Teen Pregnancy Essay Example for Free

Teen Pregnancy Essay For countless years in America teen pregnancy has been an issue for many young girls between the ages of 13 and 19 years of age. Our nation is facing an adolescent reproductive crisis, because one in three girls are becoming pregnant before the age of 20 in the United States alone. More and more teens in the United States become pregnant annually. Most if not all-teen pregnancies are unplanned and never end in abortion. Some teenagers dont plan to get pregnant, but many do. However, Teen moms often don’t have the time to focus on education, which as a result are less likely to complete high school, or enroll in community college or a four-year university. According to Teen Pregnancy Prevention 2010–2015 (2013), â€Å"As part of the Presidents Teen Pregnancy Prevention Initiative (TPPI), CDC is partnering with the federal Office of the Assistant Secretary for Health (OASH) to reduce teenage pregnancy and address disparities in teen pregnancy and birth rates. The OASH Office of Adolescent Health (OAH) is supporting public and private entities to fund medically accurate and age appropriate evidence-based or innovative program models to reduce teen pregnancy. The purpose of this program is to demonstrate the effectiveness of innovative, multicomponent, communitywide initiatives in reducing rates of teen pregnancy and births in communities with the highest rates, with a focus on reaching African American and Latino/Hispanic youth aged 15–19 years. A communitywide model is an intervention implemented in defined communities (specified geographic area) applying a common approach with different strategies. Communitywide approaches will be tailored to the specified community, and will include broad-based strategies that reach a majority of youth in the community (i. e. , through communication strategies and media campaigns); and intensive strategies reaching youth most in need of prevention programming (i. . , through implementation of evidence-based programs and improved links to services). † Pro-Choice America has long advocated for a more sensible approach to the issue of teen pregnancy programs, better access to birth control, and investing in critical after-school programs. These interventions over the next few years will reduce rates of teen pregnancy and promote more responsible behavior.

Analysing The Virtue Of Patience Philosophy Essay

Analysing The Virtue Of Patience Philosophy Essay In today s fast paced world, where things happen with click of a button, we are growing inpatient. Gone are the days when people were patient enough to wait for days for the computer to produce the results, today we expect things to happen at speed of thought. We want success, money, happiness instantly without waiting, but alas! Ask any successful person and you will know the virtue of patience. Ancient wisdom like Bhagwat Gita has recognized importance of patience through quotes like Little by little, through patience and repeated effort, the mind will become stilled in the Self. If we examine our self as a part of nature we will realize that even nature creates change very slowly and is extremely patient. Ralph Waldo Emerson perhaps said it best in one simple line:Adopt the pace of nature, her secret is patience and that patience can improve life and bring it closer to perfection if you understand nature and work with it patiently. Nature exhibits patience in various forms. For example: considering the growth of seeds into trees- when we plant a seed and water it, it slowly turns into a flower and then into a fruit. The seed had to be planted, watered, and then be given time to grow into what it is meant to be. Without prior efforts and in absence of planting or watering or the nurturing the seed would not have sprung above the surface. It could not develop into its current form without all that patience, time and efforts. In order to be able to achieve success or any goals we set we have to practice patience. Patience is different from waiting. instead we have to do the work first, lay the foundation, plant the seed, make sure the soil is right prepare get ready and then wait for all the elements to come into place before making the right decision that will drive us to greater success. Conceptual Framework Definition: word web defines patience as Good-natured tolerance of delay or incompetence . Other sources like Webster define patience as patience is the state of endurance under difficult circumstances. It is also used to refer to the character trait of being steadfast. From the above definitions we can deduce that patience is a state of persevering in case things take time or get delayed without negatively reacting or becoming sad or feeling provocated, or exhibiting patience when faced with difficulties which take a long time. Scope: This study focuses on importance of patience on individual and group behavior and performance. Importance of patience will be studied in two dimensions, first is the patience of waiting for a certain time period to end. This is perhaps what we normally mean when we use the term patience. Second, it is keeping one s mind free of distractions. It is perhaps only important when one is trying using one s mind on an important task that does not compel one s emotions. Methodology: Individuals will be interviewed independently to access the implication of the patience in day to day life and performance professional life. Implications of patience on group performance would be projected based on the study and observations in general. Five people will be separately interviewed with diverse profiles across age and profession. They include 3 students, one housewife and a bank officer. The reason for choosing people with different profile is to find out whether patience is a quality consistent across profession or does it vary across gender or work environment. Review of Literature: Patience: A Little Book of Inner Strength (Eknath Easwaran): the excerpts of the book giving its epitome are now quoted below- Patience is the ornament of the