African American In The 1920s Essay Example for Free

African American In The 1920s Essay The aspect of African-American Studies is key to the lives of African-Americans and those involved with the welfare of the race. African-American Studies is the systematic and critical study of the multidimensional aspects of Black thought and practice in their current and historical unfolding (Karenga, 21). African-American Studies exposes students to the experiences of African-American people and others of African descent. It allows the promotion and sharing of the African-American culture. However, the concept of African-American Studies, like many other studies that focus on a specific group, gender, and/or creed, poses problems. Therefore, African-American Studies must overcome the obstacles in order to improve the state of being for African-Americans. According to the book, Introduction to Black Studies, by Maulana Karenga, various core principles make of the basis of African-American Studies. Some of the core principles consist of 1)history, 2)religion, 3)sociology, 4)politics, and 5)economics. The core principles serve as the thematic glue which holds the core subjects together. The principles assist with the expression of the African-American Studies discipline (Karenga, 27). The core principle of history is primary factor of African-American Studies. History is the struggle and record of humans in the process of humanizing the world i. e. shaping it in their own image and interests (Karenga, 70). By studying history in African-American Studies, history is allowed to be reconstructed. Reconstruction is vital, for over time, African-American history has been misleading. Similarly, the reconstruction of African-American history demands intervention not only in the academic process to redefines and reestablishes the truth of Black History, but also intervention in the social process to reshape reality in African-American images and interests and thus, self-consciously make history (Karenga, 69). African American History or Black American History, a history of African-American people in the United States from their arrival in the Americas in the Fifteenth Century until the present day. In 1996, 33. 9 million Americans, about one out of every eight people in the United States, were African-American. Although African-American from the West Indies and other areas have migrated to the United States in the Twentieth Century, most African- Americans were born in the United States, and this has been true since the early Nineteenth Century. Until the mid-20th century, the African-American population was concentrated in the Southern states. Even today, nearly half of all African-Americans live in the South. African-Americans also make up a significant part of the population in most urban areas in the eastern United States and in some mid-western and western cities as well . Africans and their descendants have been a part of the story of the Americas at least since the late 1400s. As scouts, interpreters, navigators, and military men, African-Americans were among those who first encountered Native Americans. Beginning in the colonial period, African-Americans provided most of the labor on which European settlement, development, and wealth depended, especially after European wars and diseases decimated Native Americans (http://encarta. msn. com). Thus, history plays a role in the way African-Americans have shaped the world over time. The core concept of African-American religion has always played a vital roles in the African-American life since its beginnings in Africa. Religion is defined as thought, belief, and practice concerned with the transcendent and the ultimate questions of life (Karenga, 211). The vast majority of African Americans practice some form of Protestantism. Protestantisms relatively loose hierarchical structure, particularly in the Baptist and Methodist denominations, has allowed African Americans to create and maintain separate churches. Separate churches enabled blacks to take up positions of leadership denied to them in mainstream America. In addition to their religious role, African American churches traditionally provide political leadership and serve social welfare functions. The African Methodist Episcopal Church, the first nationwide black church in the United States, was founded by Protestant minister Richard Allen in Philadelphia in 1816. The largest African American religious denomination is the National Baptist Convention, U. S. A. , founded in 1895. A significant number of African Americans are Black Muslims. The most prominent Black Muslim group is the Nation of Islam, a religious organization founded by W. D. Fard and Elijiah Poole in 1935. Poole, who changed his name to Elijiah Muhammad, soon emerged as the leader of the Nation of Islam. Elijiah Muhammad established temples in Detroit, Chicago, and other northern cities. Today, Louis Farrakhan leads the Nation of Islam. A small number of African American Muslims worship independently of the Nation of Islam, as part of the mainstream Islamic tradition (http://encarta. msn. com). Presented with the fact that African-American religion is predominately Judeo-Christian, the tendency is to view it as white religion in black face. However, the rooting of the two religions varies due to the historical and social experiences (Karenga, 212). African-American over time has somewhat declined in its power. The church was once the sole basis of the community, especially to those in need. Today, this is speculated to be the link in the decline in the bonding of the African-American community. The core principle of African-American sociology integrates the various aspects and social reality from an African-American perspective. African-American sociology is defined as the critical study of the structure and functioning of the African-American community as a whole, as well as the various units and processes which compose and define it, and its relations with people and the forces external to it (Karenga, 269). African-American sociology involves the study of family, groups, institutions, views and values, relations of race, class and gender and related subjects. The African-American community, like other communities, is defined by