What are the steps for improving semantics as outlined in your Essay

What are the steps for improving semantics as outlined in your textbook Explain them - Essay Example This may be different from what the same word connotes to different people that is its implied meaning. The order of words in sentences is important in providing us their meaning more clearly than the words themselves (Kholoud 714). In order to improve semantics, our word choice and arrangement should help to clarify meaning and show respect. The way the words flow in the sentence clarifies what they mean and shows us the context in which they have been used. The use of specific language or words that narrow the meaning down from a general set to one item or inclusive group. This is the use of precise words to clarify the meaning of the phrase. This addresses the problem of semantic under specification where the meaning of a word is not complete without certain elements of context.  Another way is by the use of concrete language. This is the use of words that appeal to the intellect. Such words assist you to clarify semantic meaning by boosting understanding. Such words appeal to the senses and are related to feelings evoked by certain words or phrases. Use of language that is familiar to the recipient can diffuse confusion in a sentence. This is because familiar language is in a language context understood b y the recipient enhancing clarity and dispelling ambiguity. Through the use of descriptive details and examples in your content, you can improve semantic meaning by enhancing visual perception in the mind of the recipient. Visual descriptions help the listener to create a mental picture of what is being said and understand the concept better (Kholoud 716). Such tools increase clarity particularly in eliminating any form of ambiguity. When local and familiar examples are used in statements, listeners tend to understand the intended message and may seek further clarification with certainty. Localised examples also eliminate confusion since the explanations become customized per se. Sensitivity in communication is attained by being

JOHN BUNYAN Term Paper Example | Topics and Well Written Essays - 1750 words

JOHN BUNYAN - Term Paper Example It was after this experience with the Holy Spirit that he began preaching. However, this was not quite a smooth mission for him as he was imprisoned severally for preaching. John began preaching in Bedford, England, and it was here that he faced all those difficulties in relation to his mission; especially between 1660 and 1672. It was during his term as a prisoner when he wrote a popular classic- Pilgrim’s Progress. In his autography, Bunyan recognized the fact that the devil kept on placing mockeries in his soul. He had a feeling that his sins were not of the type that Jesus Christ died for and that he could only be forgiven if Christ descended from heaven to come and die afresh for his sins. These things tormented him for quite a long time, and that thinking of anyone of them increased his misery (Venables, 79). Although he recognized that Jesus Christ had too much love for him, he thought that He could not be forgivendue his transgressions and unfaithfulness. In addition B unyan himself thought that his sins were beyond bounds of pardon. Worst of all, he never thought that he could ever inherit eternal life, but believed that it was quite easy for the heaven and earth to pass. It was a result of these assaults that he perceived his soul to be more of a broken vessel, hence heading into despair. He even went to an extent of thinking that as far as he was concerned, conditions and promises of the new covenant could turn another way and be changed. John went to disclose that the more he thought about these issues, the more he was overwhelmed with fears, guilt and fright leading to desperation. Bunyan likened his state to that of a man who lived in tombs, always crying and cutting himself with stones (Mark 5:25). It is from this verse of the Bible that Bunyan came to learn that neither desperation nor the old covenant would save him. In addition, both the heaven and earth were bound to pass away, while both the word and the law of grace would fail or be d one away with. It was after recognition of this scripture that Bunyan experienced the goodness of Jesus Christ, got saved and confirmed that scriptures were the Word of God. Before he reached this point, one day as he sat on a bench on a certain street, Bunyan fell asleep and had a vision as though the sun that shone in heaven was against him and it could not shed enough light (Deal, 35). In addition, he saw stones on the street and tiles upon houses bend against him, and all had collaborated to eliminate him from the earth. This meant that he was unfit to live among them and he could not partake of the benefits that they harbored as he had sinned against God in Heaven. From this moment onwards, Bunyan learnt to accept and appreciate everything with thanks giving. At one time they had been commanded to go and besiege a place, but another person was chosen to replace him (Bunyan) even after he had consented. Unfortunately, the solder who replaced him was killed in that battle. Bunyan recognized that these were God’s mercies upon his life. Bunyan came to appreciate God’s divine mercies for saving his life after he fell in an extremely deep pit when he was traveling at night (Horner, 120). He also had the reason to thank God for the divine healing and provision of food, even though he was still a sinner. Bunyan recognized

The Retrospect of European Upheaval Essay Example | Topics and Well Written Essays - 1500 words

