Personal Reflection On Practicing A Clinical Skill

Personal Reflection On Practicing A Clinical SkillThis essay leave behind discuss a clinical skill in which I oblige become competent in practicing. I will use a reflective lesson to discuss how I have achieved the necessary level of competence in my nurse training programme. The reflective model I have chosen to use is Gibbs model (Gibbs 1988). Gibbs model of materialisation incorporates the following description, feelings, evaluation, analysis, conclusion and an action plan (Gibbs 1988). The model will be applied to the essay to facilitate critical thought, relating theory to practice where the model allows. news will include the k outright takege netherpinning practice and the evidence base for the clinical skill. A conclusion to the essay will then be given which will discuss my reflection skills, ack flatledge my competence and show my personal and professional development.The clinical skill I have chosen to reflect on at bottom this essay is the administration of Intramu scular (IM) injections. I have chosen this as deep down my first clinical placement this was a widely used mode of dose administration and I became involved in the process of IM injections. I therefore enquiryed the topic of IM injections and my knowledge within this area developed.The first stage of Gibbs (1988) model of reflection requires a description of events. I was asked to administer a drug to a patient via IM injection. I had observed this clinical skill on a variety of occasions and had previously administered an IM injection under supervision. On this occasion I was being observed by two subject nurses, one of which was my mentor. The drug had been drawn up and was ready to be administered and the patient consented to have a student administer the injection. My mentor was talking me through the purpose step by step and informed me that I should use an alcohol wipe to cleanse the injection site, when the other nurse interrupted and said that this was not necessary. T his was in front line of the patient, who then requested that the alcohol wipe was omitted as on previous occasions this had caused a stinging sensation. My mentor said that this was acceptable and I proceed to administer the injection, omitting the use of the alcohol wipe. On the previous occasions when I had administered IM injections I had not cleansed the site and had never been instructed to adopt this practice.I am now going to enter into the second stage of Gibbs (1988) model of reflection, which is a discussion about my thoughts and feelings. I was informed of being under the supervision of two qualified nurses and this made me feel very nervous and self conscious. Once my mentor questioned my practice, concerning skin cleansing, I became even more aware of feeling nervous and under pressure. The patient was present and I did not want the patient to feel that I did not know what I was doing. I thought that as I had been observed carrying out this clinical procedure on man y other occasions then my practice must have been seen to be correct. I was now feeling very confused about the use of alcohol wipes in the administration of IM injection. I was also concerned that the practice of the qualified nurses was so inconsistent, which led me to evaluate the whole process.Evaluation is the third stage of Gibbs (1988) model of reflection and requires the reflector to with state what was good and bad about the event. I was aware that research by Workman (1999) suggests that the use of skin cleansing wipes is inconsistent and not necessary in IM injections if the patient appears to be physically clean and an aseptic proficiency is adopted, along with stringent hand washing by the nurse. It has also been noted that the use of cleansing with an alcohol wipe can cause skin lot (Mallet Dougherty 2000). The practice policy was to follow guidelines published by the Royal Marsden Hospital (Mallet Dougherty 2000). The Royal Marsden (Mallet Dougherty 2000) advocat e the use of skin cleansing wipes, however it is stated within their guidelines that they adopt this because their patients are often immunocompromised, and give evidence of previous studies which indicate that skin cleansing is not normally necessary. Therefore my practice was within the trust protocol. This experience made me think about my attitude towards literature and how it is applied in practice. Burnard (2002) suggests that a learner is a passive recipient of received knowledge, and that training through activity engages all of our senses.The site used in the IM injection was the glute maximus, this the most commonly used site for the administration of IM injections (Greenway 2004, Workman 1999). The gluteus maximus area is some(prenominal) thick and fleshy with a good blood supply (Watson 2000). It is located in the hip area and forms the buttock (Watson 2000). It has been noted by Watson (2000) that the gluteus maximus is near the sciatic nerve and Greenway (2004) sug gests that this presents a risk of threat of injury in the administration of IM injections. When I administered the IM injection to the patient, I injected into the gluteus maximus muscle, as the evidence stipulates this is best practice.Stage foursome of Gibbs (1988) is an analysis of the event, where Gibbs encourages the reflector to make sense of the situation. I will do this by exploring the skill and sounding at the evidence underpinning it. An IM injection is the administration of medication into the muscle there are many reasons why drugs are given via the IM route (Workman 1999). These include a rapid absorption rate, the conscious state of the patient, and the drug effect being altered by ingestion (Mallet Dougherty 2000, Workman 1999). Workman (1999) suggests there are four considerations in giving an injection, the site of injection, the technique, the equipment and the route. On my clinical placement, an orthopaedic outpatient centre, IM injections were administered o n an almost daily basis. However Hemsworth (2000) comments that IM injections are rarely used in legitimate specialities and suggests that, in this case, nurses current practice in IM injections may not be up to date with recent research findings.Through evaluation of the event in question I have become more aware of different practices concerning the use of alcohol wipes in skin cleansing. I am aware that both practices have been researched, but as I develop professionally I am developing my own skills and will not cleanse the skin in future unless the trust policy dictates so or the patient requests me to do so. There is no clear evidence in this area but I will use the literature which is available to justify my actions, and therefore give evidence based care. The reason my mentor suggested using the alcohol wipe could be that she has been qualified for a long time, and practices have changed. In this scenario I have learnt from experience and through experience (Burnard 2002). Following this incident in practice I will now be more prepared to challenge the views of others in relation to my clinical practice.In conclusion, stage five of the Gibbs (1988) model, I am aware that all nurses do not use evidence in the same way and may use different methods but as long as my practice is safe and evidence based then I can practice safely. My future practice will depend on the area in which I am working and I aim to find out the trust protocol concerning clinical procedures before I commence any procedureWithin my action plan my aim is to research further into the theory of using alcohol wipes in the administration of IM injections. I am also formulation to have a discussion with the qualified nurses on the subject of skin cleansing.In conclusion my reflection skills have developed through the production of this essay. victimization a model of reflection has helped me to structure my thoughts and feelings appropriately. My level of awareness concerning evidence b ased practice, and its importance, has been enhanced with the use of critical reflection. My competence, within this clinical skill, has been further developed and I now feel that my personal and professional development is progressing. Using this reflective model has helped me to realise that my learning is something which I must be proactive in. Furthermore as a student nurse I have recognised that reflection is an important learning tool in practice.