the sharing of common space. Parts of its common space, however, are bounded areas of living, such as ghettos, which not only close African-Americans in the community, but simultaneously shuts them out from the access and opportunities available in the larger, predominately Caucasian society (Karenga, 302). The concept of isolation creates areas of poverty. Socially, isolation in ghettos prevents the cycle of diversity society, allowing prevailing stereotypes to surface. The immense concentration of African-Americans is a reason for disadvantages, such as joblessness, poverty, etc. Statistics suggest that the employment rate issue is an essential on among African-American women. The average rate of unemployment among African-American women in the 1980s was 16% and was higher for African-American men (Giddings, 350). Thus, the concept of diversity prevents African-Americans from thriving socially. The core concept of African-American politics can be defined as the art and process of gaining, maintaining and using power (Karenga, 311). The institution of politics has played a role in the African-American community since the 15th amendment was passed, allowing African-American men the right to vote (Constitution). In order to obtain political power, however, there are eight bases: 1) key positions in government 2) voting strength 3) community control 4) economic capacity 5) community organization 6) possession of critical knowledge 7) coalition and alliance and 8) coercive capacity. In order to attain these, African-Americans must unite, for unity strengthens weak groups (African-Americans) and increases the power of others (Caucasians) (Karenga, 363). Over time, African-Americans have made substantial strides in politics. Civil rights leader Jesse Jackson, who ran for the Democratic Partys presidential nomination in 1984 and 1988, brought exceptional support and force to African-American politics. In 1989, Virginia became the first state in U. S. history to elect an African- American governor, Douglas Wilder. In 1992, Carol Moseley-Braun of Illinois became the first African-American woman elected to the U. S. Senate. Today, Moseley-Braun is a candidate for the Presidency of the United States (Franklin, 612). There were 8,936 African-American office holders in the United States in 2000, showing a net increase of 7,467 since 1970. In 2001, there were 484 mayors and 38 members of Congress. The Congressional Black Caucus serves as a political alliance in Congress for issues relating to African- Americans. The appointment of African-Americans to high federal offices? including Colin Powell (chairman of the U. S. Armed Forces Joint Chiefs of Staff, 1989-1993; Secretary of State, 2001-present), Ron Brown (Secretary of Commerce, 1993-1996), and Supreme Court justice Clarence Thomas? also demonstrates the increasing power of African-Americans in the political arena (http://encarta. msn. com). Despite the advances of African-Americans in the political scene, the rate of voting has immensely declined compared to 40 years ago. According to statistics, less than 20% of African-Americans between the ages of 18 and 24, the most vital voting age group, voted in the last 40 years (http://www. rockthevote. org ). African-American votings disappointing decline over time has become a setback in regards to power, for politics control most of the issues that concern society, such as healthcare, housing, and employment: issues that the African-American community are in need of improving. The core concept of economics is defined as the study and process of producing, distributing (or exchanging) and consuming goods and services. Economically, African-Americans have benefited from the advances made during the Civil Rights era. The racial disparity in poverty rates has narrowed to some extent. The African-American middle class has grown substantially. In 2000, 47% of African-Americans owned their homes. However, African-Americans are still underrepresented in government and employment. In 1999, median income of African American household was $27,910 compared to $44,366 of non-Hispanic Caucasians. Approximately one-fourth of the African-American population lives in poverty, a rate three times that of Caucasians. In 2000, 19. 1 % of the African-American population lived below poverty level as compared to 6. 9% of Caucasians population. The unemployment gap between African-Americans and Caucasians has grown. In 2000, the unemployment rate among African-Americans was almost twice the rate for Caucasians. The income gap between African-American and Caucasian families also continue to widen. Employed African-Americans earn only 77% of the wages of Caucasians in comparable jobs, down from 82% in 1975. In 2000, only 16. 6% of African-Americans 25 years and older earned bachelors or higher degrees in contrast to 28. 1% of Caucasians. Although rates of births to unwed mothers among both African-Americans and Caucasians have risen since the 1950s, the rate of such births among African-Americans is three times the rate of Caucasians (DeBose, 1). Thus, the state of African-American economics have flourished over time, yet remains in a state of improvement. Whether one talks about poverty, incomes, jobs, etc. , all imply and necessitate the concern with economics in the African-American community (Karenga, 355). Conclucively, the possibility of problems arising towards the discipline of African-American Studies are rooted in the birth of the discipline itself (Karenga, 476). The mission of the discipline, problematic administrators, and campus opposition are examples of obstacles that often attempt to prevent the missions of African-American Studies. However, African-American Studies has continued to defend its stance over time. Thus, as long as there is an African-American culture, the quest for knowledge in the African-American studies field will remain. Works Cited DeBose,Brian. Reclaiming the Mission. Nov. 2002 . Franklin, John Hope. From Slavery to Freedom. Nashville, TN: McGraw-Hill, 2000. Giddings, Paula. When and Where I Enter . New York:Perrenial, 1984. Karenga, Malauna. Introduction to Black Studies. Los Angeles: University of Sankore Press ? Third Edition, 2002. http://encarta. msn. com http://www. rockthevote. com.

