Reflection on Task Management in Nursing

Reflection on Task Management in Nursing Description: what happened. Whilst working on a medical ward with a senior staff nurse as a mentor, I identified certain competencies which needed achieving around management of care, and negotiated these with the mentor. Accordingly, the mentor suggested that I take charge of the patient workload we had been allocated for that shift, and both prioritise the care and nursing tasks, and also attend the ward round with the medical teams, providing the nurse liaison and taking the instructions from the consultants in relation to ongoing patient care and case management. Accordingly, I agreed on the prioritisation of patient tasks and allocated the workload to the members of staff in our team, and when the ward rounds began, my mentor and I attended. However, when the doctors communicated with us, they automatically addressed her, and although she turned to me to provide key information, they continued to chiefly communicate with her, and she did not correct this. Subsequently, she took charge of the ward rounds and I remained as an observer. At the end of the ward rounds, it should have been my role to take the instructions given and to implement them in changing care plans and in directing or implementing clinical tasks. However, my mentor continued to take charge of this for the rest of the time, giving me little opportunity to experience this aspect of the role for myself. Feelings There is a great sense of responsibility associated with management tasks, which extends beyond being responsible for individual patients to being responsible for a group of patients, and for the actions of some staff allocated to their care. I felt very strongly motivated towards achieving management competencies, but also very nervous and concerned that I would do this effectively without compromising patient care. I felt that I was achieving well under supervision until the ward rounds, where the mentor ‘took over’ and did not discuss why she had done this. I then felt as if I was unable to fulfil my competencies, and that I must have failed in some way because she did not allow me to continue in the role. Evaluation It was very positive to take charge of some management tasks and to complete these effectively. In particular, other staff responded well to me taking on this responsibility (in liaison with my mentor), and this positive feedback gave me more confidence to continue in this role. However, the way that my mentor just stepped in and took charge during the ward rounds undermined my confidence and was very challenging to deal with. I felt that I should have been more assertive at this point, but did not feel I had the confidence to do this. Analysis The acquisition of the complex skills associated with the staff nurse role have always been problematic (Gerrish, 2000). However, the literature seems to suggest that nurses are learning to perform this role in a rather haphazard manner,in the light of what they perceive to be inadequate preparation and lack of support (Gerrish, 2000). Bradshaw (1998) suggests that this is partly because nursing competency is only vaguely and broadly defined, which means that preparation and assessment of competency is both haphazard and unstructured. This also suggests there may be a potential safety hazard for both patient and nurse (Bradshaw, 1998). This would certainly seem to be the case here, where the inability to fully engage with management roles does not support the student in becoming competent. Baillie (1999) in an action research study of the topic found that preparation of students for their management role as staff nurses benefits from being closely linked to practical experience, with clear learning outcomes and supportive clinical staff. In this instance, staff were generally supportive, and clear learning outcomes set, but the mentor failed to follow through to meet these outcomes completely. This may have been because the mentor felt that there was a risk to patient care and safety, but this was not communicated to the student and there may have been other ways in which this could have been managed. However, there may be other reasons for this occurrence. Cahill (1996) in a small study found there to be a type of ward culture that not only separates those with knowledge from those who need to learn, but also reinforces the position of the student through both covert and overt mechanisms of control. If such a finding were applicable in this case, then it would suggest that the mentor may have been (consciously or subconsciously) reasserting her own authority and position of power and greater knowledge. The position of student nurses may also be such that they adhere to these cultural practices in order to ensure they receive a favourable report at the end of the placement (Cahill, 1996). Lofmark and Wikblad (2001), in a study of facilitating and obstructing factors for development of learning in clinical practice, found that responsibility and independence, opportunities to practise different tasks, and receiving feedback were facilitating factors for learning. In this case, it w ould appear that responsibility was offered, but not fully, and it is problematic to see how a student can achieve true independence whilst being supervised. In Lofmark and Wikblad’s (2001) study, other perceived promoting factors included perceptions of control of the situation and understanding of the total picture. Here it would have been useful perhaps if the staff nurse had explained to the student why she retained control and why she did not follow through on her promise to allow the student to take charge. Such behaviour was found in the Lofmark and Wikblad study to be one of the obstructing factors to learning, where the nurses as supervisors did not rely on the students. Other obstructing factors were supervision that lacked continuity and lack of opportunities to practise Lofmark and Wikblad, 2001). Perception of their own insufficiency and low self-reliance were drawbacks for some students (Lofmark and Wikblad, 2001), which is also true in this reflection, but these perceptions seem to be linked to the ways in which mentors and other staff perceive and interact with students. It also appears that the NMC Code of Conduct (2004) works both to support students here but also restricts their opportunities to engage in practice, due to the need to primarily protect and support the wellbeing of the patients. Conclusion The learning that has taken place here is vitally important for continued functioning and the acquisition of confidence as a staff nurse in future. Not only do ward cultures play a large part in student experiences, but relationships are the fundamental component of how nurses function in their environment. Some aspects of the nurse-mentor relationship, while perceived as challenging, may be necessary or inevitable, and it has not become clear to me through this reflection how this can be changed, other than to raise these issues honestly with mentors during initial and mid-point interviews to acknowledge them and how they will affect the learning experience. Action Plan Explore dimensions of the nurse-mentor relationship further Raise issues of independence, power and control during initial placement interviews. Seek out ways to develop management competencies through a variety of mechanisms and experiences. Identify communication issues and potential means of addressing them. Engage in more management activities, daily, until other staff members gain trust in my ability to fulfil these roles. Attend all ward rounds to gain confidence in this area. Engage in future cycles of reflection. References Baillie, M. (1999) Preparing adult branch students for their management role as staff nurses: an action research project. Journal of Nursing Management 7 (4), 225–234. Bradshaw, A. (1998) Defining competency in nursing: an analytical review. Journal of Clinical Nursing 7 (2), 103–111. Cahill, H.A. (1996) A qualitative analysis of student nurses experiences of mentorship Journal of Advanced Nursing 24 (4), 791–799. Gerrish, K. (2000) Still fumbling along? A comparative study of the newly qualified nurses perception of the transition from student to qualified nurse Journal of Advanced Nursing 32 (2), 473–480. LÃ ¶fmark,A. Wikblad, K. (2001) Facilitating and obstructing factors for development of learning in clinical practice: a student perspective Journal of Advanced Nursing 34 (1), 43–50. Nursing and Midwifery Council. (2004). The NMC Code of Professional Conduct: Standards for Conduct, Performance and Ethics . London. Nursing and Midwifery Council.