The Retrospect of European Upheaval - Essay Example Trade developed around a ‘triangle’; from Britain to West Africa taking goods such as Glassware , cloth and ammunition, from West Africa to the Americas carrying enslaved people, and finally from the Americas back to Britain with raw materials such as sugar, tobacco and cotton. This all resulted due to developments in maritime technology as it enabled European sailors to have longer voyage. Enslaved Africans were sold to work on plantations or in the households of the slave owners upon their arrival in America. They grew cash crops – tobacco, sugar, coffee, cocoa – for the European markets. Entrepreneurs on the islands of the Caribbean and in the US depended on slave labour to grow these crops profitably as the labour was cheap. 1500 Africans during the between Spain and Britain war escaped to mountains, evaded capture for 150 years and undertook guerilla warfare against the plantation owners. The French Revolution in 1789 created a new French republic and perturbed Haiti (which was created as a result of Successful rebellion) when the slaves revolted led by the formidable soldier Toussaint L’Ouverture, who himself was once a slave and self educated. He had an army of 100.000 revolts which took control of Spanish Santo Domingo(Now known as Haiti) and freed other slaves. Later on, he agreed to stop fighting if French would abolish the slavery. Mongol Empire, Ottoman Empire, 1453, Sunni Islam When Baghdad fell to Mongols by Slejuks, they declared an independent Sultanate in east and central Asia. Later on the Slejuks were overthrown by Uthman, an Uzbek of the Ottoman clan and proclaimed the Sultan of Asia Minor in 1301. Constantinople, heart of the Byzantine Empire became the capital of the Ottoman Empire when it was conquered in 1453 by the Ottoman Sultan Mehmet II. Mehmet slaughtered many of the population and forced the rest into exile. The city was repopulated by importing people scattered in Ottoman Territories. He renamed C onstantinople Istanbul – the 'city of Islam' - and embarked for recuperating physically and politically as he made it his capital. Scramble for Africa, Berlin Conference, King Leopold II, Congo Free State In 1884 a meeting was convened at the Berlin residence of Chancellor Otto von Bismarck. Foreign Ministers from fourteen European Nations and United States promulgated rules for further exploitation of African continent without making the inhabitant’s part of the process. Otto von Bismarck wanted not only to expand German spheres of influence in Africa but had a hidden agenda to play off Germany's colonial rivals against one another to the Germans' advantage. France, Germany, Great Britain, and Portugal were the major players in the conference, controlling most of colonial Africa at the time among the fourteen nations. The French were prevalent in West Africa, while the British had occupied in East and Southern Africa. The Belgians acquired the vast territory which lat er became The Congo. The Germans ruled in 4 colonies which were all across the region. The Portuguese held a small colony in West Africa and two large ones in Southern Africa. Kind Leopold II had coerced the Africans in Congo to gather rubber, illegal killing of elephants for their ivory and to facilitate export routes, infrastructure was build. Those who failed to meet these tasks were massacred. King Leopold regime is regarded as the most excruciating disasters of Africa as 10 million Congolese had been

My Best Friends Essay Example for Free

My Best Friends Essay What do you think with your best friend’s appearance, personality and the feeling you have they to be your friends? In my opinion, â€Å"Friends† is really important for me. I can live without computer and TV but I can’t live without †friends† the persons who is sharing my mood with me whenever I’m happy or sad and I found â€Å"Them† my really best friends who had a, nice appearance , good but has a different personalities and I’m very happy that I had a best friends like them. My best friends are Jessica, Crizel and Hannah. When I first saw them or my first impression about them is, I thought that Jessica was a pretty lesbian or a boyish one because she act like a man but deep inside she was a pure girl and then Crizel was, also like a boy maybe because in the first place they are friend w Hannah which I thought that she was unkind/ rugged but in other side she’s very kind and clever. In addition, when we are not that so close for me Jessica was very annoying because she’s always shouting just to stop our other classmates for making unpleasant sound, and then before when I saw Hannah she has lot of pimple in her face and it is like overload parking lot ha-ha just kidding, but now it is much OK, her pimple was not that much. And lastly Crizel, we are not that much close and unfortunately we had a misunderstandment between two of us. What is more, for me they are so good friend and all the bad side, was so opposite when I knew there real personality. They are the persons who understand me well (I think). They always beside me when I’m upset listen to me and help me every time when I need help. When i have problem they will give me some advices and help me to solve the problem. Even when I don’t understand in the lesson they explained patiently for me to understand every time. I think I’m really lucky that I have them and I’m very happy we are friends and I think we will be friends forever. To summarizes, I think they are a nice person. They have good appearance, personality and I’m very happy that I can be friends with Jessica, Crizel and Hannah. And we learned so many things from each of us as. And they always help me in everything. Finally, I think friend is really important for me and I hope we can be friends forever.

