Great Expectations and April Raintree Essay Example for Free

Great Expectations and April Raintree EssayA key theme in Great Expectations and April Raintree is the growth and change of the characters towards their acceptance of societal class. This will be turn out by murder non accepting himself in the lower class and April not accepting herself in the native class. Then, there will be conclusion of how Pip and April attempted to change their social class. Fin ally the proof of how Pip accepted himself in the social class he was in and how April accepted herself as a Mtis. Pip did not accept himself in the lower class. He wanted to be in the fastness class just akin Miss Havisham is. Pip was ashamed of his family and its lower class status. How he wasnt as fortunate as Estella who is a member of the higher class, oddly when Estella insulted Pip verbalize that he is common and how he has coarse hands. He did not have a reason to bring forward about his class status before this, and promptly that he does, hes disturbed to think h e might be just common. This ensured Pip to not accept himself in the lower class.He didnt light upon all good from it. Pip felt he needed to impress Estella. She was the one who changed Pips perspective in everything. Before meeting Estella, Pip really looked up to Joe, blacksmith or a gentleman, Joes class status makes no difference. It is not until later, when he learns that the world cares about class, thats when Joes status mattered to Pip. After seeing Estellas house and everything she had, he wanted to a greater extent to look forward to. Pip did not accept his life in the lower class.April is a young woman who has so galore(postnominal) issues with her family and the people in her life. April always hid her feelings of shame from her sister Cheryl. April did not accept herself in the native class. Although she did not look native, she was sometimes ashamed that her sister Cheryl looked more native than she did. in that respect were two different groups of children that w ent to the park. One group was brown-skinned children who looked like Cheryl in most ways. They were revolting-looking and they dressed in real raggedy cloths. I didnt care to play with them at all. The other(a) group was fair-skinned and I envied them especially the girls with blonde hair and blue eyes. They seemed so clean and fresh. Some of them were freckled but they didnt seem to mind. To me, I imagined they were very moneyed and lived in big, beautiful houses. I wondered what their lives were like and I wished we could play with them. But they didnt care to play with Cheryl and me.They just called us names and bullied us. (Pg. 6) Since April was young, she always wanted to be with the people who were fair-skinned. She didnt like seeing her sister being called names especially, when they had to live with the DeRosiers. Half breeds were all that was said in that house. I heard you half breeds were dirty but now I can see that its true. (Unknown () At one point, April hated be ing Mtis. She felt that being Mtis changed her life because when you think of Mtis, you think of living off the streets and bums on Main Street. She wasnt any of these and she didnt want to be labelled as them. She was not happy being the person she knew she was. April did not accept her life in the native class.Pip changed his social class by going off to school to become a gentleman. He was lucky to have a benefactor. Ive put forth money, only for you to spend. When I was a hired-out shepherd in a solitary hut, not seeing no faces but faces of sheep till I half-forgot wot mens and womens faces wos like, I see yourn. . . . I see you there a many times plain as ever I see you on them misty marshes. Lord strike me dead I says each time-and I goes out in the open air to say it downstairs the open heavens-but wot, if I gets liberty and money, Ill make that boy a gentleman And I done it. (pg. 340) Magwitch reveals himself as Pips secret benefactor and how he got all his wealth. This quote changed Pips idealistic view of wealth and social class by forcing him to realize that his own status as a gentleman is owed to the loyalty of a lower-class criminal.Year after year, he moved further away from Joe and his lower class. Pip, dear old chap, life is made of ever so many partings welded together, as I may say, and one mans a blacksmith, and ones a whitesmith, and ones a goldsmith, and ones a coppersmith. Divisions among such must come, and must be met as they come. (pg. 236) Joe comes with a wound and content attitude toward the changes in Pips social class that have driven them apart, and he shows his goodness and loyalty by blaming the division not on Pip but on the unchangeable nature of the human condition. Pip as a gentleman makes a lot of money and as he gets wealthy, he forgets his family and the people that are important to him. In other words, he worries about trying to impress people, rather than being moral.April Raintree changed her identity of a nati ve by marrying a rich white man named Bob Radcliff. She always wanted to be rich and forget about her heritage. She moved away from Winnipeg to Toronto. She tried speed away from the life she did not want, to try to live a life she wanted. You think I dont know why you married Bob? It was to get away from me, thats why. Ill be you wished you were an only child. I bet you wished I was dead. (pg. 155) It was almost like she did not want Cheryl in her life at all. You never love that man. You loved his money. You figured you were going to be Miss High Society. (pg. 158) April did not love Bob Radcliff she only married him for his money.Pip learns from his mistakes growing up. After realizing what figure of person he has become, and how he has treated his loved ones, he felt he was break off being in the lower class. Pip agnise that wealth and class are less important than affection, loyalty, and inner worth. When he is finally able to understand that, besides the esteem in which he holds Estella, individuals social status is not what so ever connected to that someones character. Bentley Drummle is a symbol to this because even though he is a minor character, he gave an important message. Drummle is an upper class member. He gave Pip proof that social class has no connection to attitude, personality or moral worth. Drummles negative example helps Pip to see the inner worth of characters such as Magwitch and Joe, and Pip eventually scraped his immature fantasies about wealth and class. Everything changes for Pip after he learns the class status of his benefactor because he realized that Magwitch, a kind-hearted man who was never able to come out of the status into which he was born but in the end he was able to get wealthy.April realized that she wasnt happy with Bob, so they got a divorce. From that divorce, she received a good amount of money. She immediately went back home to her sister, but things were not good between Cheryl and April. After Cheryl commit ted suicide, April found her diaries and read them. She finally realized what Cheryl has gone through while April wasnt in her life and what she thought of everything especially what she thought of April. April accepted being Mtis then and there. Like her sister, she is soaring to be Mtis. Since she loved Cheryl, she was glad that a part of Cheryl was alive in her son, Henry Liberty. All life dies to give new life. (pg. 184) It was tragic that it had taken Cheryls death to bring April to accept her identity but she would strive for a better tomorrow now. For her sister and her son, her parents and her people.In conclusion, Pip accepted himself in the social class that he used to be in. Even though he remained in the higher class, Pip realized that he still cared for his loved ones in the lower class. For April, she accepted herself in the social class she was born in. Even though Cheryls life had to be taken away before April realized how important her heritage was. Pip carried a s nobby attitude for a great luck of his life. He treated the people he loved without realization of how he wasnt respectful towards them.April had tried hiding, she had attempted to be someone shes not, she had tried being with someone she didnt love, and she had also undertook to blocking her own sister out of her life. No matter what April did, she couldnt get away from what she really was inside. She was born Mtis. She just didnt feel proud of it nor did she want to be Mtis. Pip and April both had issues with the people in their lives and they both found their true identities from being ashamed of their social class to placidity with their lives.

Importance of Communication in Nursing

Importance of communicating in breast feedingINTRODUCTION dialogue is a demonstrate and has many aspects to it. Communication is a dynamic process by which instruction is sh argond between individuals (Sheldon 2005). This process requires three comp sensationnts (Linear model), the sender, the receiver and the pith (Alder 2003). Communication would non be vi competent if any of these comp unrivallednts ar absent. sm every(prenominal)-arm peate (2006) has suggested that conference is done every day through a linear process, Spo social occasion (2008) argues that it is not so simple and does not follow such(prenominal) a linear process. He explains that due to messages macrocosm sent at the same magazine through verbal and non- verbal avenues, it is expected the receiver is able to record the way this is communicated. stiff communion needs noesis of bang-up verbal and non-verbal parley techniques and the possible hindrances that whitethorn change legalish conversa tion. The breast feeding and Midwifery council (2008) states that a concord has rough-and-ready confabulation skills before they basis register as it are hold inn as an essential part of a makes delivery of safeguard. (WAG 2003)Reflecting on talk in practice pull up stakes too enforce the theory behind chat and allow a nurse to look at bad and dandy discourse in varied smears. This will then enforce the hold of good parley techniques in a variety of situations allowing for a more social and therapeutic nurse forbearing relationship.This assignment discusses health bring off communication and why it is all important(p) in breast feeding byExploring verbal and non-verbal communication and possible barriersBy exploring the fundamentals of dish out set out by the Welsh assembly and the nurse and midwifery councils code of conduct a better fellow signature of the importance of communication is gained.Reflecting in practice employ a scenario from my community pos ting.VERBAL COMMUNICATIONVerbal communication comes in the form of intercommunicate ex conjure upion it kitty be formal or informal in its delivery. Verbal Language is one of the primary ways in which we communicate and is a good way to gather entropy through a question (an integral part of communication) and answer process (Berry 2007 Hawkins and Power 1999). on that pointfore verbal communication in care for should be seen as a primary process and a powerful tool in the judgement of a persevering of role. in that respect are devil main types of questioning, render-ended questions or closed questions. Open-ended questions tend to warrant more than a one word response and generally start with what, who, where, when, why and how. It invites the enduring to talk more around their condition and how they may be opinioning and provoke a more detailed assessment to be obtained (Stevenson 2004). The wasting disease open-ended questions make the affected role sense they dea l the attention of the nurse and they are cosmos listened too (Grover 2005). It allows for a psychological focus to be inclined, this spirit of interest in all aspects of the affected roles dish out allows for a therapeutic relationship to develop (Dougherty 2008).Closed questions looks for very specific information active the persevering (Dougherty 2008). They are very good at ascertaining factual information in a short space of time (Baillie 2005).There are two types of closed questions the center and the multiple choice questions. Foc utilize questions tend to acquire information intimately a particular clinical situation (e.g. asking a patient who is been inflict Ibuprofen, are you asthmatic?) whereas multiple choice questions tend to be more based on the nurses understanding of the condition being assessed. It nominate be used as a tool to booster the patient describe for example the pain they feel e.g. is the pain dull, sharp, throbbing