Quality of Life for the Patient and Family Essay Example for Free

Quality of Life for the Patient and Family Essay Quality of life has a different meaning for everyone. Many personal thoughts and feelings can come into play when caring for others during the end stages of life. However as a nurse and caregiver, these opinions must be put aside at this significant time. For some health care providers, we may feel that keeping the patient comfortable and having them surrounded by family is most important. However, for the patient, personal culture, lifestyle and value for one self as well as a sense of independence in handling this time alone is most imperative. Therefor a nurse must consider the individuals past experiences, present lifestyle and personal hopes in which they choose to live in relation to their goals, expectations, standards and concerns at this stage. One must meet not only the physical needs of the patient but the psychosocial demands in this sensitive time of need. Seeking aggressive medical treatment vs. palliative care is something that is very personal and differs from individual to individual. Nurses’ opinions and suggestions of the â€Å"best care† should not be voiced to the patient or family, even if asked directly. For Mrs. Thomas, time also plays an important role. She is young and may have many other worries than those of an older age experience in preparing for end of life. A nurse must consider what areas of life are important to her and what is the relative importance of each of these areas. Personal perception that counting on family support is huge, but may not be possible in Mrs. Thomas’ situation as her children live out of town. STRATEGIES TO IMPROVE QUALITY OF LIFE The nurse should look at several strategies that directly impact the patient as well as the family. Quality of life not only looks at the health status  the patient but those directly involved in the care of the patient. This encompasses a broader set of planning including finances, housing, and employment. This will have a direct impact on the entire family. Three important strategies that are helpful to relieve overall stress and promote optimal coping skills include: 1) patient awareness of disease process, 2) available support from healthcare providers and 3) addressing physical as well as the psychosocial needs of the patient. Healthcare professionals must be prepared and speak directly with the patient and family when it is determined best to the physician’s ability, that the identified disease of breast cancer will cause death. Advance planning and preparation may be helpful in dying well if Mrs. Thomas is more aware about her status of disease. Physicians and nurses must change the plan of aggressive medical treatments of curing the disease of breast cancer and concentrate providing support and a comfortable well being of the deteriorating disease process. This in turn should provide a plan of care for relief of pain, contentment to the patient and focus on the overall whole being of quality of life. The homecare team can include doctors, nurses, home health aides, social workers, and clergy as well as trained volunteers. Most team members provide on-call 24 hours a day, 7 days a week to deliver support. The patient and family should feel the comfort in calling these resources at anytime. The nurse must remind Mrs. Thomas and her husband that they are not â€Å"bothering† any team member by asking for assistance. The team must always work together and communicate the patient’s goals for end-of-life care. It is important for all to realize this is very individualized for each patient and family member. Each individual strategy should include caring for the whole person physically, emotionally, socially and spiritually. It important for the team to develop strengths based perspectives of psychosocial interventions and listen to what the patient and family have to say to enable them to cope better. In doing so, the team must also communicate on each encounter with Mrs. Thomas and family as well as each other to assure that her and the husband’s needs are being met. HOLISTIC CARE A holistic nursing care plan in valuable in delivering care to the entire person in supporting the physical, mental, spiritual, emotional, social and  environmental needs. With this approach, nursing care needs to move away from viewing Mrs. Thomas as merely a diagnosis and treating her as a whole person. Nursing goals should be to develop immediate trust with the patient and family, provide comfort, supportive care, and symptom management. This can be achieved by effective communication and providing a calm, relaxed setting for Mrs. Thomas. Allowing her to speak openly and honestly about her feelings and emotions of grief, physical complaints such as pain, nausea, and difficulty sleeping is a good way to start to develop a trusting nurse/patient relationship. As a nurse, one must be supportive and be willing to listen openly. Once Mrs. Thomas begins to express these types of things, the nurse must review and evaluate every visit to improve specific concerns with her. More importantly, healthcare providers must display an openness to hear new concerns and prioritize the needs of the patient and family. FUNCTIONAL ABILITY Assessments to maintain the self functional ability for Mrs. Thomas should include creating a plan to achieve realistic goals and allow self care as long as possible. This in turn can give control back to Mrs. Thomas, help raise confidence and value her quality of life. Mrs. Thomas’ physical, social and environmental conditions should also be considered to help her care for herself. Discussing the 24/7 availability of visits from registered nurses and social workers, involving family and friends or volunteers that can help with running errands and meal preparation for adequate dietary intake, and discussing appropriate medical equipment to assist with ADLs such as performing personal hygiene can prove to be helpful. PROVIDING ADDITIONAL CARE When self-care is no longer possible, the importance of more frequent nurse and/or social worker visits, and interaction of clergy is valuable. In addition, further involvement of additional family, friends, home health aides or volunteers to assist not only with running errands, meal preparation and assistance with ADLs but being present in the home for longer periods to care directly for Mrs. Thomas becomes more imperative. The nurse can assist in making sure appropriate DME equipment is in the home. In  addition, this turns out to be a time when additional emotional support is of great concern for Mr. Thomas. CHRONIC DEPRESSION Mr. Thomas already suffers from chronic depression and now has to endure immense and continuous stress to care for his wife with advanced breast cancer. Over time this takes a toll his health, ability to work, finances, and their own personal and family needs. Involvement of not only the nurse, but also social worker and bereavement counselor can help Mr. Thomas tremendously. Encouraging him to take his medications will help both him and his wife. Also, reassurance that it is okay to want quiet time and allowing others to help to care for his wife should be verbalized to him in a caring manner. Taking some of the financial worries away from Mr. Thomas may help as well. The social worker can discuss resources that are of no cost from community volunteer organizations and review the reimbursement of covered services from the insurance organization at the beginning and in ongoing care of his wife. Sharing the right information with the patient’s family is very important and can assist in better coping. Again, the home care team must offer an environment that provides the openness to hear all concerns and overall needs of not only the patient but also her family.