Reflection On A Mentorship Role In Medicine

Reflection On A Mentorship Role In Medicine During this reflective piece of work I will discuss my role, responsibility and accountability as the students assessor and reflect on approaches that I have used within the mentorship role to support and facilitate the student to achieve specified learning outcomes. The ultimate goal of mentorship is for one individual to contribute to the professional development of another. (Lanser 2000) The NMC (2008) defines a mentor as a registrant who facilitates learning, supervises and assesses students in a practice setting. The student spends 50% theory and 50% in practice; practical training is an important and significant part of the nursing students education. I was informed that a third year nursing student would be attending my practice area a number of weeks before the placement start date, I used this to my advantage by contemplating about learning opportunities within the practice area. The NMC states that at least 40% of a students time at the placement should be spent with a mentor. Therefore the off duty had to be worked to reflect this, as now it is an NMC requirement for mentors to prioritise their workload to accommodate support of students. (NMC 2008) From my time as a student nurse the better placement experiences I had were when my mentor was well prepared and had thought about experiences that would enhance my learning. I feel that it is essential that from the first contact with the nursing student you are building an effective relationship. The ultimate goal of mentorship is for one individual to contribute to the professional development of another. Prior to the students start date it is important that the student has been contacted and informed of location, uniform, start time and name of allocated mentor. Fortunately my student contacted my workplace a couple of weeks before her placement began. I took this opportunity to introduce myself and went through a little of what to expect. Baumeister and Leary (1995) suggest that if students feel accepted secure, valued and respected that it motivates the students capacity to learn and instils confidence. I feel that this initial contact takes some of that first day anxiety away. The influence of the mentor on the student begins at first contacvt and forms the foundation upon which the mentor/student relationship will be based upon. The Nursing and midwifery council outlines eight domains of competency that a mentor must achieve in order to perform the role to an appropriate standard. These are: establishing effective relationships, Facillitation of learning, creating a learning environment, context of practice/ evidence based practice, assessment and accountability, leadership and evaluation of learning. On my student Sarahs first day I had allocated time to orientate and introduce her to the practice area. It is the mentors responsibility to establish an effective working relationship with the student and this starts with orientating and the setting of ground rules.(RCN 2007) Whilst going through the formal, professional, legal, national and local requirements I was conscious about making the orientation a positive experience. I introduced Sarah to the rest of the community nursing team. Levett-Jones, Lathlean, Higgins and Mcmillan() in their study discussed the students need to feel like they belonged as when students feel comfortable they engage with learning opportunities. I believe that the attitude and motivation of the mentor are crucial in creating a encouraging start to the placement experience. (cited in Beskine 2009) Reflecting on my experience as a student the negative aspects of work placements were not being supported by my mentor and feeling under valued and by remembe ring such experiences I feel that it influences how I am as a mentor. The benefit of working as a community staff nurse is that when a student is placed you work together on a one to one basis and have time to establish the student mentor relationship. Using this oppotunity to get an insight into her personality aswell as any concerns she has about the placement. Although it is good to achieve a good rapport with your student Wilkes (2006) advised caution during the social development of the relationship as the professional boundries need to be clear, as getting involved with the student socially or emotionally outside of work would influence your integrity when perfoming assessments. Also as a mentor you act as a role model and The Code(2008) requires a nurse to be of good character honest and trustworthy basing this on ones conduct behaviour and attitude. The NMC (2008) defines a mentor as someone who facilitates learning, supervises and assesses students in a practice setting. It also outlines that in order to do this effectively the mentor needs to have knowledge of the students stage of learning therefore selecting appropriate opportunities for that particular students learning needs. After orientation and Sarah shadowing me on a few visits I felt it was important to conduct the initial interview so we could discuss learning needs and opportunities in my particular area. Sarah had not had a previous community placement and didnt know what is available to learn therefore we had an informal discussion to identify the opportunities. During the initial interview I also established the students level of knowledge and expectations. I had noticed that Sarah was quite shy and was quite nervous. We looked through her portfolio from previous placements and she had passed each one. Also by reviewing the university requirements outlined in her portfolio I was able to see if Sarah was aware of her needs from this placement. My initial impression was that she may need more support than I had anticipated at her stage of learning. It appeared that she wasnt confident in her abilities. Sarah did express that she felt she would require support and guidance as the community setting was a completely new experience for her. Its also important to consider that studies have shown that placements can be very stressful for students especially in their first and third years of training.