Gibbs Nursing Model on Reflection The WritePass Journal

Gibbs Nursing Model on Reflection Introduction Gibbs Nursing Model on Reflection ). The Gibbs (1988) model of reflection suggests that the process of reflection is systematic and follows a number of specific steps in order to be successful. This model of reflection is a type of formal reflection, which draws on research and puts forward a theory as to how most effectively put into practice to process of reflection. The process can be broken down into six key steps: Description: this step explores the context of the event and covers fine details such as who was present at the event, where it happened and what happened. Feelings: this step encourages the reflector to explore their thoughts and feelings at the time of the event. Evaluation: this step encourages the nurse to make their own judgement about the event and to consider what went well and what went less well about the event. Analysis: this step delves even deeper into reflection on the event and encourages the nurse to break the event down into smaller episodes in order to facilitate analysis. Conclusions: this step explores the potential alternatives that may be used to deal with the situation that is being reflected upon. Action Plan: this is the final step in the reflection process. The action plan is put into place in order to deal more effectively with the situation if or when it may arise again. The Royal College of Nursing (2012) believes the Gibbs (1988) model of reflection to be particularly superior because emphasises the role of emotions and acknowledges their importance in the reflection process. Nursing can often be an emotionally charged career, especially for nurses working in areas such as psychiatric health and palliative care. Therefore, reflection on these emotions and exploration of how to manage them and improve management of them in the future is of particular importance in the nursing profession. Case Study Step One (Description) A young male patient aged 16 years came into the clinic around three days ago. He complained of low self-esteem and is feeling fed up and depressed because of pimples and spots on his face. The patient was worried that   Ã‚  girls would not be attracted to him because of the spots. The consultation took place with just myself present, no other nurses were in the room at the time of the appointment. The consultation lasted around half an hour, during which time myself and the patient discussed the history of his problems with his skin and the emotional distress that the spots were causing him. The patient disclosed that he had begun to get spots at around age 14 when he had started puberty and that it had begun to make him feel extremely self-conscious. The patient described the negative effect that the acne was having. For example, he has been bullied at school and is feeling apprehensive about starting sixth form in September because he believes that he will be the only sixth form er with spots. Based on the reasonably lengthy history of the acne, the presence of acne on the face and the negative emotional effect that the acne was having, a three month dosage of oxytetracycline was prescribed for the patient. Step Two (Feelings) During the consultation I had a number of feelings. Primarily I felt sympathy for the client because his situation reminded me of my own time as a teenager. I suffered from bad skin from the ages of 14 to about 20 and it severely affected my own self-esteem. In a review of the literature, Dunn, O’Neill and Feldman (2011) have found that patients suffering from acne are more at risk of depression and other psychological disorders. However, the review also found that acne treatment may lead to improvement of the psychological disorder that are so often co-morbid. This made me feel re-assured that prescribing oxytetracycline had been the right thing to do. My own experiences of acne also meant that I was able to relate well to the patient. I also felt some anger during the consultation. This anger was directed at the patient’s peers who had been cruel enough to taunt and tease the patient because of his acne. I also felt regret and guilt. I regretted not referring the pati ent onwards for emotional support and for not exploring the psychological impact of the acne in more detail. I also felt a sense of pride that this young man had the courage to come to the clinic by himself to seek help for his acne. I remembered how upsetting acne was as a teenager and I remembered that I would have been too embarrassed to have ever gone to a clinic or to have sought help from an adult. In turn, I also felt happiness. I felt happy that this young man had come to the clinic and I felt happy that I was able to help him. Step Three (Evaluation) On evaluation, the event was good in a number of ways. Firstly it added to my experience of dealing with young people and in dealing with the problems that are unique to this population of patients. I have not had many young patients during my nursing career and I welcome the opportunity to gain experience with this group. Furthermore, it re-affirmed my career choice as a nurse. During your career you always have doubts as to whether you have chosen the correct path. However, there are points in your career when you feel sure that you have made the right choice. However, there were also some negative elements. Firstly, the appointment was quite short and I am worried that this may have made the patient feel rushed and uncomfortable. After the consultation I did some research into the effects of acne in young people. Purvis et al. (2006) have found that young people with acne are at an increased risk of suicide and that attention must be paid to their mental health. In particular, the authors found that directly asking about suicidal thoughts should be encouraged during consultations