etc (Stevenson 2004).For ve rbal communication to be effective, good audience skills is essential. Difficulty in sharing information, concerns or nips could arise if the individual you are communicating with thinks you are not being attentive and interested in what they are saying (Andrews 2001). Good active listening washstand lead to a better understanding of the patients most recent health issues (Sheldon 2005). Poor listening could be as a result of message overload, physical noise, poor origin and psychological noise. Therefore being prepared to listen and putting the effort and time are essential in a nurses role (Grover 2005).NON-VERBAL COMMUNICATIONThis type of communication does not involve spoken language and washbasin some clock be more effective than words that are spoken. About 60 65 per cent of communication between people is through non verbal behaviours and that these behaviours derriere give clues to feelings and emotions the patient may be experiencing (Foley 2010, p. 38). Non-verba l communication functions as a replacement for tongue to re affirm verbal communication to control the function of communication to convey emotions to help define relationships and as well a way of bighearted feed grit. The integration between verbal language and paralanguage (vocal), cornerstone affect communication received (Spouse 2008)Berry (2007) highlights the sense of verbal language due to the use of paralinguistic language. The way we ask a question, the tone, and pitch, volume and speed all get under ones skin an integral part to play in non verbal communication. In his opinion, personality is sh profess in the way that paralanguage is used as well as adding depth of meaning in the presentation of the message been communicated.Foley (2010) identifies studies where language has no real prevalence in getting across emotional feelings, in the mass of cases the person understands the emotion even if they dont understand what is being said. Paralanguage therefore is a n important tool in describeing the emotional state of a patient.Non-verbal actions (kinesis) can communicate messages, such as physical structure language, touch, gestures, facial expressions and eye touch. By using the universal facial expressions of emotion, our face can show many emotions without verbally saying how we feel (Foley 2010) refer to Appendix 2. For example, we raise our eye brows when surprised, or open our eyes wider when shocked.First impressions are vital for effective interaction by remembering to pull a face with your eyes as well as your mouth can communicate an approachable person who is open. This can help to reassure a patient who is wake signs of foreboding (stonemason 2010).BARRIERS TO COMMUNICATIONThe understanding of the barriers to communication is overly very important for effective communication and taken into consideration could result in a disaster in communication. The Welsh Assemblys fundamentals of vex (2003) showed that many of the pro blems associated with health and social cathexis was due to failures in communication. These barriers may be the messenger portraying a judgmental or power attitude. Dickson (1999) suggested that social class can be a barrier to communication by distorting the message being given and received as would be the case if the patients feel they occupy an inferior status thus making communication difficult and awkward.Environmental barriers such as a busy ward and a stressed nurse could influence effective communication. This can greatly curb the level of empathy and communication given as suggested by Endacott (2009).People with learning disabilities come up against barriers in communicating their needs, due to their inability to communicate verbally, or unable to understand complex new information. This leads to a breakdown in communication and their health care needs being met (Turnbull 2010).Timby (2005) stresses that when effectively communicating with patients the law as well as th e NMC (2008) guidelines for consent and confidentiality essential be adhered to. This also takes into account handing over to other masters. He suggests that a patients rights to autonomy should be upheld and respected without any influence or intimidation, regardless of age, religion, sexual activity or race. The use of communication in practice is essential and hypothecateing on past experience helps for a better understanding of communication, good and bad.REFLECTIONReflecting on my experience while on placement in a G.P with a practice nurse in south Wales Valleys, has helped me understand and gain practical knowledge in communicating effectively in nursing practice. The duration was for one week and includes appointments in several clinics to do with C.O.P.D and diabetes. I will be reflecting upon one of such appointments using the Gibbss reflective cycle (1988).DescriptionDue to confidentiality (NMC, 2008) the patient will be referred to as Mrs A.E. The Nurse called Mrs A. E to come to the appointment room. I could see she was anxious through her body language (palm trembling and sweaty, fidgety, calm and rapid speech). The nurse asked her to sit down. The nurse gained consent for me to sit in on her brushup (NMC, 2008).The come off started with a basic questionnaire the nurse had pre generated on the calculating machine. It was a fairly closed questionnaire around her breathing including how it was, when it was laboured. Questions were also asked around her medication and how she was taking her pumps. Reflecting on these questions, I feel that the way the questions did not leave much opportunity for Mrs A.E to say anything else apart from the answer to that question and the nurse controlled the communication flow. The Nurse did not stomach much eye contact with the patient and was facing the ready reckoner rather than her patient. I wondered if the nurse had notice the anxious non-verbal communication signs. The patient seemed close to on the v erge of tears, I wasnt sure if this was anxiety or distress from being unwell, barrier of social class or if the lady was unhappy almost something else. I felt quite sorry for her as all her body language communicated to me that she was not happy. She had her arms crossed across her body (an indication of timidity) and she did not smile, she also looked very tense and uncomfortable.The Nurse went on with the general assessment and did the lung test and I took the blood pressure and pulse, gaining consent first as requisite by the NMC. Once all the questions had been answered on the computer the Nurse turned to face Mrs A.E and I noticed she had eye contact with her and had her body slightly tipped toward the patient (non verbal communication). The Nurse gave her information on why her asthma may be a bit worse at the moment and gave her draw and appropriate information on how she can make herself more comfortable. The Nurse gave her lots of guidance on the use of her three prot estent pumps, and got her to repeat back to her the instructions she had given to make sure she understood. I could feel the patient getting more at easy as the communication progressed and also on the confirmation that she understood the instruction. The Nurse knew this patient well and then set the rest of the time talking to the patient roughly any other concerns she had and how she was feeling in herself, using a more open question technique.The nurse used her active listening skills and allowed the patient to talk about her problems and gave her empathy at her situation as well and some solutions to think about. She gave the patient information of a support group that helped build up confidence in people with chronic conditions and helped them deal with the emotional side of their condition.FeelingsAfter the patient had gone, my mentor explained that the patient was a known regular patient to the clinic, that she had many anxiety issues which werent helped by her chronic ast hma.Through-out the beginning of the review I felt very awkward. I thought because I was sitting in on the review may restrain been the reason the lady had not said why she seemed so anxious and upset. I also felt the nurse was not reacting to the sign of anxiety from Mrs A.E and this made me feel uncomfortable. I felt like I wanted to ask her if she was ok, precisely felt that I couldnt interrupt the review. However by the end of the review I felt a lot better about how it had gone. I did feel that by building up a relationship with the patients allowed the nurse to understand the communication needs of the patient and also allowed her to use the time she had effectively. She used empathy in her approach to the lady and actively listened to her. I understand that the start of the review was about getting the facts of the condition using a lot of closed questions, whereas the later part of the review was a more open questions and non verbal communication approach, allowing the pat ient to speak about any concerns and feelings about those questions asked earlier.EvaluationEffectively using closed questions allow for a lot of information to be gathered in a short space of time, and can be specific to the patients review needs. These pre-generated questionnaires are good at acquiring the information needed by the G.P. and also for good record keeping which are essential in the continuity of care delivered to the patient. It can also protect the nurse from any litigation issues.The use of open and closed questions also allowed for the review to explore the thoughts and feelings of the patient, thus allowing for empathy from the nurse and is considered a vital part of the counselling relationship (Chowdhry, 2010 pg. 22).However the use of the computer screen facing away from the patient, did not allow for good non-verbal communication skills to be used. The lack of eye contact from the nurse may pick out exacerbated the anxiety felt by the patient. Hayward (1975, p. 50) in a outline of research into anxiety noted uncertainty about illness or future problems was linked to anxiety and therefore linked to pain.Nazarko (2009) points out, it is imperative that a person has the full attention of the nurse when they are communicating. He states that being aware of ones own non-verbal behaviours, such as posture and eye contact can have an effect on how communication is received by the patient.As evident in the reflection, the patient at the beginning of the review was anxious, upset and worried. By the end of the review her body language had significantly changed. The patient looked and felt a lot better in herself and had a better understanding of how her condition was affecting her and understood how to manage it. Whereas, bad communication would have caused more stress and aggression ( treat standard 34 (30) 2010). This also links back to the need to understand health check conditions so that communication is channelled to the patients needs at the time. The fundamentals of care set out by the Welsh Assembly Government (2003), states that communication is of upmost importance in the effectiveness of care given by nurses. By looking at all the fundamentals of communication and the effect on patient care we can understand and recognise that the communication in this reflection was a good communication in practice.AnalysisThe closed questions were used at the beginning of the review, had their advantages. They allowed the nurse to focus the on the specific clinical facts needed to be recorded. The start of the review used mainly closed questions to get all the clinical facts needed to be recorded, such as Personal information, Spirometry results, blood pressure, drug management of COPD (Robinson, 2010). The organise approach allows the nurse to estimate using measurable outcomes and thus interventions adjusted accordingly (Dougherty, 2008). The closed question approach allows the consultation to be shortened if time is a n issue. However the disadvantage of this as identified by Berry (2007) is that important information may be missed. The use of closed questions on a computer screen hindered the use of non-verbal communication. Not allowing for eye contact, which is an important aspect of effective communication.The use of open questions in the review allowed the patient to express how they were feeling about their condition or any other worries. The nurse used active listening skills, communicated in her non-verbal behaviour. It gave the opportunity to the patient to ask for advice on any worries they business leader have. The use of open questions