Wednesday, October 30, 2019

On Medical Surgical Type II DM Patients, How does RNs Obtaining Their Research Paper

On Medical Surgical Type II DM Patients, How does RNs Obtaining Their Own Accu Check Findings Compared to Nursing Assistants Obtaining the Accu Check After Timely Insulin Delivery - Research Paper Example The paper will also focus on the organization culture, expected outcomes of the solution, methods used to achieve the outcomes and the impact of these outcomes on quality of care. A good and meaningful solution to the core question of this research paper is to let nurses to take their Accu-Chek findings and adjust their staffing ratios. Currently on the med-surg units, during the day shift the nurse patient ratio is 5:1 while the night shift nurse patient ratio is 6:1. Increasing the number of nurses will enable the nurses to obtain Accu-Chek readings more easily and effectively while at the same time increasing efficiency in the hospital. The newly hired nurses would undergo training on the use of Accu-Chek meters as is the requirement by both the manufacturing company and hospital policy. A closer look at the practice in today’s hospitals would give a general idea of current practice. For example, The State Hospital of Utah has a Nursing Policy and Procedure Manual that states that all it’s newly hired staff are to receive training on the use of Accu-chek (2005). This is a realistic intervention to the setting because it increases the total number of nurses available resulting in the nurses being in a better position to take their own Accu-Chek readings and institute any urgent action that may arise based on the readings obtained. The nurses currently stationed at the hospital can train the newly hired nurses on how to use the Accu-Chek meter. This would reduce the cost of implementing this intervention to the cost of hiring new nurses. But is the intervention consistent with the organizations culture and resources? The members of staff have a basic idea of EBS. The resources required to implement the intervention are minimal as only a few nurses would be hired. The nurses would educate the newly hired nurses on the use of the Accu-Chek meter. This would allow prompt