with young people. This information only served to make me feel more anxious and I wished that I had bought this up with the patient. Step Four (Analysis) On reflection, being able to relate to the patient increased my ability to deal more effectively with the situation. I feel that the patient was able to open up more to me because he sensed my sympathy for him and his situation. Randall and Hill (2012) interviewed children aged between 11 and 14 years about what makes a ‘good’ nurse. It was found that the ability to connect to them was extremely important and so I think this is why the patient felt comfortable opening up to me. On reflection, I am also now convinced that the patient coming to see me was a very positive event. The patient could have chosen to go on suffering and could have chosen not to open up and talk about the problems his acne was causing. In a review of the literature, Gulliver, Griffiths and Christensen (2010) found that young people perceived embarrassment and stigma as barriers to accessing healthcare. Therefore, it could have been very easy for the patient to have avoided coming and seeking help. I felt a range of both positive and negative emotions during the consultation, and I think this re-affirmed for me that I enjoy nursing and enjoy helping others. It is important to genuinely care about patients and to provide them with the best care possible. This would be hard to do if you did not feel empathy for patients. The experience also helped me realise that I need to actively search out training and learning opportunities regarding working with young people with mental health issues. Step Five (Conclusion) If the same situation was to arise again I think that I would approach it in a slightly different way. In particular, I would have offered to refer the patient to further support services. During the consultation the patient mentioned that he felt that the spots on his face made him unattractive to the opposite sex. In addition to providing medication to get to the biological and physiological roots of the problem, on reflection I think it would have been beneficial to the patient to have provided information about charities that offer self-esteem and confidence building. Such charities that offer these services include Young Minds (youngminds.org.uk/) and Mind (mind.org.uk/). In retrospect, I also believe that I should have given the patient a longer consultation time in order for us to have explored the psychological impact of his acne in more detail. Coyne (2008) has found that young people are rarely involved in the decision-making process when it comes to their consultations. Th erefore, giving the patient more time to discuss his problems may have improved his sense of wellbeing as he felt more involved in his care process. Step Six (Action Plan) There are a number of elements to my action plan. Firstly, I will make sure that in the future the consultation room has leaflets and information pertaining to mental health problems in young people. This way, young people can access the information if they perhaps feel too embarrassed to talk about it. Hayter (2005) has found that young people accessing health clinics put a high value on a non-judgemental approach by health staff. Therefore, in future I would be sure to be aware of my attitude and make sure that either subconsciously or consciously; I am not making any judgements about the patient. Hayter (2005) also found that young people had serious concerns regarding confidentiality, especially during busy times at the clinic. Therefore, in the future I would be certain to reassure young people that their details and consultations are kept completely confidential. To re-assure young patients, I may ask them to sign a confidentiality form, which I will also sign in front of them. Furthermore, my action plan will include improving my knowledge and awareness of working with young people as a nursing professional. This will allow me to increase the tools and skills I have for dealing with young people with complex needs. During the consultation I felt anger toward the patient’s peers who had teased him. In the future, I will focus on being more objective when dealing with a patient who has been the victim of bullying. References Coyne, I. (2008) Children’s participation in consultations and decision-making at health service level: A review of the literature. International Journal of Nursing Studies, 45(11), pp. 1682-1689. Dunn, L.K., O’Neill, J.L. and Feldman, S.R. (2011) Acne in adolescents: Quality of life, self-esteem, mood and psychological disorders. Dermatology Online Journal, 17(1). Available at: http://escholarship.org/uc/item/4hp8n68p [Accessed 20 October 2013]. Gibbs, G. (1988) Learning by Doing: A guide to teaching and learning methods. Oxford: Further Education Unit. Gulliver, A., Griffiths, K.M. and Christensen, H. (2010) Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry, 10(1), pp. 113. Hayter, M. (2005) Reaching marginalised young people through sexual health nursing outreach clinics: Evaluating service use and the views of service users. Public Health Nursing, 22(4), pp. 339-346. Paget, T. (2001) Reflective practice and clinical outcomes: practitioner’s views on how reflective practice has influenced their clinical practice. Journal of Clinical Nursing, 10(2), pp. 204-214. Purvis, D., Robinson, E., Merry, S. and Watson, P. (2006) Acne, anxiety, depression and suicide in teenagers: A cross-sectional survey of New Zealand secondary school. Journal of Paediatrics and Child Health, 42(12), pp. 793-796. Randall, D. and Hill, A. (2012) Consulting children and young people on what makes a good nurse. Nursing Children and Young People, 24(3), pp. 14. Royal College of Nursing (2012) An exploration of the challenges of maintaining basic human rights in practice. London: Royal College of Nursing.