Structure, Language and Characterisation of Conan Doyles Sherlock Holm

The structure phraseology and characterisation of Conan Doyles SherlockHolmesIn this essay I am going to analysis and investigate the structure,language and characterisation of the detective fiction musical style. Usingthe Sherlock Holmes stories which combined strong fictional storylines with ruthless and clever villains they are regarded as some ofthe silk hat collection of examples of storybooks. Sherlock Holmes is aliterary character, created by Arthur Conan Doyle in four novels and56 short stories published between 1887 and 1927.The pi mavinering author of the detective genre was an American writerand poet called Edgar Allan Poe. The first ever story was Murders inThe Rue Morge. This was the first to feature the locked room mystery,which is a critical an inspiring element for the detective genre. Itbaffles the law and the public but is effortlessly solved withsimplicity by the stories hero. Who is intelligent and analyticalsuperior to the law enforcements? This is an additio nal commontradition in the genre were the police seem to be deficient inperfection acuteness in Neanderthal ways.Conan Doyle started writing in 1887 with his first story A assume inScarlet the story introduces Holmes and his companion Dr.Waston. Agreat majority of these stories involve mystery. The heart of thestory concerns the search for clues or evidence.While there is for certain a good variety of plot structures within theSherlock Holmes), it is safe to say that a majority of the shortstories follow the following pattern of motifs fairly closely. Many ofthese are also found in Poes Dupin stories.The story begins at 221B Baker Street, the residence of the greatdetective and his sidekick narrator, ... ... hisdisguise.the two things that the reader wonders astir(predicate) in A Case ofIdentityisHow could bloody shame Sutherland be fooled by her stepfathersdisguise and why didnt Holmes tell her the truth about Hosmer Angel?.Was Windibank secretly attracted to Mary all along so he just marriedher? If so, then why didnt he marry her in the first place, insteadof her mother? Or is Windibank just a greedy and selfish fool, whoconcocted what seemed a harmless way to keep Mary and her income athome for a bit longer?In all , the stories written by Conan Doyle are an intelligentfictional series .I some times thought that Doyle would have had to ofbeen an gifted man or of know something about detective work to writesuch an intricate set of stories. Which show ruthless clever villainsand Sherlock Holmes who powers of observation baffle any one who readsinto it .