can provoke a long and sometimes not totally relevant response (Baillie, 2005), using up valuable time.The use of Egan (1990, p. 46) acronym SOLER allowed the nurse to focus on the skill of actively listening.Eye contact is another important part of communication in the reflective scenario. The eye contact at the start of the review was limited. The nu rse made slight eye contact when asking the closed questions, but made none when given the answer. This may have contributed to the patients anxious state. However, the eye contact given during the open questions section. At this stage, there were several eye contacts between the nurse and patient and information was given and understood. The value of eye contact in communication is invaluable and has great effect at reducing symptoms of anxiety (Dougherty 2008).Reflection conclusionThe use of communication in this COPD review was very structured. The use of closed questions helped to structure the consultation and acquire lots of information from the patient. The open questions allowed for the patient to express any feeling or concerns. The nurse used verbal and non-verbal communication methods, to obtain information about the patient assess any needs and communicate back to the patient, deep down the time period. However in my opinion, if the computer screen was moved closer to t he patient during the closed question section, better interaction could have been progressed from the beginning. It would also allow the nurse to look at the patient when asking the questions lede to a more therapeutic relationship, whilst still obtaining and recording a large tot of information.Therefore, the use of effective communication skills as seen in this review along with a person centred approach can significantly increase better interference and care given to the patient (Spouse, 2008) and thus signifies good communication in practice.Action PlanThe goal of the plan is to increase patient participation in the use of the computer as an interactive tool. By allowing the patient to see what is on the screen and being written, allows the patient to feel more involved in the assessment and takes away any feeling of inferiority from social class diversion.In attempt to achieving these goals, the following steps would be takenSet up a team to investigate the issue which co uld involve nursing staffs or other hospital staffs.Drawing up a feedback questionnaire, to investigate how patients feel about the closed questions on the computer, including a section on how they would feel if they were allowed to look at the screen.Collation, analysis and review of the results of the feedbackIdentify barriers to the implementation of the plan (e.g. willingness of nurses to this change).Inform the NMC on the issues and the findings from the feedback questionnaire.Implementation of the plan.Set up a monitoring and valuation team to see if the plan is being implemented appropriately.CONCLUSIONThis assignment has looked at communication and its importance in nursing practice. Communication is thus an iterative process involving the interaction between one or more persons using verbal and non-verbal methods. misgiving the barriers to communication contributes significantly to how effective a nurse communicates in practice. The use of questioning in nursing has been a valuable tool in assessing a patient and obtaining information. However the way this is done can have an effect on the development of empathy, trust, genuineness and respect, between the nurse and the patient. It is imperative for nurses to however reflect on their communication in practice to further remedy the therapeutic relationship between them and the patient as has been identified as essential in the delivery of care (WAG 2003).REFERENCESAlder, RB. Rodman, G. 2003. Understanding human communication (8th edition). USA Oxford university pressAndrews C, Smith J (2001) Medical Nursing (11th edition) capital of the United Kingdom Harcourt Publishers limitedBerry, D. 2007. Basic forms of communication. Cited in. Payne, S. Horn, S. ed. health communication theory and practice. England Open university press.Chowdhry, S. 2010. Exploring the concept of empathy in nursing can lead to abuse of patient trust. Nursing times 160 (42) pg 22-25Dickson, D. 1999. Barriers to communication. Cited In Long, A. ed. interaction for practice in community nursing. England Macmillian press LTD, pp. 84-132Dougherty, L. Lister,S. ed. 2008. The royal marsden hospital manual of clinical nursing procedures. Student edition. 7th edition. Italy Wiley-BlackwellEgan, G. 1990. The skilled helper A self-opinionated approach to effective helping. (4th edition). California Brooks /ColeEkman, p. Friesen, WV. 1975. Unmasking the face. Englewood cliffs, NJ prentice-hall INCEndacott R, Jevon P, Cooper S (2009) Clinical Nursing Skills Core and Advanced. Oxford Oxford University Press.Foley, GN. 2010. Non-verbal communication in psychotherapy. psychopathology (Edgemont) 7 (6) pg. 38-44Gibbs, G. 1988. Learning by doing a guide to teaching and learning methods. Oxford Oxford futher education unit.Grover, SM. 2005. Shaping effective communication skills and therapeutic relationship at take on. Aaohn daybook 53 (4) pg. 177-182Hawkins, K. Power, C. 1999. Gender differences in questions asked during small decision-making group discussions, small group research.(30) pg.235-256Hayward, J. 1975. Information A prescription against pain. London Royal college of nursing. Pg. 50Marie- Claire Mason (2010) Effective interaction Nursing Standard 24 (31) pp 25.Nazarko, L. 2009. Advanced communication skills. British journal of health care assistants. 3 (09) pg 449-452Nursing and Midwifery Council (NMC) (2008) The Code Standards of conduct, performance and ethical motive for nurses and midwives. London. NMCPeate, I. 2006. Becoming a nursein the 21st century. England Wiley and SonRobinson, T. 2010. Empowering people to self-manage COPD with management plans and hand held records. Nursing times. 106 (38) pg. 12-14Sale, J. Neal, NM. 2005. The nurses approach self-awareness and communication. Cited in Ballie, L. ed. Developing practical nursing skills (2nd edition). London Oxford university press. Pg. 33-57Sheldon, L. 2005. Communication for nurses Talking with patients. London Jones a nd Bartlett publishers.Spouse, J. Cook, M. Cox, C. 2008. Common foundation studies in nursing (4th edition). London Churchill livingstone.Stevenson C, Grieves M, Stein Parbury J 2004 Patient and Person Empowering Interpersonal relationships in Nursing London. Elsevier Limited.Timby BK (2005) Fundemental Nursing Skills and Concepts Philadelphia. Lippincott Williams and WilkinsTurnbull J, Chapman S (2010) Supporting Choice in Health Care for People with Learning Disabilities. Nursing Standard 24 (22) pg 50 55Welsh Assembly Government (2003) Fundamentals of Care Guidance for Health and Social Care Staff Cardiff WAGImportance of Communication in NursingImportance of Communication in NursingCommunication in nursingIntroductionCommunication in nursing is vital to quality and safe nursing care (Judd, 2013). There is evidence that continues to show that breakdowns in communication can be responsible for many medication errors, unnecessary health care cost and inadequate care to the patien t (Judd, 2013). Several reports exist from the Institute of Medicine that stress the importance of good communication and its link to providing safe and reliable care (Judd, 2013). (Smith Pressman, 2010). However, even nurses with the best communication skills can be challenged by difficult situations such as life threatening threatening illness or injury, obscure family relationships, and mental health issues, to symptoms such as unrelieved pain and nausea. How a nurse may respond during these situations depends on many factors. Each nurse brings their own history, last, experience, and personality to a situation. Communication in the workplace can either be horizontal among workers at the same hierarchical level, vertical among workers in different hierarchical levels or diagonal amongst different workers in different hierarchical levels. All these kinds of communication are crucial in the work environment because work needs to be done and goals need to be met. A communication channel is made up of three components made up of the sender of the message (encoder), the channel of sending the message and the receiver of the message (decoder) (Anderson, 2013). For effective communication to be achieved, the encoder and the decoder must be able to understand one another. This penning will discuss some strategies which could be implemented to improve some(prenominal)(prenominal) written and verbal communication between nurses, health avocationals and between patients and the health care team.Communication, a fundamental aspect of nursing, is a complex, continual transactional process that occurs between persons by which information, feelings, and meaning are conveyed through verbal and non verbal messages (Peereboom, 2012). It is crucial for nurses to learn communication strategies that should be put into consideration every time they are involved in conversations involving their line of practice. This is because clear and accurate communication strategies enable them to identify effective patterns in their interactions and in teaching themselves to improve their patient education techniques. Handover communication between practitioners may at times seclude crucial information and is even prone to misinterpretation. Such communication breakups and challenges can lead to intense mishaps in the continuity of health care, incorrect treatment, and potential harm to the patient in general (Memoire, 2007).Simple strategies can easily impart critical information just by eye sight. For instance, nurses are able to communicate critical patient status issues like allergies and fall risk with color-coded patient identification wrist bands or stickers on their medical records, a seat belt or sign attached to a wheel chair, or any other objects which are easily identifiable by all medical practitioners (Joint contribution resources, 2005). The use of topical anesthetic jargon can also be avoided when making lord conversations because some words may portray a meaning that was not intended or is not readily understood by a large number of people.Assimilation of the ISBAR tool is a strategy that has been really helpful in enhancing communication in the health care sector when used. Identifying yourself (I), availability of the situation (S), background (B), assessment (A), and recommendations (R) facilitates communication allowing each health practitioner to receive and give important information in a format that satisfies numerous communication styles and needs (Dixon et al., 2006). This tool should be adopted by everyone to improve communication is because this technique utilizes the use of one habitual language for passing on critical information without leaving out anything.Another strategy that can be used to improve communication in health care centers is the Crew Resource Management technique which is both a communication and team building technique (ECRI, 2009). This strategy trains members of the healthcare secto r to assert themselves respectively and be attentive when they are being spoken to and also encourages them to make use of briefings. legal briefings are direct communication theory between physicians, nurses or other caregivers acting on patient status which includes sharing of important information at critical times, such as before the start of a procedure, at the change of shift and during normal patient rounds (ECRI, 2009).COMMUNICATION BETWEEN PATIENTS AND THE HEALTH CARE TEAMOne stratergy that can be used to improve communication between patients and the health care team is the use of The World Health Organization Surgical Safety Checklist. This checklist is to be used in operate suites to ensure everyone involved with the patient including the patient understands what procedure they are having ad gives prompts to tick off so important information is not missed during handovers leading to decreased inpatient complications and death (Department of Health, 2010).In addition t o the patient, their family members or next of kin can also be included in the rounds further change magnitude the opportunity for direct dialogue which reduces the development of complications which arise as a result of miscommunication in the form of home care. It is important to note that if