Elderly Patient on Psychotic Depression ward

Elderly Patient on Psychotic Depression ward In this assignment I will be carrying out a Critical Incident Analysis on an incident taken from my portfolio that was encountered whilst in practice placement. This type of analysis was first used to analyse flying missions by pilots, as a way of raising their performance (Flanagan, 1954), in more recent years Norman et al. (1992) and Perry (1997) described this type of analysis as being an important and valid tool for use in nurse training, as it allows the student to choose and use an incident that made an impact on them, from their practice placement that was either positive or negative, so that they can analyse, reflect on and learn from it, showing their development as a practitioner and a person whilst linking theory to practice and helping them move from novice to expert, as outlined by Benner (1984) . Model used for reflection For the purpose of this assignment I have selected the Gibbs (1988) reflective framework model which is an iterative model meaning it is cyclical in nature, the six points covered by this model are: Describe the activity or experience in objective detail. Discuss and explore any feelings you were having at the time of the experience. Evaluate the experience: What really happened? What was good about it? What was bad? What factors contributed to the event? Analyse the experience: What can you learn from it? Conclusion: What could you have done differently? Anything you wish you had done? Wish you hadnt done? Action Plan: What can you plan on doing in the future? (Bethann, 2004, p167) This is also the model I use in my portfolio as along with critical incident analysis, it centres on reflective practice, an essential skill in nursing practice allowing situations to be analysed in detail, identifying areas of potential change, Jasper (2003) and reinforcing the need for certain practices by highlighting their benefits. I also find the logical, straightforward structure of this framework allows the reflection to be written clearly, providing opportunities to look at incidents from different perspectives. The Critical Incident Stages one and two of Gibbs model of reflection are covered here, where the incident is described along with my feelings at the time of the incident. I chose this particular incident as it put me in a very challenging position where I had to think on my feet, it made me test my abilities as a communicator and a nurse under stress, whilst highlighting the importance of some of the more basic nursing techniques like non-verbal communication through touch, educating patients to help themselves, looking out for physical signs that can indicate a patient is in distress and how working closely with a patient can earn their trust whilst building up the therapeutic relationship In order to keep the patient and the practice placement confidential, as indicated in the NMC Code of Professional Conduct (2002) and the N.M.C. guide for students (2002), the practice placement is kept anonymous and the patient will be referred to as Tom. The patients consent was also obtained, as it is the patients right to choose whether or not they wish details to be written about them, highlighted by Johnston and Slowther (2003) also outlined in section 3.7 of the N.M.C Code of conduct (2002) with reference to patients who suffer from mental illness. The patient, Tom a 72 year old man, was admitted to my practice placement suffering from Psychotic depression and anxiety, my placement is at a Psychiatric admissions ward, for patients over sixty five years old. On assisting Tom with his activities of daily living (A.D.Ls), (Roper et al, 1980) after, rising one Monday morning, It became apparent when helping Tom dress that his right arm was causing him pain, in the area of his right shoulder, I relayed this to the nursing staff who explained Tom had fallen unobserved on the Friday night and had been seen by the Doctor who on examination felt no other investigations were needed. On further discussion about his arm and the fall, between myself and Tom, he eventually admitted to having also fallen on the Sunday night and had not told anyone about it, once I had explained this to the nursing staff the Doctor was again consulted and felt that Tom should have an X-ray to rule out any broken bones. I accompanied Tom as an escort to the x-ray department where he became increasingly agitated, anxious and was mumbling to himself with delusional content of speech evident, concerning the N.H.S. which had not been known about, as Tom had only recently been admitted, he felt they (the N.H.S) were going to cause him, bodily injury (a persecutory delusion Gamble Brennan, 2003) due to his doing them out of money when he was younger, I did my best to give constant reassurance that I would not let anyone harm him, but when someone holds a delusional belief it can be very firmly maintained and difficult to dissuade from, in particular when they are in a state of high anxiety like Tom, as indicated in Stuart and Laraia (2001). I was quite worried about how the situation was going and that I might be out of my depth as I did not know Tom very well and felt a little awkward trying to reassure someone who was this distressed, feeling I was doing little or no good for him. After he had his x-ray and I was assisting him to get dressed in the x-ray cubicle the Radiologist came in and told us that Toms shoulder was broken and that we would need to go round to casualty to be seen by a Doctor there. This news made Toms level of panic escalate considerably and he began to have a panic attack in the cubicle, most likely a situationally predisposed panic attack, which occurs on exposure to a situational cue or trigger (DSM-4) Tom had become quite pale and began to perspire profusely, along with his breathing becoming very shallow and rapid to the point