AIDS and Philadelphia (1993)

Later, the virus can enter the host's bloodstream through a hole in the surface of the tissue. The risk of this happening is the biggest among anal sex, whether it is between two men or between men and women. HIV is transmitted by direct exchange of blood or blood products This type of infection is most common when injecting drug users injecting drugs Hemophilia patients and other people receiving blood transfusion, As well as the fetus of the mother of HIV. Since the onset of AIDS epidemics, AIDS has caused considerable interest and controversy. This scene is taken from the box office income of Philadelphia. The 1993 TV series has become the first movie to discuss publicly about AIDS, crossing the wall of the movie. Philadelphia is also a representative example of homophobia in the workplace (irrational fear and hate against homosexuals). Homosexuals desire equal and equitable treatment in the workplace (Mc Naught 65); recognizing this, the movie is doing very well. Philadelphia cla ims that it meets all four criteria and is a successful high quality social drama. (Social drama is a movie including reality (modern) social problem.Social drama must deal with conflict as some plots contain solution to the problem.) Philadelphia is preparing to conduct a critical analysis of Philadelphia movie (1993). Please answer the following questions. * Homosexual myths and stereotypes, and those living in HIV / AIDS (PLWHA) will help promote him to be dismissed by the company? * Prejudice, discrimination, oppression and institutional discrimination. * Including analysis of gay and lesbian other issues such as granting legal authority, violence against them, out, race, AIDS. * Proposed Strategy ... Star Wars became an American classic in popular culture. George Lucas is a wonderful person behind the movie, and he suggests everything we call now Star Wars. He is the creator of this wonderful phenomenon in popular culture. He can not do it by himself, but many people are involv ed in film production. Music is the most important factor in making movies. As he heard, Lucas decided to pass this responsibility to the famous composer John Williams When Philadelphia was released in 1993, it helped to change these perceptions. The movie is the story of a young gay attorney, acted by Tom Hanks, who was fired by his company after discovering that he had AIDS. This is the first Hollywood movie to deal with AIDS and homophobia. Until there were few people who wanted to discuss the theme, it helped to delete themes. Gary Bell, advocate of HIV, says:

Dubai economy Essay Example | Topics and Well Written Essays - 750 words

Dubai economy - Essay Example On January 4th 2006, following the death of Sheikh Maktoum bin Rashid Al Maktoum, His Highness Sheikh Mohammed bin Rashid Al Maktoum became the Ruler of Dubai. He is a man of many guises-poet; champion horseman; author of the book 'My Vision - Challenges in the race for excellence', Chairman of DTCM, United Arab Emirates Vice President, Prime Minister and Defense Minister.Past two -three years witnessed a boom in the construction sector. Large scale, world class constructions such as Burj Dubai (which would be world's tallest building - height 818M, Floors-162, completion by 2009) have taken place and are in progress. Apart from that a number of real estate projects like the Walk, Jumeirah Beach Residence, Business Bay, the Executive Towers, Vision Tower, Bay Avenue, the Villa, etc also became popular. Real-estate values surged fourfold over the past five years, fueled by a supply shortage and an influx of expatriates. Rising commodities prices drove inflation, which accelerated to a record 11.1 percent in 2007. The population of Dubai expanded from 12,00,000 in 2003 to 14,78,000 in 2007. Dubai's real gross domestic product (GDP), which surged to a record Dh198 billion in 2007, is predicted to sustain an average growth rate of 11 per cent for the next eight years. Dubai's exports have been growing by an average of more than 28 per cent annually during the past five years.Financial sector also witnessed ample growth during the previous years. The Dubai International Financial Centre (DIFC), opened in September 2004, is the world's fastest growing international financial centre, and has attracted high caliber firms from around the globe as well as its region. A world-class stock exchange, NASDAQ Dubai (formerly known as the Dubai International Financial Exchange or DIFX), opened in the DIFC in September 2005. Financial services in the DIFC are regulated to international standards by the Dubai Financial Services Authority (DFSA). The credit market also has become more competitive, currently there are 13 lenders in the market including four international banks - Standard chartered, HSBC, Llyods TSB and Barclays Bank. Dubai Shopping Festival (DSF) conducted normally in January gained international reputation year after year and attracts thousands of foreign tourists. Hotels, travel agents and tour operators contribute to the selling of the event worldwide. Development and expansion activities for Dubai International Airport continued. The new terminal 3 became fully operational in October 2008. Work on a Cargo Mega Terminal has begun. A metro link with the city is expected to be operational by 2010. There were fast developments in information and communication sectors in Dubai in the past few years. 'du', the integrated telecom service provider in the UAE, launched mobile telecommunication services on 11 February 2007 across the UAE in addition to internet and pay TV services in some of the free zones of Dubai. It is 40 percent owned by the UAE Federal Government, 20 percent by Mubadala Development Company, 20 percent by Emirates Communications & Technology Company LLC and 20 percent by public shareholders. It is listed on the Dubai Financial Market (DFM) and trades under the name du. Emiratization programme also got momentum in respect of higher management and technology levels. The Department of Tourism and Commerce Marketing (DTCM) has initiated an Emiratization drive in Dubai through attracting a dedicated and talented workforce. As part of the Emiratization process, the du has recently announced the appointment of two senior executives in key areas of the company's technology operations. Ahmed Hassan Al Hosni is the new Senior Vice President (SVP) IT and

INTERNATIONAL ECONOMICS AND FINANCE Essay Example | Topics and Well Written Essays - 2000 words

INTERNATIONAL ECONOMICS AND FINANCE - Essay Example The two eminent theories of Heckscher-Ohlin and Ricardian theory of international trade by David Ricardo have been discussed below. An introspection of the two theories provides an insight of the main controversies in the field of international trade and the current problems in policy that is affecting international trade. The Ricardian model explains comparative advantage in international trade by taking into account factors like natural resources and technology advancements of a country. The factors of comparative labour and capital have not been considered by Ricardo while explaining comparative advantage. The Heckscher-Ohlin model of international trade on the other hand assumes that the labour and capital are abundant resources that vary from one country to another and technology in long term prospects are assumed to be same. Heckscher-Ohlin derived that a country exports such goods that make optimal utilisation of local factors and imports those goods which could not make use o f available factors. David Ricardo: Ricardian theory of international trade International trade is necessary for the sustenance of globalization. ... Ricardian theory, however, holds the underlying assumption that the labour is the primary input for production and the trade at international stage occurs due to relative ratios of labour of the different nations (Rivera-Batiz and   Oliva, 2003, p.4). The other assumptions in the Ricardian model of international trade says that the labour as an input of production of the countries is also inelastic and there is no cost of transportation and no international trade barriers. The theory of comparative advantage has been explained by two factors namely, the opportunity cost and the production possibility frontier. The opportunity cost of the countries can be determined as the loss incurred for a certain production due to increase in another production. In international trade theory, the opportunity cost to a country is the decrease in cost of production arising out of scarcity of some factors for which the country imports goods and services from another country where those factors are present. The countries would carry out international trade in such a way that the opportunity cost is high. This could be done by international exports of goods that have abundant factors available in the boundary of the country and through import of goods that have scarcity of factors in the national boundaries. The production possibility frontier explains that the output of the country remains same for a certain level of technology and international trade takes place due to difference in outputs as a result of different levels of technology achieved by different countries. Heckscher-Ohlin - Heckscher Ohlin theory of international trade Capital and

Euthanasia †Not Only at Patients Request :: Euthanasia Physician Assisted Suicide