brave, Easwaran s wise grandmother used to say. In relationships, patience is the mark of love. An experienced spiritual teacher who combines humor with practicality, Easwaran gives powerful insights and sometimes surprising advice for developing patience at home and at work. Stories offer quiet interludes throughout this little book. Anecdotes about animals, sports stars, and happy family outings make these short, varied readings as entertaining as they are instructive. Gentle reminiscences of India, tales from Easwaran s Hindu heritage, and inspiration from Gandhi and the world s saints lift our spirits and give us courage. Just keep trying, Easwaran says, and you ll find there s no end to your patience no end to the wisdom, love, and compassion in your heart. Economist Magazine http://www.economist.com/science/displaystory.cfm?story_id=9898270: This article elaborates- Studies conducted to correlate subtle human traits such as patience and fairness with that to closest evolutionary relatives of human, apes such as chimpanzee. The article mentions that the essence of patience is the ability to delay the gratification of an appetite in favor of a greater ultimate reward. Past tests of the degree to which animals other than people can delay their gratification have focused on birds and monkeys. Both groups can delay gratification if a bigger reward is on offer, but only for a few seconds. Human, All Too Human: in this paper, philosopher Friedrich Nietzsche argued that -Being able to wait is so hard that the greatest poets did not disdain to make the inability to wait the theme of their poetry. He notes that Passion will not wait, and gives the example of cases of duels, in which the advising friends have to determine whether the parties involved might be able to wait a while longer. If they cannot, then a duel is reasonable [because]to wait would be to continue suffering the horrible torture of offended honor. Patience and Religion: Source: Wikipedia.org: Patience is one of most important virtue as recognized by most of the important religions. o Judaism: Patience and fortitude are prominent themes in Judaism. The Talmud extols patience as an important personal trait. o Christianity: In the Christian religion, patience is considered as a very valuable virtue that it propagates people to imbibe. Increasing patience is viewed as the work of the Holy Ghost in the Christianity. This holy God who has accepted the gift of salvation. Patience is also regarded as one of the seven virtues in Christianity which are- -alongside chastity, -temperance, -charity, -diligence, -kindness, and -humility o Islam: Patience in Islam is one of the best and most valuable virtues of life. Through patience, a Muslim believes that an individual can grow closer to Allah and thus attain true peace. o Eastern Religion: In Buddhism, patience (Skt.: kshanti; Pali: khanti) is one of the perfections that a bodhisattva trains in and practices to realize perfect enlightenment also known as Bodhi. Patience is also praised in Hinduism, particularly in the Bhagavad Gita. In both Hinduism and Buddhism there is a particular emphasis on meditation which leads to patience, and an effective and well-organized thought. Healing Anger: The Power of Patience from a Buddhist Perspective: This book is written by Dalai Lama. In this book he has attempted to address the issue of anger. He argues that the issue of anger can be remedied through patience. He has suggested some meditation practices even for novice people. The book seems to be hard to follow if one is not much familiar with Buddhist scripture. Empirical Study and Generalization: Data Collection method employed: Interview. To study the implication of patience on individuals, I carried interview of individuals with different social and professional background. The interview consisted set of 10 questions and the answers were first recorded and then analysed to take cues and then finding the similarities and dissimilarities across the answers of the interviewees. The 10 questions used for this study are given below- Q1. Do you get fidgety if things that you want do not happen or take a lot of time to happen? Q2. Why do you behave the way you do? Q3. Are you patient in every situation alike or does your behavior depends on some factors? Q4. Do you think being patient helps? Q5. Whenever you are patient is it because you feel it will help make things right i.e. had you known that situation is surely going to worsen and you can t help in a situation will you still try to be patient? Q6. Did you develop patience over the course of your life because of certain incidents/ experiences or have you always been patient Q7. How do you react if someone is being impatient or restless in front of you? Q8. What is your impact on others when they behave impatiently, do you find success in convincing them about not being impatient? Q9. Do you take any efforts to be more patient (like meditating, yoga etc?) Q10. When are you normally more impatient? When anticipating good things or when you feel bad things may happen Findings of study and Generalization Interviewee A: This person appears to be impatient; she understands the importance of patience and is ready to help others if they are impatient. She lacks the motivation to be patient but would like to earn techniques like yoga to get self control. She would need to learn meditation, self motivation to act patient in good and bad situation. Interviewee B: This person appears more patient than the others. He has developed his patience over the course of life. He is firm believer in god and has learned to accept which are beyond control. He values personal relationships over materialism and hence whatever impatience he experiences is only confined to personal matters which are close to his heart. Interviewee C: She practices yoga to gain self control. She has developed patience after shouldering the responsibility of younger siblings. She appears to accept good thing and do not show over enthusiasm. She needs to learn to help other impatient people. She knows her