Nothingness in A Clean Well-Lighted Place by Ernest...

Nothingness in A Clean Well-Lighted Place by Ernest Hemingway Man is often plagued by the question of his own existence. Existentialism is a subjective philosophy that is centered upon the examination of man’s existence, emphasizing the liberation, responsibility, and usually the solitude of the individual. It focuses on individuals finding a reason for living within themselves. The philosophy forces man to make choices for himself, on the premise that nothing is preordained, there is no fate. Men must find a truth in themselves, a truth that they must be able to live for. Existentialism is in harsh contrast to a belief in a higher power or a god. quot;A Clean, Well-Lighted Placequot; is a story by Ernest Hemingway about men in†¦show more content†¦At first he believed it would give him something to believe in. He believed it would give him a purpose in life, living to die for his country. It would give him a feeling of patriotism, of honor, of courage. But something is missing. The soldier has not found his existential truth fo r himself. The army isn’t it. The soldier is left tormented with the hollow feeling of nothingness, a hollowness that he attempts to temporarily fill with immediate sexual gratification. The younger waiter recognizes the soldier’s need: quot;What does it matter if he gets what he’s after?quot; (199). But the experience will only leave the soldier feeling more empty. The young waiter is aware of the nothingness of an existential life but does not quite know how to deal with it. The waiter desperately uses his relationship with his wife as his truth, or reason for living: quot;I have a wife waiting in bed for mequot; (200). He acts as if he is certain of his role in life when he says, quot;I have confidence. I am all confidencequot; (201). But in reality he does not. The young waiter is in a hurry to leave the cafeacute; and the company of the old man: quot; ‘I want to go home to bed.’ ‘ What is an hour?’ ‘More to me than to him’ quot;(201). He quot;wouldn’t want to be that old. An old man is a nasty thingquot; (200). The young waiter’s confidence in his own existence is not strong around the old man because he sees nothingness in the old man. He seesShow MoreRelatedA Clean Well Lighted Place Summary1203 Words   |  5 PagesPart I: The Lost Generation â€Å"The Lost Generation† Article Questions The authors included in the Lost Generation are, F. Scott Fitzgerald, Ernest Hemingway, John Dos Passos, Sherwood Anderson, Kay Boyle, Hart Crane, Ford Maddox, and Zelda Fitzgerald. The common elements and themes that these authors pursued in their personal lives as well as their writing were brutal war experiences, their youthful and impractical actions such as love affairs and drinking, feeling lost and hopeless in societyRead MoreA Clean Well-Lighted Place 11111 Words   |  5 PagesA Clean Well-Lighted Place In the short story â€Å"A Clean Well-lighted Place† by Ernest Hemingway the setting is very important. The story takes place in a Spanish speaking country in a cafà ©, but more so than the actual place the time is what makes the setting so crucial to the story. The story takes place at night Hemingway uses this in contrast to the well-lighted cafe with its artificial light. The contrast between dark and light is the main idea of the story and it is best expressed through theRead MoreEssay on A Clean, Well-Lighted Place1069 Words   |  5 PagesLife: Torture of the Mind Ernest Hemingway captures the essence and origins of nihilistic thought in â€Å"A Clean, Well-Lighted Place†, written in a time of religious and moral confusion shortly after The Great War. The ideas expressed in this short story represent the post World War 1 thinking of Hemingway, and the notoriously nihilistic Lost Generation in Paris, which was greatly influenced by the many traumas of war. Learning from his unnerving experiences in battle, Hemingway enforces the idea thatRead MoreA Clean, Well Lighted Place By Ernest Hemingway1024 Words   |  5 PagesWhen profound emotions and heartfelt experiences lay beneath a narrative subtext, a simple short story can become an elaborate puzzle where one continues to discover new pieces. Ernest Hemingway’s, â€Å"A Clean, Well-Lighted Place† is a fascinating short story that has a powerful theme of ‘nothingness’ and ‘loneliness’ enveloped beneath its dialogue. This short story’s re-r eadability pulls us, the reader, back into its’ text just to discover that a specific character’s dialogue could elude to yet anotherRead MoreA Clean Well Lighted Place1202 Words   |  5 PagesCameron Craig Craig 1 Lancaster English 1302.68 25 March 2015 â€Å"A Clean Well-Lighted Place† In â€Å"A Clean, Well-Lighted Place†, Hemingway uses themes of depression and life as nothingness by using symbols, and imagery. Two waiters in a Spanish cafà © are waiting late one night for their last customer to leave. As they wait, they talk about the old, deaf man sitting at the bar. It is revealed that he has recently attempted suicide. The younger waiter in the cafà © is very agitated and wantsRead MoreA Clean, Well-Lighted Place Essay938 Words   |  4 PagesIn â€Å"A Clean, Well-Lighted Place,† written by Ernest Hemingway conflict is clearly evident. Conflict in â€Å"A Clean, Well-Lighted Place† is determined by other elements of fiction, more importantly, characters, setting, and theme. Conflict is seen in this short story in many aspects, such as man versus man and man versus self. The characters in Hemingway’s short story add to the conflict throughout and conflict appears both between the characters and within the characters themselves. Hemingway clearlyRead MoreA Clean, Well Lighted Place By Ernest Hemingway1640 Words   |  7 Pages â€Å"A Clean, Well-Lighted Place† is possibly one of Hemingway’s most excellent short stories. It depicts the techniques of his signature writing style. The narrative is a perfect example of an initiation story, a short story that focuses on the key character that comes across a concept, encounter, practice or knowledge he never knew. The characters in his story are the old man, young waiter, and the old waiter. Hemingway employs a number of literary tools in the story to convey his themes of lifeRead MoreA Clean Well Lighted Place Analysis986 Words   |  4 Pagesfurther understand the story from what little information they do receive. In a short story, written by Ernest