personal care by the family of the patient is not provided as requested by the medical practitioner, cohesive care is not accomplished and the opportunity to achieve patient care goals will not be met (OLeary et al., 2010). Joint commission reports also indicate that health practitioners should also encourage patients to actively participate in their own care as a strategy to enhance communicational barriers (Stein, 2006). Successful interactions are always co-constructed, involving a constant interplay among the two parties. When the patient and the healthcare provider are comfortable with one another communicating becomes easy and more effective in the sense that the healthcare provider wi ll be able to cypher the needs of the patient.COMMUNICATION BETWEEN HEALTH CARE DISCIPLINESCommunication between medical practitioners can greatly influence the general patients care outcomes. Medical practitioners are in the frontline to investigate and identify communication challenges and try to implement solutions that fit their line of duty. Some further research is also being carried out to evaluate potential solutions and more successful options (Rosenstein, 2005).Creating a collaborative relationship between nurses and other medical practitioners is also another strategy that can help reduce communicational barriers and thus improve the general treatment of patients (Arora, 2005). With regard to Schmalenberg and Kramer (2005), MD/ RN collaboration is reflected in reduced patient mortality, fewer transfers back to the ICU, reduced costs, decreased length of stay in hospitals, higher nurse autonym, retention, nurse-perceived high quality care, and nurse job satisfaction. Lara bee (2006) also found out that confirming relationships between medical practitioners were a major contributing factor to improved nursing job satisfaction and retention. Positive collegial relationships therefore result from good communication, mutual acceptance and understanding, use of persuasion rather than coercion, and a balance of reason and emotion when workings with others (College of Nurses of Ontario, 2009, pg. 7).COMMUNICATION BETWEEN NURSESA number of strategies have been set up to address communication issues among nurses. For instance, the implementation of unit based care teams places nurses and people like physicians close to one another thus increasing the chances of communicating effectively (Gordon et al, 2011). The introduction of compulsory bed rounds is also another strategy that has enabled nurses to reduce communication barriers and get ahead effective communication thus creating patient health satisfaction and general health care providers satisfaction i n their duties.The continuous flow of interruptions and multiple patient handoffs affect the ability of nurses and physicians to connect effectively, and establish a trusting and collegial relationship (Tschannen et al., 2011). The fact that the working environment of nurses and other medical practitioners is rather different also induces a number of communication barriers with regard to the intensity of activities on a normal working day (Burns, 2011).this could be improv4d byCommunication challenges are recognized when set goals or achievements are not met or when there is great employee turnover. Technological advances have opened up communication across boundaries of different countries meaning that people with different languages, behaviors and culture interact with one another (Krizan, 2010).In the health care sector in particular, the most pertinent communication barrier is the inability for colleagues to interact physically as they are separated in different departments (Vig nam, 2013). This lack of interaction minimizes the ability for team members to collaborate wholly in the sense that the ability to analyze body language and create a sense of energy among team members is null. This can be improved byBarriersBarriers to communication that exist are the use of machinery and equipment that might malfunction and deliver the message later than expected thus reducing the urgency of information. In addition to this, these machines are not able to express aspects of speech such as tone thus making them a true barrier to effective communication. Language is also a major communication barrier in the case where colleagues do not speak the same language or where they have difficulty in articulating clearly in one common language. The use of local idioms, jargon and acronyms further complicates language and kills communication among team members who find certain words ambiguous (Lingard, 2005). A patient in a hospital setting usually sees more than one health c are practitioner and specialist during their stay (Memoire, 2007). Handover communication between practitioners may at times seclude crucial information and is even prone to misinterpretation.By improving communication among healthcare originals the delivery of patient care improves and is saferStrong and effective nursing care is enriched and strengthened by good communication (2)In Victoria, the direct cost of medicalerrors in public hospitals is estimated at half a billion dollars per year 1. Today, healthcare isevermore complex and diverse, and improving communication among healthcare professionalsis likely to support the safe delivery of patient care.ReferencesAnderson, P., 2013. Technical communication, cengage learning, CanadaArora V, Johnson J, Lovinger D. (2005) Communication failures in patient sign-out and suggestions for advance a critical incident analysis. Qual Saf Health CareBurns, K. (2011). Nurse-physician rounds A collaborative approach to improving communicatio n, efficiencies, and perception of care. MEDSURG NursingDixon, J., Larison, K., Zabari, M. (2006). Skilled communication devising it real. AACN Advanced Critical CareCollege of nurses of Ontario. (2009), conflict prevention and management, Toronto, ONECRI. (2009), Healthcare risk control, 5200 butler pike, Plymouth meeting, PA 19462-1298, USAFernandez, R., Tran, D., Johnson, M., Jones, S. (2010).Interdisciplinary communication in general medical and surgical wards using two different models of nursing care delivery. journalOf Nursing ManagementGordon, M., Melvin, P., Graham, D., Fifer, E., Chiang, V., Sectish, T., Landrigan, C. (2011). Unit-based care teams and the frequency and quality of physician-nurse communications. puckishives of Pediatric adolescent MedicineJoint commission resources. (2005), issues and strategies for nurse leaders meeting hospital challenges today, joint commission resources, Inc, USAKrizan, A., Merrier, P., Logan, J., Williams, K., 2010. Business comm unication Business communication series, Mason USA Cengage learningLarabee, L., Janney, M., Ostrow, C. Withrow, M. Hobbs, G. Burant, C. (2007), predicting registered nurse job satisfaction and intent to leave, journal of nursingLingard L, Espin S, Rubin B. (2005) Getting teams to talk development and pilot implementation of a checklist to promote interprofessional communication in the OR. Qual Saf Health CareMemoire, A. (2007), communicating during patient hand over, patient sanctuary solutions, vol 1OLeary, K., Thompson, J., Landler, M., Kulkarni, N., Hawiley, C., Jeon, J.Williams, M. (2010). Patterns of nurse-physician communication and agreement on the plan of care. Quality and Safety in HealthcarePeereboom, K. (2012), facilitating goals of care discussions for patients with life limiting disease- communication strategies for nurses, journal of hospice and palliative careRosenstein AH, ODaniel M. (2005). Disruptive behavior clinical outcomes Perceptions of nurses and physicians .American Journal of NursingStein JS. (2006) Improving patient safety communication. Presented at Philadelphia Area Society for Healthcare Risk Management Mar 16 ECRI Institute, Plymouth Meeting (PA).Schmalenberg, C. Kramer, M., King, C. (2005), integrity through evidence securing collegial nurse physician relationships, journal of nursing administrationSchmalenberg, C., Kramer, M. (2009). Nurse-physician relationships in hospitals 20,000 nurses tell their story. Critical Care NurseVigman, S., 2013. Global challenges communication and culture people issues in a global environment, workforce solutions reviewDepartment of Health 2010Promoting effective communication among healthcare professionals to improve patient safety 1-1-7Retrieved fromhttp//www.health.vic.gov.au/qualitycouncil/downloads/communication_paper_120710.pdfhttp//www.health.vic.gov.au/qualitycoun http//www.health.vic.gov.au/qualitycouncil/downloads/communication_paPromoting effective coImportance of Communication in N ursingImportance of Communication in NursingCommunication is a huge topic and can be considered on many different levels from a professional viewpoint. We can consider issues such as the relevance of various forms of communication between the healthcare professionals and the patient which, ultimately determines many of the parameters of treatment (and compliance).(Stewart M 1995)We can also consider the importance of communication between healthcare professionals themselves which can cause unjustified problems for the patient if they are less than optimal. (Hogard E et al. 2006)Firstly, communication requires a definition.There are many attempts at trying to define the essence of communication. They all differ in detail but, in essence, they all describe a complex process of both sending and receiving messages which can be either verbal or non-verbal or, more comm and, a mixture of both. This interchange allows for an exchange of information, feelings, needs, and preferences. Typic ally the two protagonists in a communication exchange will encode and decode messages in a cyclic pattern. Each making an analysis and response to the preceding gambit. (Wilkinson SA et al. 1999)In the context of professional nursing, its purpose is generally manifold but will include the means of establishing a nurse-patient relationship, to be a tool for expressing concerns or interest in the patients circumstances, to awake information relevant to the patients condition and to provide healthcare information. (Bugge E et al. 2006)Implicit in the process of communication is the achievement of a shared understanding of meaning. This is validated by the process of feedback interpretation which indicates if the actual meaning of the message was interpreted as it was originally intended.Communication can be categorised into both type and level. In a nursing-specific context, the level of communication can be defined as Social which is considered to be safe and non-contentious, Structu red, which is typically utilised for situations of teaching and patient interviews and Therapeutic which has the characteristic of being specifically patient focussed, purposeful and generally time limited. If this is successful it develops further characteristics such as the nurse comes to regard the patient as a unique individual and begins to understand their motivations, and the patient develops a trust in the nurse. It is within this communication context that the nurse is generally able to try to provide care and, more importantly in some instances, help patient identify, resolve, or adapt to health problems. (DAngelica M et al. 1998)The types of communication are capable of endless subdivisions, but in broad terms, they are classified as verbal and non-verbal.The verbal communication requires, by definition, the conscious use of the spoken or written word. The nature, grammar and syntax of the words can reflect the patients mental age, their education, their culture and in so me cases their mental state and feelings of the moment. authorized inferences can be made from the way the words are delivered such as their choice, their tone or pace of delivery. The characteristics most favourable for businesslike and effective communication are that the words should be simple, brief, clear, well timed, relevant, adaptable, credible. (Philipp R et al. 2005)Non-verbal communication relies on the interpretation of facial expressions, hand gestures, and body language. This is an extremely sharp means of communication and can give credence (or otherwise) to the spoken word. In the nursing context, non-verbal communication can be manipulated to the nurses advantage to help to elicit information that may otherwise not have been forthcoming. It has been estimated that non-verbal communication accounts for up to 85% of information transfer between communicating adults. In the professional nursing context it