Importance of Sleep in Shakespeares Macbeth Essay -- GCSE English Lit

Macbeth: The Importance of Sleep Macbeth Sleep is a time when our minds are at rest and the subconscious comes out to play. Sleep is oftentimes considered the place where we are able to see into our future and perhaps figure out how to solve our problems. Sleep is also what heals and cures our minds and bodies. Without sleep we slowly begin to disintegrate. Mind and body no longer cooperate without the healing force sleep brings with it. Shakespeare uses sleep both as a reward and as a consequence in his plays. If a character is innocent and pure, he is allowed restful, fulfilling sleep. If the character lacks these traits of goodness, he is condemned to a lifetime of insomnia and other problems. In Shakespeare’s tragedy, Macbeth, the reader can see this idea manifest itself in many different ways. From the beginning, when Macbeth hears the voice to the end of the play when Lady Macbeth sleepwalks, the reader sees many examples of this use of sleep. One first encounters the idea of sleep in Macbeth when the central character, Macbeth, murders the sleeping king. After the murder, Macbeth believes he hears a voice cry out, "Sleep no more†¦ Glamis hath murder'd sleep, and therefore Cawdor shall sleep no more, Macbeth shall sleep no more"(II.ii.58-60)! At this point the reader does not really think much of this warning, assuming it to merely be Macbeth's guilty conscience rather than anything important. But as the signs of the voice's prophecy begin to surface like the symptoms of a disease, Macbeth slowly becomes irrational and ruthless. This is partially due to the, "terr... ...ally 'good' people were changed drastically after sleep was withheld from them. King Duncan and his sons, Malcolm and Donalbain, were considered innocent in this play and therefore they were allowed to sleep. Their sleep was a restful, healing sleep that gave them clear judgment and, in the case of the sons, the will to avenge the wrongful death of their beloved father. For their 'good behaviour' they were able to sleep unhindered. Innocence and purity in a Shakespearean play have rewards attached to them. If a character is good, he is allowed a deep, peaceful, refreshing sleep. If he is evil, he is barred from sleep as a reminder of and a punishment for his wrongdoing. This, in turn, leads to a decline in his mental, emotional and physical well being as is evidenced in Macbeth by the plight of both Macbeth and Lady Macbeth.