(Stuart 2007 cited in Beskine2009) Taking my concerns into consideration and Sarahs request we then created a learning contract, the goals set were based on mutually identified need. I decided that initially I would become as Berne(1961) described nurturing parent to Sarah to demonstrate boundries to ensure she felt safe. Until her confidence grew, then the relationship would be on an adult-adult basis on the same level for discussions and mutual expectations. Although fluctuations between different ego state as different circumstances arise throughout the mentor student relationship. In order to help Sarah I felt that by acting as an advocate would promote her confidence and self-esteem. (Neary 2000) To formulate an effective learning contract it has to have essential components as de scribed by Stuart (2007) learning objectives, the activities to facilitate these , strategies and resources for learning. As a registered health professional you have a responsibility to ensure the safety of the public. Therefore by mentoring pre-registration nurses you are accountable for ensuring students fulfil their learning outcomes for your practice area and develop practice competence. (NMC 2006) Assessing a students competence can become complicated by the mentors subjective view of what is competent? (Higgins and McCarthy 2005) Duffy (2003) concurs it is often easier to identify clear incompetence than those students borderline on achieving competence. Mentors need to address the issue of non-competence as soon as it is recognised. The study Duffy (2003) carried out found that mentors tended to give students the benefit of doubt. A view which has been highlighted in a recent survey in the Nursing Times (2010) which said 40% of mentors participating in the survey passed students as they could not provide sufficient evidence to back up their concerns. Before meeting with the student to discuss the issue it is important to collect evidence which has lead to your concerns about the students competence. Going through assessment documentation can help highlight if learning outcomes are achievable for that particular students ability. This evidence would be helpful for you to explore/understand reasons why the student is not achieving and early discussion can prompt students to consider their practice thus facilitating progress. (Duffy and Hardicre 2007) As the student doesnt seem to be aware of their limitations, for patient safety it is essential that you gently alert the student of their unconscious incompetence but if the motivation is there I would as a mentor be confident that they could develop competence. Feedback is a large part of assessment and progression and in this particular issue it is important to provide feedback so the student is aware that they are not meeting the required standard. An effective mentor should offer honest and constructive feedback to students (RCN 2007) Constructive feedback is objective and non-judgemental and should be based on specific observation to encourage discussion and allow future learning to take place. (Pearce 2004) It can be tempting to avoid giving negative feedback but performance cannot be improved without knowledge of what was wrong (Stuart 2006) Feedback to the student would be given in the form of the praise sandwich. NMC (2006) uses this form of feedback in its documents where it state that mentors should contribute to the evaluation of student learning and assessment experiences by proposing aspects for change as a result of evaluation. Mentors should remain positive and supportive also try to empathise with the student and how they will be feeling. A learning contract/action plan that is formulated collaboratively with the mentor and student can specify what the student will learn how it will be achieved and the time scale in which its success can be measured. (Nicklin and Kenworthy 2003) The RCN also advises regular meetings between the mentor and student to discuss progression and make adjustments to action plans based on the students learning. (RCN 2007) Ultimately the NMC in safeguarding the wellbeing of the public sets standards for pre-registration theory and practice competency and requires students to be fit for practice and purpose at the point of registration. (NMC 2008) Some of the learning outcomes were easy to facilitate with experiences that were available from a community placement but others not so easily accommodated. In order to address this we discussed other specialisms within the community neighbourhood team where she could spend time to achieve outcomes. In the initial interview with my student it was important to identify what stage of learning she was at and also determine her motivation to learning. Rogers (2002) suggests adults come to learning with intentions and that they have their own personal expectations of the learning process and hold personal reasons why they want to learn. After discussing mutual expectations from the placement it is essential to understand the students style of learning in order to best facilitate learning activities and opportunities and select appropriate learning strategies to integrate her learning practice and academic experience. Also to be effective learners students should also be aware of and understand their own learning style and manage their own learning. (Siviter 2004) There are various theories on learning styles, I chose to give my student a questionnaire based on the theory by Honey Mumford (2000). This model is broken down into four categories Activist, Reflector, Theorist and