Reflective Essay on Communication

I am a health care assistant (HCA) on an elderly care surgical ward and we nurse many different patients who have had elective surgery and corrective surgery after a trauma. I have a lot of contact with patients who suffer with dementia, ongoing confusion due to urinary tract infections and can often display challenging and aggressive behavior.I have found on a daily basis that patients become can frustrated when they cannot communicate what they want, and I was sure that with my strong accent I would come across as harsh. This left me feeling worried and sometimes inadequate because it is in my job and personal nature to want to help those in my care. As part of my Personal Assessment Document (PAD) my mentor and I decided that I would I would push myself to speak with patients more and see how they reacted to me. I would read the patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s purple à ¢Ã¢â€š ¬Ã…“This is meà ¢Ã¢â€š ¬Ã‚  folder to try and engage them on a more personal level.With this reflective ac count I will be discussing an experience that I had on my ward and how through reflection I have managed to gain more confidence in my ability to talk to my patients and convey my compassion in the way I communicate with the patients in my care.I will use the reflective framework devised by Atkin and Murphy (1994) to construct this account. It is the right model of reflection for me to look back and learn from my experiences.Personally, being a good student and health carer does not just come with reflection in the mind but also reflective practice which, according to the nursing standard à ¢Ã¢â€š ¬Ã…“enables a student to develop their skills, increase their knowledge and deal with emotionally challenging situationsà ¢Ã¢â€š ¬Ã‚  (RCN 2012). Reflection is something that should be engaged with on an everyday basis and from very early on in your health care career. It enables you to carry on caring about the patients you treat and how to improve yourself personally and professiona lly.I enjoy both the personal rewards and the challenges that go hand in hand with working with patients with dementia. I find that on the drive home I tend re-evaluate everything in my life and be grateful for the now. A patient whom will go by the pseudonym of à ¢Ã¢â€š ¬Ã…“Pollyà ¢Ã¢â€š ¬Ã‚  to maintain her confidentiality (The NMC Code of professional Conduct, 2004) was admitted to the ward with a fracture to the neck of her femur.I was advised that the patient was very confused, and would spit at staff and be both physically and verbally aggressive when approached but would constantly cry out that she needed help. She was in the early to middle stages of Alzheimerà ¢Ã¢â€š ¬Ã¢â€ž ¢s disease and had come from a care home for those suffering with dementia. Alzheimerà ¢Ã¢â€š ¬Ã¢â€ž ¢s disease is characterised à ¢Ã¢â€š ¬Ã…“by the loss of short term memory, deterioration in both behaviour and intellectual performance and slowness of thoughtà ¢Ã¢â€š ¬Ã‚  (Dictionary of Nurs ing 1998).In handover that morning I found that I would be working with her that day, and as she was post operative I would need to wash her and try to mobilise her to sit out in her chair so that the physiotherapists could help her to walk again and get her on the pathway to being discharged back to her care home. I found that I was nervous in approaching this patient as I did not want to upset her or get hurt. Personally I would always wake patients like Polly who require the attention of more than one member of staff last as it is better to leave the patient to sleep so that they are well rested. That, and from handover I had learned that Polly had experienced a rather active night.Before waking Polly I had read her personal à ¢Ã¢â€š ¬Ã…“This is meà ¢Ã¢â€š ¬Ã‚  purple file to find out if she had any preferred names, and how she liked to be spoken too. This is me was devised by the Alzheimerà ¢Ã¢â€š ¬Ã¢â€ž ¢s society and à ¢Ã¢â€š ¬Ã…“is intended to provide professionals w ith information about the person with dementia as an individual. This will enhance the care and support given while the person is in an unfamiliar environmentà ¢Ã¢â€š ¬Ã…“(Alzheimerà ¢Ã¢â€š ¬Ã‹Å"s society 2011). With this information I could help maintain a similar routine for Polly and I would not confuse her by overloading her with too many questions and instructions.I woke Polly up gently, and sat myself down in the chair by her bed so that I was not standing over her. I spent almost thirty minutes with Polly getting her up and ready, the patient did not get upset or frustrated with me, and  she was able to do most of the washing and dressing herself with help from me. Once this was completed I handed over to physiotherapists that they too should take this approach with Polly.I spent twelve days in total with Polly. In this time she was aggressive with me, and she would spit at me