Gawains Moral Superiority Revealed in Sir Gawain and the Green Knight :: Sir Gawain and the Green Knight

Gawain's Moral Superiority Revealed in Sir Gawain and the Green Knight In the final scenes of Sir Gawain and the Green Knight, Gawain’s encounter with Sir Bertilak allows Gawain to perceive his own flaws, manifested in his acceptance of the Green Girdle. The court’s reaction to his personal guilt highlights the disconnect between him and the other knights of the Round Table. Gawain’s behavior throughout the poem has been most noteworthy; his understanding of his sin, one that many of us would dismiss since it was propelled by his love of life, enhances his stature as a paragon of chivalry. When Gawain shows up at the Green Knight’s chapel, his mere presence provides comfort to his host, who greets him: â€Å"Sir so sweet, you honour the trysts you owe.† Perhaps the green gallant had been expecting Gawain, as representative of the crumbling House of Arthur, to be derelict in his duties. Gawain lives up to his good name. Similarly, he resisted the unbearable temptations of Lady Bertilak on numerous occasions, providing a mere kiss, in accordance with the code of chivalry. Yet, Gawain did err in accepting the girdle; that much cannot be denied. We, the reader, can forgive him since he repents fully, even going so far as to impose penance (of wearing the girdle eternally as a mark of his fall) on himself. It takes a mild rebuke by the Green Knight to crack Gawain’s faà §ade of confident valor. His conscience compels him to break down when confronted by his host as to his indiscretion. However, this happened only when the host had revealed himself to be the same as the Green Knight. We realize that Gawain had previously perceived in Sir Bertilak an equal in knighthood; thus his ease in deceiving him in the exchange of winnings game. When Gawain realizes he was the subject of a test, he sees Bertilak/Green Knight in a different light. The Green Knight now becomes Gawain’s confessor and in doing so assumes a fatherly role. We see that Bertilak perceives Gawain’s fault, his love of life, and irrespective of it, loves Gawain. Despite having sinned, Bertilak sees in Gawain a first-rate knight, far superior to his peers in Camelot, who, faced with the spectre of death, grew silent with cowardice, as the honor of the King lay unguarded.

A Womans Awakening :: essays research papers

The novel The Awakening by Kate Chopin tells the story of a woman who is married and has an awaking of her true feelings. The situation is very complex and Edna cannot handle the complexity of it. In the end she commits suicide. The novel The Awakening by Edna is described as a woman who is strong and able to persue her dreams. The novel also shows how people should live their lives for themselves instead of other people. Chopin uses characterization and symbolism to develop the meaning of the novel The Awakening. Ethan From is seen as a tragic person. He dreams of escaping his farm and living a life outside of Starkfield. Ethan was forced to leave college to care for his aging and ailing parents. He married Zeena because he feared loneliness and felt he owed her something for her help with his parents. Ethans character is described in the beginning of the novel as a man in his fifties, disabled, silent, and a farmer. Physically Ehtan is tall and bent-looking. His circumstances have made him weak. Ethan is a man of bad luck who is in his current situation due to circumstances and not by choice.   Ã‚  Ã‚  Ã‚  Ã‚   Edith Wharton portrays the land in Starkfield as harsh, the people are hard and unfriendly, and poverty as a mean way of life.She uses the landscape to reflect the personality of the characters. Her choice of winter is a symbol of the barrenness of the characters' lives. They are cold and isolated, like the temperature outside. The situations and conflicts are represented by Frome's stony landscape, the old apple trees, and the graveyard. In conclusion, Kate Chopin uses characterization and symbolism to develop the meaning of the novel The Awakening.