Pragmatist. The activist is open minded, enthusiastic and enjoys immersing themselves into new experiences. The characteristics of a reflector are cautious observers. Using all the information available to them to make conclusions. Theorists think things through in a logical manner and value rationally and objectivity. Finally pragmatist act quickly on ideas and are keen to put new techniques into practice. My student felt that she was a reflector and was motivated by understanding nursing processes in order to be able to work well and be a valuable team member. I felt that the strategy I would commence in order to meet the needs of a reflective learner would be facilitating experiential learning followed by reflective practice. Students benefit from action planning to assist them through the transitional period onto new placement areas by setting goals (Quinn Hughes 2007) A learning contract that is designed collaboratively by the mentor and student can specify what the student will learn, how it will be achieved and time span. (Nicklin Kenworthy 2003). Considering this we decided to match the nursing procedure to be trained with specific learning outcomes from the students portfolio and discussed in the initial interview process. Urinalysis was the skill that we focused on in this exercise. Therefore it was appropriate to teach this skill in the sluice area which was a quiet and spacious area where we wouldnt be disturbed. We discussed possible reasons why as a nurse you would take this test for example infection and as a reflective learner I felt that I should explain how her ability and knowledge of urinalysis would benefit her when working as a fully qualified nurse. We then went through the procedure showing all the clinical equipment needed and different ways in obtaining a sample. I tried to relate to practice to enable the student to take what she has learnt to future placement areas. In order for us to reflect on the task we went to a quiet office to avoid distraction. Studies have shown having quality time for reflection and one to one discussion with their mentor were very important to the student. Watson(2000) I felt that the student centred teaching strategy worked well with this particular student as she learnt best by doing and reflecting on the procedure afterwards rather than just being informed by others. Kolbs(1984) learning cycle describes four stages in the learning process from the experience to applying the new learnt information to similar situations, and therefore a component of reflective learning. NMC (2006) suggest that prioritised workload while you are mentoring giving you time to carry out the mentor role. I ensured that the allocated workload would enable me to have more time for effective listening and discussion. Also it gave us the opportunity to discuss events of the day and reflect and give feedback on a daily basis. The process of assessment I feel has to be continuous and developing with my student Sarah due to her lack of confidence I didnt want to increase any anxiety by making formal assessments of her practice. As the ENB/DOH( 2001)document that a mentor should observe a students achievement of a period of time to ensure validity in assessment. Having identified the learning that needed to take place from the university portfolio and personal development on the students part as discussed in the learning contract. The NMC (2007) clearly outlines the requirements for assessments of student nurses. The students performance should be assessed in practice with accountability resting with the mentor who is carrying out the assessment. It is important that a student is able to self assess, and after our discussion in the initial interview Sarah did identify that she needs more support to enhance her self-confidence, and due to this we incorporated this in our learning contact along with the learni ng outcomes in her portfolio. It is also important for a student with confidence issues to self assess as they will see that progression is being made in their learning, therefore gaining confidence.(chap. assessment of student practice from uni lib) A continuous assessment of the students practice is a more reliable tool as supervising/assessing the student on a day to day basis in a relaxed environment it is more likely to reflect the true ability of that student. (Stuart 2007) The NMC (2006) under the leadership domain specifies that mentors need to display leadership qualities within the practice environment. I feel that by planning series of learning opportunites for the student and prioritising workload to ensure time to support the student i have achieved this. Without planning or prioritising a busy workload it would inevitabley be to the detriment of the students experience. Interim interview is the first more formal assessment of the students abilities/progress so far. The learning outcomes/competences were discussed and documented at initial interview in the form of a learning contract. I ensured that we had time to discuss Sarahs progress and competences. Although Sarah has made progress with her self-confidence there is still areas to improve therefore a new action plan was formulated and mutually agreed. We clarified the area of weakness and advised how she would progress further and arranged for her to work with other assessors within the team so to ensure fairness. (Gopee 2008) Feedback is essential in the process of formative assessment Pryor (1998) highlighted the importance of feedback not only identifying what the student has learned but also what they may accomplish in future practice. ( cited in Gopee 2008) Feedback should when possible be given in private (RCN 2007) as this would prevent other people from listening to any discussion. There is also the potential for the audience effect (Quinn and Hughes 2007) where the student feels that