Rape: The Opening of a Taboo :: Crime Violence Women Essays

Rape The Opening of a Taboomissing works citedI had been working a while, maybe an hour or so, when I became sure of the sound of breathing behind me. A man was standing there, watching me type on the laptop. He had been there for quite some time, wrote a mama Institute of Technology student in the universitys in the altogetherspaper, the Tech.Concern about the victimization of female college students has grown in this country since 1990, fit in to the Sexual victimisation of College Women report by the National Institute of Justice (NIJ) and the Bureau of Justice Statistics (BJS). The rising alertness of sexual victimization has displaced the ideal of college campuses as ivory towers for the pertly fear that campuses invite become hot spots for criminal activity, the report said.Awareness about this topic began to grow with the passing of the Student Right-to-Know and Campus Security take on of 1990. This act forced any college that was participating in a federal student aid programs to publish and distribute to its students and employees an annual report containing security policies and campus umbrage statistics for the university, the NIJ and BJS report said.The Campus Sexual Assault Victims Bill of Rights was added to the act in 1992. The federal law requires that the victim has the right to change their academic schedule and their residence hall, accord to James Ferrier, Associate Director of Public Safety at Northeastern University. Now often times the woman says Wait a minute, hes the one who did it. Hes the one who should move or hes the one who should pose his schedule changed. why should my life be changed? wherefore should I move out from out of my circle of friends and move somewhere else? The answer there is clear, its a due process issue. At that point, the culprit hasnt been found responsible of anything, hes innocent until proven guilty. Just on an accusation, it would violate that persons rights of due process, Ferrier said.Campus StatisticsMany studies have been done since the act was passed in 1990 to collect the statistics of sexual assault on college campuses.The statistics that are used are 35 out of 1,000 college-age women will raped individually academic year. On a campus with 10,000 students, thats 350 a year, said Sarah Dawgert, Public Education and Volunteer Coordinator at the Boston Area Rape Crisis Center (BARCC). hotshot out of six or one out of ten is a victim of sexual assault during her college career.Rape The Opening of a Taboo execration Violence Women EssaysRape The Opening of a Taboomissing works citedI had been working a while, maybe an hour or so, when I became aware of the sound of breathing behind me. A man was standing there, watching me type on the laptop. He had been there for quite some time, wrote a milliampere Institute of Technology student in the universitys newspaper, the Tech.Concern about the victimization of female college students has grown in this country since 1990 , according to the Sexual using of College Women report by the National Institute of Justice (NIJ) and the Bureau of Justice Statistics (BJS). The rising awareness of sexual victimization has displaced the ideal of college campuses as ivory towers for the new fear that campuses have become hot spots for criminal activity, the report said.Awareness about this topic began to grow with the passing of the Student Right-to-Know and Campus Security bend of 1990. This act forced any college that was participating in a federal student aid programs to publish and distribute to its students and employees an annual report containing security policies and campus curse statistics for the university, the NIJ and BJS report said.The Campus Sexual Assault Victims Bill of Rights was added to the act in 1992. The federal law requires that the victim has the right to change their academic schedule and their residence hall, according to James Ferrier, Associate Director of Public Safety at Northeast ern University. Now often times the woman says Wait a minute, hes the one who did it. Hes the one who should move or hes the one who should have his schedule changed. Why should my life be changed? Why should I move out from out of my circle of friends and move somewhere else? The answer there is clear, its a due process issue. At that point, the culprit hasnt been found responsible of anything, hes innocent until proven guilty. Just on an accusation, it would violate that persons rights of due process, Ferrier said.Campus StatisticsMany studies have been done since the act was passed in 1990 to collect the statistics of sexual assault on college campuses.The statistics that are used are 35 out of 1,000 college-age women will raped all(prenominal) academic year. On a campus with 10,000 students, thats 350 a year, said Sarah Dawgert, Public Education and Volunteer Coordinator at the Boston Area Rape Crisis Center (BARCC). 1 out of six or one out of ten is a victim of sexual assault during her college career.

