Family Are Involved In The Care Decision Process Nursing Essay

Family Are Involved In The Care Decision Process Nursing Essay According to Eilbert Lafronza Partnerships comprise of a social system or individual based agreement between participating organizations to collaborate on a common goal in which benefits and risks, as well as resources and power are shared fairly. Patients and families cannot entirely be involved in the care decision process unless they have established a solid partnership between their health care providers i.e Doctors, Nurses, General practitioners etc . (McQueen :2000).2 Some of the way that patients and their families can be involved in the care decision process is by making informed decisions on: Whether the patient wants treatment or not: Selinger (2009)3 states that the patient has every right to make an informed decision on the right to determine what investigations and treatments to undergo, and this decision must be respected by all doctors, nurses and caregivers. Whether the patient wants to complete a Do Not Attempt Resuscitation (DNAR) form or not: Healthcare professionals have an important role in helping patients to participate in making appropriate plans for their future care in a sensitive but realistic manner, making clear whether or not attempted CPR could be successful. Helping patients to reach a clear decision about their wishes in respect of CPR should be regarded as a marker of good practice in any healthcare setting (British Medical Association (BMA), the Resuscitation Council (UK) and the Royal College of Nursing (RCN) : 2007)4 And finally, what right the patient has to be involved in decisions about their medication. The National Collaborating Centre for Primary Care( 2009)5 states that patients have a right to be involved in decisions about medicines to the extent that they wish and it is the role of health professionals to facilitate and support patients in their involvement in decision-making and to support patients in taking medicine if the decision has been to prescribe. Patient and family partnerships are very important in the care decision process because without them numerous problems may arise. Some of which are: self-discharge, readmission, deterioration of condition and death. (Smith and Hider: 2009)6 According to Gott et al. (2000)7 successful patient partnerships are those in which the patient and healthcare practitioner meet as equals with different expertise. The doctor or nurse has the medical knowledge and skill, but the patient has personal knowledge and skill. This is useful because it provides two different perspectives which in turn will provide the best outcome for both the patient and the healthcare provider. For the most part, patient and family involvement is beneficial to the care process because the patient knows their own condition the best and if we assume that they are close to their family and share their struggle with managing their condition/disease with them then they too know what the patients condition well. Anderson and Funnell (2009)8 state that patient and family involvement in care decisions revolve mostly around decision making and empowerment. Patient involvement in decision-making is now generally regarded as a feature of good quality health care. Many health professionals, institutes and government policies such as the Department of Health (2007)9 now advocate that patients should be involved in some way in decisions about their health care. According to the RCN (2003)10 empowering patients is a central element of nursing care, by forming a solid patient- nurse partnership, and encouraging the patient and their family to be part of the decision making process, this allows the patient to feel empowered and in control of various aspects concerning their health. However according to a study carried out by Dickerson (2004)11 shows that although patient and family involvement is crucial in care decisions, various authors might argue that a lot of patients search for and find information/new treatments about their illness/ condition on non-credible sources such as the internet, magazines and social media and believe that whichever fact or new never trialled before treatment they read or hear about might be a diagnosis to their symptoms or a solution to their illness. The study showed that many patients (50%) relied on friends and family to navigate the Web, and most of patients reported that the information that they sought was unrelated to their clinical visit. This study shows that although patient and family partnerships are crucial to the care decision process, some patients and their family take the wrong path when seeking information about their condition, this is usually after a clinical encounter for diagnosis and/or reassurance or beca use of dissatisfaction with the amount of detailed information provided by the health professional during the encounter. (Kaimal AJ et al. :2008)12. According to McMullan (2005)13 Health professionals are reacting to the more Internet informed patient in some of the following ways: The health professional either feels threatened by the information the patient brings and responds defensively by asserting their expert opinion (health professional-centred relationship). Or, the health professional and patient collaborate in obtaining and analysing the information (patient-centred relationship) (Pautler et al. : 2001)14. Although the health professional almost always comes to a decision to progress with the latter option, feeling threatened and being defensive about the internet based information being presented to them by the patient and their family is usually the health professionals first reaction. An alternative approach would be for the health professional will