Hemingway, A Clean, Well-Light ed Place, tells the life of an elder man who spends his nights in the light. The unusual setting, the use of diction and the dialogue, creates that short story desire from the reader. It is the elder man’s quiet presence in the story, that allowed Hemingway to set the frank tone that would further develop the character and the story. Sitting in a cafà ©, approachingRead MoreThe Importance of Themes in A Clean, Well-Lighted Place by Ernest Hemingway803 Words   |  4 Pages â€Å"A Clean Well-Lighted Place†, a short story written by Ernest Hemingway first appeared in a collection of short stories titled, Winner Take Nothing. Soon after the collection of stories had been published in 1933, â€Å"A Clean Well-Lighted Place quickly became one of Hemingways most eulogized short stories. Through his excellent use of character development, Hemingway provides the reader with a lively portrayal of theme, plot, and symbolism throughout the entire piece. We are taken through a journeyRead MoreTheme: a Clean, Well-Lighted Place Essay810 Words   |  4 PagesTheme: A Clean, Well-Lighted Place Sadness, frustration, or discontent, however it’s put, there is an obvious difference with the characters in, â€Å"A Clean, Well-Lighted Place† by Ernest Hemingway, and their ideas of mortality and old age. The short story shows the concept of â€Å"nothingness,† displayed through a very depressing view on life. This suggesting that all people, even those who are happy and content, will eventually end up lonely, drunk, or unhappy. By allowing a reader to view this from

Motivational and Organizational Culture - 883 Words

Motivation and Organizational Culture Cassandra Clyburn HCA 250-The Psychology of Health December 9, 2012 Ebony Thomas Axia College Motivation and Organizational Culture When you first start a job you have fears of being able to fit in, your nerves are on edge and if you are a supervisor or manager you have many more fears as our subject Ayame Nakamura may have had. She is a Japanese immigrant who is fortunate to have landed a position as a Project Manager for a pharmaceutical company. Her work ethics differ from what she is being accustomed and the management style, which is confrontational, makes it difficult to receive feedback and affects her motivation. In the Japanese culture when one works for a company they develop a†¦show more content†¦Providing recognition to employees that have met the expectations of the company and give small rewards such as a day off, Starbucks gift card or a flexible schedule is one of the many ways a company to get results. In France there is a company who has done remarkably well with motivating their employees in a pharmaceutical company. â€Å"Our experience suggests that bonus schemes can be very m otivational and result in a ‘win-win’ for company and employees alike — as long as they are well designed and properly implemented. (Turner et al., 2007).† This company’s strategy was to be fair across the board and allow the salespersons to make up to 40% in bonuses. Their process was known as the â€Å"Commitment Process† which aligns the interests of the individual and company harmoniously and incentive sales people to stretch their performance and maximize sales results; this resulted in low turnover rate and the employees felt that they were valued employees. In Ayame’s position it would be to her benefit to find a company with these values or convince management to change their style or they would lose her as an employee and others who might feel the same way. References Todeschini, M. (2011). Webs of Engagement: Managerial Responsibility in a Japanese Country. Journal of Business Ethics, 101, 45-59. Turner, R., Lassere, C., amp; Beauchet, P. (2007). Marketing MetricsShow MoreRelatedDeveloping Effective Teamwork in Organizations by Considering the Organizational Structure, Culture, Employees’ Motivational and Leadership Aspects.9709 Words   |  39 PagesASSIGNMENT TITLE: Developing effective teamwork in organizations by considering the organizational structure, culture, employees’ Motivational and leadership aspects. LEARNING OUTCOME 1 TASK 1a AN ORGANISATIONAL STRUCTURE There are many different opinions and definitions of organizational structure. Structure in a sense is the arrangement of the functions used to do the work. Thompson said the structure is the inner structure of the differentiation and the relations. He referred to the structureRead MoreHow Communication Affects Organizational Leadership1328 Words   |  6 PagesHow Communication Affects Organizational Leadership, Motivation, and Commitment Within any organization the elements of leadership, motivation, and workforce commitment are inextricably meshed with the effectiveness of communication. Organizations develop their respective cultures through communication among leadership and with all employees, regarding their mission, values, and goals (Robbins Judge, 2007). Formal and informal leaders within organizations use communication to motivate othersRead MoreTransformational Leaders : Organizational Values, Aspirations, And Ethical Measurement1428 Words   |  6 PagesTransformational leaders set the organizational values, aspirations, and ethical measurements required. Additionally, the result of the transformational leader concerns them with creating growth of the follower. Developing the followers into leaders through coaching, directing, and raising their awareness levels to know or expect the unexpected and the overall issues of consequences. This development builds a collective future through the shared values of the leadership and the followership. Read MoreSupervisory Roles And Theories Of Motivation1370 Words   |  6 Pagesmotivation used to achieve organizational effectiveness. Additionally, this paper will discuss the Human Resource Model and how this theory of motivation is used. Furthermore, this paper provides insight on why this theory was selected, as well as the anticipated benefits and challenges. Furthermore, this paper provides information on how principles of motivation can be applied within an empowerment environment and how motivational theory supports an organizational culture in the human services professionRead MoreEssay about Intro to Human Resources1561 Words   |  7 Pageswhether HRM matters -Conceptual Arguments - resource based view - the value of resources depends on several factors - are good