Monday, October 28, 2019

Aristotles concept of justice Essay Example for Free

Aristotles concept of justice Essay In his book The Nichomachean Ethics, Aristotle discusses the concept of justice in Book V. Justice is used with its many different connotations. However, in order to explain the statement that justice can only be found in the laws established by the state I would like to point out the last two types of justice and the notion of equity Aristotle refers to in his book. The first is natural justice, true for everyone, and next to that there is conventional justice which can differ in different societies and there is the notion of equity that works in unusual cases. With understanding these three concepts we can reach to the conclusion that according to Aristotle justice can not only be found in the laws established by the state and he is right in claiming such an idea. Anyone who is a virtuous person can also be just. But not everyone who is just is also virtuous. Would you consider someone who kills the murderer of his wife a murderer? Would you put him in the same position as Jack the Ripper? Do you think justice is protected by the law? Is it just to stone adulteresses to death even if it complies with the law? Which law is just and which is not? What are the criteria? Are the laws of the state enough to maintain justice?Such questions can be boosted up to thousands if one starts to think about justice, itsconnotations and the relation between justice and law. The debate is a long-lasting one. In his book The Nichomachean Ethics, Aristotle discusses the concept of justice in Book V. Justice is used with its many different connotations. There is particular justice, distributive justice, reciprocal justice, political and social justice, domestic justice, natural and conventional justice. I would like to point out the last two types of justice in order to understand Aristotles idea of law and justice relation in a state. According to Aristotle, there is natural justice, true for everyone, and next to that there is conventional justice which can differ in different societies. Natural justice is the kind of justice that can be applied to every human being regardless of nation, race, religion, etc. It has the same validity everywhere and do not depend on acceptance. Aristotle argues that the things which are not just by nature but by human enactment are not everywhere the same, since constitutions are not the same, though there is  by one which is everywhere by nature the best (124). Accordingly, the conventional justice is set by the society and in some cases by the rulers of the society. However, Aristotle suggests that, for the laws established by the state, a law can be just whether it is for the advantage of the law makers or the rulers or the dominant class. In The Nichomachean Ethics, he says that the laws†¦on all subjects aim at the common advantage either of all or of the best or of those who hold power†¦ (108). He adds that every kind of conventional justice is created in one way from the natural justice and it is normal that they may differ from one society to another. For instance it is by the law to drive on a certain side in Turkey and in Britain people drive on the other side of the road. Both laws are created to maintain justice and order. However there are laws which are created by the state such as the law that women have to wear veils which seems to us not just but what is important to Aristotle is not what we think but how that society with that particular law is affected. As long as the law works for the society, regardless of its rightness, it maintains justice. Lets give an example, at the times of Roman Empire the gladiators fight with each other or with lions, they know that they are going to die at the arena but they do not show any fear, they fight with their honors and they die with an honorable death. Mentioning that laws are created to be functional, to stabilize and control the society, Aristotle talks about the equitable justice in which he stresses that there are cases in which the universal law or justice does not suit to the case in hand. He suggests that laws guide people in the direction of justice but they do not encompass all the cases about justice or injustice. In such conditions he suggests that the judge interferes and corrects the law where it is defective owing to its universality (133). Equity means the correction of the law when it is too abstract for the situation in hand. Aristotle here suggests that the judge or the