guide patients to r eliable health information websites. It is vital that health professionals acknowledge patients search for knowledge, that they discuss the information obtained by patients and guide them to reliable and accurate health websites. It is suggested that courses, such as patient informatics are incorporated in health professionals education (Sommerhalder et al. : 2009)15. The Department of Health (2003)16 states an effective discharge as A process and not an isolated event. It has to be planned for the earliest opportunity across primary, hospital and social services, ensuring that individuals and their carers understand and are able to contribute to care planning decisions as appropriate. Here we see the DOH (2003) describing an effective discharge as one that co-ordinates all of the services needed by the patient in order for the patient to have input on the discharge and for everything to be ready for the patients discharge. Nurses and other health care professionals recognise that planning for patients hospital discharge during the inpatient stay sets the stage for effective and therefore successful self-care management at home. (Nosbusch et al.:2010)17. According to the Wales NHS effective discharge policy document (:2009)18 an effective discharge constitutes of the following 6 principles: Communication when it comes to the transfer of care process, it is important that good communication consists of mutual understanding and having a common language between everyone involved. This requires effective dialogue and sharing of up to date information amongst patients, carers, providers and commissioners. Casey and Wallis (2011)19 state that Nurses and the nursing staff are at the core of the communication process: they assess, record and report on treatment and care and handle information sensitively and confidentially .To establish a healthy nurse- patient relationship, good communication is crucial. As a nurse, building a close rapport with your patient is one of the ways to make your patient feel listened to, understood and involved in their care. Good communication is vital in the process of decision making. Jonsdottir et al. (2004) 20 state that communication skills are one of the most imperative aspects of nursing, considering that nursing always is two-folded with b oth task-oriented and relational aspects. A nurses communication skill is an essential requirement for patient participation in decision making. Communication discrepancies have been recognised as one of the major barriers to partnership building between nurses and patients (Keatinge et al. 2002)21. Good communication in the care decision process is vital In order to achieve a seamless discharge for the nurse, patient, the patients family and all other healthcare practitioners/Multidisciplinary team (MDT) members involved. The NHS Trust Discharge policy (2010)22 states that before planning a discharge, the nurse and other healthcare practitioners must decide and inform the patient and their family on whether it is a simple discharge: one that involves minimal disruption to the patients activities of daily living, does not prevent or hamper a return to their usual place of residence and will not require a substantial change in support offered to the patient or their carer in the comm unity. Or whether it is a Complex Discharge: A discharge process that deviates from the simple discharge pathway and requires complex coordination of services to enable safe discharge. To ensure that the patient and their family is involved in the care decision process of discharge, the nurse and other clinicians must be certain that an effective and well-timed discharge plan is put in place. The main objectives of this will be to plan, inform, liaison and negotiate to ensure a smooth discharge for patients and their families. Supporting this is the need for an early establishment of what the discharge dates might be, including pre-admission planning, effective communication between individuals and across settings, good clinical management plans and the alignment of services to ensure continuity of care(DOH :2010)23. Assuming that it is a simple discharge, once the discharge plan has been put into place and is carefully explained to the patient and their family, the patient can then begin to contribute in the decision making process alongside the nurse and members of the MDT team.( Shepperd et al. :2010)24. Some of the ways a patient can contribute in the decision making process when it comes to discharge is to work alongside the nurse and members of the MDT team in order to inform and help them assess whether the patient can- Obtain and self-administer medications- the patient should inform the nurse and other clinicians (such as pharmacist) on what regular medication they take, what form they prefer their medication: liquidised, dosette boxes etc. How well the patient performs self-care activities, and does the patient eat an appropriate diet or otherwise manage nutritional needs and whether the patient is able to attend any follow-up outpatient appointments (Bull and Roberts: 2001)25. Atwal (:2002)26 states that ensuring that the patient and their family have full involvement in making the above decisions and steps to be discharged from the hospital will gi ve the patient a sense of control and therefore empowerment and in turn guarantee an organized discharge as well as patient satisfaction and the nurse feeling confident that they have done their best for their patient and therefore feel fulfilled in their role as a nurse. It is prominent that a patient must be an active participant in his/her empowerment, signifying that Nurses cannot empower patients: the role is to facilitate and support the empowerment (Laverack :2005)27. .