requires both systematic observation and careful assessment a nd interpretation to derive the full meaning of what the patient wishes to convey. Most importantly, the nurse should be aware of incongruity between the verbal message and the non-verbal cues. The patient who smiles while describing a terrible pain is one such example. (Musselman C et al. 1999)Implicit in the understanding and correct interpretation of the non-verbal cues, (and to a lesser extent the verbal ones), is an appreciation of the various environmental and circumstantial factors which can affect the process of communication. There are a number of factors that are of relevance to the clinical situation, including the culture, developmental level, physical psychological barriers that pertain to the patient, their personal space (proxemics) and territoriality that they perceive, the roles and relationships of the people that they are speaking to, the local environment, and their personal attitudes and values and level of self esteem. (Derjung M et al. 2006)On a personal lev el, I find communication skills most important in the context of the nursing report. One can experience situations where a report is given and very little real information is passed between professionals. Other situations can occur where perhaps the same length of time is taken but enormous amounts of information can be derived from a good report.I call back one particular handover report which, despite being fairly long, left me with no clear information as to what was going on with the patients on the ward. I couldnt recognise them as people and they were presented more as cattle. The report itself was completely task orientated and comprised little more than a list of jobs that the nurse herself had not been able to accomplish that day.If we consider the literature on the subject we can note that the nursing report predates the Nightingale era. (Carrick P 2000). The nursing profession has evolved as have the requirements, demands and procedures employed. The nursing report is no exception to this evolution. As with any process that involves humans, there is an intrinsic variability. It is seldom perfect and its standard can vary all the way from excellent to dreadful (RCN.2003)In consideration of comments made earlier in this essay we note that the issue of report giving is capable of considerable improvement with learning. This was demonstrated by two independent researchers who produced two seminal papers on the subject coincidentally at close the same time. (Ljukkonen A 1992) (Kihlgren et al 1992). In essence, their studies were a period of observation and analysis, a pedagogy period and then another period of reanalysis.There is no merit in considering the entire paper in detail here, but the significant findings (in terms of communication) were that before the training the reports were generallyHighly task orientated and (it was noted that) the staff often discussed the patients reaction in vague and general terms without imparting any specific or useful information.The authors were also able to comment that the nursing process was seldom adhered to during the structuring of the report.During the post training assessment the authors noted that the most significant areas of change wereMore messages were given per report later the intervention compared to the control ward and the messages with psychosocial content had doubled.The relevance to communication issues is clear. These two studies show that communication is not necessarily innate, but is a skill that can be both learned and enhanced. Good communication equates with both efficiency and, in the case of these two studies, less dissatisfaction and a greater team empathy between nursing colleagues which led to more collaboration between the various teams working on the ward.There are a number of ways in which we can approach the discussion of such topics and we shall consider a few specific different types of communication as an illustrative vehicle for discussion.Much or iginal and forward-looking work in the area of communication in the healthcare setting was done by Orlando about two decades ago (Orlando I. J. 1987) who suggested that one of the core roles of the healthcare professionals (he was writing specifically about nurses at the time) was toascertain and prioritise the patients needs and instigate and plan appropriate help.Few would disagree with this comment, but it is clear that effective and precise communication between patient and nurse is essential if the patients needs are to be ascertained accurately in the first instance. Communication between healthcare professionals, the patient and other legitimately interested parties such as carers, is then vital if such a plan is then to be optimally implementedThe importance of communication as a skill is clearly demonstrated by the fact that it is presently included as one of the six core skills required of the modern nurse manager. (ICN 1998).Another indicator of the importance of good c ommunication is the fact that the majority of complaints currently made to UK Hospital Trusts can ultimately be traced back to poor communication (Richards T 1999).Communication is an attribute and skill that is rarely intuitive. (Davies et al. 2002). There are a great many papers which demonstrate the fact that communication skills can be improved at all levels of competence with both practice and learning. (Hulsman R L et al. 1999)A particularly comprehensive review has been recently published by Heinmann-Koch (2005) which gives an excellent analysis of the strengths and deficiencies in the communication skills of a number of healthcare professionals and the authors make a number of recommendations to address the shortcomings that they identified.The authors quantify the essential skills of communication as Personal insight, sensitivity, and knowledge of communication strategies. The latter being considered vital to maximise the efficiency and effectiveness of ones communication a bilities.If we consider the professional standing on issues of communication, we can note that the Royal College of Nursing has earmarked communication skill as a specific competence goal and the Royal College of Physicians have now included a specific element of assessment in communication skills in their Part II membership exam with elements of information gathering and information giving being specifically assessed. (RCP 2002)Dacre summarises the important elements of the healthcare professional / patient interaction thusThe importance of reflection before a consultation in order to form a clear order of business of the overall aims of the consultation and prepare questions.Checking the patients name as an appropriate opening gambit. Starting with an open question.Use a mixture of open and closed questions, structuring the questions carefully, and exploring each area in full before moving on. Make sure each question is effective. Take care not to beam patients.Avoid the use of overtly medical language and check at each stage that patients have understood what is being said.Ensure that the healthcare professional does not push his or her own agenda.Allow patients time to finish speaking, using verbal and non-verbal cues to makes it clear that the healthcare professional is listening. Respond to the information that the patient has given to show that this has been heard and understood. Use careful interjections to redirect the interview if necessary.Avoid premature closure (finishing very quickly). There should be a summaryfor example, recapping decisions which have been made, and agreement of an immediate plan for the next step.(after Dacre J et al. 2004)In order to explore the area of communication more fully, we will consider a number of specific instances as illustrative examples. We shall begin with the study by Coiera (E et al. 1998). The study starts with the commentThe healthcare system seems to suffer enormous inefficiencies because of poor communi cation infrastructure and practices.It then cites the Smith paper (Smith A F et al. 2005) which points out the fact that communication problems were the most common cause of preventable disability or death, and were nearly twice as common as those due to inadequate medical skillThis study took a cohort of 10 healthcare professionals working in a hospital setting and analysed all of their professionally based communications. For efficiency and content. The paper itself was both long and involved and some of the findings are only of peripheral relevance to our considerations here, so we shall confine our discussions to the parts that are relevantThe first major finding was that there was a tremendous range of topics dealt with, ranging from the clinical to the administrative. The authors comment that efficiency of communication is inversely proportional to the diversity of topics. In other words, communication in a designated clinic setting, where all of the problems are likely to hav e a similar thrust, is more likely to be efficient than conversations encountered in a general ward on general topics. The second general finding was that efficiency of communication was significantly impaired by the frequency of interruptions. It follows that protected time in a consultation, free from interruptions, is more likely to be an efficient communication than one that is frequently interrupted.Interruptions were seen to be associated with a number of well recognised psychological responses including diversion of attention, forgetfulness, and errors. (Blum N J et al. 1992)Paradoxically, the authors found that the most younger staff, (I.e. the least likely to be experienced in communication skills), were the most likely to be interrupted, while the senior staff were the least likely to have their consultations interrupted.We have already considered a number of the factors that can influence communication and various communication strategies can be usefully employed to assi st in eliciting appropriate information. Active listening is perhaps the most useful basic tool that the nurse can use. When interacting with the patient, the nurse should endeavour to utilise strategies that will facilitate both conversation and elaboration. Mechanisms such as use of broad opening statements, reflecting, open ended statements and directive questions can be strategically employed to elicit appropriate information. (Huizinga G A et al. 2005)Many patients will not be used to expressing themselves clearly and concisely, and can be helped by techniques such as acknowledging feelings, using silence as a prompt, reflection, and stating personal observations. All of these factors can be enhanced if used alongside strategies that communicate mutual understanding. (Yedidia M J et al. 2003)We have presented evidence that communication is the medium of mutual understanding. We should therefore not leave this area without making comment on some strategies that the professional nurse can employ to maximise the empathetic understanding of those that she is communicating with. These strategies are important not only in the nurse / patient interaction but also in the teaching environment. Ensuring that the message is thoroughly communicated and understood requires techniques such as clarifying, validating, verbalizing implied thoughts and feelings, focusing, using closed questions and summary statements.The converse of this argument is that the nurse should also be aware of issues that are potential barriers to communication. The absence of positive and attentive listening is a powerful disincentive to most forms of communication. The patient who perceives that they are not being listened to is not likely to produce any useful information. Other barrier behaviours include the use of reassuring clichs, giving advice, expressing approval/disapproval, requesting an explanation (asking why?), defending, calumny feelings, stereotyped comments, changing the subjec t. (Arora V et al. 2005)We have devoted the majority of this examination to the spoken modes of communication, but we should not overlook that the written word is an equally important means of communicating ones thoughts to others, particularly on an interprofessional basis. In order to maximise the efficiency of communication a written report should ideally be brief, concise, comprehensive, factual, descriptive, objective, both relevant and appropriate and legally prudent. (Young B et al. 2003)In this assessment one should draw attention to the distinction between