Racial Discrimination and Disparity in the United States Justice System

Introduction The issue of racial disparity in the criminal justice system has been a longstanding debate in this county. According to Tonry (as cited in Cole & Gertz, 2013) African Americans make up to 50% of the prison population but are only 12 % of the total United States population. Bobo and Thompson (2006) stated that Hispanics make up to 18 % of the prison population but are only 14 % of the total United States Population, while Caucasians make up to 75 % of the total population and are only 35 % of the prison population in American. (Coker,2003) supports Cole and Gertz and states that African Americans make up to half of the prison population while only accounting for 12 % of the population in the United States. According to NACP statistics (http://www.naacp.org/pages/criminal-justice-fact-sheet) African American and Hispanics make up 58% of all prisoners even though African Americans and Hispanics make up 25 % of the United States population. According to Hurwitz and Peffley (2010) Cauca sian men older than 18 have a 1 in 106 chance of being imprisoned, while in comparison to a 1 in 16 chance of being imprisoned for African American men in the same age range. According to (Coker,2003) estimated that 28 % of African Americans will be incarcerated at one point in their lifetimes. Small (2001) stated that one out of three African Americans in their twenties are either in jail, prison, on probation, or parole. Small (2001) stated that although African Americans make up 13 % of all drug users in America, they are 35 % of the people arrested for drug possession and 55 % of the people convicted for drug possession. According to Small (2001) African American men are sent to prison for drug offenses at rate 20%-57% times great... ... Criminal Justice: How Much Is Too Much? Journal of Criminal Law & Criminology, 100(3), 903-932. Engel, R.S., & Calnon, J. M. (2004). Examining The Influence Of Drivers' Characteristics During Traffic Stops With Police: Results From A National Survey. Justice Quarterly: JQ, 21(1), 49-90. Hurwitz, J., & Peffley, M. (2010). And justice for some: Race, crime, and punishment in the US criminal justice system. Canadian Journal of Political Science, 43(2), 457-479. Nation Association for The Advancement of Color People. Criminal Justice fact sheet. Retrieved from http://www.naacp.org/pages/criminal-justice-fact-sheet Small, D.( 2001) The war on drugs is a war on racial justice. Social research, 68(3) 896-902. The Bureau of Justice Statistics. Thomsen, F. (2011). The Art of the Unseen: Three challenges for Racial Profiling. Journal Of Ethics, 15(1/2), 89-117.