level of patience and has clear goals and targets. Interviewee D: She being housewife has more care about family. She has accepted her role as homemaker and believes in letting others take the decision; this acceptance has made her more patient in non family matters. Interviewee E: She gets impatient if her activities make trouble to others. She has followed mentor approach for encouragement. She shows acceptance for the things beyond control and tries to be aloof from them. Generalizations- Above analysis shows that people show various degree of patience. Their profession, experience, age and family has considerable impact on how they learn to accept the thing and get along with the problems. There is awareness about the techniques to develop patience in all the age groups but people normally don t follow them as they don t get time or are unable to manage their time for it. Personal problems have more impact on the level of patience and this trait appears to be common among respondents. Similarly Bad incidents have more impact on patience than good .Mostly there is a willingness to help others in case of trouble. I also deduced that normally patience is a trait that can be acquired and developed over the course of time. People find motivation to become patience on seeing the negative repercussions of being impatient that they experienced in their past or saw people experience in their past. They also find motivation by looking at the positive effects that patience as a virtue brings along. It was also seen that patient people are better at convincing others or making them feel calmer as compared to impatient people. Lastly a surprising finding was that people normally behave patiently because they feel it will help them achieve their immediate goals and not because it is a part of their intricate nature. i.e the desire to be patient is more driven by its perceived benefits than by the fact that it is a established virtue. Implication of Group Work: Patience is one of the one of the most important virtue to possess. Patience can have positive impact on individual and hence group performance. Being haste to get results hampers the ability of an individual to consider all the possible option for solution of a problem. It often leads to suboptimum choice and hence failure. Being patient does not means more time, but it s an emotional state wherein individual is not concerned about the quick output at cost of quality or effectiveness. Patience is the ability to perceive hard enough till desired output is obtained. All the major scientific breakthroughs had lot of hard work and patience behind it. Patience plays major role in negotiations, which demands a win-win situation for the negotiating parties. Individuals need to develop patience by assessing their current level of patience. One needs to set the goals and work hard enough to achieve them. Impatient people are often o Dissatisfied o Withdraw prematurely in jobs, relationships etc o Feel overwhelmed by the goals and lose motivation When one grows patient stress is reduced and one enjoys the process of accomplishments without getting overwhelmed by the time. It makes individual to relax and develop healthy lifestyle and achieve effectively. Individuals when work in group, the leader need to be patient and motivate the others to be patient in achieving group objectives. Impatient leader cause hasty actions by group which often is destructive and may cause delay or disorientation from group objectives. Patience is thus one of the most valuable qualities to possess for betterment of an individual and society. Contribution to OB Patience leads to a stable mind which is better at concentrating, and hence indirectly patience is related to a positive work performance. Its impact on job performance and hence satisfaction makes it a very important topic of study from the point of view of organizational behaviour. From this study, I have established that even impatient people perceive the value of being patient and that patience can be inculcated by various means like meditating, practicing yoga or by following positive reinforcement for people who are already patient. This study is a contribution to OB as it forms a base which can be further built upon by conducting further research on effectiveness of the techniques to establish patience and how to maximize the gains or benefits that one derives out of being patient in a organization. Conclusion: Time is subjective. When one is one is enjoying the time flies. In suffering time seems forever and leads to impatience and grief. Patience makes one to learn acceptance and overcome the grief. Being patient can have positive results in ones professional, personal and spiritual life. Patience can be learnt through religious techniques such as meditation. Patience is in nature, look around in nature and observe how life takes form. And hence why should we be unnatural by following impatience when we can instead be patient and experience all the benefits associated with it.

One to One Communication :: Communication Body Language Health Care Essays

One to One Communication To practice one to one communication I spoke to someone who regularly attends the ‘Princess of Wales’ Hospital, Bridgend for physiotherapy on his knee after an operation 6 months ago. From this interaction I found that the service from the NHS was satisfactory and adequate, but could use some improvements. I spoke to the patient mainly about waiting times for appointments and operations, as that appeared to be the main cause for concern. I conducted the one to one interaction in the patient’s living room, so that the surroundings were familiar to him and he would feel more at ease. As the room was decorated in warm colours it created a welcoming and relaxed atmosphere, which contributed to making it easier to open up and talk freely. Skill Used ========== Comment ======= Body language I used open and friendly body language towards the client and didn’t cross my arms or anything so that I didn’t come across as intimidating. This is because body language