5 : Sexual Offences, Public Morals and Disorderly Conduct: Offences Tending to Corrupt Morals. Section 163 of the Code describes child porn as â€Å"a visual representation, whether or not it was made by electronic or mechanical means†, that â€Å"shows a person who is or is depicted as being under the age of eighteen years and is engaged in or is depicted as engaged in explicit sexual activity†, or â€Å"the dominant characteristic of which is the depiction, for a sexual purpose, of a sexual organ or the anal region of a person under the age of eighteen years.† ( C-64. Canadian Criminal Code. Section 163.1) Canadian government has recently introduced a bill to crack down on child porn on the internet, if passed it would b ecome on of the only countries in the world to restrict access to child porn online. This bill includes accessing, creating, and selling the material and would carry a possible 5 year prison sentence. Japan is the official child pornography capital of the world. It produces about four fifths of all the films, books, and magazines that are distributed worldwide. The Japanese National Police recently composed a report showing that there was a dramatic rise in criminal cases last year surrounding child pornography. There was 1455 reported cases involving children under 18. In Canada unlike Japan, Hentai is considered a form of child pornography and can be charged in court for the possession of it. On Monday January 20th 2012. Jeffrey Bedford, 41 , was sentenced to six months in jail for having over 1,100 images of animated child pornography on his computer. Police confiscated his laptop and found 1,135 sexual pictures of young girls aged four to fourteen. Bedford pleaded guilty but his lawyer asked the judge to consider that the girl were electronic cartoon and not real people. â€Å"It’s not the situation where an actual young person is victimized,’’ said his lawyer, Bruce Ritter. However the judge disagreed and stated that anime is the same as actually photographs and the purpose of the photos are the same. This is the problem that plagues Japan, is adult amine porn? Most people in North America would argue yes but it has been so deeply entwined in Japanese society that it is not seen as an illegal act. The contrast between Japan and Canada when discussing child pornography is extremely apparent . Japan has few laws and even fewer that are strictly enforced while Canada abides by a solid definition and set of laws restricting any contract with the taboo material. The numerous aliases of child porn , the country’s laws, and important legal cases are factors in shaping the country’s view on child pornography. Works Cited Umeda, Sayuri. â€Å"Japan: child pornography–Child Pornography Law Amendment discussed.† Global Legal Monitor (2010). Gale Power Search. Web. 1 June 2012 â€Å"Child porn law struck down.† Canadian News Facts 1 Jan. 1999: 5804. Gale Power Search. Web. 1 June 2012 â€Å"The darker side of cuteness.† The Economist [US] 8 May 1999: 32. Gale Power Search. Web. 1 June 2012 Page, Barnaby. â€Å"Canada Considers Tough Online Child Porn Laws.† TechWeb 16 Mar. 2001. Gale Power Search. Web. 1 June 2012 â€Å"Tough on child porn.† Maclean’s 7 Dec. 2009: 8. Gale Power Search. Web. 1 June 2012 â€Å"Outraged innocence; Child pornography in Japan.† The Economist [US] 20 Mar. 2010: 55EU. Gale Power Search. Web. 1 June 2012 â€Å"Child-porn case goes to top court.† Canadian News Facts 16 June 1999: 5892. Gale Power Search. Web. 1 June 2012 http://www.therecord.com/news/local/article/663204–six-month-sentence-sends-strong-message-about-animated-child-porn

ERP Strategies and Vision - 1228 Words

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The dangers of this phase however is having a vision that is overly ambitious, poorly defined or not realistic; which results in having an ERP implementation strategy that is impossible to deliver and ultimately impossible to gain business value (Ganly, 2012). Not understanding an ERP within the context of the organisations application portfolio will lead to an ERP implementation that is not appropriately scoped and does not align to business and IT strategies (Ganly, 2012). Taking a pace-layered approach according to Ganly (2012) is vital for ERPs long-term success within the organisation as well asShow MoreRelatedThe Business Process Reengineering ( Bpr ) Essay1573 Words   |  7 Pagesthe business process to determine the changes within or outside the enterprises to streamline the operations of the business. Enterprise resource planning (ERP) is software platform that helps the organization to determine how to utilize the available resources. 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