that he was panting, I found it quite distressing to see Tom in this condition. I had never encountered someone quite as panicked as this and I felt quite concerned. I thought calling out for someone to help might only panic him more, so I decided to try some deep breathing exercises to relax and calm him down first, then if that did not work I would seek help. I knew from reading Toms notes that he did not have a heart condition or other health problem that would have been causing these symptoms and it had been recorded that Tom suffered from panic attacks, although I was still watchful for any change in his symptoms that might indicate an alternative medical reason for his condition. Initially I sat beside Tom with my arm around him, asking him to take slow deep breaths, but with his level of panic and no eye contact meant he was not concentrating on me, so I knelt down on the floor in front of him took his hands, spoke to him gently but firmly using his name and with direct eye contact got him to focus on what we were doing. I explained his symptoms were due to his panic attack and the breathing exercises we were doing would help relax him, calm him down and make him feel better. Tom started to comply and began with my instruction, breathing in slowly through his nose holding it for a moment then breathing out slowly through his mouth. In a relatively short time his breathing began returning to normal and he started to relax, enabling us to go on to the casualty department to see about his shoulder. In the casualty department Tom still required reassurance not only verbally but also with touch as he asked me to hold his hand, bringing home the importance of this simple yet significant form of non-verbal communication and despite needing another brief set of relaxation breathing in the casualty cubicle Tom was notably calmer. I felt privileged that he had put his trust in me and that we had moved on further in our therapeutic relationship, as while waiting in casualty Tom who had hardly spoken to anyone let alone myself, began discussing how scared he had been and talked about some of his delusional beliefs, which helped me empathise with how terrified he must have been. I was also able to discuss what Tom told me with the qualified nurses on return to the ward giving a deeper insight into his condition. Critical Discussion of the Incident For this section of the Critical Incident Analysis stages three and four of Gibbs reflective framework are covered, allowing me to look at what was good and bad about the incident along with contributing factors (Gibbs 1988), I am going to discuss, analyze and reflect upon three key issues: Panic attacks, the relaxation technique of Deep breathing and Touch therapy, that were encountered during the incident and that I felt were of significant importance. Panic attacks I felt this topic was important to the critical incident as it is a common condition closely linked to anxiety which a great number of mental health patients experience often along with their main diagnosis but most commonly alongside depression as in Toms case, Clayton (1990) and Merikangas et al (1996) stated that comorbidity between panic and depression is the single strongest type of anxiety-mood comorbidity found in both treatment and in the general public. Panic attacks are often talked about and appear in patient notes but this critical incident brought home for me how absolutely terrifying and totally debilitating the panic attack was for Tom and how distressing it can be to witness a patient in this condition. Anxiety is a normal healthy reaction to the stresses of everyday life as suggested by Trevor Powel (2001) and even necessary for us to perform at our best as Yerkes-Dodsons Law (1908) explains, illustrated in the graph below. Here levels of anxiety are referred to as arousal and a direct correlation to performance is demonstrated, it tells us that if we have low levels of arousal then our performance becomes decreased (distress, as introduced by Seyle (1956)), at medium levels our performance levels peak (eustress as described by Seyle (1956)) and when our arousal levels become high our performance levels and subsequent ability to function drop again (resulting in distress) as seen in Toms situation. (Yerkes Dodson 1908) Peplau (1963) defined anxiety in four levels: Mild anxiety- everyday life stress. Moderate anxiety- Immediate concerns focused on, with narrowed perceptual field, although able to function when necessary. Severe anxiety- Greatly reduced perceptual with difficulty focusing on anything except what is causing anxiety. Panic- Person feels terror, dread as is unable to reason with the threat causing anxiety blown out of all proportion, making it almost impossible to communicate or function, with little or no control over themselves causing panic attack. Toms anxiety level was clearly at the panic stage which cannot be allowed to continue indefinitely as being in a panic attack state is not compatible with living, as described by Stuart and Laraia (2001), who believe if prolonged can result in total exhaustion or in extreme cases even death. Panic attacks affect between 3 and 5 percent of the population at some point in their lives (Lynch E, 2005). The findings of an American study carried out this year showed that people suffering from panic attacks account for around 25% of those attending casualty departments or G.Ps. (Ham, P. et al, 2005) often having trouble breathing properly as found with Tom, with most people suffering from panic attacks, stating hyperventilation as being one of their main symptoms (Holt and Andrews, 1989), or with patients believing they are having a heart attack. Toms panic attack was mainly evident by the physical symptoms he displayed, described previously, physiological symptoms often being the only visible signs of a panic attack as described by Stuart and Laraia (2001). In