Euthanasia – Not Only at Patient's Request      Ã‚   No indeed, euthanasia and assisted suicide would not only be at a patient's request. This false presumption has been disproven time and again by the practical working-out of euthanasia and assisted suicide in locales where it has been legalized. And yes, there are complications, which are not given great media exposure, but which appear in journals devoted to this debate. It is the intention of this essay to correct these false notions - with copious professional documentation.    As one of their major goals, euthanasia proponents seek to have euthanasia and assisted suicide considered "medical treatment." If one accepts the notion that euthanasia or assisted suicide is a good medical treatment, then it would not only be inappropriate, but discriminatory, to deny this good treatment to a person solely because that person is too young or mentally incapacitated to request it.    The way that the judicial process works in the United States is this: A surrogate's decision is often treated, for legal purposes, as if the patient had made it. That means that, if euthanasia is legal, a court challenge could result in a finding that a surrogate could make a request for death on behalf of a child or an adult who doesn't have decision-making capacity. Legally, this is the way the courts would handle it.    In the Netherlands, a 1990 government-sponsored survey found that .8% of all deaths in the Netherlands were euthanasia deaths that occurred without a request from the patient.(Medical) And in a 1995 study, Dutch doctors reported ending the lives of 948 patients without their request.(Hendin)    Suppose, however, that surrogates were not permitted to choose death for another and that doctors did not end patients' lives without their request. The fact still remains that subtle, even unintended, pressure would still be unavoidable. Such was the case with an elderly woman who died under Oregon's assisted suicide law: Kate Cheney, 85, reportedly had been suffering from early dementia. After she was diagnosed with cancer, her own physician declined to provide a lethal prescription for her. Counseling was sought to determine if she was capable of making health care decisions. A psychiatrist found that Mrs. Cheney was not eligible for assisted suicide since she was not explicitly pushing for it, her daughter seemed to be coaching her to do so, and she couldn't remember important names and details of even a recent hospital stay.

Promote children wellbeing and safety Essay

The safety and welfare of the children is very important in every se? ng as indicated in sec? on 3 of the statutory framework for the early year’s founda? on stage 2014. All providers must meet the necessary requirements to make sure the children are kept safe and well. In my se? ng we have three rooms which are the baby room, toddler room and pre-school. As I work in the toddler room I care for children age ranging between 16 months to 27months old. The children to sta) ra? o is very important as this ensures that the children’s needs and  safety is met. If the children are under two years old then we have a sta) ra? o of 1 adult to 3 children and if the children are over 2 years old then we have a sta) ra? o of 1 adult to 4 children. The toddler room can hold up to 27 children with 9 members of sta) ranging from a room leader, senior nursery nurse, level 2 and 3 quali+ed and some sta) who are unquali+ed but working towards their quali+ca? on. All sta) members are CRB checked to make sure that the children are safe hands.