people rare? Yes depending on the economy - are good people inimitable? Yes because they create history, they create culture, they make numerous small decisions-gt; none of these can be copied -Case Studies - examine companies that do well/struggle financially to see if they do good/poor job managing HRM - Container Store -QuantitativeRead MoreOrganizational Commitment and Communications Paper1151 Words   |  5 PagesOrganizational Commitment and Communications Paper Jennifer Watson COM/530 Communications for Accountants Allen Sutton July 4, 2011 Organizational Commitment and Communications Paper The selected organization is Walt Disney Company. In this paper the subject to discuss is how different leadership styles affect group communication, analyze different sources of power and the affects on group and organizational communication, identify the motivational theories effective within the culture ofRead MoreWhat Does Culture Affect Hr Philosophy, Policies And Programs?1098 Words   |  5 Pages1.- Culture gives societies their distinctive flavor and provides a guide as to how people interact and what they expect from one another. How does culture affect HR philosophy, policies and programs? Culture consists of symbolic system of values, attitudes, beliefs, and perceptions about appropriate behaviors that are shared in our society as a way of life. In other words, culture is a set of meanings (senses) and values that inform a particular way of life. It is lifestyle that shape and formRead MoreOrganizational Behavior : An Organization1596 Words   |  7 PagesOrganizational Behavior Analysis Organizational behavior is vastly unique for each organization. Positive or negative behavior has far reaching effects on the internal and external environments. What elements helps develop the behavior of an organization? Organizational behavior is the main ingredient of all organizations, and can be the building block that rejoices successful, or screams failure. Elements such as the type of culture, form of communication, disposition of authority, motivationalRead MoreAmeritech Case Study1162 Words   |  5 Pagesother Asian countries as well. Bill Dawson was assigned as the plant manager and a Filipino DLSU MBA Graduate was hired to be his assistant. The purpose of his assistant was to bridge the gap of culture. However, the assistant is a Manileno while the workforce is Cebuanos; this resulted in another sub-culture gap. Productivity of the plant was decreasing over time and Bill’s decisions are antagonistic in the point of view of the workforce. The result of this is c onsistent employee turnovers and everRead MoreLeadership As A Global Organization1335 Words   |  6 Pagesneeds of the employees’, internal stakeholders, and the organizational needs. Thus, as described, the effectiveness of the organizational team is directly associated with the teams’ leadership abilities, expertise in establishing motivation, trust, and positive effect of the human capital (Khan, 2016). Leadership is essentially responsible for the organizational structural norms, vision, and mission accomplishments. Therefore, the organizational leadership is both directly, in some instances indirectly

Smart Phones Use Versus Face With Face Interaction

Smart Phone use versus Face-to-Face Interaction Justin Trapani Adelphi University Abstract: My proposed research study seeks to examine the rationale of smartphone usage in social contexts. Smartphone usage is a very prevalent occurrence in our present day. We live in a society that is overly consumed by technology and inevitably we have become dependent on it. This led us to wonder whether the use of smart-phones is a pathogenic method of conforming to social norms or simply an adventitious occurrence. If an individual pulls out their smart-phone in the presence of another person, typically, the other individual will pull out their smart-phone, (whether to check emails, check texts, play games, etc.) however, is this because they lack the interpersonal communication skills to keep the flow of conversation? Our study focuses on uncovering the following factor: do individuals use their smartphones as an escape from face-to-face interaction? The purpose of this research study would be to determine if smart-phones have an impact on face-to-face communication/interaction. Addit ionally, I am interested to see if having a small number of people in the room (5), or a room with a large number of people in the room (15) plays a role in smart-phone usage versus face-to-face interactions. Introduction: There may have been a time when owning a smartphone was uncommon. In contemporary society, it is uncommon to not own one. Although smartphones have allowedShow MoreRelatedGender Differences And Communication Technology877 Words   |  4 PagesGender Differences and Communication Technology Use Among Emerging Adults in the Initiation of Dating Relationships. Marriage Family Review 50.3 (2014): 269-84. Print. The authors study shows how technology has impacted the way young adults engage each other at the start of a relationship. They analyzed how dating has changed from previous generations with the emergence of communication technologies. Their findings show that males and females prefer to use different technologies when starting to developRead MoreThe Article Etiquette : Reintroducing Real- Life And A Smartphone Obsessed Society `` By Ian Brown1116 Words   |  5 Pagesthe Globe and Mail has developed a number of valid arguments on how technology negatively influences society. In particular, he focuses how smart phones have negatively affected individuals’ day-to-day lives. He develops his thoughtful and well-structured arguments through the usage cause and effect, compare and contrast and lastly, examples. Ian Brown uses cause and effect in his article; this helped prove his point. By using actual events that occurred in Toronto and analyzing their causes andRead MoreSmart Phones Use Impact On Face4313 Words   |  18 Pages Smart Phone use impact on Face-to-Face Interactions Tammy Segal New York University Abstract: My proposed research study seeks to examine the rationale of smartphone usage in social contexts. Smartphone usage is a very prevalent occurrence in our present day. We live in a society that is overly consumed by technology and inevitably we have become dependent on it. Not only do we depends on technology but it also decreases the