legislator should find the balance and give the right decision in such situations. Taking these ideas into consideration, according to Aristotle, the laws of  the state are enough to maintain justice for their people only to a certain extent because in some cases the decision making authority is not the law but the judge. I think Aristotle is right in making such a claim because of many reasons. First of all, if the conventional laws are the extensions of natural laws and the natural laws are universal and do not change in any situation but still there are circumstances in which the natural law is tooabstract for the case and the judge and the legislator is the one who is to adapt the law to the case, we can not say that either the natural laws or the conventional laws (the laws established by the state) maintains the justice. Furthermore, if there arecases in which the law does not work, we can not say that the laws established by the state maintain the justice at all times unless we see the starting argument as a generalization. However it is also not possible to know the qualities of the judge whether he is biased toward the case that he balances with the law. Accordingly there may be some cases in which justice may not be maintained because of the origin (in Aristotles words universality) of the law does not cover the case or because of the judges personal qualities. Consequently if the conventional laws are the extensions of natural laws and the natural laws are universal and do not change in any situation but still there are circumstances in which the natural law is too abstract for the case and the judge and the legislator is the one who is to adapt the law to the case, we can not say that either the natural laws or the conventional laws (the laws established by the state) maintains the justice. Bibliography: The Nichomachean Ethics, Aristotle

Saturday, October 26, 2019

Essay Comparing Hemingways A Very Short Story and Fitzgeralds This Si

Comparing Hemingway's A Very Short Story and Fitzgerald's This Side of Paradise When you first read a tragic, melodramatic love scene you feel like your heart is breaking too. Sometimes you cry. It is only after the initial rush of feelings that you begin to feel cheated. Usually the kind of writing that gives you the urge to be demonstrative does not stay with you as long as something more subtle. In Scott Fitzgerald's This Side of Paradise, the reader is presented with such a love scene in the form of a play. I admit to having sobbed for a solid minute after reading about the ill-fated romance between Amory Blaine and Rosalind Connage. However, the same subject, with different characters, told in a much more concise, objective manner in Ernest Hemingway's A Very Short Story had a much deeper effect on me. It may be that the honesty of experience had much to do with the differences between the stories. This Side of Paradise is often seen as a loosely based autobiography, but there is no direct basis in reality for the Amory and Rosalind episode. Fitzgerald did have a turbulent relationship with his wife Zelda, but the tragic parting in the novel and Rosalind's later marriage to another man firmly place the story in the realm of fiction. Hemingway's account of the meeting and parting of two lovers, on the other hand, comes directly from his own life. While there is a feeling in This Side of Paradise that Fitzgerald is trying too hard to make the story realistic, Hemingway's account cannot help but convey the honesty that is generally found when a writer draws directly on his own experience. The style and structure of the Hemingway story also make it more believable and more effective. Even the... ...ing in a taxi cab through Lincoln Park," that Hemingway's protagonist tried to forget about his lost love by indulging in the more shallow gratification of easy sex. Fitzgerald's Amory Blaine turns to alcohol instead, but the concept is the same. However, after nine pages of Amory's bar exploits we have already begun to forget what the problem was in the first place. Two more disparate accounts of a short-lived love would be difficult to find. Each is successful in its own way. The Fitzgerald version elicited an immediate and powerful reaction from me, but it was the Hemingway story that made me understand the subject more deeply. While A Very Short Story, at first glance, may seem unable to convey the depth and breadth of feeling of the longer Fitzgerald passage, it actually accomplishes its aim more quickly without sacrificing meaning.