this instance, although Toms Psychotic Depression was the likely reason for his anxiety with the resulting panic attack, I felt trying to deescalate his anxiety levels, by getting the panic attack and hyperventilation under control was my main priority, there would have been no point in me trying to deal with his delusional beliefs at this point as this takes time and experience, of which I had neither, plus Toms panic levels were so high it was difficult for him to concentrate. Therefore it seemed logical to concentrate on something which it was perhaps possible to change. I hoped that using the deep breathing technique would be successful in helping return Toms body systems to normal which would stop the hyperventilating making Tom feel a lot better and knew that breathing techniques could be very effective but did not want to put Tom at any risk by doing so, I had to make a judgment call about how I was going to handle the situation and decided I was going to try and deal with it using the breathing exercise. Relaxation Techniques Deep breathing The next topic I am going to cover is Relaxation Techniques and the technique of Deep Breathing in particular, I feel it is important to cover this topic as it was a key factor in the outcome of the incident as by guiding Tom through the breathing technique, enabled him to control his breathing resulting in his panic attack and hyperventilating coming to an end. Toms physical symptoms indicated that he was hyperventilating or overbreathing, the mental health handbook (Trevor Powell, 2001) tells us this is a normal response to threat by our bodies to bring more oxygen to the muscles, preparing us for Fight or Flight, but if the extra O2 is not needed by the muscles, i.e. the situation is only an imagined threat as in Toms case, the normal level of gases in the blood and lungs becomes out of balance, due to breathing in to much oxygen (O2) and pushing out too much carbon dioxide (CO2), this causes the blood to become alkaline which brings on many of the unpleasant symptoms Tom was suffering from. There are several ways of overcoming hyperventilation, possibly the most commonly referred to, is breathing into a paper bag to facilitate the breathing back in of the carbon dioxide being breathed out, as explained in the Nursing Times article, Facts: Panic Attacks (2003), which also acknowledges the importance of controlling the patients breathing, Stuart and Laraia (2001) also agree that relaxation techniques are an accepted therapeutic intervention in the treatment of anxiety. Since I had no paper bag with me, I decided to use the three stage deep breathing technique to retrain Toms breathing which, Risser and Murphy (2005) agree, improves panic symptoms and associated disability, this type of breathing which is commonly used in yoga helped to slow down and control Toms breathing which also stopped him hyperventilating, it is carried out by: Inhaling slowly and deeply through your nose. When youve taken in a full breath, hold it for a moment and thenà ¢Ã¢â€š ¬Ã‚ ¦ Exhale slowly through the nose or mouth, depending on your preference. This action although different to the paper bag technique brings about the same desired effect, in the case of Deep Breathing carbon dioxide is not being re-breathed but the rate it is expelled by is being slowed down along with holding it a little longer in the lungs which results in the levels of carbon dioxide in the blood rising, correcting the acid/alkaline balance in the blood, which relieved Toms unpleasant symptoms, bringing his breathing rate back to normal and making him feel calmer. At the time of the incident I really hoped that the breathing technique would be successful although I was not entirely sure whether to trust my instincts and try it out. On reflection I was very impressed at how effective such a simple procedure could be and was glad not only for Toms sake but also my own that I had decided to try it out, as it gave me more confidence in my abilities as a nurse even though at the time I was carrying it out, although outwardly calm, I had felt quite anxious. Touch Therapy The final key issue I wish to highlight from the critical incident is the benefit of touch as a therapy, which I felt was vital as a way of communicating with Tom during his panic attack along with giving him reassurance that I was there for him, empathising with his situation and helping him focus on what we were trying to do. There are several terms used to describe the different types of touch used in nursing, some of which are: necessary touch which covers task and instrumental touch that is mostly used when a procedure or task needs to be carried out on a patient as opposed to non-necessary touch which is described as spontaneous and emotional physical contact between the nurse and patient, introduced by Routasalo (1996), expressive touch comes under the non-necessary touch umbrella with the same type of nurse patient contact, described by McCann McKenna (1993) which is similar again to caring and protective touch highlighted by Estabrooks (1989) and finally therapeutic touch, which is an alternative therapy similar to reiki, discussed by Meehan (1998). Nesbitt-Blondis and Jackson (1982) agree that touch is probably the most important of all non-verbal communications that we use in nursing and can be particularly useful in cases like Toms panic attack where his ability to understand and communicate was diminished, when patients are unable to communicate verbally or understand verbal communication for reasons such as dementia, those with learning or cognitive difficulties and in panic attack situations like Toms, touch can be an excellent means of communication. Unfortunately, McCann McKenna (1993) reported that in the U.K. there is little use of expressive, non-necessary or caring touch by nurses. Many nurses see touch as just something that is used when a procedure