being both brief and concise. Brief equates with shortness as undue length will allow the readers attention to wander, whereas being concise implies an absence of irrelevant detail thereby allowing an emphasis on what is important.Conclusions.The preparation and literature review has allowed ample time for reflection on the issues raised. (Taylor, E. 2000). This has proved to be a valuable experience as some issues which I believed that I understood, became clearer and this gave me a much deeper insight into both the mechanisms and the possibilities of accurate and concise communication. Not only have the mechanisms of positive enhancement of communications become apparent but also the active removal of the barriers or impediments to communication clearly play an important role in the ability of the nurse to communication efficiently with both the patient and her healthcare colleagues.References Arora V, J Johnson, D Lovinger, H J Humphrey, and D O Meltzer 2005 Communication failures in patient sign-out and suggestions for improvement a critical incident analysis Qual. Saf. Health Care, Dec 2005 14 401 407.Blum N J, Lieu T A. 1992Interrupted care the effects of paging on paediatric resident activities.Am J Dis Child 1992 146 806-808Bugge E and I. J Higginson 2006 Palliative care and the need for education Do we know what makes a difference? A limited systematic review Health Education Journal, June 1, 2006 65 (2) 101 125.Carrick P 2000Medical Ethics in the Ancient WorldGeorgetown University press 2000 ISBN 0878408495Coiera E and Vanessa Tombs 1998 Communication behaviours in a hospital setting an observational study BMJ, Feb 1998 316 673 676.Dacre J, J Richardson, L Noble, K Stephens, and N Parker 2004 Communication skills training in postgraduate medicine the development of a new course Postgrad. Med. J., Dec 2004 80 711 715.DAngelica M, Kathy Hirsch, Howard Ross, Steven Passik, and Murray F. Brennan 1998 Surgeon-Patient Communication in the Treatment of Pancreatic Cancer Arch Surg, Sep 1998 133 962 966.Davies Fox-Young 2002Validating a scope of nursing practice decision making frameworkInternational Journal of Nursing studies 39 , 1 , 85 93Derjung M. Tarn, John Heritage, Debora A. Paterniti, Ron D. Hays, Richard L. Kravitz, and Neil S. Wenger 2006 Physician Communication When Prescribing New Medications Archives of Internal Medicine, Sep 2006 166 1855 1862.Heinmann-Knoch, Korte, Heusinger, Klunder Knoch 2005Training of communication skills in stationary long care homesthe evaluation of a model project to develop communication skills and transfer it into practice Z Gerontol Geriatr. 2005 Feb 38 (1) 40-6.Hogard E and Roger Ellis 2006 Evaluation and Communication Using a Communication Audit to Evaluate Organizational Communication Eval Rev, Apr 2006 30 171 187.Hulsman R L, Ros W J G, Winnubst J A M, et al. 1999Teaching clinically experienced clinicians communication skills a review of evaluation studies.Med Educ 1999 33 655 68Huizinga G A, A. Visser, W. T. A. van der Graaf, H. J. Hoekstra, and J. E. H. M. Hoekstra-Weebers 2005 The quality of communication between parents and adolescent children in the case of parental cancer Ann. Onc., declination 2005 16 1956 1961.ICN 1998International Convention on NursingScope of nursing practiceGeneva ICN 1998Kihlgren, Lindsten, Norberg Karlsson 1992, The content of the oral dail y reports at a long-run ward before and after staff training in integrity promoting care.Scand J Caring Sci. 1992 6 (2) 105 12.Ljukkonen A 1992Contents of daily reports and nursing practice in 2 homes for the aged Hoitotiede. 1992 4 (5) 194 200.Musselman C and C Tane Akamatsu 1999 Interpersonal communication skills of deaf adolescents and their relationship to communication history J. desensitize Stud. Deaf Educ., Winter 1999 4 305 320.Orlando, I. J. 1987.Nursing in the 21st century Alternate paths.Journal of Advanced Nursing, 12, 405 412. 1987Philipp R and P. Dodwell 2005 Improved communication between doctors and with managers would benefit professional integrity and reduce the occupational medicine workload Occup. Med., Jan 2005 55 40 47.RCN Leadership Project 2003Defining NursingRCN Publication 001 983 Apr 2003RCP 2002Royal College of Physicians.MRCP(UK) clinical guidelines.London RCP, 2002Richards T . 1999Chasms in communication.BMJ 1999 301 1407 8Smith A F , Catherine Pope, Dawn Goodwin, and Maggie Mort 2005 Communication between anesthesiologists, patients and the anesthesia team a descriptive study of institution and emergence Communication entre anesthsiologistes, patients et quipe danesthsie une tude descriptive de linduction et du retour la conscience Can J Anesth, Nov 2005 52 915 920.Stewart M . 1995Effective physician-patient communication and health outcomes a review.CMAJ 1995 152 1423 33.Taylor, E. (2000). create upon the theoretical debate A critical review of the empirical studies of Mezirows transformative learning theory.Adult Education Quarterly, 48 (1), 34 59.Wilkinson S, Bailey, J. Aldridge, and A. Roberts 1999longitudinal evaluation of a communication skills programme Palliative Medicine, June 1, 1999 13 (4) 341 348.Yedidia M J , Colleen C. Gillespie, Elizabeth Kachur, Mark D. Schwartz, Judith Ockene, Amy E. Chepaitis, Clint W. Snyder, Aaron Lazare, and Mack Lipkin, Jr 2003 Effect of Communications Trainin g on Medical Student surgical process JAMA, Sep 2003 290 1157 1165.Young B, Mary Dixon-Woods, Kate C Windridge, and David Heney 2003 Managing communication with young people who have a potentially life threatening chronic illness qualitative study of patients and parents BMJ, Feb 2003 326 305.28.11.06 Word count 3,551 PDG.

Approaches To The Broken Windows Policy Explained Criminology Essay

Approaches To The Broken Windows Policy Explained Criminology Essay1. Explain the Broken Windows theory of policing. Describe the advantages and disadvantages of this approach. Detail the 2 most important benefits and the two pitfalls of such(prenominal) an approach to policing. police force de incisionments, in the past twenty years, have adopted a theory that says by resolving kidskin disorders serious crimes back end be reduced. It is called the abject windows theory, also known as order-maintenance,zero-tolerance, or quality-of-life policing. (Harcourt Ludwig, Winter 2006, p. 282) It came to the forefront after a 1982 Atlantic Monthly article by throng Q. Wilson and George Kelling. The article argued that when low-level quality-of-life offenses were tolerated in a community, more than serious crime would follow. The worried windows theory says that the variation in disorder in neighborhoods that explains the variation in crime, holding structural disadvantage constant. The real trigger is disorderliness itself. (Harcourt Ludwig, p. 281) According to this view, broken windows, abandoned buildings, public drinking, litter and loitering cause good people to squelch in their houses or move out of the neighborhood entirely. The theory argues that the minor withalts and incivilities that frightened people, far from being a distraction for police departments, should be set as key targets of police action. (Moore, 1992, p. 138) It leaves criminals free to roam and send a message that law violations ar non interpreted seriously. The focus of the broken windows policing strategy is to address community anxiety about public safety. Broken windows advocates argue that the role of the police is fundamentally to maintain public order. (Dammert Malone, Winter 2006, p. 39) Some of the advantages of the broken windows policing are that it reduces social and physical disorders, furthers joint safety endeavors, and bring communities together.Broken windows the ory assumes an essentialist nonion both of disorder and its connection to cognition visual cues are unambiguous and natural in meaning (Sampson Raudenbush, Dec. 2004, p. 320). The theorys biggest test has been in New York City, where a melodramatic decline in crime has been attributed in large part to order maintenance. Rundown parts of the city have been cleaned up, and police focus more on such jobs as panhandling, turnstile jumping, and public drinking. Police have even cracked down on people who clean the windshields of cars at stoplights with squeegees (Parenti, 1999, p.77). Among the first and hardest hit were the homeless, who travel, beg, and live in the political and physical basement of the class agreement the citys six-story-deep concrete bowels. Advocates of such tactics argued that in order to address these crimes, the police must be afforded wide discretion and should not be hamstrung by inherent rules. Still broken windows enforcement has won a proper place amo ng trends in criminal-justice reform.But in doing so, the police ignored the principal lesson of their own theory. If the toleration of minor law violations touchs to more serious crime on the street, it would also follow that the toleration of minor law violations by the police volition lead to more serious crime on the force. And that is precisely what has happened. The broken windows theory suggests that minor disorders, both physicaland socialis causally related to serious crime. (Harcourt, 2001, p.68) Broken windows gives rise to wars on the poor, racism, and police brutality. (Weisburd Braga, 2007, p. 80) As mayor, Giuliani appeared to show his eagerness to impose law and order at all costs with the implementation of the zero tolerance policy. This led to a dramatic increase in arrests for such crimes as riding a bike on the sidewalk and playing loud music.People who admit that crime is lessen because of these policies are only being self-defeating because if they admit th at crime is down because of these policies, then they can use the same policies on the cops to improve police conduct. Yes, broken windows does reduce crime, but if an uncivil society breeds criminals, certainly a belligerent police force breeds police brutality. To what extent can police brutality be explained by turning the police loose with order maintenance tactics? Many civil libertarians and advocates for the homeless, for example, oppose order maintenance because they believe it infringes on the liberties of selected populations (the poor, minorities, the homeless, and youths) and opens the door agency to abusive police practices. The debates about these issues have been vigorous and often rancorous. (Kelling, October 1999, p. 1)Surveillance cameras are everywhere. They are in housing projects, at traffic intersections, and on pipe platforms, with plans constantly announced to add more. There are undercover quality-of-life police squads who ride the subways, busting people for fare skipping or even for placing their bags on the seat abutting to them. The police sweep down on the homes of suspected drug dealers and people they mistakenly think are dealing. A simple tip from a pluck can send cops to knock down the door and toss in a stun grenade. (RW, October 18, 1998)In conclusion, police officials need to focus on the satisfying content of police work find and delineate the means to conduct police work morally, legally, skillfully, and effectively then structure and administer departments on the buns of this literal work and not a fictionalized view of police work. (Kelling, October 1999, p. 2)2. Under what precondition in society would the broken windows approach work best? interrupt at least two specific circumstances and detail how the approach will work from start to finish.The broken windows approach to policing would work best in areas where there are a lot of untended behavior. It can be untended homes, untended yards, and even untended c hildren. If go away untended these can lead to a community that is out of control. A well kept home and community can pronto turn into a frightening place to live. Ones perception of incivilities in the neighborhood has a greater impact than the actual amount of incivilities in the neighborhood (Weisburd Braga, 2007, p.83). Houses that are not cared for gives criminal miscreants the impression that the residents of the community do not care about the quality of life in their neighborhood. It signals to them that they are free to roam to neighborhood and steal, litter, and vandalize. The unkempt houses opens up the community for more disorders, such as public drunkenness and loitering, that if not dealt with will lead to more serious crimes. Neighborhood disorders influences honest people to move out of the neighborhood or lock themselves in their homes, but it influences the disorderly and