amount of face to face interaction and therefore raisesRead MoreAlbertsons Ditches Self-Checkout in Favor of Human Contact628 Words   |  3 Pagesdiscusses the relationship between involvement, sales personnel, and the likelihood of self-service. Cashiers are a basic form of sales personnel. Describe Albertsons service environment in terms of involvement and the appropriateness of sales personnel versus self-service. According to the text, self-service is predominant in low-involvement purchases, and the likelihood of a salesperson increases as involvement increases. Grocery shopping can be a routine and low-involvement activity, like buying milkRead MoreLeadership and Communication Across Generational Lines Essay example1016 Words   |  5 Pagescommunication (Huggins, 2008). Baby Boomers were born between 1946 and 1964. This generation has watched technology evolve and have grown accustom to using it, however this generation is disheartened that technology is slowly replacing personal interactions. This generation is less formal, and tends to balance electronic communication with verbal communication (Huggins, 2008). The generation X group was born between 1965 and 1981. This generation grew up during the personal computer era, soRead MoreData Analytics And The Retail Industry938 Words   |  4 Pagesinformation is collected using software specifically geared towards collecting, identifying and storing information for use by the company. The information is gleaned from different forums, with social media being the most rich and useful. The information is then quickly sorted and organized for use by the collecting agency (Turban, Volonino, Wood, Sipior, 2002, p. 6). The use of data analytics really took flight in 2010 when different companies offered software that enabled a company to implementRead MoreThe Use of E-Therapy to Improve Quality of Care and Increase Number of Patients1025 Words   |  5 Pagesï » ¿ The Use of E-Therapy to Improve Quality of Care and Increase Number of Patients HCS/531 January 13, 2014 The Use of E-Therapy to Improve Quality of Care and Increase Number of Patients As a member of ABC consultants, New York Presbyterian has hired me to pinpoint ways to improve and expand their patient care. New York Presbyterian Hospital based in New York, whose â€Å"healthcare system serves residents of Manhattan, Brooklyn, Queens, and the Bronx, as well as Westchester, Long IslandRead MoreEffect Of Smartphones On Teenagers1570 Words   |  7 PagesSmartphones on Teenagers Any given teenager has their own insecurities or social ills, however, are smartphones the paraphernalia leading to teenagers being easily able to not think for themselves along with feeding their issues, fears, and desires? As the use of technology has reached an all-time high, the dependence on smartphones has peaked as well. Scientists, especially psychologists, have taken an interest in the uprising of the interconnected world as some believe the constant access to smartphonesRead MoreAutomation In The Workforce. 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Lapointe Lapointe, through a relatable series of emotional developments, targets teens and families caught up in social media to clearly inform

What Is Intimate Partner Violence - 1351 Words

What is Intimate Partner Violence? If one has not lived through it, the meaning is unknown. When we hear the term, we tend to picture a woman covered in bruises. In reality, the damage is much worse. There is many long term effects that run deeper than the physical injuries (Giardino, 2010). Victims experience shame, isolation, detrimental physical and mental health consequences and financial stressor. This also causes dramatic effects on the families of the victims. This violence also affects the children who may be at an increased risk of physical abuse. Children who live through IPV suffer through the trauma of witnessing the violence and having feelings of fear, guilt, and shame. Intimate partner violence is defined as a†¦show more content†¦It is believed that a large part of the population is in risk of this type of victimization (Giardino, 2010). With the health care community taking more interest in this issue, new screening tools have been developed to guid e in the victim’s safety and find a way for them to leave the relationship (Giardino, 2010). In addition, intervention programs have been developed for the purpose of decreasing the risk of perpetrators from re-offending. There is an estimated 5.3 million IPV cases among woman that have occurred each year in the United States (Giardino, 2010). Two million have resulted in injuries and 1,300 deaths. It is more common for females to be victims of IPV but there has been cases where the victims are male or transgender. They are either married or single, involved in a heterosexual or same-sex relationship, and are members of any ethnic or socioeconomic group (Giardino, 2010). The myth of victims being poor, uneducated women is false. There is controversy in regards to the race and economic status of victims of intimate partner violence. There is no relationship between IPV and race, economic status, or educational level (Giardino, 2010). According to the National Violence against Women (NVAW), the ethnic groups of women most affected by IPV are American Indian, Alaskan Native, African American, and Hispanics

Improving Oral Healthcare In Hospitals Health And Social Care Essay Free Essays

The initial inspiration for this proposal was a conversation with co-workers which so progressed into an experimental study over a period of eight hours. Ten staff nurses and one sister so took portion in replying a questionnaire. ( See appendix 1 for consequences ) The infirmary where I work does hold a attention program for unwritten hygiene ( see appendix 2 ) but it was designed for ‘general usage ‘ instead than to run into the specific demands of automatically ventilated patients ( MVP ) . We will write a custom essay sample on Improving Oral Healthcare In Hospitals Health And Social Care Essay or any similar topic only for you Order Now It shortly became evident from the consequences and the conversations that there was a demand for an assessment tool and guidelines as to what was considered to be best pattern to run into the single demands of MVP. This is when and why my undertaking began. 