everyone is watching or listening to the feedback in her performance. Feedback is most effective when given at the time or soon after and activity occurs. This ensures that the experience is still fresh in both mentor and students mind. Therefore the information discussed is more accurate and detailed making it more useful for the student. Not only is a mentor there for supervising and supporting the student it is advantageous to the student when giving detailed feedback it guides the to learn what is expected of them to improve that particular episode of nursing. My main concern was making Sarah feel comfortable when receiving feedback as within the interim interview there still remained things to improve on. I ensured that my body language was warm and open. Giving eye contact and smiling and nodding. It is important that when giving positive feedback she felt that I was honest and w hen discussing feedback on a more constructive basis she felt that I was self-assured in the information that I was imparting. We collaboratively devised an action plan for the last couple of weeks of placement. Involving Sarah enhancing her management skills and to gain confidence in her own decision making. The NMC (2004) state that prior to entry to the register pre-registration students should be able to manage the delivery if care with the scope of ones own responsibility. (cited DuffyMiddleton 20) To facilitate this I delegated the care of patients within a residential home, as working in community it isnt easy for the student to work independently without direct supervision due to visiting patients within their own homes. But in the residential home environment I was around but not directly supervising. At this stage in the placement I felt that Sarah had developed her confidence and that this experience would help in realising her own capabilities. As Sarah had now spent a couple of weeks within the practice environment and within the community nursing team she began to open up about previous experiences whilst on placement. She felt that not all of her relationships with her mentor has not been a positive experience. Darling (1984) did some research about the mentor/mentee relationship and creating the learning environment and those mentors who didnt create a positive environment he described as toxic mentors. Three different forms of the toxic mentor were dumpers, blockers and destroyers. The first of these describes those individuals who dump there students into experiences out of there depth. Blockers were those who didnt allow the student to partake in learning opportunities. Destroyers as the word describes, destroys a student confidence by undermining them and criticising without offering another possibility. Darling (1984) was also able to identify what the basic attributes that a mentor should possess, roles as an insp irer, investor and supporter. (cited in Pellatt 2006) Whilst discussing the subject with Sarah it became apparent that her confidence had been knocked by two negative mentor experiences in the past. As a girl who is quiet in nature was having trouble recovering from this. Refecting on my discussion with Sarah I came to realise the impact the mentor can have on the student and how detrimental this had been for Sarah. I was fortunate enough to be able to take part in all of Sarahs placement and therefore feel that spending time with my student put me in a better position to assess and be content with my evaluation on Sarahs ability. It enabled us to focus on areas were highlighted in the initial meeting. (Stuart 2006) Working in community one of the challenges as a mentor which you have little control over is the learning environment. Whilst for the interviews I was able to ensure we had a quiet room back at base. And reflective discussions took place in the car. The actual learning environment altered every visit to different homes. As Sarah hadnt had a community placement before I felt that I would inform her of problems that may arise. These included poor hygiene, living conditions but also discussed that we live within a culturally and socially diverse environment. The final interview is the only summative part of the assessment process as a mentor it is my job to reflect on the students abilities as a whole in my opinion and also draw on other team members experiences with my student. Therefore being an objective view, also by using the university portfolio as a guide to see if all learning outcomes have been completed. As a mentor I am aware of the accountability that I have when deciding if a student meets the required standard. Especially on a students last placement there can be no benefit of doubt as the pre-registered student will not have time to develop before registration occurs. Time was allocated at the end of the final meeting to ask the student how she had found her experience with me as a mentor . The role of the mentor is very important in the stage immediately prior to student nurses achieving registration is imperative in producing nurses who are fit for practice and purpose. (NMC 2004) The study carried out by Duffy and Middleton(20) concurred that a longer last placement gives students time to settle and become part of the team encouraging their confidence to grow. It enables the student to get their practical skills up to the required standard and also developing their management competences, an essential skill within the staff nurse role. Unfortunately it must be acknowledged that not all students will achieve the required outcomes to become competent and safe practitioners. Duffy (2005) stated that there has to be the recognition that some students need to fail. It is important to be aware as a mentor the assessments that we are taking is to safeguard professional standards, patients and the general public. During my time with my student it was essential that