makes a great impact on interaction. Gestures I regularly used hand gestures to put emphasis on what I was saying as gestures are a strong part of effective communication. Eye contact I regularly maintained eye contact with the client during my interaction. This helped to show that I was interested in what he had to say and also so that he knew when it was his turn to speak. Facial expressions I used appropriate facial expressions to match my topic of conversation so not to confuse the client, and to show interest in what he had to say. Open questions Open questions require extended answers and make the client feel that their opinions are valued. I tried to use mostly open questions to facilitate the conversation and so that the conversation flowed and did not feel like an interrogation. Closed questions I tried not to ask many closed questions, unless I needed more specific information, as they can make people feel uncomfortable and inhibit conversation. Probes and prompts I used probes and prompts to make the client give more in depth information and to help him to think more about the subject that I was questioning them on. I used prompts to help the client understand what I was asking by suggesting a possible answer. Paraphrasing To check that I had heard and understood the client properly I used paraphrasing as a way of reflecting back to him. Paraphrasing also helped him to clarify exactly what it is they were saying, because he had to listen to the paraphrase and work out whether that is what he meant to say. The particular individuals involved, the relationship between the individuals, the subject of the communication and the physical

The Characters Hidden Values and Needs in To The Lighthouse Essay

The Characters Hidden Values and Needs in To The Lighthouse  Ã‚   Woolf's chosen role as an author is to uncover the hidden values and needs of her characters' psychologies, and by extension of this, those of her readers — each frequent realization of the character's is a real and vividly personal epiphany, the like of which 'real-life' persons do not have such a feel for on a day-to-day basis; the characters are in a very real sense perhaps too self-aware to be considered 'real'. (Tansley and Lily at the dinner table each understand their situations perfectly.) The underlying message Woolf seems to be seeking to present is that this self-knowledge is not necessarily inherently of any worth — Tansley, for instance, is unable to control his desire to subjugate others in his own mind to prop up his own insecure self-esteem; his realization of this fact is not an empowerment to alter the fact. Lily feels restrained in a similar fashion; years after their utterance, Tansley's words (p94) "women can't write, women can't paint", though cush ioned with the knowledge that "clearly it was not true to him but for some reason helpful" (also p94), still cannot be completely discounted from her mind. Lily's struggle to marshall her memories into a cohesive and enduring monument of canvas is a metaphor for the intensity of human experience; the significance being that ultimately it does not matter — for that intensity will not be retained even then, no matter the struggle; once captured the reality of the situation fades, and it is time to 'move on'. Her efforts are symbolic of the inability for the power of memories and emotions to be lastingly captured — so strong is this urge that her desire to imprint a meaning upon events perpetuate... ...have been more verbose and less nebulous in form ("in MS ... more explanation is given" p233, "in MS, Tansley's atheism is more emphasized and contrasted with Lily's belief" p227 — and there are records of many other editing outs or 'smoothing' revision.) It is not difficult to imagine that Woolf would have been exceptionally gratified by a comment which she made about another author in a critical essay: that a work offered (p248) "a complete presentation of life ... as always [he] creates carelessly, without a word of comment, as if the parts grew together without his willing it, and broke into ruin again without his caring." Woolf's version is more forced; but perhaps this is what is necessary for a work of such questing magnitude. Seeming spontaneity requires patience. Works Cited Virginia Woolf, To The Lighthouse, Penguin Twentieth Century Classics, 1992

Works of Howard Phillips Lovecraft Essay -- Howard Phillips Lovecraft

Works of Howard Phillips Lovecraft It is morning on August 20, 1890 and the world of literature is about to change, though it will not understand just how much so for decades. It is on this morning that a precocious child, Howard Phillips Lovecraft, is born. Lovecraft would begin his writing career at the tender age of six with his short story â€Å"The Noble Eavesdropper†. He would grow up to be well read and well learned (he was producing scientific journals for his friends at age nine), despite never finishing high school (Joshi para 1- 4). Now, nearly three quarters of a century after his death, he still influences the genres of horror, science fiction, and fantasy. His influence can be felt in the creations of Robert Bloch (Psycho), Stephen King (The Dark Half, et al), Neil Gaiman (Sandman, The Day I Sold My Dad for Two Fish), and Alan Moore (Watchmen, From Hell). (Wikipedia: Lovecraft para 1-2) How can one man influence so many, and not just in the genres of fiction? A simple internet search will reveal site after site devoted to the works of HP Lovecraft, the creatures of his creation, and the mysterious Necronomicon. This last is especially interesting as many of those sites recount the significance of this tome to magical and spiritual endeavors. In fact, books claiming to be English translations can be purchased online and in bookstores. It is, of course, purely fictitious. The writer of the tome, one Abdul Alhazred, was a name that Lovecraft had created at the age of five because of his fascination with Arabian Nights. (Straub 831) So what is it about his works that they have such an effect that people would believe a work of fiction to be real? Could he indeed be a conduit of greater myster... ...e faith. Bibliography Fonda, Marc. â€Å"Fonda’s Jung Notes: Summary of Jung’s Psychology.† Notes on CG Jung. 8 December 1996. 6 December 2005. Joshi, S.T. â€Å"Howard Phillips Lovecraft: The Life of a Gentleman of Providence.† The HP Lovecraft Archive. 13 April 2004. 6 December 2005. â€Å"Lovecraft’s Influence In Popular Culture from: Lovecraft.† WikiPedia, the Free Encyclopedia. 5 December 2005. 6 December 2005. Lowell, Mark. â€Å"Lovecraft’s CTHULHU MYTHOS.† Explicator Fall 2004. 6 December 2005. Database: Academic Search Premier. P 48 â€Å"Monomyth.† WikiPedia, the Free Encyclopedia. 6 December 2005. 6 December 2005. Straub, Peter ed. HP Lovecraft: Tales. New York: Literary Classics of the United States, 2005. pg 831 and text quotations for â€Å"The Thing on the Doorstep†