4.2 Important Deoxyribonucleic acid surveies have confirmed that up to 90 % of Ventilated Associated Pneumonia ( VAP ) is caused by pathogens colonizing the oral cavity. Within hours of admittance into the Intensive Care Unit ( ICU ) , the unwritten physiology of the patient begins altering. ( Nieuw Amerongen 2007 ) A Survey by Schleder A ; Lloyd ( 2002 ) has associated chest infection and pneumonia with hapless unwritten hygiene. Ventilator associated pneumonia ( VAP ) is the taking cause of decease among hospital-acquired infections. ( Bercault and Boulain, 2001 ) . ( Claridge, Edwards, Swanson, Fabian, EL at 2007 ) ( Kollef 2004 ) . After several yearss in the ICU, the intubated patient ‘s unwritten pathogen population rises to a higher per centum of beings increasing the hazard of VAP, their length of stay and mortality. VAP costs by and large range from $ 12,000 to $ 40,000 per patient. Crude mortality rates range from 27 % -76 % . ( Jones, Newton, and Bower 2004 ) 4.3 Policy Drivers The triggers for improved oral cavity attention have come from Department of Health ( DoH ) brochure entitled ‘Delivering Better Oral Health ‘ . An evidence-based toolkit for bar was published in September 2007. Older people are at considerable hazard of unwritten infection, with infection identified in 80 % of one survey population ( DoH, 2007 ) , There are indicants that 69 % of grownups may hold periodontic disease. With current regional alveolar consonant attending runing from 40 % in southern countries to 60 % in the North East ( DoH, 2007 ) , it is sensible to presume that many patients might hold preexistent hapless unwritten wellness before contact with national wellness services ( NHS ) ( Nicol et al, 2005 ) . ( Xavier, 2000 ) . For the ICU the High Impact Intervention No 5 Care package for ventilated patients ( DoH 2006 ) merely advises ‘that everyday unwritten hygiene as per local policy ‘ is recommended. National Institute for Health and Clinical Excellence ( NICE ) in their booklet on proficient patient safety solutions for ventilator-associated pneumonia in grownups recommends Chlorhexidine oral cavity rinse or gel to be used on MVP. 4.3 Evidence to back up proposal. The revised Kernel of Care ( DoH, 2010 ) has proved to be an of import starting point for supplying grounds for the demand to develop an unwritten hygiene bundle for MVPs. The brochure sets out the criterion by which best pattern and attention is presently assessed or measured in order to help practicians to develop a patient-focused and structured attack to sharing and comparing pattern. It has enabled wellness attention forces to work with patients, or in some instances their relations, to place best pattern and to develop action programs to better attention. The Kernel of Care has twelve benchmarks, one being personal hygiene which consists of six factors. ( See appendix 3 for a elaborate list. ) This benchmark highlights mouth hygiene as a precedence. Therefore an appraisal must be done, the staff must be capable of executing the undertakings, their cognition must be appropriate, functional written records must be kept for scrutinizing and single unwritten pit cleaning equipment should be provided for each patient. The Centres for Disease Control ( CDC ) specifically advises that each ICU patient should be portion of an unwritten hygiene plan with frequent soft brushing of the dentitions and gum, oral cavity swobing with an antiseptic agent, and in the endotracheally intubated and automatically ventilated ( EIMV ) patient, frequent suctioning of the oral cavity and subglottic countries. A comprehensive reappraisal is to be found in Appendix 6 and is besides farther considered in the subdivision Literature Review ( 5.4 ) 5.1 Aim The purpose of this undertaking is to present an unwritten appraisal tool and a mouth hygiene cleaning protocol for ICU. It will be specifically used with patients who are automatically ventilated and will be supplemented with an educational bundle. 5.2 Purpose of Project The overall intent of my undertaking is to maintain patients safe and cut down the hazard of VAP. The unwritten pit has been identified as a possible menace. Nurses Code Number 35 *** mention states we must present attention based on the best available grounds or best pattern To make this a systematic procedure is required. Current pattern has excessively many failings. The current pattern is a simple tick box on the ICU chart simply entering that oral cavity attention has been performed. At present, mouth attention in many instances, merely consists of a pink sponge and unfertile H2O to wash the oral cavity, crude oil lip balm to halt the lips from checking and if the anesthesiologists remember, chlorhexidine gel prescribed four times a twenty-four hours. From my treatment with co-workers, evidenced by the questionnaire in Appendix 1, an unwritten appraisal is seldom done on patients with EIMV. Using a toothbrush, with fluoride toothpaste, is merely normally performed on patients who are non sedated, which could be 40 eight hours or longer after they were foremost intubated. Within 40 eight hours, the bacteriums in the oral cavity displacements from the normal dwellers to those that are the usual suspects for doing pneumonia: Staphylococcus aureus, Strep tococcus pneumonia, Pseudomonas. These pathogens exude substances in order to organize a biofilm matrix, or plaque. Within these protective shelters, bacteriums quickly multiply and spread throughout the unwritten pit. ICU nurses play a critical function in supplying effectual unwritten attention and advancing unwritten hygiene. However, unwritten hygiene by wellness attention workers has frequently been overlooked or performed on an ad hoc footing. In some cases, it has become a ritualistic and commonplace activity. The research is sporadic ensuing in conflicting advice to practicians. An illustration of this fickle advice is the debut of H peroxide and Na hydrogen carbonate being recommended as a gargle which if non diluted carefully will do superficial Burnss. It is still presently in usage in some ICUs. ( **Reference* ) This undertaking aims to rectify this incompatibility and give counsel and the tool for best patterns. 