The Quintessential Negative Utopia in George Orwells 1984 Essay

The Quintessential Negative Utopia in George Orwell's 1984 1984 is George Orwell's arguably his most famous novel, and it remains one of the most powerful warnings ever made against the dangers of a totalitarian society. George Orwell was primarily a political novelist as a result of his life experiences. In Spain, Germany, and Russia, Orwell had seen for himself the peril of absolute political authority in an age of advanced technology; he illustrated that peril harshly in 1984. Orwell's book could be considered the most acknowledged in the genre of the negative utopian novel. The mood of the novel aims to portray a pessimistic future. This prospect is to show the worst human society imaginable and to convince readers to avoid any path that might lead toward societal degradation. Orwell's world of post-atomic dictatorship, in which every individual is ceaselessly monitored through the telescreen seemed just possible enough to terrify. When Orwell postulated such a society it was only 35 years into the future that made the horror depicted by the novel seem more relevant and real. While the year 1984 has long since come and gone it is more than obvious that the world Orwell describes has not materialized. But the message of 1984 remains relevant enough to frighten, and accurate enough to feel possible. War is used as a device for political manipulation on television--a concept presented strikingly in the recent film Wag the Dog. The governmental forces have historical records rewritten to match the political ideology of the ruling Party. This is a technique has been used by the Soviet Union and is still all too common in some parts of the world. The warning remains significant: the world has not completely escaped from the dangers Orwell describes. The novel is based on the experiences of Winston Smith, an insignificant member of the ruling Party in London, in the nation of Oceania. Everywhere Winston goes, even his own home, he is watched through telescreens, and everywhere he looks he sees the face of the Party's omniscient leader, a figure known only as Big Brother. The Party controls everything from history to language. The Party is currently forcing the implementation of an invented language called Newspeak, which attempts to prevent political rebellion by eliminating all words related to it. Even thinking rebellious thoughts is illegal. Thoughtcri... ...r reading this novel. Big Brother is the figurehead of a government that has total control. The Big Brother regime uses propaganda and puts fear in its citizens to keep the general population in line. â€Å"Big Brother is watching you†(5) is just one example of many party slogans that puts fear in its citizens. Big Brother uses various ways to catch people guilty of bad thoughts And the term Big Brother is used though out other literature as well as other forms of media and communication. Lesson Ideas 1. The entire class would have to comply with the societal rules that Winston has to. By either having the class have a discussion on how to make everyone completely equal. If one person has glasses they all would have glasses. Etc. 2. Write a paper in Newspeak, or have a class conversation in Newspeak. 3. How would they feel if their entire life was predestined? What if the only was to survive was to conform. 4. What is freedom? What is this type of society born from? If a class of seniors is they involved with government or do they allow it to happen? 5. Might teach Civil disobedience along with this. At least a supplemental reading for a one-day discussion.