Nursing Case Studies on COPD

In this reflective piece of writing I will be explaining how chronic obstructive pulmonary disease (COPD) affects the patient physically, psychologically ,and socially ,I will also explain how the disease affects his daily routine and how it impacts on his family life. I will give an overview of the clinical signs and symptoms, how the disease alters the pathphysiology of the lungs, and what these changes cause within the body. I will be using the reflective model â€Å"What, So What, Now What â€Å" (2007). The patient I have chosen to write about is a seventy year old male who has been married for nearly fifty years. He has two grown up sons, both married with children of their own. Mr Woods has Chronic Obstructive Pulmonary Disease diagnosed ten years ago. Prior to this disease Mr Woods was a lifelong smoker, beginning at the age of fourteen years, smoking up to thirty cigarettes per day. Mr Woods condition has progressively worsened over the past few years, and he now requires home oxygen therapy. A patient was brought into the emergency department by the paramedics complaining of difficulty in breathing. On arrival he was tachypnoeic, had a respiratory rate thirty two and was found to have an audible wheeze. He stated that he had a productive cough and was expectorating green coloured sputum. The patient felt warm to touch. He looked pale, was sat upright, slightly leaning forward in a rigid posture on the ambulance stretcher. I was delegated the role of undertaking Mr Wood’s initial assessment, which included ensuring the patient was undressed ready for examination by a doctor, and also carrying out a baseline set of observations. I was happy to undertake this task, because I had the required training, skills and was deemed competent to carry out the necessary care required to look after Mr Woods. The nurse in charge informed me of Mr Woods medical history prior to me entering the cubicle, including what had precipitated his attendance to the emergency department which on that particular day had been his worsening shortness of breath. On entering the cubicle, I helped Mr Woods get undressed and into a hospital gown because any slight exertion made him more short of breath. I carried out a baseline set of observations. His blood pressure was 165/95, he had a pulse rate of 125 beats per minute, a temperature of 38. c, a respiratory rate of 32, on 2 litres of oxygen his saturation level was 88%, and his blood glucose level was 4. 4mmol/l. Although some of these observations are not within ‘normal’ range, for a person with COPD some of these observations maybe acceptable because the disease affects the path physiology of the lungs. The airways leading to the lungs, the bronchi, become inflamed. The inflamed airways produce too much mucus (sputum) which can lead to a p ersistent cough, wheeze and increasing shortness of breath. This happens because the air sacs (alveoli) become overstretched, rupture and merge which causes them to lose their elasticity. This causes the oxygen absorbing surfaces to be reduced, and with the narrowing of the airways gas exchange is less efficient (Parker, 2009). The lungs over inflate which reduces the air volume moving in and out of the lungs which can lead to tachypnoea (abnormally rapid rate of breathing), breathlessness on exertion, respiratory distress, abnormal posture I. e. leaning forward to help open the airways (Nursing Standard, 2001). Patients with Chronic Obstructive Pulmonary Disease can have a tendency to have low oxygen saturation levels, usually around 88% on air. In healthy patients their levels are usually between 95%- 100%. COPD patients often need supportive treatment of 2 litres of oxygen to maintain oxygen saturations normally acceptable for that specific patient. However oxygen therapy higher than 2 litres may cause their carbon dioxide (CO2) levels to rise (Abrahams, 2009). As Mr Woods COPD had progressively worsened he had been commenced on home oxygen which he uses throughout most of the day. This helps him to undertake the most simplistic of daily activities of living. Mr Woods lives at home with his wife who, due to the impact of this disease on Mr Woods, has now become his main carer. She helps her husband with his daily activities such as washing, showering and preparing his meals. He needs help mobilising to the downstairs shower room, and, once there, needs assistance to get undressed. Whilst in the shower room Mr Woods needs to sit on a shower stool because he cannot manage to stand for any length of time due to breathlessness. He is also unable to walk upstairs because he gets short of breath on exertion so he has had a stair lift installed which enables him to go upstairs to bed. This enables Mr and Mrs Woods to fulfil both the physical and psychological aspects of their relationship. COPD can affect the psychological wellbeing of the sufferer. Before Mr Woods condition deteriorated he was able to go out, he used to enjoy going fishing with his sons and playing with his grandchildren. Because of his condition, Mr Woods is prone to feelings of inadequacy and depression. He also feels guilty because of his growing dependency on his wife for the simplest of daily tasks such as making a cup