Translating Names of Minerals to Gemstones and Back

When certain minerals compress under specific conditions, most often below the surface of the earth, a process occurs which forms a new compound known as a gemstone. Gemstones can be made of one or more minerals, and as a result, some minerals refer to more than one gemstone name. In order to better understand the interaction between the two, reference the two charts below — the first details each gemstone and the minerals that combined to form it and the second lists each mineral and the gemstones it can produce. For instance, Quartz can form Amethyst, Ametrine, Citrine, and Morion (and a few more) gemstones depending on which other minerals and elements compress together and at what depth in the earths crust and temperature the compression occurs at. How Gemstones Are Formed Most gemstones are formed in either the crust or the very top layer of the earths mantle in the molten magma bubbling in the depths of the world, but only peridot and diamonds are formed deep in the mantle. All gems, however, are mined in the crust where they can cool to solidify in the crust, which is made up of igneous, metamorphic and sedimentary rock. Like the minerals that make up gemstones, some are associated with one kind of rock in particular while others have several types of rock that go into the creation of that stone. Igneous gemstones are formed when magma solidifies in the crust and crystallizes to form minerals then an increase in pressure starts a series of chemical exchanges which eventually cause the mineral to compress into a gemstone. Igneous rock gemstones include amethyst, citrine, ametrine, emeralds, morganite, and aquamarine as well as garnet, moonstone, apatite, and even diamond and zircon. Gemstones to Minerals The following chart serves as a translation guide between gemstones and minerals with each link going to photos of the gems and minerals: Gemstone Name Mineral Name Achroite Tourmaline Agate Chalcedony Alexandrite Chrysoberyl Amazonite Microcline Feldspar Amber Amber Amethyst Quartz Ametrine Quartz Andalusite Andalusite Apatite Apatite Aquamarine Beryl Aventurine Chalcedony Benitoite Benitoite Beryl Beryl Bixbite Beryl Bloodstone Chalcedony Brazilianite Brazilianite Cairngorm Quartz Carnelian Chalcedony Chrome Diopside Diopside Chrysoberyl Chrysoberyl Chrysolite Olivine Chrysoprase Chalcedony Citrine Quartz Cordierite Cordierite Demantoid Garnet Andradite Diamond Diamond Dichroite Cordierite Dravite Tourmaline Emerald Beryl Garnet Pyrope, Almandine, Andradite, Spessartine, Grossularite, Uvarovite Goshenite Beryl Heliodor Beryl Heliotrope Chalcedony Hessonite Grossularite Hiddenite Spodumene Indigolite/Indicolite Tourmaline Iolite Cordierite Jade Nephrite or Jadeite Jasper Chalcedony Kunzite Spodumene Labradorite Plagioclase Feldspar Lapis Lazuli Lazurite Malachite Malachite Mandarin Garnet Spessartine Moonstone Orthoclase, Plagioclase, Albite, Microcline Feldspars Morganite Beryl Morion Quartz Onyx Chalcedony Opal Opal Peridot Olivine Pleonast Spinel Quartz Quartz Rhodochrosite Rhodochrosite Rhodolite Almandine-Pyrope Garnet Rubellite Tourmaline Rubicelle Spinel Ruby Corundum Sapphire Corundum Sard Chalcedony Scapolite Scapolite Schorl Tourmaline Sinhalite Sinhalite Sodalite Sodalite Spinel Spinel Sugilite Sugilite Sunstone Oligoclase Feldspar Taaffeite Taaffeite Tanzanite Zoisite Titanite Titanite (Sphene) Topaz Topaz Tourmaline Tourmaline Tsavorite Garnet Grossularite Turquoise Turquoise Uvarovite Uvarovite Verdelite Tourmaline Violan Diopside Zircon Zircon Minerals to Gemstones In the following chart, the minerals in the column on the left translate to the gemstone name on the right, with links contained therein forwarding to more information and additional of the minerals and gemstones associated. Mineral Name Gemstone Name Albite Moonstone Almandine Garnet Almandine-Pyrope Garnet Rhodolite Amber Amber Andalusite Andalusite Andradite Demantoid Garnet Apatite Apatite Benitoite Benitoite Beryl Aquamarine, Beryl, Bixbite, Emerald, Goshenite, Heliodore, Morganite Brazilianite Brazilianite Chalcedony Agate, Aventurine, Bloodstone, Carnelian, Chrysoprase, Heliotrope, Jasper, Onyx, Sard Chrysoberyl Alexandrite, Chrysoberyl Cordierite Cordierite, Dichroite, Iolite Corundum Ruby, Sapphire Diamond Diamond Diopside Chrome Diopside, Violan Grossular/Grossularite Hessonite, Tsavorite Garnet Jadeite Jade Lazurite Lapis Lazuli Malachite Malachite Microcline Feldspar Amazonite, Moonstone Nephrite Jade Oligoclase Feldspar Sunstone Olivine Chrysolite, Peridot Opal Opal Orthoclase Feldspar Moonstone Plagioclase Feldspar Moonstone, Labradorite Pyrope Garnet Quartz Amethyst, Ametrine, Cairngorm, Citrine, Morion, Quartz Rhodochrosite Rhodochrosite Scapolite Scapolite Sinhalite Sinhalite Sodalite Sodalite Spessartine Mandarin Garnet Sphene (Titanite) Titanite Spinel Pleonast, Rubicelle Spodumene Hiddenite, Kunzite Sugilite Sugilite Taaffeite Taaffeite Topaz Topaz Tourmaline Achroite, Dravite, Indigolite/Indicolite, Rubellite, Schorl, Verdelite Turquoise Turquoise Uvarovite Garnet, Uvarovite Zircon Zircon Zoisite Tanzanite