5.3 Accomplish and Achieve. Ongoing unwritten appraisal should be performed day-to-day to forestall unwritten complications such as VAP and to guarantee optimum unwritten wellness ( Kollef 2004 ) . The assessment tool that I want to present on my ICU is based on the ‘BRUSHED ‘ appraisal tool developed by Hayes and Jones. ( See appendix 5 ) It has antecedently been adapted to be used by ICU nurses to measure the grade of badness of the jobs happening in the patient ‘s unwritten pit. Abidia ( 2007 ) , Hayes A ; Jones ( 1995 ) Using this tool, the ICU nurse could measure the gum for marks of disease. This review should include coloring materials, size, form, consistence and surface texture. Other marks to look for would be ulcerations or sores on the unwritten mucous membrane. After the appraisal the nurse will enter in item, in the patient notes, their observations. Any other appropriate action can so be taken before administrating unwritten hygiene. This tool was made to motivate nurses to loo k into for peculiar clinical marks during unwritten appraisal. Oral hygiene in the ICU is a normally performed nursing process in which the purpose is to guarantee that patients ‘ oral cavities are cared for ( Kite, Pearson1995. ) Pritchard and David ( 1988 ) indicate that oral cavity attention is required to: Achieve and keep unwritten cleanliness Prevent infection/stomatitis Keep the unwritten mucous membrane moist Promote patient comfort 5.4 Literature Review To place potentially relevant grounds, I searched The Cochrane Library, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health ( CINAHL ) , and Medline ( restricted to 1990-2009, English linguistic communication, and human research ) , including the related links option and diary cross citing for documents non antecedently identified. The hunt produced a figure of articles on unwritten hygiene and VAP in grownup ICU. The Iowa Model encourages the usage of instance studies, adept sentiment, and theories to inform pattern when research findings are non available ( Titler et al. , 2001 ) , leting protocols to be developed based on â€Å" best available grounds. † The Iowa Model begins by promoting staff nurses to place pattern inquiries, triggered either through designation of a job or through new cognition. The pattern inquiry aligned with organisational precedences is best positioned for allotment of back uping resources. Fourteen articles were identified as relevant to adult unwritten attention in the ICU scene and were later appraised ( See appendix 6 ) . They included two systematic reappraisals, two randomized controlled tests ( with equal sample size ) , four non-randomized tests ( or randomized with little sample sizes ) , one comparative test and five adept sentiments. Merely 10 of the 14 articles were specific to the grownup population. Using definitions developed by Stetler, Brunell, Giuliano et Al ( 1998 ) , degrees were assigned that rated the quality or strength of grounds of the 14 surveies. Degrees ranged from Level I ( meta-analysis of multiple controlled surveies ) to Level VI ( sentiments of well-thought-of governments, or the sentiments of an adept commission, including their reading of non-research-based information ) ( Stetler et al. , 1998 ) . The more strict degree of grounds, Level I reports, evaluated the effectivity of pharmacological intercessions included in unwritten rinses and toothpastes in cut downing unwritten bacterial vegetation, dental plaque, and dental cavities. The deficiency of robust research grounds related to direct nursing pattern of unwritten attention in the ICU scene is important for future research. Across the â€Å" best available grounds, † three nursing intercessions were identified for unwritten hygiene attention in the Intensive care unit: 1 ) unwritten appraisal, 2 ) mechanical intercessions, 3 ) pharmacological intercessions. A figure of articles highlighted the importance of regular unwritten appraisal to steer good unwritten attention ( Hayes A ; Jones, 1995 ; McNeill, 2000 ; O’Reilly, 2002 ) . A meta-analysis performed by Chan and co-workers showed a important decrease in VAP with the usage of anti-septic gargle. The survey, nevertheless, was unable to show any differences in other end points such as mortality, continuance of mechanical airing and length of ICU stay. ( Chan, Ruest, Meade A ; Cook 2007 ) . The published NICE guidelines, as discussed earlier in subdivision 4.2, recommend chlorhexidine on all MVP 5.5 Method The appraisal tool that I want introduce to my ICU, is based on the BRUSHED appraisal tool developed by Hayes and Jones ( 1995 ) which been adapted by Abidia ( 2007 ) ( with permission ) to be used by ICU nurses to measure the grade of badness of the jobs in the patient ‘s unwritten pit. ( See appendix 5 ) 5.6.1 Invention: How it would be implemented. Education and Training This assessment tool should be used as outlined in 5.3 above. It is to be supplemented with a elaborate instruction bundle to ease preparation. ( See appendix 6 ) It is presently designated as a ‘draft ‘ as it has yet to be ratified and approved. This facet of the proposal would be coordinated with the unit ‘s pedagogue. It is proposed that ab initio, a power point presentation, with some clip for inquiries, enduring about 30 proceedingss, would be used. This would be accompanied by a written booklet to enable staff to reflect upon the process and besides be the first point of mention should any trouble occur. A ‘link nurse ‘ would be allocated to take the lead with the pedagogue. Link nurses are described as â€Å" Identified nurses within a squad who have expressed involvement in a specialist country and go a formal nexus for the squad. † McKeeney ( 2003 ) . Nurses frequently take upon themselves these functions as portion of their Knowledge and Skills Framework as it provides grounds of their continued professional development. Ideally the power point presentation would be attended by staff at the start or coating of a displacement as there is a A? of an hr convergence that has antecedently been used for preparation intents. It is envisaged that all staff will hold completed their initial preparation within two months. The pedagogue would maintain a signed registry of attendants as portion of the unit auditing. After this initial developing a questionnaire would be used to determine the effectivity of the preparation, to arouse any farther or future jobs and to measure the quality of the processs that are now in topographic point. The consequences of the questionnaire would besides find such issues as to whether the hazard factor has been hazard assessed right, whether farther education/training is necessary or whether any alterations to the new process are needed. It could besides organize portion of scrutinizing the unit which is needed as portion of Clinical Governance. 