when I approached her. Yet, once I used her preferred name and tailored my approach to what sh e needed from me, I found that Polly was a pleasant and wonderful lady, who could be the complete opposite to the patient that was first handed over to me that first morning.Morris and Morris state that the symptoms of dementia are experienced by each person in à ¢Ã¢â€š ¬Ã…“their own unique wayà ¢Ã¢â€š ¬Ã‚  (2010) and this is reinforced by the publication of the à ¢Ã¢â€š ¬Ã…“this is meà ¢Ã¢â€š ¬Ã‚  leaflet. It enables staff to really look at each individual patient and assess what their needs are. In reflection, if I had not read this leaflet and just gone ahead and woke Polly up as I do each patient, the events of the day could have taken a very different path. I found that by talking to Polly as requested in her leaflet that she reacted in a calmer manner and did not get as anxious or frustrated as quickly as my colleagues had prepared me to think.Reflecting over my first day with Polly, I do not remember struggling to say my words more clearly than what I normally would have done. Polly was not deaf, nor was she a child and I kept it in my mind that this patient was still a scared lady who had broken a big part of her body and was in a large amount of pain. Furthermore, she might not be able to communicate this fact as clearly as someone without dementia.Hobson states that, the HCA will need to à ¢Ã¢â€š ¬Ã…“learn to adapt how they attempt to understand what the person is saying to themà ¢Ã¢â€š ¬Ã‚  and that this can only be achieved by à ¢Ã¢â€š ¬Ã…“entering the same world as the person with dementiaà ¢Ã¢â€š ¬Ã‚  (2012, P337). At times Polly would pretend to cry like a child and repeat the words à ¢Ã¢â€š ¬Ã…“Oh Mummy, mum, mum. Oh Mummyà ¢Ã¢â€š ¬Ã‚  but not be able to give an answer when questioned what was wrong and how could we help her. Taking this into consideration, Polly might not be actually asking for her Mum but actually trying to communicate a much deeper need.My understanding of how patients with dementia communicate lead me to point to Pollyà ¢Ã¢â€š ¬Ã¢â€ž ¢s hip and ask her if she felt pain there when she moved, to which she replied yes she did. In reflection I found this was a much better approach rather than just asking if Polly wanted any pain relief. Elkins has stated that asking the patient with dementia a direct question is almost a waste of time, as the patient does not have the information to give you. Instead it is more beneficial for the patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s sense of self worth to ask them a question with an optional answer of à ¢Ã¢â€š ¬Ã…“yesà ¢Ã¢â€š ¬Ã‚  or à ¢Ã¢â€š ¬Ã…“noà ¢Ã¢â€š ¬Ã‚ . It could also be said that a statement rather than a question is better because it leaves the patient feeling more in control (2011).From this experience, I suggested to the nurses that when doing their drug round that they should lower themselves down to Pollyà ¢Ã¢â€š ¬Ã¢â€ž ¢s eye level and ask her if her hip hurt her, rather than standing at the end of her bed or beside her asking if she wanted any pain relief. This suggestion meant that Polly had more regular pain relief, and as a team we knew when she was in pain.Furthermore, this information could be added to her file and become part of Pollyà ¢Ã¢â€š ¬Ã¢â€ž ¢s future care pathway. Elkins raised the very same argument that à ¢Ã¢â€š ¬Ã…“once an effective communication bridge had been achieved, the individual is much more like to remain calm and anxiety freeà ¢Ã¢â€š ¬Ã‚  This would show that dialogue between patient and healthcare professional had been greatly improved and would continue to do so in the future (2011).In reflection, I have found that I was so focused on the need to be understood through my use of English that at times I under-estimated the importance of non-verbal communication. Now, having taken a step back I see that I am almost in the same boat as the patient suffering with dementia, we are both just à ¢Ã¢â€š ¬Ã…“an individual attempting to communicateà ¢Ã¢â€š ¬Ã‚  (Hobson, 2012) a nd as a HCA the method of employing à ¢Ã¢â€š ¬Ã…“feelings and emotionsà ¢Ã¢â€š ¬Ã‚  should become more à ¢Ã¢â€š ¬Ã…“significant than the spoken wordà ¢Ã¢â€š ¬Ã‚  (Hobson, 2012).Although my confidence in speaking to patients is always growing, I am more appreciative of how much more effective my body language, and the tone of my voice can be when communicating with a patient with dementia. Yes, looking after these patients can be a challenge but getting past the dementia and working in ways that compliment the patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s mindset will be of more  benefit to the patient. By spending some time reading each patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s information leaflet I am able to help maintain a patientà ¢Ã¢â€š ¬Ã¢â€ž ¢s well being and create a more anxiety free environment for our patients.