I Stand Here Ironing

These events had to do with Email's father align out on them, Emily having to go to daycare In her early years, and also self esteem Issues from not looking Like the other girls In school. The central Idea In this story seems to be the mother's search of an understanding of her daughter's personality and outlook on life. The majority of the story Is the mother trying to depict reasons for why her daughter is the way she is, so delicate, reserved, needless, and even unhappy at times.She seems to also defend her parenting choices by making excuses or blaming the urges of others in order to not have all the blame on her. She peaks about how she had no other option but to put her in the care of someone else at the age of two, even though she knew the teacher was â€Å"evil† (Peg. 925). â€Å"It was the only place there was†¦ The only way I could hold a Job† (peg. 925). The main conflict in the story is internal, the mother vs.. Herself. I would also say there is a slig ht conflict of Emily vs.. Herself and an external conflict of the mother vs..Emily. The mother defiantly had and internal conflict within herself with her decisions and how things could have been done differently while raising her daughter. The conflict reface real early in the story, when the mother goes to say, â€Å"Or will I be engulfed with all that I did or did not do, with what should have been and what cannot be helped. † (peg. 924) During the story the mother expresses regrets and seems to be, in a way, tormented by her parenting decisions because she can easily recall every moment in Emily childhood.Clearly the mother had a deep love and concern for her daughter. In the end, the mother's conflict within herself is resolved. She states, † Let her be. There is still enough to live by†¦ Only help her to know-that she Is more Han this dress on the ironing board, helpless before the Iron† (Peggy). The mother has decided that what has been done cannot be changed, and does not want to spend any more time dwelling on It. Just let her be, she will be fine. The conflict of the mother vs.. Resell and the central Idea of the mother trying to explain why her daughter Is the way she Is are both related In that they are both based on how the mother has raised her daughter. I enjoyed this story; I think the mother shouldn't be so hard on herself because parenting Is not a skill that can be mastered to perfection. I Stand Here Ironing By sensationalism Tillie Olsen. In the story, a mother of a nineteen-year-old girl named Emily is ironing some clothes, as she is pondering a recent message she received from one of Emily The mother begins to think back to the very beginning of Emily life.She starts stating all the various events that took place in Emily life that could have played a role in why Emily is the way she is now. These events had to do with Emily father walking out on them, Emily having to go to daycare in her early years, and also sel f esteem issues from not looking like the other girls in school. The central idea in personality and outlook on life. The majority of the story is the mother trying to depict Let her be. There is still enough to live by†¦Only help her to know-that she is more than this dress on the ironing board, helpless before the iron† (Peggy). The mother spend any more time dwelling on it. Just let her be, she will be fine. The mother vs.. Herself and the central idea of the mother trying to explain why her daughter is the way she is are both related in that they are both based on how the mother has raised her daughter. I enjoyed this story; I think the mother shouldn't be so hard on herself because parenting is not a skill that can be mastered to I Stand Here Ironing These events had to do with Email's father align out on them, Emily having to go to daycare In her early years, and also self esteem Issues from not looking Like the other girls In school. The central Idea In this story seems to be the mother's search of an understanding of her daughter's personality and outlook on life. The majority of the story Is the mother trying to depict reasons for why her daughter is the way she is, so delicate, reserved, needless, and even unhappy at times.She seems to also defend her parenting choices by making excuses or blaming the urges of others in order to not have all the blame on her. She peaks about how she had no other option but to put her in the care of someone else at the age of two, even though she knew the teacher was â€Å"evil† (Peg. 925). â€Å"It was the only place there was†¦ The only way I could hold a Job† (peg. 925). The main conflict in the story is internal, the mother vs.. Herself. I would also say there is a slig ht conflict of Emily vs.. Herself and an external conflict of the mother vs..Emily. The mother defiantly had and internal conflict within herself with her decisions and how things could have been done differently while raising her daughter. The conflict reface real early in the story, when the mother goes to say, â€Å"Or will I be engulfed with all that I did or did not do, with what should have been and what cannot be helped. † (peg. 924) During the story the mother expresses regrets and seems to be, in a way, tormented by her parenting decisions because she can easily recall every moment in Emily childhood.Clearly the mother had a deep love and concern for her daughter. In the end, the mother's conflict within herself is resolved. She states, † Let her be. There is still enough to live by†¦ Only help her to know-that she Is more Han this dress on the ironing board, helpless before the Iron† (Peggy). The mother has decided that what has been done cannot be changed, and does not want to spend any more time dwelling on It. Just let her be, she will be fine. The conflict of the mother vs.. Resell and the central Idea of the mother trying to explain why her daughter Is the way she Is are both related In that they are both based on how the mother has raised her daughter. I enjoyed this story; I think the mother shouldn't be so hard on herself because parenting Is not a skill that can be mastered to perfection. I Stand Here Ironing By sensationalism Tillie Olsen. In the story, a mother of a nineteen-year-old girl named Emily is ironing some clothes, as she is pondering a recent message she received from one of Emily The mother begins to think back to the very beginning of Emily life.She starts stating all the various events that took place in Emily life that could have played a role in why Emily is the way she is now. These events had to do with Emily father walking out on them, Emily having to go to daycare in her early years, and also sel f esteem issues from not looking like the other girls in school. The central idea in personality and outlook on life. The majority of the story is the mother trying to depict Let her be. There is still enough to live by†¦Only help her to know-that she is more than this dress on the ironing board, helpless before the iron† (Peggy). The mother spend any more time dwelling on it. Just let her be, she will be fine. The mother vs.. Herself and the central idea of the mother trying to explain why her daughter is the way she is are both related in that they are both based on how the mother has raised her daughter. I enjoyed this story; I think the mother shouldn't be so hard on herself because parenting is not a skill that can be mastered to

Reaction Paper: Made in Dagenham Film Essay

In the film that we’ve watched entitled Made in Dagenham, we have seen how powerful strikes can be. It is done so that the rights of the workers will be upheld, and that, only upon compliance of the Legal Requirements may it be declared a valid strike. Many are the reasons why workers would engage in such an activity, one of which was the discrimination of gender which the film presented. We have also seen in the film how it would take one brave union leader to lead a strike in upholding the rights of the workers and that engaging in a strike would require sacrifice in the part of the striking employees since they are not entitled to payment of wages for unworked days during the period of the strike. We have seen the struggles they had between their families during those days. Also, the film showed an application of the valid ground for strike or lockout, that is, strike should be a means of last resort after they have exerted all efforts to resolve the unfair labor practices. It was seen in the film when the two women representatives had a meeting with the mediation board in resolving the discrimination of gender by paying the female workers lower wages than the male workers. What is most amazing was that the 1968 Ford Dagenham strike led to the establishment of the Equal Pay Act in 1970, which banned the discrimination on pay and working conditions between men and women.