of tea or answering the door. Because of the growing demands of her husband’s worsening condition Mrs Woods now has to depend on other family members to facilitate her with tasks that Mr Woods can no longer undertake due to his COPD, and frequent visits to the hospital with recurrent chest infections. Whilst Mr Woods was in the emergency department it was my responsibility to make sure Mr Woods was comfortable and that his observations were done regularly and documented. I was happy to do this as I am deemed competent and have the required training to carry out these duties. I made sure Mr Woods was sitting upright as this would help him with his breathing by improving his lung capacity and making sure oxygen was prescribed by the doctor and administered via nasal cannulae as per trust policy. I noticed Mr Woods remained tachyponeic, so repeated his observations. Even though on 2 litres of oxygen his saturation levels still remained low so I informed the nurse in charge that Mr Woods observations remained unstable. A doctor was notified and the patient assessed which involved listening to his chest. The doctor then prescribed nebulisers, oral steroids and paracetamol. A chest x-ray was also requested. I had to ask a qualified member of staff to administer Mr Woods medication, because I am not qualified to dispense drugs to a patient as a student assistant practitioner as this does not fall within my scope of practice or within the boundaries of my role. I think the fact I know my limitations and boundaries make me a safe practitioner. I made sure I had documented Mr Woods observations and that I had informed the nurse in charge of his condition making sure that I had dated, timed and signed what I had written. I got my documentation countersigned by a qualified member of staff as stated by the Nursing and Midwifery Council (NMC, 2008). The doctor asked me to cannulate and take some blood from Mr Woods. I was comfortable with this request because I am qualified to undertake the task. I explained to Mr Woods that I needed to put a needle in his arm and take some blood and that I would be leaving the cannula in his arm for any medication his may require later. I put the equipment together that I needed to cannulate, making sure that it was on a clean trolley and that I had a sharps bin. I then washed my hands, put on my apron and gloves following universal precautions. I then proceeded to cannulate Mr Woods explaining everything I was doing throughout the procedure. Once the cannula was in I disposed of my sharp in the sharps bin and put my dirty equipment in the clinical waste and then washed my hands. Mr Woods was then taken for his x-ray. Once labelled I then gave the blood to the doctor to send of to the path lab. I then filled in the cannulation documentation form as per hospital trust policy. I was pleased that I managed to get the cannula in on my first attempt because Mr Woods had terrible veins and I did not like the thought of having to put him through the procedure again as it can be quite painful and distressing. Mr Woods x-ray showed he had a chest infection for which he was prescribed intravenous antibiotics. Mr Woods was then transferred to the Medical Assessment Unit for further treatment by the medical doctors. Reflecting back I believe I have developed my knowledge about chronic obstructive pulmonary disease. Reading articles, text books and trust policies on COPD has allowed my to enhance my ability to recognise when patients are clinically unwell and have the confidence to highlight these abnormalities to the relevant members of the multidisciplinary team I. e. the nurse in charge and doctor, so the patient can be managed promptly and appropriately. Also the information I gained from talking to Mr Woods was invaluable in allowing me to gain insight and therefore a greater understanding of how the disease affected not only the patient but also his family on a day to day basis. Witnessing first hand the debilitating affects the disease process has on an individual such as Mr Woods and his family left me feeling a little sad due to the fact that my role as a student assistant practitioner limited my involvement in his treatment. Having been the first member of staff to attend to Mr Woods on his arrival to the department and to have spent time developing a therapeutic relationship with him I felt that involving another member of staff to carry out an aspect of care may make him question my abilities to look after him as I could not administer his medication. I could address this issue by explaining to the patient that my role as student assistant practitioner does not allow me to give medication but explain that I am competent in carrying out all other aspects of care. Developing my existing knowledge on the psychological and physiological affects of Chronic Obstructive Pulmonary Disease has been consolidated by caring for a patient that has attended the emergency department with this chronic long term condition. Extending my knowledge base on this condition and the long term effects it can have on the individual will ensure that I treat each patient on their needs rather than just on their condition. Also looking back on this assessment I believe I acted professionally, promptly and efficiently. I feel I carried out my duties to a high standard of care within the boundaries of my role as a student assistant practitioner which in turn enabled Mr Woods to receive the treatment and medication he required to ensure the best possible outcome. Looking after Mr Woods has shown that I can work effectively as a member of the multidisciplinary team. I am able to assess, implement and evaluate my care which has enabled other members of staff to witness my holistic and high level of care delivery within the emergency department. I believe this can benefit not only the patients attending the department but also help develop my role within the team.

Bite Me: A Love Story Chapter 21