Social Work Psychosocial Assessment

APRIL’S PSYCHOSOCIAL ASSESSMENT Referral April was not a referral client; rather she did her own research after feeling unsupported by her previous therapist. She found this practice on the Pratt Institute listserv as she was looking for a psychologist close to school. According to April, she received a diagnosis of stage three Non-Hodgkin Lymphoma five weeks ago and had not told anyone close to her. She wanted to talk to someone â€Å"objective† to figure out what steps to take next. Client IdentificationDemographics: April is a 23 year-old woman who currently lives on campus at Pratt Institute studying architecture and urban planning. Her parents are married and she has a 21 year-old brother, Daniel, who has a diagnosis of Down syndrome. Her father used to be in the army and now works for the US Department of Veterans Affairs, her mother cares for her brother. Employment/Education: April is in her second year at Pratt and presents to overwhelmed with current workload, yet managing to get by.She seems focused and undeterred by her presenting issue to complete her education. It is unclear if April is employed, she did not mention it. Income and Source: As stated above, it is unclear if April is currently working, receiving financial help from her parents, or receiving government loans and bursaries. Further information on her sources of income may need to be clarified to determine as this could have an impact on the care available to her in the near future. However, her interest in alternative medicine could mean she is not worried about finances.Living Environment: The specifics of April’s living environment are unknown. She has not stated any concerns about her living situation. Sources of Information The information contained in this assessment was acquired in an in person appointment with April that she scheduled. No information was obtained from any other sources. Problem Definition April was diagnosed five weeks ago with stage three N on-Hodgkin Lymphoma. April stated she feels â€Å"tired† and has been experiencing â€Å"night sweats† lately.Although, she states that she â€Å"knows† she has cancer, she seems to be in denial about the severity of her illness. April has a hard time talking about her diagnosis (she had to write it down), and seemed to be avoiding what she came to talk about although she expressed wanting to talk with someone objective who was not personally invested in her well-being. April was previously seen by a Pratt therapist, which she stated did not go well though she found her old psychiatrist â€Å"nice enough†, she felt that she was only a good listener with â€Å"nothing to say†.She seemed to be annoyed with the previous therapists attempts to contact her after she decided to stop going, although she did not let her know she would not be returning. April became very defensive when talking about her family, when this worker asked if she felt that her br other took up most of her mother’s time, she quickly shot the idea down. She presents as being exceedingly independent, yet extremely loyal to her family. April communicated that she is falling behind on her schoolwork, she seems particularly concerned with maintaining her current life and does not appear to be taking her diagnosis seriously.April expressed wanting to explore her other options of acupuncture, herbal therapies, and meditation even though her oncologist suggested she begin chemotherapy immediately. April appears to be experiencing an internal conflict and seems to have a hard time trusting others or asking for help. History/Antecedents: April stated that she had a cough that would not let up, as she grew tired of coughing in class she finally went to the health counter at Pratt. She was prescribed antibiotics, which did not help her cough.She had resigned herself to wait to speak to her dad, a retired army official now working for the US Department of Veterans Affairs. When she began experiencing night sweat she returned to the health center, where she was annoyed to be accused of taking diet pills or using cocaine. After being sent to the Brooklyn hospital for a chest x-ray, a big mass was discovered behind her spine. A bone marrow biopsy was done and she was diagnosed with stage three non-Hodgkin lymphoma. It has been five weeks since April’s diagnosis and she has not told her parents or anyone close to her.It is unclear if April is aware of the magnitude of her illness, though she stated she knows she has cancer, she does not appear to be taking the diagnosis seriously rather she is carrying on with her life as if nothing has changed. April expressed that perhaps she does not want treatment and maybe she would rather die than put her life in someone else’s hands. It is unclear if April truly believes that she has cancer. Past Solutions: As indicated previously, April received her diagnosis five weeks ago and presents as b eing in denial as to the seriousness it entails.She previously was seeing another therapist, however she did not like her and stopped going after only two sessions. It is not clear as to what was discussed in these sessions, as April only said that her previous therapist was not much older that her, had â€Å"nothing to say†, and told her â€Å"the same story twice†. She stated that she stopped going without