Thursday, October 24, 2019

Disraeli’s second ministry Essay

â€Å"Disraeli’s second ministry deserves the title a great reforming ministry† Discuss how far you agree with this view in relation to Gladstone first Ministry. A great reforming ministry is a government which manages to radically alter the political and social scene, aiming to deal with the most pressing problems and creating a long term legacy whereby later ministries aim to protect and improve what has been achieved instead of trying to alter radically. This is why it becomes clear that Gladstone ministry and not Disraeli’s should be considered a great reforming ministry. The aims of both ministries were radically different. Gladstone’s aims for his ministry when he came into power in 1867 were to try and create a more efficient and meritocratic society which removed privileges and advocated individualistic self-reliance. This ideology of beliefs were formed due to Gladstone long held religious beliefs which drove him and in the liberal ideas of equality of opportunity, tolerance and individualism he saw the best system to try and create a society based on Christian morals. Throughout all his legislation Gladstone aimed for the fair and just decision explaining his desire to try and pacify Ireland. This is in contrast to Disraeli’s aims as Prime Minister from 1874. Disraeli had managed to finally get the conservatives elected after being out of power for over ten years, and he achieved this through radically modernising the Conservative party which was represented in his Tamworth manifesto speech where he proclaimed the aims of the Conservative party were to protect institutions and traditions, strengthen the empire and alleviate the condition of the people. However Disraeli never had a clear agenda of reforms before he came into power instead his main aims were ensuring the continuation of power for the Conservative power, this meant Disraeli aimed not to disrupt his key support base of the middle and upper class and focused on reducing taxes. Additionally although due to his promise of alleviating the condition of the people he was forced to create social legislation to ensure minimal government intervention he aimed to make the acts permissive weaken their impact and focussed on areas which were non-controversial and where mild reforms could be implemented. This contrast reflects the differing impacts the two ministries wanted to achieve. Gladstone’s ministries reforms had a substantial impact. The 1870 education act with the setting up of board schools to complement the existing structure of voluntary religious schools reflect Gladstone’s desire to try and create equality of opportunity and to encourage individual self-reliance. This reform became the very foundations of the mixed school system which is present today, reflecting the long term impact this reform had. Additionally Gladstone introduced key reforms to remove privilege and create a more efficient government and army with the 1871 civil service reforms which meant entry to the civil service could only be achieved through examination and the army reforms that were carried out between 1870-1872 whereby the act of purchase was abolished and instead officer class could only be achieved through merit and amount of time privates would have to spend in the army was reduced to encourage higher uptake. This reflects the impact Gladstone was trying to achieve he didn’t shy away from attacking key sectors of power within society because he believed it was morally right and fair to remove privilege from the upper classes. This was particularity important for a working class which aimed to be free individuals who wanted the vote and an equal footing. Whilst Disraeli’s legislation although Important was hampered due to Disraeli’s desire to minimise the impact of reform and to only focus on non-controversial areas. The 1875 Artisans dwelling act is a clear example of weak legislation, the act meant that councils could compel owners of slums to sell their property and allow the council to knock-down the slums and then sell the land to private building firms. However the legislation was permissive so the council didn’t have to ensure slums were removed and it required councils to give compensation to the landowners and so by the end of Disraeli’s term the act had only been used in 10 councils making its impact very mild. Whilst other acts such as the 1875 Agriculture holdings act show Disraeli is unable to make truly effective legislation because he wishes to protect the power base of the upper class. The act should of ensured that tenants that improve their land receive compensation but Disraeli made the act permissive and stated that if there was a condition in contract which stated the landowner didn’t have to pay compensation then the landowner didn’t have too. Due to this again the impact of the legislation was minor. Other legislation shows Disraeli’s opportunistic nature and aim to keep power such as the 1875 conspiracy and protection of property act which reformed a piece of Gladstonian legislation which banned peaceful picketing this act allowed peaceful picketing which Disraeli hoped would give the Conservative support from the trade unions, to try and weaken the threat from the Liberal party. Even when Disraeli produced legislation which was aimed at alleviating the condition of the people such as the 1874 Factory Act which meant that by law women and children weren’t allowed to be made to work more than nine and half hours in a day but deliberately avoided the majority of the working population which was male and although the legislation had the impact of forcing factories to close earlier which effected male working hours as well it wasn’t the intention. Overall examining the legislation shows the difference in impact the two different ministries legislation had with Gladstone causing a huge impact whilst Disraeli’s showing only a very minor effect focusing on refining Gladstone previous legislation or reforming on very specific small issues to try and gain support. However both ministries were flawed though, for all Gladstone large and influential reforms he was voted out in 1874 and although Disraeli aimed not to lose any support he also was voted out in 1880. The reason why Gladstone was voted out were that his legislation was so wide ranging it impact on nearly every sector of society and as such Gladstone also lost his wide spectrum of support. The upper classes disliking his aims of efficiency feeling that they were breaking the traditional power structure of society against their favour. The middle and working classes were effected by Gladstone’s controversial legislation which was highly unpopular at the time such as the Licensing Act of 1872 and the 1871 Criminal Amendment Act. Both of these act reflects sometimes Gladstone misjudgement on what was beneficial for the people and how to create a fairer society. Also Gladstone failed in one of his key aims which was to pacify Ireland but he was the one of the few politicians who was truly trying to find a workable solution instead of coercion. Whilst Disraeli was voted out not because he had made a massive impact but because he was Prime Minister whilst the economy entered recession, this meant that his mild measure had even less impact and his expensive imperialistic aims were highly controversial. So due to the recession Disraeli failed to alleviate the condition of the people and his other aims meant his government appeared to stall resulting in his popularity dropping. Overall although his legislation was occasionally flawed the overall improvement and effect that Gladstone’s ministry had on the country reflect a great reforming ministry. Gladstone’s Liberal beliefs in meritocratic and individual society have become corner stones of British society reflecting the ministries long term impact and legislation such as the licensing act although unpopular at the time has only been amended never removed by later governments as they see the positive impacts of the restriction of alcohol. This reflected against Disraeli’s achievement of mildly modify Gladstone’s legislation and avoiding awkward decision domestically or trying to alter the status quo shows that his ministry cannot be considered a great reforming ministry. As such I disagree with the view that Disraeli’s government was a great reforming government instead arguing that it was his predecessor Gladstone that was clearly the great reforming ministry.