5.6.2 Invention: How it would be implemented. Administratively and Procedurally Oral appraisal and attention ( OAC ) are indispensable for the betterment of overall wellness and for the patterned advance towards recovery and well-being of the ICU patients. Without OAC the patient could see serious infections which would take to protraction of ICU stay, increased morbidity, significantly increased costs of attention, and possible mortality. ( Jones Newton Bower 2004. Abidia 2007 Gillam A ; Gillam 2006.Koeman, van der Ven, Hak 2006 ) the unwritten guidelines ( bill of exchange transcript **** cheque right appendix see appendix 7 ) are based upon a thorough literature hunt. The bill of exchange new guidelines are in conformity with the trust format, which is found in policy Corp 60. The process to follow in order to guarantee smooth execution of the proposed new process is foremost to set up a meeting with my equals and the clinical lead for countenance of the proposal. It would so be forwarded to the Policy Coordinator for look intoing and understanding prior to presentation to the Evidence Based Practice Committee. The commission are responsible for the concluding blessing. When this has been achieved, the guidelines will be forwarded to the Business Unit Lead for printing on the trusts intranet. All trust employees would so hold entree to the bill of exchange guidelines. The clip frame for the execution is hard to accurately buttockss but a period three months before initial instruction commences would be a sensible estimation. The paper work would be checked by the new matrons as portion of their function in our trust is to look into certification 5.6.3 Invention: How it would be implemented. Costings. In order to implement this new process in its entireness, from academic exercising into pattern, it is non expected that a heavy fiscal load to the trust will happen. The logistics for implementing alteration are already in topographic point so no new degrees of bureaucratism are envisaged. The costings would be every bit simple as copying paper at ?2.00 per ream. The clip allotment for the pedagogue needed for planning and implementing preparation for about 90 five staff who work in ICU, High Dependence and Coronary Care Units, observing that the demands of the dark displacement may ask some out of normal contacted hours, are the lone other disbursal. Once adopted the process would be a upper limit of ?5.00 per patient per hebdomad. Of class the current costs for unwritten hygiene should be deducted from this amount as they become excess. New equipment as listed in item in Appendix 7 has besides to been taken into history. 5.7 What are the sensed /anticipated barriers to alter? Experience dictates that during the busy day-to-day activities of patient attention in the ICU it can be improbably hard to systematically execute such a simple undertaking as everyday unwritten hygiene. There are so many pressing, dangerous events, which take precedence over everything else. Guaranting that oral cavity cleansing is completed sunglassess into insignificance, even looking to be regarded as an optional undertaking. This is farther downgraded as it is recorded simply by a tick in a box that can be unthinkingly given. Hence, in pattern the predominating attitude, the ward civilization that now exists is that ; ‘It ca n’t be that of import! ‘ What was one time good pattern has over the old ages become corrupted. This is in kernel why my proposal to present a new process for the unwritten attention of ventilated patients is of import. It is critical that in order to accomplish optimal public presentation such professional patterns are reviewed and revise d. The barriers to be overcome are apathy and complacence! The unwritten pit is known to be a reservoir for pathogens to turn and boom. Poor unwritten hygiene can take to complications such as gingivitis, halitosis, dry mouth, plaque formation, dental pits and others that have been antecedently mentioned. There are many factors that may prevent the ICU nurse from executing necessary OAC ( see appendix 8 ) ( Jones, Newton A ; Bower 2004. Gillam A ; Gillam 2006. Koeman Ven A ; Hak 2006. Furr, Binkley A ; McCurren 2004 ) 5.8 What schemes will be usage to get the better of these barriers? Roberts ( 2001 ) reported that the bringing of unwritten attention within institutional scenes is fragmented. A reappraisal by Chan ( 2005 ) states nurse ‘s descriptions of their unwritten attention patterns covered unwritten wellness appraisal, cleansing the unwritten pit and attention of the environing countries. Chan ( 2005 ) findings revealed the undermentioned important factors that influenced ICU nurses in supplying unwritten attention: Their perceptual experiences of the intent of unwritten attention. Their frights about supplying it. The precedence of unwritten attention. Inadequate support for unwritten attention. Rello, Koulenti Blot et Al ( 2007 ) and Chan ( 2005 ) ) besides concluded that their findings indicated that nurses unwritten attention patterns were non grounds based. Munro A ; Grap ( 2004 ) besides indicated that present unwritten attention preparation should be revised. Their findings besides highlighted the influence of ward civilization on nurses ‘ precedences in supplying unwritten attention. Appropriate stuffs, equal staffing degrees and the constitution of an evidence-based unwritten attention protocol may in future facilitate the proviso of unwritten attention in the intensive attention unit. ( Chan 2005 Munro A ; Grap 2004 Rello, Koulenti Blot et Al 2007 ) Oral appraisal is an built-in portion of unwritten attention and should take topographic point upon admittance. Evidence has suggested that early appraisal can cut down both the incidence and badness of unwritten complications. ( ****** ) Once an unwritten appraisal has been carried out it is of import to give ap propriate unwritten attention intercessions based upon the single patient ‘s demands. 