telling her therapist she would not be returning and was overtly annoyed when the therapist tried to reach her many times after, which she felt was â€Å"over the top†.April stated she has not yet began seeking medical treatment, nor has she confided in her family as to her situation for their support. April seems overly concerned with the reaction her family will have upon receiving the news of her illness. It is likely that she is keeping this information from her family to protect them as well as to maintain her independence. Contributing Factors: Aprilâ €™s diagnosis of non-Hodgkin lymphoma was not brought on by any factors determined in the session. However, April’s tiredness and night sweats are probable symptoms of her illness.It is likely that April’s independence is making it hard for her to tell her family and friends about her illness. She also stated that her brother’s autism took up a lot of her mother’s time and that â€Å"no one talks about her† this could show where her independence developed from. April spoke about her recent break up with her boyfriend who she remains good friends with but has a new girlfriend from a well off family. April stated that she has not told her boyfriend or friends about her diagnosis; April may be believing her denial of her diagnosis and keeping it to herself, makes it less real.Her inability to talk about her diagnosis may be a factor of her need to control her life as an independent young woman and not wanting to ask for support with her illness sh ould be further explored. The Client System Functioning: April became defensive several times during this interview. She stated that she did not want to talk about her cancer diagnosis many times during the session. She expressed that she has been feeling tired and having trouble sleeping, experiencing night sweats and waking up in a soaked bed. Other than the above April appears to be still functioning at a high level nd is able to get to school and besides her recent assignments is doing fine at school. It should be noted that April appears physically to be in good health, she is a well-dressed, attractive young woman. She appears to be well spoken and intelligent, yet she is in denial about her illness. Strengths/Coping Skills: During this interview April was commended for her independence, also her loyalty towards her family was also a strength brought to her attention. April seems to have a strong support system, although she is not using it at the moment. She has family and fr iends who care about her.April’s ability to remain in school and continue on with her studies is also a strength to be noted. Her communication skills are well developed, even though she was unable to express herself in this meeting there is potential for it in the future. Relationships and Social Support: It is unclear what the extent of April’s relationship with her family, friends, or community is. As stated earlier, April is a very independent young woman and though she did mention her family in the interview, she has not told them about her illness as she does not want to put any stress on them.Further exploration regarding the depth and quality of her relationship is needed. During the interview, April expressed that she and her ex-boyfriend are still â€Å"good friends† and that they get along great. He however is unaware of her diagnosis. April mentioned she has other friends but no other details were provided. April seemed to take a liking to this worke r, and expressed being happy that this worker was older than she had expected. She seemed to have an easy time talking as long as she was guiding the conversation but closed up upon being asked questions she did not feel like answering.Resources/Obstacles: April acknowledged that she does not like to ask for help, she stated that she was able to go see a therapist at school. Though the sessions were quickly terminated they lead to her finding this practice and setting up an appointment. Although, she finds them inefficient, April identified the school’s health center and her oncologist as a present resource available to her. April mentioned her family but it is unclear if she sees them as a resource. She stated her brother suffers from autism and takes a lot of her mother’s time, and father is often busy.April also mentioned she has a good relationship with ex-boyfriend but acknowledged that she does not confide in him or her other friends. This suggests that April is used to fending for herself and her independence is an important resource to her. April’s need to control a situation presents as a obstacle for her, as she seems to close people off when they get too close to asking information she is not ready to share. This may have been the case with her previous therapist who she stopped seeing, claiming she was â€Å"incompetent†. April did not mention any other support systems.It is unclear if she has other individuals she can rely on and appears to have issues with relatedness. Professional Opinion April appears to be in denial about her diagnosis of stage three non-Hodgkin lymphoma and what it entails. April appears to be taking the diagnosis as a big inconvenience rather than recognizing the seriousness if holds. April has not began treatment, although her oncologist has recommended that she begin immediately. She appears