Play format to influence the audiences feelings Essay

Examine how Arthur miller uses the play format to influence the audiences feelings towards Eddie The play ‘A view from the bridge’ was written in 1955 by Arthur Miller; a man who’s play was heavily influenced by the work and lives in the communities of dockworkers and longshoremen. This play examines individuals, characters like Eddie, and their responsibilities and position in society. In addition, Miller also reveals to the audience a meaningful understanding way of how Eddie thinks, acts and behaves to his surroundings. While doing this, he also portrays a different perspective of what family and Italian culture is like, based on his own past experiences with Italian immigrants. It is this, which dramatizes the themes of conflict, betrayal, love and obsession. The American immigration system at the time was at its peak and due to the ‘American dream’ many were illegal. Arthur Miller’s play was influenced by this immigration system in America as he had heard stories and personal experiences involving illegal immigrants. At first he didn’t act upon this idea, but after visiting Italy it inspired him to write a play influenced by the social, historical and cultural background of these Italian communities. At the beginning of the play Alfieri sets the scene by showing his perspective through a monologue. The language he uses is direct, formal and expressive of what the characters mean. By the end of Alfieri’s first speech Miller uses the dialogue to influence the audience into thinking their interpretation of Eddie Carbonne to be one of the main characters and to be identified as the hero of this particular tradgedy. The opening of the play also highlights Eddie to be seen as a decent and respected member of the community as he and his wife Beatrice were responsible for bringing up Catherine, Beatrice’s niece, when her parents died. This established Eddie as a father figure, which could explain why Rodolpho and Marco came to stay with him when they first arrived in America. The respect earned from this conveyed in many ways, such as Catherine fetching and lighting a cigar for him, and a more important way in terms of status, twice interrupting his wife in mid speech, and putting words into her mouth if anyone asks her about the immigrants in their house:’ Eddie suppose somebody†¦ ‘ ‘I don’t care what the question is. You-don’t-no-nothin’. He is drilling this idea into her head slowly so she understands the importance of not telling anyone about the Marco and Rodolpho. Miller uses this repeated interruption, which happens towards the opening of the play, to show how early on tension is evident in Eddie and Beatrice’s marriage therefore showing Eddie to be considerate. The first characters Miller presents to the audience are Catherine and Eddie. At first we see Eddie to be quite an overprotective father who sees the naivety of Catherine and tries to explain to her the fact that she’s, â€Å"Getting to be a big girl, you got to keep yourself more, can’t be so friendly†. Eddie still sees her as a â€Å"baby† as does not seem to be able to handle the fact that she is growing up and wants to be noticed by boys. Catherine’s character is presented to the audience as happy and confident, but maybe a bit forward. Eddie sees the craving of attention when she is â€Å"walking wavy† like she is selling her body to the opposite sex. Eddie does not like the fact that the boys â€Å"heads are turning†. This conversation takes place early in the first act into the story and already there has been a change in relationship whereby the audience question Eddie being jealous of the younger boys. Catherine is naive about Eddie’s reactions and thinks nothing of it. There is a lot jealousy developing in their relationship between Eddie and Catherine. Eddie becomes upset at the fact that maybe Rodolpho has won over the affection of Catherine and Eddie has been unsuccessful. Eddie retaliates through jealousy by telling Catherine that Rodolpho is using her for an American passport when they are alone. The stage directions influence the audience, as Catherine is â€Å"smiling but tense†. It is as if you can feel the friction in the air. We sympathize with Catherine as she only wants to grow up and Eddie is holding her back and still treating her like a child. Eddie is doing this because he is scared of the fact that Rodolpho is taking his â€Å"baby† away. However, later on in the play, another side of Eddie is shown. When Eddie had finished the phone call to the immigration bureau and is own his way home he bumps into Louis and Mike, they ask him to come bowling but Eddie at this time turns down the offer, as he is feeling guilty. When Eddie is back into the house Miller presents to the audience the development in Eddie and Beatrice’s relationship. Eddie expects Beatrice to respect him and do as he says â€Å"a wife is supposed to believe a husband. † This dialogue highlights Eddie’s character as being very demanding and uncompromising. The final paragraph uses poetic language and Alfieri says it in an emotional tone. Alfieri shows some admiration in his ending speech for Eddie, â€Å"I will love him more than all my sensible clients. † Alfieri admires Eddie as his heart was in the right place and he didn’t settle for half. This last speech influences the audience into thinking that throughout the play Eddie had always been loyal and decent to his family. Eddie Carbonne is a prime example of a tragic hero, as he was an honest man who nurtured and raised an orphan and gave a home to illegal immigrants. He had a fatal flaw, which, combined with other negative characteristics such as stubbornness and selfishness, led to his downfall. His death was an indirect result of his own actions, and he would have stayed alive had he not incestuously loved his niece, and tried to stop then getting married. Eddie allowed himself to be open with his personality as he portrayed his whole character in the play, from kindness to cowardness.

Online Barmy Online Roulette Myths That Need Dispelling

Blog 31 – Barmy online roulette myths that need dispelling No other online casino game quite sells glamour like online roulette. The drama of the spinning wheel is almost unmatched no matter where it is you choose to play. While the appeal of online roulette is clear for all to see, it seems that over the years several ridiculous myths have been attached to the game. Many of these myths are simply barmy in nature and need dispelling. Thankfully, we have done our research and are finally able to address several roulette ubran legends, hopefully putting them to bed once and for all. Myth 1 – All roulette wheels are the same It is ridiculous that in 2015 that some players still believe this. Online roulette is now a game that comes in†¦show more content†¦Being more specific, the green slot means that a 50/50 bet will never ever be possible no matter how many number combinations you utilise. Myth 3 – Mathematics is the key to online roulette success People like to compare online roulette to the likes of blackjack and poker in the sense that they feel a mathmatical approach can lead to victory. The problem is that mathematics holds not grounds within the game of online roulette and holds no ground as far as stratergy is concered. There is no data that you can analyse or startergy that you can implemenet that is going to change the fact that online roulette is a luck based game and little more. Myth 4 – You can trick an online casino through offset bets No matter what any online roulette betting strategy tells you, there is no way to trick the game or the casino to improve your level of profit. The common myth attached to such relates to using offset bets, with the idea being that you will win more. For example, you choose to be  £15 on evens, then you bet  £10 odds, coming to a  £25 total. The myth is that this will create enough of an offest on the odds that no matter the outcome you will come out with profit in hand. While in the world of sports betting their could be an argument for such startergy, it relates to nothing but nonsense in the world of online roulette. Myth 5 – Money management methods can affect the house edge The final myth on this countdown is probably the easiest