1. How, Specifically Is the Process of Attribution Illustrated in This Case?

Case Module 5 1. How, specifically is the process of attribution illustrated in this case? Ans. The process of attribution regarding the case referred, flags relatively regarding the behavior of the customer’s eye contact wrong implication. The case study stated that a in certain supermarket dozen females claimed the issue of drawing the unwanted attention for maintaining eye contact. There was no clear information as how many female employees were employed there. This may raise several questions of the internal causes and external causes of behavior.The nature of the twelve women was unknown regarding other issues outside their work place. The case study does not apparently satisfy the â€Å"consistency† of the attribution. This implies the behavior of the female employees and the customers they face behave in the same manner in other situations for knowing the distinctiveness of their claims. If the case study had satisfied the arguments then this would have helped in better understanding of the concept of attribution. 2. What do you suppose is being done to help train people to be friendlier toward customers?In other words, what would you imagine goes on in Safeway’s †smile school†? Ans. There is an underlying concept of positive reinforcement that satisfies the organizations in treating people for the desired returns in the form of sales or goodwill. In the Safeway supermarket they send their employees for the friendliness school called â€Å"Smile school†. They make their employees to follow certain trivial manners that greatly affect the positivity in people like smiling face towards customers, maintaining eye contact for three seconds, calling the people by their name when they pay by check or credit card.Respective to the case study the smile school seems enforcing its policies irrespective of the employees’ consignment. 3. Describe what you believe might be the progressive discipline steps outlined in the warning letter sent to unfriendly Safeway clerks? Ans. The concept of the progressive discipline elevates the steps form letting know the curtness of the respective unfriendly employee individually, and then increasingly enforce the degree of the punishment like officially state the undesirable behavior of the employee, then warning the employee in form of a letter with all negative evaluations.Considering the case study the letter must state all the previous warnings to the unfriendly employee, and then warn the employee that continual curtness leads to suspension without pay and may lead to dismissal for unchanged unfriendliness. 4. What perceptual errors did the customers make? Ans. In accordance to the case study the questions gives ideas regarding the issue of the false judgment. As stated in the case the male customers anticipated the positive reinforcements from the supermarket employees as acts of flirtation.This relates the concept of the Halo effect where the appearance of the employees and their positive behavior triggered the false judgment. The basic idea formation of the first impression is totally based on the internal causes of individual behavior. In another instance stated in that case, one shopper followed a female employee to the car in a false disposition. This may lead to the negative reinforcements form the employees and can effect the other customers. 5. What forms of operant conditioning did Safeway use? Ans.The case study relating to the operant conditions inclines to the policies of the supermarket, one such is â€Å"superior service† policy. The concept states that the reaction provided initially, gets back. It is also called Law of effect. The principle of any customer service is providing best customer service. In the case study the Safeway supermarket also provides it employees a positive reinforcements strategies like maintaining the eye contact for three seconds, smile at customers, anticipating the customers needs. It a lso maintains undercover shoppers to ensure the employees are working properly.There is a â€Å"Smiling school† that helps the employees in understanding the operant conditioning and outcome from it. This can be drawn from its spokesperson that their concentration is not on discipline but on treating customers the best way. 6. What characteristics would a Safeway clerk need in order to be successful in complying with Safeway's policy? Ans. Abiding to the policies of the Safeway supermarket, that employees should maintain smiling face and should have at least three seconds of eye contact. There should be certain point in the causalities of the individual behavior where one can personally realize awkwardness beyond that.Maintaining three seconds of eye contact may be offensive for some of the customers and smiling for that long may trigger false impulses in some of them. These external issues of the behaviors of the shoppers are not in the hands of the employee. As stated first in the case study, smiling and eye contact are basic manners in any customer care services. It is individual realization that smiling and maintaining eye should be at a level that does not cause any false perceptions on the shoppers. In that way an employee may successfully sustain in customer services field with out encountering a surly experiences.