or task needs to be carried out on a patient, but Tutton (1998) suggests that touch in nursing and the powerful expressions it conveys to patients are sadly underutilised. Routasalo (1996) also suggests that non-essential touch although not absolutely essential, can be extremely important and necessary to the patient. The benefits of this type of touch in nursing are strengthened further by Moore Gilbert (1995) who found patients interpreted the use of touch by nurses as a display of affection and attention which they greatly appreciated, with patients interviewed in Routasalo Isolas (1996) study, describing touch by nurses as extremely comforting. Davidhizar Giger (1997) whilst acknowledging the important role that touch can play in the nurse patient relationship, also points out that the value of touch is not appreciated by all health professionals or considered appropriate or desirable by some patients. Bearing this in mind as long as the correct manner of touching is employed, and there is no way it could be seen as being inappropriate with the patients personal and cultural beliefs being taken into account, it is one of our most valuable communication nursing tools. The extent of physical contact carried out in a society is governed by sets of well-defined behavioural norms for whatever circumstance we find ourselves in (Pratt Mason 1981). Jourard (1966) recognised that the incidence of touching within our Western society declines from childhood onwards but Montagu (1986) discovered that the need for touch did not reduce with age. It is felt that the level of touch common in childhood can return in situations of sickness or incapacity (Barnett 1972). This may mean that, the need for touch in illness might be more important than our ideas of proper behaviour. I felt the touch element in this incident: my taking of Toms hands to help him focus, get his attention and convey my empathy, was extremely important and was in fact the turning point in the whole incident which allowed me to gain Toms trust and initiate the breathing technique which stopped him hyperventilating. I feel that without the touch element it would have been almost impossible for me to reach Tom and the outcome of the incident would have been very different. Implications for Professional and Personal Development In this final section of the Critical Incident Analysis, the two final stages of Gibbs model of reflection (1988), five and six are covered, here we look at what was learned from the incident, what could have been carried out differently or should not have been done, along with what was missed out concluding with a plan for future action. I found in utilising the Gibbs (1998) reflection tool, the impact the incident made on my personal and professional development was made much clearer. Through carrying out this Critical Incident Analysis I have been able to see what I have learned through reflection, as the Department of Health (1999) states, reflective practice is necessary in order to further our continued personal and professional development and leads to a greater understanding of our own needs. Described as a form of self discovery by Freshwater (2004) with a deeper understanding of the needs of the patient and improved patent care highlighted by Davies (1995). From this I feel the analysis made me examine my communication skills on a deeper level for although I feel that I am a natural communicator, and have had many years experience working with people suffering from dementia, I had not fully thought about the use of touch or the great importance it has in communicating with patients . Without the use of reflective practice I would not have researched into the concept of touch so fully or really understood its relevance and consequences in my nursing practice. Or recognised the significance touch played in the successful deescalating of Toms panic attack and hyperventilating in this critical incident. This Critical Incident Analysis has definitely taught me to have more faith in my abilities as a nurse but has also taught me I have more to learn as a communicator. Similarly with the topic of panic attacks which I was obviously familiar with and had some knowledge on, having been through the incident with Tom and then carrying out the reflection on the incident, allowed me to see the field of panic and anxiety disorders with a deeper understanding and much more from the patients viewpoint. Having witnessed the real distress and levels of disability it can inflict will enable me to really empathise with patients like Tom going through this type of disorder when I come across them in my future career. The area of relaxation breathing was something which I had used myself in yoga practice and did know of its benefit in anxiety situations, but I had not expected to have to start teaching it to a patient that day in the X-Ray cubicle. I was quite shocked when Tom had began hyperventilating but on reflection I should have perhaps saw it coming with his rising levels of anxiety after our arrival at the hospital, especially after I had read only that morning that he had a history of panic attacks. Again on reflection I could have asked the nursing staff the best way to deal with it should the situation arise. I have learned from this that I could have been better prepared before escorting Tom by asking questions and having a plan of action to use if necessary. I had been worried about putting Tom at risk by trying the breathing technique with him as I stated earlier, and perhaps it was wrong of me to have tried it in the first place, but I had made a judgment in an emergency situation, and I did not make the decision lightly, being aware that help was nearby should it be needed. I did not want to distress Tom further by calling out, resulting in people rushing into the cubicle and in conclusion felt the breathing exercise was worth a try, but I