to be an intelligent, independent, young woman; it is possible her apprehensions on sharing her diagnosis with family are related to her not wanting to lose her independence.April appears to be more concerned with what her family’s reactions to diagnosis will be and the stress it may cause them, rather than what the diagnosis means for her health. It is this workers opinion that April is used to taking care of herself and is fearful that her parents will not be there to support to her if she puts herself out there. April’s having chosen to look into alternative medical treatment, even with her oncologist’s advice to begin immediate treatment, shows her need to be in control of her life.It is this worker’s opinion that April is fearful of giving up the one thing she has depended on her entire life; her independence and ability to care for her. During the interview, April mentioned other relationships; her ex-boyfriend, his new girlfriend, and friends. While these people maybe able to provide support to her in the future, April is currently not ready to share her diagnosis or ask them for help. Plan An intervention plan was not created as April left without formulating a plan or scheduling a second session.However, it is this worker’s opinion that the following steps need to be taken; April needs to recognize that there is no shame in asking for help or relying on others in her time of need, April should talk to her oncologist about her considering alternative medicine and see how she thinks she should proceed, and April needs to tell her parents about her diagnosis. As she left without scheduling an appointment and this worker is unaware if she will call to schedule one, it is unclear of what will transpire. However, this plan will be further discussed with April if she does make a second appointment.

Never Let Me Go, By Kazuo Ishiguro - 1714 Words

We ask a question of who we are as both individuals and as humans are brought up in studies of addressing the crisis surrounding this subject area of science in regards to clones. In the novel â€Å"Never Let Me Go,† by Kazuo Ishiguro he addresses the issue about clones and how they grow up in an institution meant to get the students ready to conquer in a human environment. Ishiguro’s novel â€Å"Never Let Me Go† serves an approach to the â€Å"Cloning argument. In the novel a character named Kathy H was one of the primary ones who was cloned along with a few others. This helps us to answer the question of how clones should be treated in relation to human verses non-human concept, as Ishiguro attempts to define humanity through the eyes of Kathy H., a clone with experiences much like that of any ordinary human out there. 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Students Taking Online Courses On Campus - 902 Words

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Democracy and Majoritarianism - 955 Words

Democracy and how the government is run are behind theories. Majoritarianism is a theory of what both political scientist and ordinary citizens think the democracy should be. Unfortunately this is known as a poor way to find out data for elections through pulling data from Americans that may not be interested in politics or are unaware of the system. â€Å"Elite theory holds that society is ruled by small number of people who exercise power to further their own self-interest† (Schmidt, Shelley, Bardes, 2011). Elite theory is known as the American system. People prefer to have their country ran by elite people verse privileged minorities. The politics in pluralism can become a struggle for some and conflicts may be accommodated through†¦show more content†¦I feel that statement is not true. I feel that the elite theory best describes our American system. Our leaders have been recruited from the top at all aspects of our society and in our government. Not only through mass media, elections, debates, and theories, our leaders have been voted upon to lead us through what in hopes the majority of our nation wants. Our elite people such as our president, high ranking military officers, and key cabinet members prides themselves on democracy and always react in their best interest to support their key ideas and what they believe is what needs to be done effectively and efficiently in our system of government at the time. I am one person that I have to say that I am not educated on our political system. I am part of the statistics that I do not know who my running leader for congress, school systems, and other offices. It is unfortunate that I have not had an interest in politics. As I have aged I realize that it is important for me to understand how our government and political systems work as it impacts me and now my kids as well. I can honestly say that I have only voted one time for our president and that was around 10+ years ago and just recently I voted for some community chairs who I did not know anything about. I definitely can say that the people I surround myself with have impacted me on my choices when it comes to voting. I need to be more awareShow MoreRelatedElectoral Rules Functions : The Development And Maintenance Of Democracy1675 Words   |  7 PagesMajoritarian electoral rules function as the pragmatist’s approach to democracy by attempting to deliver tangible results while proportional representation aims to deliver the symbolic values of democracy such as equality and fairness. 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John Bulls Other Island by George Bernard Shaw free essay sample