Software Piracy Essay -- Computer Software Copyright Violation

Softw ar Piracy Softw be piracy is the copying and selling of copyrighted software. There are many types of software that can be pirated including operating systems, application programs, internet downloads, including music, software, or movies. Many people do this knowing that they are partaking in something wicked however some people have no clue that they are breaking the law. In some cases a person may have unwittingly purchased pirated software. The consequences of having or distributing pirated software can be serious in some cases. Software piracy is a common practice that can be slow avoided. Software piracy is an equal offense to downloading of music, movies, books, magazines, or any other copyrighted material. It is as simple as downloading a program from the internet, or victimization a friends copy of Office. Software piracy can also be as complex as a computer stack away re-selling software with a fake or counterfeit product key or regis tration code. To avoid this look out for software that seems less dearly-won than it should be or software that comes with a key generator. If you suspect software piracy you can contact, The Software & Information Industry Association, on their website http//www.siia.net/piracy. On their website they are actually offering rewards of up to $50,000 to any person that reports a company that is using pirated software. People partake in software piracy because it as an informal way out of purchasing software. Some software programs can cost over a thousand dollars, whereas some only cost twenty or thirty dollars. Software piracy has said to have begun around the 1960s. Over time it has grown and it accounts for 25% - 50% of software curr... ...83%Tunisia82%Kenya80%Thailand80%Nicaragua79%El Salvador79%Bolivia78%Guatemala77%Lebanon74%Romania73%Morocco73%Honduras73%India73%Philippines72%Venezuela70%Works Cited mark About Piracy. Prevent Software Piracy. 2005. Intuit. 8 November 2005. . What is Piracy? Anti Piracy. 2005. The Software & Information Industry Association. 8 November 2005. . Massachusetts Man Pleads Guilty in clean Hampshire Software Piracy Conspiracy. Software Piracy. 2005. U.S. Department of Justice. 8 November 2005. .

Computer Hacking :: essays papers

Computer HackingPrecis of Whos reading your E-mailThe article exposes the vulnerability of computing machine data and ofcorporations with the popularity of the Internet. The Internet canallow hackers access to any estimator in the world, with understatedease. Break-ins can go virtually undetected.Major corporations and government gage departments haveacknowledged that hacker break-ins be out of control. Some companiesare too fearful to join networks because of this. Software programsbrought out to rent with the growing problem, such(prenominal) as firewalls, are nolonger totally effective. New technology has been developed such asPilot Network Services (offering supervised Internet access)Netranger (a monitor crook used by Pentagon) and Encrypton(software that jumbles messages).The basics of computer warrantor (using difficult passwords, andguarding of data) are not being met in a disturbingly large number ofAmerican companies surveyed. A new bill demands that system operato rsbecome responsible for security. Hackers can be prosecuted (withsubsequent heavy penalties) only if the exposed company has activelyshown that it was security conscious. Further more, exposed companiesare liable to other companies if their lack of security precautionsallowed their computer network to become an opening for other companybreak-ins.Companies are dis-inclined to repute breaches in security as it denotesa poor image and highlights their vulnerability. Clients demandsecurity, and lack of it will send them elsewhere.Billions of dollars annually is spent on protection devices. Others areutilizing the expertise of former convicted hackers to fine tune andupdate their security features. It is a case of befriending the enemyin order to learn more. These hackers come out of remnant with a readymarket for their expertise, and great financial rewards.The explosion of the Internet use, and networks around the world havebrought with it a need for greater security consciousness a mongst itsusers and systems operation managers. Technology needs to beconstantly updated in the war against the ever-growing insidious andmalicious hacker.Precis of Hackers Taking a byte out of computer crime by W. Roush.Roush discusses the changing face of computer crime with the advent ofthe modem and stricter laws. The article touches on the effect thesechanges are having on hackers themselves, and the measures that are putin place to deal with the problem. It also explores the common groundwhich hackers and computer security experts agree on.In the 1960s the dictionary definition of a hacker was that of acomputer virtuoso. Hackers comprised of young, computer literate andrebellious gangs vying for the status symbol image and thrill ofbreaking into a computer network.This all changed with the popularity of the modem and an increasing

Imagery and Themes in the Epic of Gilgamesh Essay -- Epic Gilgamesh es

Historical Context - Imagery and Themes Rosenberg notes that Gilgamesh is probably the worlds first human hero in literature (27). The Epic of Gilgamesh is based on the life of a probably real Sumerian king named Gilgamesh, who ruled about 2600 B.C.E. We learned of the Gilgamesh myth when several clay tablets written in cuneiform were discovered descent in 1845 during the excavation of Nineveh (26). We get our most complete version of Gilgamesh from the hands of an Akkadian priest, Sin-liqui-unninni. It is unknown how much of the tale is the invention of Sin-liqui-unninni, and how much is the original tale. The flood story, which appears in the Sin-liqui-unninni version, is probably based on an actual flood that occurred in Mesopotamia around 2900 B.C.E. (26). The Sumerian culture influenced the entire Near East (Swisher 13). The success of their culture was mutually beneficial on the agricultural viability of the field of honor. Every year there were floods which provided rich silt for successful farming that encouraged the people to stay in the same area year after year instead of migrating to find new areas for crops (19). There are indications that the Sumerians were composed of two different peoples which mingled in the same area. The Semites are believed to pack mixed with the Highlanders. The Semites were patriarchal hunters and more warlike than the Highlanders. The Highlanders were matriarchal and peaceful. Swisher suggests that there is evidence of both social groups and that the combination of the two led to changes in the perception of the roles of the gods and goddess as well as the men and women (21). Sumer was originally small groups of people that eventually grew to form cities. As a country it included 13 ... ...der to receive never-failing life. The apparent belief in an afterlife which is indicated by the burial with useful objects may show that eternal life is achieved after physical death. The Flood - reco unted by Utanapishtim is representative of the purification of human life by the gods. Their transgressions are swept away (with most of the population) and they are reborn into a fresh, new world and human relationship with the gods. Ark - the symbol of the gods love of the humans and their interest in preserving the human race. We also identified five themes in the Epic of Gilgamesh Conflict between chaos and order, delineated by nature and civilization Mans quest for immortality and knowledge Dealing with loss Male bonding/brotherhood Heroism (mans victory over nature).