An analysis of Who’s for the Game? By Jessie Pope Essay

War is a highly debatable topic that has influenced many poets. An issue that is important in Jessie Pope’s 1914 poem Who’s for the game? This essay will explore a range of literary devices used within the poem to help analyse the explicit and implicit meanings. Furthermore, it will use appropriate literacy terminology to back up quotes within the poem. Additionally, this essay will analyse the structure of the poem to show how meaning is conveyed. Pope, a naive poet, speaks of a highly debatable topic known to man. However, she makes reference to the war as being a game, she suggests that it is â€Å"The biggest that’s played† though, she does not anticipate the destruction which war may bring. The poem is reliant on propaganda which relied heavily on men’s guilt. It could be seen that this encouraged men to fight and defend their county. This is shown through a literary device, a metaphor. An example being, â€Å"And who wants a seat in the stand † the use of this device prominently states that spectating the war will result in deepest regret because they are not defending their country. It could be suggested that the emphasis of the metaphor helped influence men’s participation in the war. Arguably, though Pope promotes the so called glory of war, it is seen that not protecting their country could result in an invasion. Here, Pope addresses that without soldiers at war, their country could be destroyed. Alternatively, Pope makes use of personification indicating the realism of war. She writes, â€Å"Your country is up to her neck in a fight†. Here, the poet personifies their country as a woman, implying that the war is at its most extreme. This addresses the men that their country needs them the most at this point in time. In contrast, it is clear that the implicit meaning of this literary device exposes the brutality of war, vicious and scary. Jessie Pope has written her poem in a conversational manner making â€Å"Who’s for the game?† memorable and persuasive to the readers. The poet has also made use of a metrical rhythm throughout the entire stanza’s. Furthermore, the poet has made use of rhetorical questions throughout the first three stanzas. She emphasises the word â€Å"Who†, an example being, â€Å"Who’s for the game?† Pope has used the word to present the invitation of recruitment to men. It is seen that these specific questions are without a doubt persuasive, and have encouraged men of all ages to fight  in the war. Throughout the third stanza, it can be seen that Pope has replaced aggressive words with more light hearted descriptions. She speaks of â€Å"Picnic†, a known and enjoyable experience. However, Pope has used the implicit phrase in an informal manner raising the awareness that war is difficult and unpleasant. The structure of the first stanza has a three syllable foot with the first two syllables unstressed and the third one stressed. Similarly, throughout the last three stanzas the poem misses some of the unstressed syllables but the effect of the stressed syllable is predominate. The final line â€Å"And she’s looking and calling for you† draws heavily on the promotion for recruitment. The significance of â€Å"she† refers to the war as an animal being discussed. Having analysed the literary devices, terminology and structure in Who’s for the Game? It is seen that the entire poem draws heavily on men’s guilt who want to protect their country and family, although they are afraid. Pope certainly glorifies war within this poem, thought she raises false hopes for the wrong reasons. The whole poem is justification of the brutality faced when at war.

The Cost Of Higher Education - 1100 Words

Over the past four decades, the costs of higher education has risen at a rate that surpasses the rate on inflation. Students, parents, and policymakers are concern about the rapid increase. The literature supports that there are multiple trends such as a decline in federal and state support as well as outdated policies and practices that have contributed to continued rise. Thelin (2015) analyzed Edwin Slosson’s 1910 anthology on Great American Universities, which provided data on fourteen prominent institutions of that era. They were both private and public institutions. He examined why college costs so little a century ago. The data was compiled in 1908-1909, by the Carnegie Foundation of the Advancement of Teaching (CFAT). Please†¦show more content†¦Since the recession, public colleges and university across the United States have increased tuition to offset the decline in state funding (Mitchell, Palacious, and Leachman 2014). Tuition at four-year public colleg es has risen by 28 percent after adjusting for inflation. Over the past two decade, tuition has increased faster than median income. The authors stated that federal student aid and tax credits have increased, but not enough to cover the shortage of increased tuition costs. In fact, please note that tuition only accounts for part of revenue losses from state funding reductions. Public institutions have had to cut faculty positions, curriculum offerings, closed campuses, closed computer laboratories, and reduced library services, etc. (Mitchell etal, 2014). The University of Carolina, Chapel Hill cut 493 positions, 16,000 course seats, increased class sizes, computer laboratories, and eliminated two distance education centers. Additionally, the literature indicates that future jobs will require a more educated workforce, and adequate funding for higher education is vital to keep tuition affordable and to maintain high quality public colleges and universities. Indeed, states must i nvest in developing a skilled and diverse workforce to compete for jobs. The authors also posit that policymakers must make sound budget decision to bring higher education back to pre-recession levels. This mayShow MoreRelatedThe Cost of Higher Education754 Words   |  3 Pages For most high school seniors the cost of higher education may be a daily or at least. It is an even a concern in that a group of students, who all share a common, concern, around the same age, but with no reliable income. Each one is making a huge investment in their future, but in majority of cases adding more and more debt to their lifestyles. Though majority of students receive financial aid, the amount of debt which tuition builds is beyond stressing. 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