would have called for help quickly if it did not appear to be working. On discussing the incident and my actions back on the ward, my mentor also felt I had made the right choice. This made me think about the fact that as a nurse there are times when it is up to you to make judgment calls regarding patient care and that it is important to remember that you are accountable for your actions. To carry this level of responsibility demands a sound knowledge of practice and an ability to think calmly and clearly even under stress. I was both relived and delighted that the breathing technique worked so well for Tom and felt honoured that he decided to put his faith in me. As stated earlier, this prompted Tom to confide some of his fears to me, which showed trust on Toms part and fostered a deeper understanding of his condition on mine. This advancement of the therapeutic relationship between Tom and I has continued during my placement where I have worked quite closely with him and where I have taught him how to practice the breathing techniques when he feels calm making it easier for him to utilise in panic situations, which he has been doing with good effect. As a follow on from this incident and after seeing the efficacy of relaxation techniques in action, at my practice placement I asked my mentor if it would be possible to carry out some relaxation groups with carefully screened groups of patients who had anxiety problems. My mentor and other nursing staff thought this would be a good idea both for the benefit of the patients and for my personal and professional development. After researching the subject and finding appropriate music along with compiling a script, the groups were initiated with great success and are now regularly used on the ward, which has given me some sense of achievement and helped build my confidence in my abilities as a nurse. Along with being very beneficial in analysing this particular incident the use of reflective analysis has definitely improved my practice in placement, and although I have used this model of reflection in my portfolio for some time now, it has made me re-examine the importance keeping and using a portfolio to further my professional and personal development. I also feel this helps me to benefit more from my placement as I fully understand the concept behind reflection and use it positively as a tool rather than a task I need to perform. When using reflection now I am able to draw more insight from my experiences on placement, while previously I had only skimmed the surface of the subjects when carrying out reflection. This has increased both my self awareness and my ability to link theory and practice together. Overall, I can see clearly how reflection is a useful tool in helping nurses to focus on their skills and behaviour which consequently enables them to provide the best care possible for patients, as discussed by Somerville (2004). Action Plan Preparing and utilising action plans is an important way of improving both our personal and professional development as nurses, whilst building on improved nursing practice. To be prepared for this kind of scenario in the future I have identified the following plan of action: Make sure I know and understand all relevant information regarding patients. Have good communication with other members of staff about patients. Have a plan of action thought out for any incidents that may arise. Remain calm and consider actions carefully. Empathise with the patient by trying to understand what it would be like to be in that situation. Where possible help the patient to help themselves, i.e. by educating them to use breathing techniques so when a panic situation arises they are in a better position to take control themselves.

Gun Control in Canada :: Second Amendment The Right To Bear Arms

Part I:Introduction The issue of gun control and violence, both in Canada and the United States, is one that simply will not go away. If history is to be any guide, no matter what the resolution to the gun control debate is, it is probable that the arguments pro and con will be much the same as they always have been. In 1977, legislation was passed by the Canadian Parliament regulating long guns for the first time, restructuring the availability of firearms, and increasing a variety of penalties . Canadian firearms law is primarily federal, and "therfore national in scope, while the bulk of the firearms regulation in the United States is at the state level; attempts to introduce stricter leglislation at the federal level are often defeated". The importance of this issue is that not all North Americans are necessarily supportive of strict gun control as being a feasible alternative to controlling urban violence. There are concerns with the opponents of gun control, that the professional criminal who wants a gun can obtain one, and leaves the average law-abiding citizen helpless in defending themselves against the perils of urban life . Is it our right to bear arms as North Americans ? Or is it privilege? And what are the benefits of having strict gun control laws? Through the analysis of the writings and reports of academics and experts of gun control and urban violence, it will be possible to examine the issues and theories of the social impact of this issue. Part II: Review of the Literature A) Summary In a paper which looked at gun control and firearms violence in North America, Robert J. Mundt, of the University of North Carolina, points out that "Crime in America is popularly perceived [in Canada] as something to be expected in a society which has less respect for the rule of law than does Canadian society..." In 1977, the Canadian government took the initiative to legislate stricter gun control. Among the provisions legislated by the Canadian government was a "Firearms Acquisition Certificate" for the purchase of any firearm, and strengthened the "registration requirements for handguns and other restricted weapons..." . The purpose of the 1977 leglislation was to reduce the availability of firearms, on the assumption that there is a "positive relationship between availability and use". In Robert J. Mundt's study, when compared with the United States, trends in Canada over the past ten years in various types of violent crime, suicide, and accidental death show no dramatic results, "and few suggestions of perceptible effects of the 1977 Canadian gun control legislation". The only positive effect, Mundt, found in the study was the decrease in the use