6.0 Evaluation When reflecting upon the literature and the proposal it is of import that the undermentioned standards are considered: ICU patient ‘s single demands for unwritten attention should be portion of the admittance appraisal. Education of nurses to supply accomplishments in unwritten appraisal and unwritten attention is indispensable. The unit pedagogue can develop nurses to better the unwritten appraisal and sweetening of unwritten attention for ICU patients. The usage of an assessment theoretical account such as the â€Å" BRUSHED † Assessment tool is recommended for the immediate designation of unwritten jobs for every patient and should be carried out daily. The usage of a comprehensive protocol such as the Mouth Care Protocol presented in Table 1 a bill of exchange that will hold to travel to the grounds based commission be for recommended. The frequence of unwritten attention is an country of contention and may depend more on the patient ‘s status. However, brushing every 12 hours and unwritten dampening at least every two hours while the patient remains intubated is recommended until farther research is done in this country. Some solutions and types of equipment used by nurses for unwritten attention are non optimum and, hence, cautiousness must be applied if they are used. Examples include H peroxide and Na hydrogen carbonate, if non diluted carefully, may do superficial Burnss. Lemons Glycerine Swabs can do annoyance and decalcification of dentitions. Alternatively, chlorhexidine is recommended. Foam swabs are uneffective in taking plaque, whereas the usage of a soft little caput toothbrush is recommended alternatively. Further research is needed to find the most effectual manner to execute unwritten hygiene attention in critically sick patients every bit good as make up one’s minding on the most appropriate frequence of unwritten attention. Research is besides needed to find the impact of unwritten wellness and improved unwritten wellness position on patients ‘ result How to cite Improving Oral Healthcare In Hospitals Health And Social Care Essay, Essay examples

Advances to being bilingual free essay sample

Speaking two languages rather than just one has obvious practical benefits in an globalized world. Many countries in the World has demanded that every student has to take foreign language. Today, many companies around the World is also require their employees have to know more than one language. In recent years, scientists have begun to show that the advantages of bilingualism are even more fundamental than being able to converse with a wider range of people. Being bilingual makes it is easier to find a job, understand a new culture, make you smarter. Foreign languages are as important as they have never been before. The World that we live is becoming more and more international since the last century, being bilinguals will help you get a job easier, especially English is need skill. Today, people around the World use English to communicate with each other all the time. English is now influencing everyones life. We will write a custom essay sample on Advances to being bilingual or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Learning a new language maybe help easier to find a job in the future, it will give you many advantages. In fact, being bilinguals is the most needed kill foe every one right now. Being bilingual’s gives you access to two cultures and makes you more tolerant and open to others. By being able to communicate in two languages, you are free to learn about diverse cultures, traditions and social behaviors as well as be a part of them. If you move to a new country, being bilinguals will make our life much easier than if you are not. People who speak two languages is already have one more window than other people, it help you open to the World to enrich their life. Many studies shown that bilinguals people have better task switching capacities because of their acquired ability to inhibit one language while using another. There is simple evidence that in a bilingual’s brain both language systems are active even they are using only one language, thus creating situation in which one system obstructs the other. In other word, speaking two languages forces your brain to recognize two language systems. So, basically, you become smarter Inclusion, being bilinguals has become the indispensable skill today. That skill helps you easier to find a job, understand a new culture, and make you smarter. Many scientists said that learning a new language is also helping you delaying Alzheimer’s disease. I hope that my essay helped encourage you to learn a new language.

Art Today Essay Example For Students

Art Today Essay Comparing television today to television ten years ago, the changes become very clear when we start evaluating the evolution of programming shown on television. Looking at specific examples such as Married with Children or Simpsons, it is clear that no such television programming was available ten years ago. Ten years ago, we were more formal as people, we were less accepting and comfortable on certain issues, hence our television reflected our formality. However, times have changed, and so have people. This change is very evident when you watch television shows such as Will and Grace. Comparing the leading characters of Will and Grace to I Love Lucy, you can see how tremendous of a change television programming and filtering has taken place. We can compare Will to Ethel and Grace to Lucy. Here are two sets of best friends who have become great television personalities, and whose shows were and are embraced by millions of people. However, their relationship and the content of their relationship is so remendously different. The audience would not have accepted a Lesbian Ethel. We can also see a tremendous change in how news is presented to us. Before, news programming was very serious. But now, with morning news, we get to see how the correspondents spent their weekends, what their favorite jokes are, and so on. We also get to see their clothes and some skin, which ten years ago, was a very rare sight. In addition, ten years ago, there were no television reality hows, except for the Real World on MTV. But today, we get to see Real World and countless other realities shows. The audience today is interested in the lives of others, whereas in the past, they might not have been so accepting of how others lived their lives. Lucy? s pregnancy made headlines, but today, we see live deliveries on television and we think nothing of it. Television personalities have a great impact on us and sometimes, we watch television because of the personalities in it.