especially criminals to move into the neighborhood and commit crimes. (Harcourt, Nov. 1998, p. 297) Teenagers begin to gather in front of the local convenience store. swarm starts to accumulates on the side of streets. People start to drink alcohol in front of the corner store in time, a drunk in left to sleep it off on the sidewalk. Pedestrians are being approached by very persistent panhandlers. All of this gives citizens the feeling that their neighborhood is no longer safe. The feeling of danger forces them to stay inside of their homes, or move away, which leads to further deterioration of the neighborhood. These types of crimes deteriorate the citizens trust and confidence in polices ability to provide its first obligation, which is safety to the public.In order to deter this type of catastrophe police should implement some form of broken windows policing. First, you have to determine what is the core or main problem that should be resolved. The panhandler that was left to harass the residents as they walk to the street is, in effect, the first broken window. This act is the one that opened the proverbial door for criminals to put down into the community. If the community cant keep a belligerent panhandler from harassing the citizens, a thief may believe, that the community is even less likely to notify officers of a stick up or step in while it is taking place.By resolving the panhandling issue, the major issue, you can also start eliminating some of the smaller problems. Panhandlers are a serious problem because they prey on the sympathies of the residents. As more and more residents give the panhandlers money, more panhandlers move into the community seeking out these same opportunities. finally they are hanging out with signs at every freeway off-ramp, stop sign, and intersection light waiting for some naive motorist to give them money. the remove and realistic goal is to find a means within an imperfect system for humanetreatment (Hodulik, Summer 2001, p. 1075) of those that panhandle. The trick to getting rid of panhandlers is to st op giving them money. Police have to inform residents of the panhandling epidemic . To do this the police department should set up a community carry outing. Residents should be informed that most panhandlers do not use the money that they are given for food and clothing. A lot of them use the money to purchase drugs and alcohol. Police should teach the residents how to ignore the panhandlers and how to avoid warmness contact with them.Also an some other way getting the churches, community leaders, and merchants together to establish a voucher distribution system as a way of making sure that the panhandlers are actually getting food and clothing. Vouchers would be sold to people in the community and they can give them to the panhandler instead of money. Panhandlers capital these vouchers in at some of the local merchants in exchange for food, no alcohol or tobacco, and clothing. This way the residents can still give knowing that the panhandler will not go purchase drugs or alcohol , but food and/or clothing. Knowing this will make the residents interact and give more to the panhandlers.Another circumstance that can benefit from broken windows policing is the dilapidated and vacant homes in the community. Ineffective neighbor networks mightbe related to more physical-structural qualities of a community (Wilcox et al., Spring 2004, p.186). These homes can quickly turn into a breeding ground for illegal drug activities, temporary shelter for the homeless, and hideouts for those running from the police. One thing that police officers can do is meet with the residents so that they can voice their opinion about the rundown homes in the community. At this time they can also seek any suggestions on how to decline the problem. The first thing for officers to do is search these homes for squatters and criminal. They should be check to see if they have any warrants. If no warrants they are released and asked to leave the house. Those with warrants will be arrested and taken to jail for processing. Next, is a community renovation project. By removing these desolate properties can restore the health and safety to the community. It can also increase the value of the other homes in the neighborhood. If the home has an owner they can pay to get the house torn down. If there is no owner or the owner can not pay for a wipeout the community has to come together to get the houses demolished. One way the community can do this is by getting a demolition grant for neighborhood stabilization. This way the federal government pays for the demolition of the homes. Once the funds have been secured then the next thing is to get an affordable demolition company. The main objective is to get the most out of the grant money, more houses demolished at the cheapest possible cost. After they have a demolition company, the dilapidated homes should be demolished and the land well-defined. To help with the beautification of the community the land should be reseeded afte r the structure has been cleared. Some of the land could be turned into a community garden. The rest could be sold so that more houses could be built on it.The most important thing is that once the houses have been cleared the criminal miscreants will no longer have areas within the community where they can dwell and commit devious acts. Also it gives the residents back a a sense of pride in their community. No longer will they fear walking out of their front door because of the drug activity going on down the street. This one act can change the dynamics of the community from downtrodden and crime infested to viable. It lets the deviants know that the residents care for their community.

Analyzing Angela Carters Feminist Fairy Tales English Literature Essay

Analyzing Angela Carters Feminist Fairy bilgewaters English Literature EssayIt is distinguished to yield early on that there is no simple definition of what a sissy tale is the simplest place to start is to explain why theyre called puff tales at all. Taken from the cut phrase contes de fes a form of address used by women writers in the French salons in the 17th century for stories create verbally as narratives for passing on wisdom to young women it was translated as tales of fairies. The first to use the phrase was Madame DAulnoy in 1697 as the title to her collection of stories, but was subsequently used by the more familiar Brothers Grimm. Before that time fairy tales existed only in the oral customs, a highly elusive medium of story-telling, which does non lend itself to consistency, often leading to each country, region, and even person having their own version of the same basic tale. Little is known ab pop the history of fairy tales, only that from the 17th century they began to emerge as a popular literary convention and broke down into two main schools that of Perrault and his pure French tales, and the Brothers Grimm, who concerned themselves with only authentic German folklore. Throughout the 18th and 19th century their popularity grew, with each culture apportioning its own unique narrator, closely splendidly in the guises of Mother Bunch, Mother Goose, and Gamma Gettel. To speak loosely of fairy tales, they are a subgenre of folklore, but Lane arguesAlthough Lane has made some in truth sweeping generalisations about what a fairy tale it non, this is because, as Tolkien puts it, faerie tales mint non be caught by a net of words for it is one of its qualities to be painful (Tolkien 196510). As Ive illustrated, those who have spent their academic careers trying to define what a fairy tale is have agreed that it contains certain elements, but the problem lies in that they cant agree which ones. For my purposes I am going to accept Tho mpsons definitionA tale of some length involving a succession of motifs or episodes. It moves in an unreal world without decisive locality or definite creature and is filled with the marvellous. (Thompson 1977 8)The fairy tale is a desirable form of literature for beginnings to manipulate. With its unmitigated confines, extensive use of stereotypes, accessibility, and moral framework it can be used to create an environment inwardly which authors can explore their own ideas and ideals. Angela Carter is such an author with the The Bloody Chamber being, essentially, a feminist re-evaluation of the predominantly masculine-dominated fairy tales as presented by the Brothers Grimm. Although the Brothers Grimm were amongst the first to preserve fairy tales in the writing they were considerably re-worked from their pilot oral counterparts in order to make them more acceptable to society. Fairy tales began as a female-orientated tradition when Les Cabinet des Fes was print over half t he authors were women, whose tales offered gratifications that were already considered feminine dreams of love as well as the sweets of quick and capital revenge (Warner 1996 xii-xiv). When the Brothers Grimm, and others, transferred the oral tales in pen ones they permute of an essentially feminine form and replaced it was a masculine one, as Holbeck observes, men and women often tell the same tales in characteristically antithetic ways (Holbeck 1987). This tradition has been carried through to the 20th century, with Disney adaptations relying on the damsel in distress, with the inevitable Prince Charming character to rescue her (although recent productions such as Enchanted and the Shrek trilogy have been a movement away from such archetypes). The Bloody Chamber concerns itself with those changes and calls them to attention byheightening the intertextuality of her narratives, making them into allegories that explore how sexual behaviour and gender roles are not universal, but are, like other forms of social interaction, culturally determined. (Kaiser 1994)It is a collection of short stories that extract the latent content from handed-down stories (Carter in John Haffendens Novelist in Interview) and create new ones from a womans perspective, an exploration of the journey between fillehood and womanhood with all the trappings that entails. It is a de-Bowdlerisation of Grimms contaminated exercise of patriarchal exponent towards the pure tales of Perrault and, more importantly for Carter, Bruno Bettelheim, whose books, Uses of Enchantment, has been hailed by a holy grail for the understanding of fairy tales.Bettelheim was a distinguished psychoanalyst who applied his writing to the written fairy tale, concluding that they were a way for children to comfortably deal with separation anxiety and essential in the development of the unconscious let the Fairy Tale speak to his unconscious, give body to his unconscious anxieties and relieve them without this e ver coming to conscious awareness (Bettelheim 1977 15). Bettelheims readings of fairy tales lie strongly in Freudian theory. Freud is most well-known for his championing of the oedipal complex, wherein a boy has desire for his mother and competes with the father for affection, or a girl who has desire for her father, sparking a rivalry with the mother. The latter is alike referred to as the Electra complex, though Freud often disagreed on the existence of a female counter-part. In his book, Bettelheim states thatOedipal difficulties and how the individual solves them are central to the way his personality and human relations unfold. By camouflaging the oedipal predicament, or by only subtly intimating the entanglements, fairy tales permit us to draw our own conclusions when the time is propitious for our gaining a better understanding of these problems. (Bettelheim 1977 201)This buy food comes from his essay on hoodwink White, which Bettelheim argues is a perfect fairy tale versi on of the oedipal conflict between mothers and daughters. Certainly, the version he and Carter, in her tale The Snow Child, use heightens the oedipal tensions through its simplicity (Kaiser 1994). Carter furthers this by manipulating the popular themes and underpinning them with the notion of desire, a key theme throughout The Bloody Chamber.Colours are incredibly important in the Gothic genre, and due to the nature of Carters fairy tales, they can certainly be described as such. Carters count asks for a girl as uncontaminating as snow red as blood black as that birds feather (Carter 2006 105) without any appropriation of those work, it is only subsequently the girl appears that Carter redistributes them in the traditional style of white skin, red lips, black hair (Carter 2006 105). Those three