Workplace Ethical Dilema

Ethical dilemmas can occur at any workplace. For this reason, codes of ethics are developed to help guide and set the standards for moral conduct for that profession. Code of ethics also helps establish procedures on how to deal with misconduct. While serving in the United States Navy, I came across several ethical dilemmas in my workplace. One dilemma that I remember clearly is one in which an officer (higher rank) and enlisted (lower rank) were involved in fraternization. Fraternization in the Navy is not acceptable and is referred to as a relationship between an enlisted and officer who are dating, who engage in intimate behavior, share a home, borrow money or gamble. Fraternization in the military can be punishable under the Uniform Code of Military Justice. On board the Navy ship there were approximately a total of 350 service members who were both men and women. Interaction between both sexes was inevitable; however two service members on board took it too far. There was a service member (enlisted male) who began to have a relationship with his boss (female officer). Both agreed to keep their relationship a secret while onboard the ship. One after noon I was out in town at a local store when I spotted both members holding hands together. I was not friends with either one, and did not say anything to them. I realized that their behavior was non ethical, but I did not want to be involved. Looking back at the situation my thoughts about it followed the principles of nonmaleficence. Nonmaleficence refers as doing no harm or mischief. I thought to myself that they were not causing harm to anyone therefore I did not want to report them. Through an ethical relativism view I realized that the dilemma was not morally wrong however, the situation in which they were engages did not follow the ethical standards of the workplace. However my view about the whole situation changed when I talked about it with another co-worker and she informed me that the female officer was married. The fact that she was married completely changed my perspective about the situation. Now, not only was it ethically wrong but it was morally wrong too. At this point the dilemma then interfered with my personal values. My personal values are may not be the same to the ones of others; however the choices they made went against my beliefs and values. Growing up I was always taught that fidelity and commitment to your partner is very important. I put myself in the spouse’s shoes and realized I would never want to go through that. The behaviors the engaged were bothersome and I felt very uncomfortable around them. I can relate this dilemma to the thoughts of Socrates, that no one voluntarily does evil when they know good. If evil is done is because there is some type of benefit within for that person committing evil. The officer in this case is aware of the evil she is committing, however she is gaining comfort, perhaps love, or pleasure from her behavior with the enlisted male. Both personnel practiced ethical egoism, due to fact that they only care about their happiness and did not care about those who got hurt. This is when I realized that I needed to speak up about this dilemma. In order to resolve this dilemma I needed to speak up and report what I knew and saw to my higher chain of command. I would have to say that I applied the theory of Kant. Good will and motivation was the base of my decision to report the dilemma. I knew that making this decision was going to bring bad consequences for both members, however I did what I thought was best. In my decision making process with the Kantian approach, ethical decisions were based on my sense of duty. The word duty is derived from the Greek word deon (deontological). Duty refers to the acts of a person based on the principles of morality. In this decision making approach I had to make decisions based on what is right rather than the good or bad consequences that will follow. A person must make the morally right decision regardless of the good or bad outcome. Categorical imperative is what determines whether an act is morally right or wrong. The requirements of categorical imperatives are that moral principles are applied by respecting humanity. In this deontological point of view a person should act rational person and make self-imposed decisions. After reporting the situation to the chain of command, I was asked to speak up and testify along with others who had observed the same behaviors. Both services members were punished by the UCMJ and forced out of the military. The consequences to their behavior are what constitute it to be wrong. The ethical dilemma went against my personal values and belief. This is why I decided to speak up and report what I knew regardless of the consequences. Both members were aware of the good and evil and instead decided to go for the evil not that they could hurt others. This ethical dilemma not only affected them in a personal level but affected the work place as well. After all the consequences, sailors onboard are very careful about fraternization. Workplace ethical dilemmas can happen at any work place, therefore it is important to maintain an updated code of ethics. This will help and guide employees on procedures , employee conduct and misconduct consequences.