21. Being the Chronicles of Abby Normal: The Mopey Monosexuality of an Outcast Cutie Corpse Much like the guy in Herman Hesse's novel Steppenwolf (which everyone knows means, â€Å"wolf going up the steps†) who runs into the ENTRANCE NOT FOR EVERYBODY sign outside of the Magic Theater, when it comes to romance, I am definitely not on the list. Loneliness is my â€Å"plus one.† Bitterness is my boo. Oh, it was sweet waking up at sundown, nearly in the arms of my Dark Lord, snuggled up in our utility shed on the roof. I probably shouldn't have snatched that pigeon out from under the eave and sort of sucked its little throat, but in my defense, breakfast is the most important meal of the day, and I swore off anything with feathers because they are nasty. Still, I think Lord Flood would have forgiven me spitting bloody feathers on his linen trousers if my tail hadn't harshed our search plan. There, now everyone knows. I have a tail. Which is kinda the reason we had to return to the love lair instead of continuing our search for the Countess. Foo called just before sunup to say that all the rats had died. So I'm like, â€Å"Non sequitur much, Foo? If you miss me, you can just apologize and grovel a little and we'll move on.† And he's like, â€Å"No, Abby, you don't understand. There's something in their DNA, they just sort of expire after a week or so of being a vampyre.† And I'm like, â€Å"My poor, sad Foo Dog, are you sure that your mantenna isn't just using dead rats to send an S.O.S. for a return to tuna town? Hmmmm?† And he's all, â€Å"No, Abby, you have rat DNA tied in with your vampirism, the same way Chet has human DNA.† And I'm all, â€Å"Nuh-uh.† And he's all, â€Å"You have to come back here. Abby, I know you have a tail.† And I'm like, â€Å"Fucksocks,† and I offed my phone. So when Flood and I come to in the shed on the roof, I'm like, â€Å"We may need to check in with Foo.† And Flood is like, â€Å"Call him and tell him that there are old vampyres here to clean up. He needs to be ready. We'll be there in a few minutes.† And I'm like, â€Å"I'll text him. I'm not speaking to him right now.† So, like, Tommy showed me how you couldn't run too fast, or someone would notice something was up, so you had to sort of go in bursts and I wasn't supposed to jump over cars and whatnot because that shit is a dead giveaway that you are nosferatu. Although I did â€Å"rawr† some tourists on the cable car, because they needed it. And if you ask them they will all be, â€Å"She was trs scary, and back in Cowfuck, Nebraska, we know that ‘rawr' is totally a thing because we have family values and whatnot.† So after running in bursts for like three blocks I rawred down a cab that was halted by my awesome dark powers and the hundred-dollar bill I was waving, and we rode to the love lair, where Jared let us in. And Jared was all, â€Å"OMG, OMG, OMFG, Abs, the rats are dead!† And I'm like, â€Å"Not news. Awesome vamp robot pirate ship, equals news.† And Jared is like, â€Å"For realz?† And I'm like, â€Å"Totes.† And he kind of does a gayboy squee that was a little embarrassing, so I'm all, â€Å"Where's Foo?† And Foo comes out of the bedroom and I go to kiss him and he sort of stops and holds up his little blood vials, like, â€Å"Oh, no kisses, Abby, I have breakables.† So I backed off. And he's like, â€Å"Abby we need to change you back. Right away.† And I'm like, â€Å"No way, Foo. I am finished with your petty human weakness.† And he like waves to all the rat boxes, and all the rats are just lying in the bottom of them. And I'm all, â€Å"So?† And Foo's like, â€Å"They just dropped, within hours of each other. There's some incompatibility with the vampyre virus.† â€Å"It's a virus?† goes Tommy. And Foo's all, â€Å"I don't know exactly what it is, but it binds to the host DNA and it carries the DNA to the infected.† And I'm like, â€Å"So?† And that's when Foo blurts out that I have a tail to Flood, and I just want to crawl in a hole and die, except for it being redundant. Then Jared's like, â€Å"Would you guys like something to drink? Some blood or something?† And I'm like, â€Å"No thanks, I had a pigeon.† And Flood is like, â€Å"Yes, I'll have some.† And he's about to take a sip from a wineglass that Jared poured, and I see his fangs, which are trs sexy now that he's not ripping my throat out with them, and he's like, â€Å"Oh, Abby, if this turns out to be drugged, tear Steve's arms off.† And I'm like, â€Å"‘Kay,† then to Foo, I'm like, â€Å"Rawr. Shut up.† And Foo's like, â€Å"It's not drugged.† So we tell Foo and Jared about the ship and the old vampyres and how they are here to clean house, and about what the Kona guy said about second generation vampyres. And Foo's like, â€Å"That's you, Tommy.† And Flood is like, â€Å"I know. I have to find Jody. And you and Jared need to get away from this apartment. Go somewhere, stay until you hear it's all clear or the Raven leaves.† And Foo is like, â€Å"How did you think to go to the dock anyway?† So we told him about Madame Natasha and the sunken ship in the north end of the City and whatnot, and he's all rolling his eyes, because he doesn't believe in magic, despite the fact that he's rolling his eyes at two vampyres. And he's like, â€Å"Did you try the Sunken Ship?† And we're like, â€Å"Whaaaa?† And he's like, â€Å"It's a bar down on Jackson Street. It was built on top of one of the Gold Rush ships that was abandoned there. You can still see the ribs of the ship in the basement.† And Flood's like, â€Å"The Sunken Ship? That's what it's called?† And I'm like, â€Å"Kind of obvious.† And Flood's like, â€Å"We need to go there.† And Foo's all, â€Å"No, I have to change you both back. You could drop any minute.† So I go, â€Å"As if. We have to find the Countess.† And Tommy's all, â€Å"After. All that after.† So Foo goes, â€Å"Well, then take these.† And he gives Flood and me each a thing that looks like an aluminum flashlight with a blue glass erection. And I'm all, â€Å"Uh, we can see in the dark, and heat, and we have someone on retainer who can see into the future, so, thanks, but†¦Ã¢â‚¬  â€Å"They're UV lasers,† goes Foo, in the middle of my dismissal. â€Å"They use them to fuse UV sensitive polymers in vacuum chambers.† And Tommy looks at me like, â€Å"What?