Wednesday, October 23, 2019

A Critical Review of the Theory of Person Centred Essay

In counselling and psychotherapy, it is fundamental aspect for practitioners to use theory as a way of informing the way the work with a client. (McLeod). The goal of this essay is to explore the humanistic personality theory of Carl Rogers. The essay will begin by giving a summary of key theoretical construct which includes Rogers’s view of self, his view of human condition and his rational for improvement of these conditions and then give examples to how such instances play out in clinical practice with a client using a published case material. The essay addresses how a psychoanalytic practitioner might have approached his work differently with the same client, and finally the essay proposes and provides directions for future research. Different personality theories have put forward varieties of explanations for behaviour and what constitutes a person. Carl Rogers developed a theory of personality in the early 1940s known as a theory of client centred and later came to be called person centred theory. The theory of person centred is a theory of personality or concept of a person. The Person centred counselling is a non directive therapy that begins and ends with experience. The concept of experiencing makes the phenomenological stance very important to person centred approach. The concept of experience includes feelings, action tendencies and thoughts which is constantly changing. (McLeod) According to Rogers, both the therapist and the clients are trustworthy beings. This trust starts with the belief that people are capable of reaching their full potential and hence they do not require irect intervention from the therapist in order to understand themselves or resolve their problems. They are capable of self-directed growth or actualizing tendency if they are trusted by their therapist whose role is to establish the best possible condition for its fulfilment. The therapist aim is to constantly empower a person’s autonomy which leads to development of capacities to maintain and enhance growth towards becoming. The concept of actualising tendency is the only motivation force in the theory. (Corey, 2005). In Person centred, the ‘self is a central construct in this theory. Human beings are viewed as having individual uniqueness, with a complex personality unlike any other human being and they are acting to fulfil two needs, which are self actualization and need to be love and valued by others. Therefore person centred therapist understands that to uncover subjective perceptual world of the client can be very difficult and only clients themselves can do this with great effort. Client’s perception of their world depends on the social evaluations experiences they have had into their self concept. If a person is accepted and at the same time disapproved, their self concept is exposed to condition of worth. The ‘self’ is related to a distinctly psychological form of actualizing tendency known as ‘self actualization tendency’. This means the realization of individual potential in accordance with one’s conscious view of what one is. The development of self concept and self actualization are connected to secondary needs which are needs for positive regards from others and needs for positive self regards which are assumed to be more likely learned from childhood. Favoured behaviours are consistence with the person self concept. Locus of evaluation is another idea which is connected with the understanding of the operation of self concept. This is the idea that people could be guided by their defined beliefs and attitudes when evaluating and making judgement about issues. If they rely heavily on external evaluation they continue to be exposed to conditions of worth, and therefore, person centred therapist encourages the client to acknowledge and act based on their internal locus of evaluation. Human beings are seen has having capacity to strive for fulfilment and growth. Rogers referred this capacity as the ‘ideal self’. Enabling a person to move in the direction of their self defined ideals is major aim of the person centred therapy. Human beings are viewed as fully functioning persons who are open to experience and able to live existentially, trusting in own organism, expresses feelings freely, acts independently, are creative and lives a richer life which involve a process and a direction, and not a destination (Rogers, 1961, p. 186). Therapy can develop and psychologically change those who do not have an optimal childhood in order restore the organismic valuing process (Rogers, 1959). This idea portrays an importance strand contrast to psychoanalysis whose orientation of their theory as reflected by Freud was towards understanding and explaining pathology or illness. There are three important aspects to the therapist’s approach; congruence, unconditional positive regard and accurate empathic understanding. These are three core conditions that facilitate the actualization and growth. These conditions relate to the shared journey in which therapists and clients reveal their humanness and participate in a growth experience together. Its only when these core values are offered, that social environment is generated into client’s condition of worth. By adopting an open and caring stance in the relationship, problems are safely explored, client facades are breached and the client become empowered to direct their own life Congruence strongly refers to the authenticity and genuineness of the therapist during the therapy session. The therapist outer expression need to reflect their inner feelings, as a result this helps client to begin to adopt the same attitudes towards themselves. Being congruent