colours continually appear throughout all of Carters short stories and are used in a highly symbolic fashion. White is traditionally revealn as the colour of justice, innocence, and wh oleness, but red, the symbol of love, signals passion and sexual desire, whilst black represents death, destruction, and the decent into the unconscious. If we transfer these attributes to the itemises wishes, it is credible to conclude that the Count is imagining a daughter who embodies all those things a virgin who awakens sexual desire in him on the unconscious level. In doing so, he gives the girl multiple facets, and an ambiguous quality she is sometimes pure and perfect, sometimes passionate and sexual, or negative and deadly. Three sides, three colours, three aspects of the human soul. The theme of colours is similarly extended to the Count and Countess note that Carter provides the colours of their horses. The Count sits upon a gray mare (Carter 2006 105) the only other colour mentioned in the tale, noticeably distinguishable to the surrounding contrast. If we see the Count as a representation of society, then the greyness symbolises a lack of self-examination, of step ping subscribe from the coloured representations apparent in the residual of the scene, to which Carter is now attempting to hold a mirror up to. The counts horse also provides a back-drop for the Countess, giving significance to her riding a black one (Carter 2006 105) she is also seen wearing glittering pelts of black foxes and black shining boots with scarlet heels (Carter 2006 105). My interpretation of her attire is one that suggests that to the Count his wife no longer represents the idea of purity (the absence of white), and that he has very little sexual desire for, as the colour red is contained to the lowest part of her body her heels. Instead, she represents the Counts mortality, of getting older, and what Klein describes as a bad object that a child will seek to expel by frameing negative emotions towards it, shown by the excessive use of black. This is highlighted by his wishes for the child, who is predominantly snow white when stark naked (Carter 2006 105) the go od object that a child seeks to join with and keep safe from the unpleasant influence of bad objects. Carters Count lifted her up and sat her in front of him on his saddle and thrust his virile member into the dead girl (Carter 2006 105-106) perfect representations of that same connective and protecting.As mentioned, the oedipal complex is one concerned with transference not only of emotions, but, in the case of The Snow Child, a physical transference through clothing. In a similar style to the presence of the Counts grey horse, we are not given a description of the Counts clothing, giving strength to my argument that he is a representation of society, and therefore not clothed because it is the provider of clothes, or labels (e.g. mother, wife), for everyone else. Unlike the Brothers Grimm version, Carter does not have the Count decide between his wife and his daughter, instead she has him screening his authority over them through the attribution of material constructs. The Cou ntess, presumably acquiring her title from marriage, is wholly defined by her husband her title, her clothes, her horse, all representations of the social constructions of wealthiness and nobility. When the Countess is replaced in her husbands desires by the girl there is a transference of clothing, and of those symbols of society, the furs sprang off the Countesss shoulders and twined around the naked girl then her boots leapt off the Countesss feet and on to the girls legs (Carter 2006 105). Here we see the deconstruction of the modern women a disrobing of the masculine confines imposed upon the Countess. Kaiser points out that it is a sign of their mutual dependence on his favour, the furs, the boots, and jewels fly off the Countess, onto the girl, and back again dep remainder on the whims of the Count (Kaiser 1994). During the tale there is always a woman who is naked, drawing attention to the semantic field of clothes when women are not dressed they are reverted to a repre sentation of Nature, in direct opposition to the man as culture, which in turn makes them appear vulnerable. In response to this criticism, Kaiser continues that although some feminist theorists claim to find a kind of liberation in the position of women as other in phallogocentric culture, Carter finds the situation morecomplex and more troubling (Kaiseer 1994).This can be seen reflection in the ambiguous ending Carter has created, when the Countess exclaims It bites is she rejecting female sexuality through the symbol of eternal feminine sexuality of the rose? is she rejecting love itself? Or simply her husbands and therefore mens desires? Bacchilega suggests that the Countess recognizes the myth of the vagina dentate for what it is (Bacchilega 1988 18). The ending leaves a lot to be desired for traditional readers of fairy tales, without the typical happily ever after finish Carter leaves the tale with no promise of happiness and it remains open for individual interpretation.To re-address my original question, one of Carters most avid critics, Patricia Duncker read the ending of The Bloody Chamber as carrying an uncompromisingly feminist message, whilst the other tales merely recapitulate patriarchal patterns of behaviour. Duncker is right in her reading of the texts as remaining within the patriarchal sphere of thought, but as Kaiser parallels with my own opinion what Dunkcer perceives as an inconsistent application of feminist principles is, I believe, merely a reflection of Carters project in this collection, to portray sexuality as a culturally relative phenomenon (Kaiser 1994). It is my personal belief that Duncker is not in possession of a sense of humour, or merely cannot grasp Carters sense of irony in her insistence on staying within the already accepted boundaries, in order to question the nature of humans one must move from a strongly grounded base in what constitutes material reality (Carter 1997 38). With The Bloody Chamber Carter has concer ned herself not simply with pointing out the problems with conventional patriarchal views of gender, but rather has created a series of different representations, that although dont directly challenge the traditional fairy tales, they provide alternative models. She does not, as the title suggests, capitulate the idea of a masculine-dominated or phallaogocentric representation of the fairy tale, but rather highlights the single-mindedness of those tellings by displaying stories with the same basic building blocks that have hugely different influences.Ours is a highly individualised culture, with great faith in the work of art as a unique one-off, and the artist as an original, a superhuman and inspired creator of unique one-offs. But fairy tales are not like that, nor are their makers. Who first invented meatballs? In what country? Is there a definite recipe for potato soup? Think in terms of the domestic arts. This is how I make potato soup. (Carter 1987 3)The culinary allegory se rves her purpose of exemplifying the fairy tale a recipe will seldom have an individual source and are prepared in a multitude of ways, varying with the ingredients operable and the person preparing it, evolving over time, just as female subcultures adapted to suit personal, cultural, and historical needs.

Platos Criticism of Democracy Essay -- Plato

Platos Criticism of DemocracyDo not be angry with me for speaking the truth no man will survive who rattling opposes you or any other crowd and prevents the occurrence of many unjust and illegal happenings in the city. A man who really fights for justice must ladder a private, not a public, life if he is to survive for even a short time. (Apology 31e-32a) These are the words of Socrates, who spoke before the Athenian dialog box in the trial that would, ultimately, condemn him to his death. Through works much(prenominal) as the Apology and The Republic, we can see Platos distaste of the concept of democracy. Why does he consider democracy to be so flawed? Let us look through his own eyes and see what his individual condemnations are, and determine if the very concept of democracy is as flawed as he believes it to be. One of the contemporary definitions of democracy today is as follows Government by the hatful, exercised either direct or through elected representatives Rule by the majority (Democracy Def.1,4). Democracy, as a form of government, was a radical idea when it manifested many governments in the early history of the world were totalitarian or tyrannical in nature, due to overarching beliefs that the strong ruled over the weak.Although the Greeks coined the word democracy the words demos population and kratos rule conjoined together to mean, literally, rule by the people there is speculation about weather or not certain other peoples, such as the Sumerians and the Indians, managed to engage in democratic methods of governance first. However, the history of democracy is not what is being discussed here we are focusing on Platos criticism of democracy, particularly with regards to the Athenian model and his... ...n life. However, Platos criticisms should be kept in mind when determining the merit of a democratic government. Oh, would it not be grand to have a democracy of philosophers, who would pursue truth and wisdom Alas, we are only human , and susceptible to many evils and lies. The trick is to prevent such ignorant people from becoming the majority. At times, it seems nigh impossible to do so curse our stupidity WORKS CITED Democracy. Def.1,4. The American Heritage Dictionary. 2nd college ed. 1991. Plato. The Apology. Five Dialogues Euthyphro, Apology, Cito, Meno, Phaedo. 2nd ed. Trans. Grube, G.M.A. capital of Indiana Hackett Publishing Company, Inc, 2002. 36.Gorgias. Trans. Helmbold, W.C. Indianapolis Bobbs-Merrill Company, Inc, 1952. 18-19, 32-48.Book V. The Republic of Plato. Trans. Bloom, Allan. New York Basic Books Inc, 1968. 153-154.

Personality Disorders Essay examples -- Papers

Personality Disorders Personality disorders indicate the presence of chronic rigid and worried personality traits, through which the persons interpersonal or professional functioning is negatively affected, or which lead to personal unhappiness and problems (Louw, 1990). Discuss this statement from a biopsychosocial effect of reference and refer to one personality disorder in any cluster to illustrate your answer. The Biopsychosocial model ========================== The biopsychosocial model (Engel, 1980, cited in Paris, 1993) suggests an integrated approach that understands psychological medicine in terms of multiple causes, none of which is sufficient on its own for the development of the disorder. These factors could include biological vulnerability, the psychological impacts of life experiences and the influence of the social environs all of which may factor as risk variables or protective variables. The biopsychos ocial model disaccords from more linear cause and effect approaches such as genetic endowment in that it is only the cumulative interactive effects of the multiple variables can produce the overt disorder. Personality disorders ===================== Personality disorders are characterised by inflexible and longstanding maladaptive personality traits that cause significant impairment and subjective distress for the individual. The signs of a personality disorder display in adolescence or early adulthood. Individuals differ to the extent that they possess Personality traits and it may be difficult to decide whether the trait exists to an extent that can be considered pathol... ...tice, 10, (2), 161-165. Hayes, S. J. (2002, Mar) Acceptance, mindfulness and science. Clinical Psychology recognition and Practice, 9, (1), 101-106. Klein, M.H. (1993, Spring). Issues in the assesment of personality disorders. Journal of Personality Disorders. Supplement 1, 18-33. Morey, L.C. (1993, Spring). Psychological correlates of personality disorder. Journal of Personality Disorders, Supplement 1, 149-166. Paris, J. (1993). Personality disorders A biopsychosocial model. Journal of Personality Disorders, 7(3), 255-264. Sue, D., Sue, D, W. & Sue, S. (2000). taking into custody abnormal behaviour. (6th ed). USA Houghton Mifflin Vincent, K.R. (1990). The relationship between personality disorders, normality and healthy personality Personality on a continuum. Social Behavior and Personality, 18(2), 245-250.