† And I look at him like, â€Å"No fucking idea.† So Foo runs on like, â€Å"They would just burn me or Jared if you held it on us, like a high-intensity sunlamp. But you'd have to hold it there for about five seconds.† So Flood looks at me like, â€Å"What?† And I look at him like, â€Å"I got nothing.† So Foo takes Tommy's flashlight from him and he goes, â€Å"Like this.† And he points the flashlight at one of the dead rat boxes and it busts out with this intense blue beam and whoosh instant rat charcoal. So Flood and I are like, â€Å"Oh.† â€Å"You can't just leave them on like the UV jackets. They work with a capacitor that builds a charge and lets go with a two-second burst, but you can probably cut a vamp in half in that time. I made them for Rivera and Cavuto.† And Tommy goes, â€Å"Well don't give one to them, for fuck's sake, they're hunting me and Jody.† â€Å"And me,† I go. â€Å"And me,† goes Jared. And we look at him. And he goes, â€Å"Not because I'm a vampyre. Because that big cop hates me.† Then he looked embarrassed and he goes, â€Å"Hey, you guys, your eyes are bleeding.† And I look at Tommy and I'm all, â€Å"WTF?† And Foo's like, â€Å"You guys should probably wear sun-glasses with UV filtering if you're going to use those, or, you know, they could hurt your eyes.† So Flood's like, â€Å"Good to know.† And Foo's like, â€Å"You should know that they can't go to mist if they're hurt or under exposure to any significant UV. I tested it with the rats. Which means you can't either.† And we're all, â€Å"Uh-huh.† And he's like, â€Å"What will you do?† And Flood is like, â€Å"We're going to the Sunken Ship and see if we can find Jody, and then I guess we're going to see if we can get on a pirate ship. What about you?† â€Å"I have to break the lab down first, but I know some guys in my program at Berkeley that have an extra room. I can stay there.† And Flood is like, â€Å"Take Jared with you. Elijah saw him. Anyone Elijah knows or who knew about him is in danger.† And Jared is all, â€Å"Nooooo, Berkeley is way too butch.† So I ‘splain to Tommy, â€Å"Jared is afraid of butch lesbians. They were invented in Berkeley.† And Foo is like looking at Jared, and looking at me, and looking at Flood, and looking at his dead rats, and he's all, â€Å"Can't you at least leave Abby here and let me change her back?† And Flood looks at me and I'm all, â€Å"Bitch, please, I have a light sabre.† And I grabbed Foo and kissed him hard, but I could feel him pulling away. And he's like, â€Å"Abby, after this is over-â€Å" And I'm like, finger on his lips, â€Å"Shh, shh, shh, Foo. Do not awkwardize the moment with sniveling. I've been preparing my whole life for this.† And I have. So we jammed. And outside Flood is like, â€Å"You okay?† And I'm all, â€Å"Yeah. Do you think I'm a freak because I have a tail?† And he's all, â€Å"No, not because of that.† Which was awesome for him to say. So we did the low-profile walk to Walgreens, where we bought three pairs of sunglasses and a disposable cell phone for Tommy and I got some Gummi bears, which I am dipping in blood and eating now-biting off their little bear heads. Then we go over to the financial district and we find the bar called the Sunken Ship on Jackson Street in the old section, and there's a big picture of a sailing ship, and THE SUNKEN SHIP is carved in big letters, and we're not two blocks from the roof where we spent the night, and I'm all, â€Å"Oops.† And Flood is like, â€Å"Now what?† And I'm like, â€Å"Don't you have fake ID?† I was kind of fucking with him for pretending to be five hundred years old when we first met, when he's only nineteen. And he's like, â€Å"No, do you?† â€Å"Yeah. Like six of them. I'll go in and look around.† And he's like, â€Å"Okay.† So I start to go inside, where all these suits and citizens are, and I hear, â€Å"Hey,† a girl's voice. Quiet, but like she knows we can hear. And it's the Countess, palming a door shut on this below-street apartment. And she's in like black jeans carrying a pair of Nikes, but her hair is all glorious, and in like an instant she's up over the rail, not even touching the stairs, and in Tommy's arms. And it was beautiful, and sad, and I felt my heart break, but then it was like leaping for joy, because I really do love the Countess, and I love Tommy, but they love each other, and well-fucksocks. So I'm like, â€Å"Cold-faced killers on the clock, bitches, we don't have time for your bonery right now.† And the Countess like lets Tommy go and gives me a big hug and she's like, â€Å"So, girl-e-girl, the dead thing, it works for you.† And I'm like, â€Å"Duh.† And she looks at Flood and she's, â€Å"I'm not sure about the tropical thing though.† And he's like, â€Å"Abby sprayed pigeon blood on my pants.† And she's like, â€Å"No, that part's good.† And he's like, â€Å"She has a tail.† And I'm like, â€Å"Traitor!† Then she looks all sad, and she's like, â€Å"Tommy, we need to talk.† And he's like, â€Å"No, we need to move.† So, while we walk toward the water we explain about the old vamps and the clean up, and the Raven and whatnot. ‘Kayso, now we're on the roof of the Bay Club, which is a really nice gym across the street from the dock, and we are staking out the Raven, and from up here we can see into the cockpit, which is like the size of a whole apartment. And they're there. The three of them and Kona, the blond Rasta guy. Two women and a guy. And they're looking all fly in their black bodysuits and black trench coats and all. But the tall blond guy has something on the table, a long case, and he takes something out and starts putting it together. I'm all, â€Å"What's he got?† â€Å"It's a rifle,† goes the Countess. WTF? WTF? WTF? I go, â€Å"A gun?† And Tommy goes, â€Å"What's with the gun?† And I'm like, â€Å"Yeah, guns are for shit on vampyres. Uh, us.† I still totally don't want to get shot. And Jody's like, â€Å"They're not going after vampyres.† And Tommy's like, â€Å"Abby, would you stop typing. Please?† And I'm like, â€Å"Rawr!† And Jody's like, â€Å"He's leaving the ship.† And I'm all, â€Å"WTF?† And Jody's all, â€Å"We have to follow.† ‘Kayso, gotta jet. L8erz.