and authentic also implied development of a positive alliance between the therapist and the client. However self disclosure doesn’t relate to the disclosure of all inner feelings and reaction by the therapist, but well timed and appropriate self disclosure. Unconditional positive regard refers to genuineness, acceptance and true caring of a client without any conditions. This involves true caring which is unconditional regardless of the client’s behaviour wether good or bad. There is a strong belief that if a client is cared for and accepted unconditionally, they begin to experience a sense of worthiness. This also empowers the client to respect themselves by listening and trusting their inner feelings. The therapist behaviour needs to communicate a warm, caring and an acceptance atmosphere which empowers the client to express their feelings freely, without having fear of losing their therapist acceptance. Empathic understanding refers to therapist deep and sensitive understanding of their client’s feelings as they emerged during therapy session. The therapist endeavour to understand their clients’ experiences in the here-and-now. This implies that the therapist view and sense the client’s world as their own, but without being caught in them. Reflection and clarification are the two processes involve in the facilitation of empathetic understanding. The therapist reflects back to client what they have said in order to reflect non judgemental understanding of client statements and conveyance of their presence in their client’s journey. This encourages client to become reflective themselves. Clarification involves the therapist repeating the meaning of the expressions to the client after hearing a set of remarks from them. Recently there have been new development in person centred theory although the root of the theory is still based on Rogerian’s ideas. Mearns and Thorne (1988) wrote the classic ‘manual’ of person centred practice, but their idea too, were largely based on early work and knowledge. These have been debated by many, but it was until in the 1990s that saw considerable new ideas which have achieved greater support among the person centred community. These crucial ideas are the pluralistic self, the nature of relational depth, and the concept of difficult process. The pluralistic self refers to idea that there is existence of different parts of self, which stands for specific units of the experiences and individual’s identity. Different approaches such as gestalt, object relation and theory of transactional analysis have incorporated the idea of ‘pluralistic self’, as central to their practice. However this idea is not far from Rogers, description of self. Even though Rogers view self as a unitary structure, he acknowledged that changes occurred during process of growth, fulfilment and self actualization but influenced by internal conflict. Mearn and Thorne (2000) looked further on this issue and argue that practitioners and theorist view the self differently, and therefore there have always been an indirectly ‘self split’ between ‘growthful part’ of the self and ‘not for growth part’. For example, depressed have unpleasantly blamed their feelings, thoughts and action frequently, although this criticism have been viewed as beneficial to others, as it helps them to understand their inner critic and become knowledgeable about this specific part of self. Other researchers have raised the idea that the self can be a group of related voices, which have been found to be useful to person centred tradition. (Still & Glick 2002 ). In Person centred practice it elieved that the key to effective counselling depend on the quality of therapeutic relation, however Roger’s core conditions accounts for limited in-depth explanation about therapeutic relation, neither is Border (1979) alliance model. (Cooper 2004. ). In attempt to a more comprehensive explanation of highly productive therapeutic relation, Mearn and Cooper (2005) came up with their analysis of the nature of relational depth which means a very intense state where individuals’ engagement and contact is tr uly real with each other, and in which the connectedness and sense of contact between therapist and client is continuous. Schimid (2007) argues that the therapist needs to open and understands the other side of the client by seeking and establishing ‘Thou-I’relationship,in order for the client to feel a sense of real connectedness in the relationship. Finally, the concept of difficult process developed by (Warner 2002a) refers to the idea an individual perceive their world differently and process their experiences such as thoughts feelings and action tendencies differently. However person centred practitioners have always generalised model of process for clients regardless of situations. According to Warner (2002a) there are two main difficult processes, the first one is called fragile process which occurs due difficulty in maintaining or the steady processing experiential material. In this process the person lose the problematic feelings and thoughts and all that he was exploring disappears. The other difficult process is called dissociated process which occurs when a person jumps from one area of experience to another. This may be due to a client trying to protect painful memories and diverting his attention to a unimportant things. Mearn and Thorne (2007) included a further example of difficult process known as Ego-syntonic process which means a person becomes self centred due to fear of social relationships. Prouty et al (2002), suggest that in order for a person to begin to emerge from difficult process and fully engaged with her experiences there is a need of attentive empathic engagement by the therapist.