both Sarah and i recognised her lack of confidence and doing so early as possible interventions can be initiated within the work placement to achieve the required competences. As the mentor is accountable it is important that along with the professional standards and competences outlined, the NMC require that the registrants are of good health and character. Another aspect that the mentor is responsible for. Most teaching within the practice area does deal with all those aspects, the clinical skill itself and the interpersonal and management skills involved. The educational taxonomy considers that any learning topic has to be judged from three angles in relation to what the student has to learn. Those being psychomotor; the physical skills to conduct the duty. Cognitive; the understanding of the evidence base for the duty. Affective is the ability to conduct the duty with the appropriate communication and interpersonal skills. The assessment was mainly continuous in a formative basis and using the aids of learning contracts and facilitating achievement of the outcomes by allocating patients and tasks, liasing with professionals. On all the tasks I felt that my student Sarah had arrived with a lack of confidence but through the process of practice feedback and reflection and the support she was given from myself and the community nursing team all of the outcomes were achieved well. As a mentor it is my responsibility to identify and apply research and evidence based practice to my area of practice (NMC 2008) I think it is important that as a mentor you should assess your personal strengths and weaknesses as to me it is important that I gain confidence in my abilities as a nursing student mentor. Feedback from the student perspective on the practice area as a learning environment is advantageous as it is part of the ongoing evaluation of the learning environment. As it reviews the learning opportunities and audits the placement so to develop skills of the professionals within the team. Enabling the workforce to contribute in developing the profession for the next generation of nurses. (ENB/DOH 2001) Also these audits will highlight the practice areas where students are struggling to achieve and thus giving the University opportunity to address the concerns. The University have a responsibility to where possible ensure the placement has the necessary opportunites to facilitate adequate learning experiences to reflect the student experience. (RCN 2006) Action plans are defined as a must achieve device that identifies competences that need to be achieved by an identified date during the practice placement,non achievement of which would lead to a fail mark being awarded. (Gopee 2008) It is essential within any assessment that a mentor perfoms you are prepared, fair ,objective, honest timely and give effective feedback. All these componets ensures that evidence collected and documented within the students portfolio is a true objective illustration of the students competences and ability. Barriers that would affect the mentors role is documented by Gopee (2008) organisation, lack of resources, personality clashes attitude problems either student/mentor. As a mentor the main challenge in being able to perform mentor duties is that there is inadequate time to fulfil this role along with your clinical duties. Obviously on a day to day basis it is hard to forsee how your day may go as you never know what you will find when you open the door to each patient. But to minimalise this as much as possible I put my leadership and management skills into practice so that opportunites /experiences were planned to an extent and timetabled as much as we could with the nature of the profession. Therefore reassuring the student that I my motivation was that she got the best out of her experience within the community nursing team. By setting an action plan also helps promote underlying skills such as planning, scheduling, goal setting, negotiations and management. Skinners theory devised in1974 states that the environment is essential to any learning that takes place and if the environment is suitable then learning will occur as connections are formed from responses to stimuli and reinforcement of these occurs.(cited by Quinn 2000) As part of Sarahs action plan we discussed other resources available to her for example having practice days with other professionals within the neighbourhood teams. Nurses are expected to be able to validate their clinical decisions with research based evidence that results in care should be patient centred and clinically effective. (DOH 2000) Within the community some of the treatments we provide for example compression therapy for treatment of leg ulcers have a large evidence base for that treatment but also as a professional we also use the evience from patients living with these condtion and consider both those as evidence to provide a rational for certain decisions made about treatment. Fitzpatrick(2007) in her literature review found that opinions on what evidence based practice was depended on the perspective of the individual. Evidence can be sourced from experts, literature and views of patients. All assessment descisions must be evidence based. This is seen as crucial as the future of the profession, in both its integrity and knowledge are in the hands of students currently training to become registered nurses. (Hand 2006)

Co-Occurring Disorders and Behavioral Health Services