Examines plays dramatic critique of cultural political issues from Marxist perspective. George Bernard Shaw wrote a number of what have come to be called philosophical comedies, and three of these/*Major Barbara, Man and Superman, and John Bulls Other Island have been viewed as a trilogy in this genre because all of them deal with the issue of the bankruptcy of nineteenth-century liberalism in the face of the prevailing forces of sex, nationalism, and poverty. John Bulls Other Island specifically represents a counter to the neo-Gaelic movement then under the leadership of William Butler Yeats. Indeed, the other island referred to in the title is Ireland, and John Bull is the name for the British government, much as we refer to the American government as Uncle Sam. Shaw does not make an overt Marxian appeal in this play, but his analysis of the exploitation of the Irish by the British demonstrates an understanding of the nature of Karl Marxs ideas

Leonardo da Vinci’s The Last Supper Essay Example

Leonardo da Vinci’s The Last Supper Essay Leonardo da Vinci’s famous oil painting, The Last Supper, depicts the Biblical story of Jesus’s last dinner with his disciples before his crucifixion.   The colors used by the artist are rich, deep reds, blues and other jewel tones contrasting with the darkness of shadows.   Although the picture historically has been thought to portray Jesus and the twelve disciples it appears that in fact, Mary Magdalene is the sole woman pictured with the group of men and is seated next to Jesus.   The lighting is focused to the right of the page, while the upper left corner is enclosed in shadows.   All of the men pictures are either looking or gesturing toward the figure of Jesus in the middle, making it obvious that he is the center of the image.   The faces are solemn, but all appear in conversation or interaction other than Jesus, who gravely looks down toward the table.   Bread and other small assorted items are laid upon the table and the sandal adorned feet of all are visible below the draping white tablecloth.   The objects such as walls, tables, etc other than the characters of the picture have sharp edges giving a contrast to the soft folds of the men and woman’s robes.Upon viewing the image, I have a feeling of somberness and importance.   Based upon the dark shadows, deep colors, looks upon the faces of all figures, there is a sullen overtone to the piece.   The feeling of importance stems from the focus upon Jesus at the center of the group.   Disbelief or confusion also seems to be evident in the expressions of several figures that are looking away but gesturing toward the center of the table with their hands.   The juxtaposition of Mary and Jesus at the center is very interesting.   As was referenced by Dan Brown in the novel, The da Vinci Code, Mary and Jesus appear to be mirror images of one another, both in their position, facial features, and coloring of garments.   Perhaps this is intended to represent some s ort of relationship between them.   Da Vinci seemed to intend this painting to be taken very seriously and to be a realistic depiction of this famous scene in the life of Christ.   The exact moment was intended to be the reaction of the apostles following the announcement by Jesus that one of them would betray him.   It was painted during the 1400’s in a Europe focused on Christianity and devoted much time and funding to promoting it.   The painting now hangs in a church in Milan where it may be viewed for only a short time, due to the work’s delicate nature and multiple needs for restoration.   The fact that is shown within a church, gives it even more weight in being a historical representation of what is regarded to be truth by the church.Being created during this religious era, the work was obviously influenced by the importance of Christianity in society at the time.   If the character, who appears to be Mary, is in fact her and not one of the disciple s, this would give that particular element of the picture a completely different meaning.   While it may not have been influenced by a particular belief of da Vinci’s that Mary was equally important to Jesus, as has been fictionalized, it may mean simply that da Vinci found her to have an important role in the last days of Christ.   It is important to be aware of both possibilities when viewing this work, so as to not be biased since there is no definitive answer regarding that figure’s sex.   However, how an individual perceives art will never be identical to another’s perception.   Thus, there is no exact meaning to attribute to this lack or existence of Mary.As a work of art, this painting has a high value.   It was composed by one of the greatest master artists of all time and is one of his most famous works.   The image is captured very realistically, and the use of color, tone, and figure placement adeptly conveys the tone and feeling.   The embodiment of an important part of Christianity and the fact that it has remained so highly regarded and admired 600 years after its rendering, only amplify The Last Supper’s value to the art community.