Revolution Girl-style Now! Essay -- essays research papers fc

Revolution Girl-Style Now belly laugh Grrrls were in the first place born out of the Punk scene where rebellionwas expressed in attitude, appearance, style, and music. Defining Riot Grrrl is oft like defining Punk. There is no central organization, no authoritivedefinition, just an attitude concerned with pointing out social hypocrisy andempowering people to do it yourself, creating a culture of their own when theysee that the mainstream media does not reflect their concerns or provide outletsfor their efforts. Riot Grrrl is a supportive environment for girls and youngwomen which is concerned with feminist issues such as rape, abortion rights,bulimia/anorexia, sexism, sexuality, double standards, self-defense, fatoppression, classism, and racism. Riot Grrrl is a network of fanzines that areproduced by the angry girl revolutionaries who identify with the music that isassociated with Riot Grrrl. The fanzines, self-designed and self-written,uncensored and uninhibited photocopied publ ications, are often intenselypersonal. That personal outlet is translated to larger political action when thefanzines are available to the public, bringing people unneurotic for conventionsand other consciousness-raising activities. The ethos is about supporting eachother and empowering each other. In actuality, Riot Grrrl is a frame of mind.Its a way for them to come together in a common cause Revolution Girl-StyleNow. Since no specific person or people claim they created it, Riot Grrrl hasmeant many things to many people. to the highest degree girls do not attempt to define it anymore.EVERY GRRRL IS A RIOT GRRRL. All you need is a healthy dose of pissed-of-nessat the treatment of womyn in our society. We are NOT all punk, all white, alllesbians, all musicians, all fanzine editors, all vegetarians, all victims ofabuse, all straight edge. There is no stereotypical Riot Grrrl. (Knight 9)The former(a) Riot Grrrl scene was a loose-knit affiliation of feminist Punks,formed circa 1991 in Olympia, Washington and Washington D.C. The philosophy of do it yourself and you can do anything seemed to apply for the most part to boys, whowere the ones making the music and dictating the styles. By the early 90s, moreand more girl bands started springing up, but ironically they found themselvesbattling sexism and discrimination within a movement originally based in aconsciousness about youth ... ...ther in acommon cause Revolution Girl-Style Now.BibliographyCarlip, Hillary. Girl Power youngish women speak out. New York Warner Books, Inc.,1995"Grrrls kick ass". Online. Available HTTP http//www. Micoks.net80/tiffani/girl.htmlHanok, Emily. The Girl Within. New YorkFawcett Books, 1989Knight, Zain. Luster fanzine. San Fransisco. Madhu.. "Riot Grrrl". Online.Available HTTP http//www.angelfire.com/nj/alienshe/grrrl.htmlOrviro, Rachel. "I Am a Girl". Online. Available HTTPhttp//www. voiceofwomen.com/sac/girl.html. Pipher, Mary, Ph.D. RevivingOphelia Saving the Selves of Adolescent Girls. New York      Ballantine Books,1995 "REVOLUTION GIRL STYLE NOW". Online. Available HTTPhttp//www. Smu.edu/hnovales/girl.html Sam."I AM XL & PROUD". Kingfish fanzine. SanDiego. Spirit. "What is a RiotGrrrl anyway?". Online. Available HTTPhttp//www. columbia.edu80/ril 3/music-html/bikini kill/girl.html "SoWhat the heck is Riot Grrrl?". Online. Available HTTPhttp//www. indieweb.com/riotgrrrl/rg-perplexed.html Wilson, Jodi.Crisco fanzine. San Fransisco.