Co-Occurring Disorders and Behavioral Health Services Jasmina Vuksanovic Co-Occurring Disorders and Behavioral Health Services Co-occurring disorders exist â€Å"when at least one disorder of each type can be established independent of the other and is not simply a cluster of symptoms resulting from a single disorder.†1 It has also been defined as the co-occurrence of â€Å"two or more psychiatric disorders.†2 Depending on the disorders involved, comorbidity may be homotypic, which involves disorders from the same diagnostic group, such as alcohol use and drug use, or heterotypic, which involves disorders from different diagnostic groups, such as alcohol use and depression.2 Prevalence and Demographic Factors Major depressive disorder (MDD) is one of the most prevalent mental disorders in the United States, affecting approximately 6.7% of U.S adults each year.3 Alcohol use disorder (AUD), defined as both alcoholism and harmful drinking, is also prevalent in the United States and often co-occurs with MDD. AUD affects approximately 17 million Americans each year.4 Although research has not established a definitive etiological risk factor for both MDD and AUD, there are several proposed theories as to the association between these two disorders. Studies have shown that depressive symptoms may emerge during periods of heavy drinking and withdrawal.5 Continued heavy alcohol use may be a precursor to stressful life events, which in turn increases the risk of depression.5 Conversely, individuals battling depression are likely to drink heavily in order to cope with the depression, which in turn increases the risk of developing AUD.5 Among those with AUD, women have higher depression than men, as do Whites, compared to racial and/or ethnic minorities.5 In the general population, alcohol dependent men have a 24.3% lifetime prevalence of major depression, whereas alcohol dependent women have a 48.5% lifetime prevalence of major depression.5 In clinical samples, the lifetime rates of co-occurrence for women range from 50% to 70%.5 Co-occurrence of AUD a nd MDD is also associated with increased morbidity, mortality, functional impairment, and risk of suicide.6 Another co-occurring disorder of interest is schizophrenia and substance use disorder. Schizophrenia is a chronic illness associated with hallucinations and disorganized behavior, while the most common substances of abuse are alcohol, cannabis, and cocaine.1 Schizophrenia affects approximately 1% of Americans, and approximately 50% of individuals diagnosed with schizophrenia also suffer from a co-occurring substance use disorder.7 When compared to individuals who suffer from schizophrenia only, dually diagnosed individuals have lower adherence to treatment, increased risk of HIV, higher hospitalization rates, are more prone to violent behavior, and are more likely to commit suicide.7 Schizophrenia runs in the family. If one parent has schizophrenia, the risk of a child developing the disorder is 13%; if both parents have schizophrenia, the risk increases to 46%.8 Schizophrenia does not discriminate and affects men and women equally. Symptoms often begin between the ages of 16 and 30 and does not commonly occur in children or adults older than 45 years.8 Additionally, individuals diagnosed with schizophrenia and a substance use disorder often experience onset earlier in their life than do those who suffer from schizophrenia only.8 Service Delivery Barriers and Strategies to Overcome These Barriers The fragmented health care system poses a huge barrier for individuals seeking care for co-occurring disorders. Due to this fragmentation, patients are not able to receive comprehensive and coordinated care for addiction services and mental health care. Of those struggling with co-occurring disorders, â€Å"8.5 % of individuals receive treatment for both disorders; 38.4 % receive treatment for one or the other disorder; and 53 % receive no treatment at all.†1 One strategy for overcoming this barrier is by integrating mental and physical health care delivery. Combining mental and physical health funds to pay for services would not only increase access to coordinated care, but it would streamline the coding and billing process through the use of common codes. It would also create a network of mental and physical health providers, who would all be responsible for well-being of each patient, thus encouraging coordinated care. A second barrier is the stigma associated with mental illness, which impedes help seeking. This barrier can be combated by educating patients about the resources available for treatment and the overall importance of a healthy mind and body. Businesses should do more to educate employees about mental health benefits, as many may not be familiar with them. Establishing behavioral health clinics, such as the WestBridge Clinic, would provide the compassionate care many individuals with co-occurring disorders are in need of and would likely encourage these individuals to seek treatment. A third barrier is one that is faced by Medicare patients as same day separate billing for mental health and medical care is not covered under Medicare.†1 With the oncoming demographic shift, this segment of the population cannot be ignored. Though this is a more difficult barrier to overcome, policy changes should be made to ensure the elderly have access to mental health services in the primary care setting. Increasing the scope of practice for clinical staff may be a feasible strategy for overcoming this barrier. Implications for Behavioral Health Throughout this course we have learned that organizational leaders and clinical staff must exhibit a certain level of commitment to providing quality care in order to effectively treat dually diagnosed individuals. As we see look at Accountable Care Organizations, the benefits of coordinated care become even more apparent. The ACA shifts the focus to evidence-based practices, which will become integral for more effective treatment and improvement in service delivery of co-occurring disorders. Adequate screening methods and health assessments by primary care providers are the first step in the treatment and recovery process1 and will undoubtedly lead to improved detection rates and treatment of dually diagnosed individuals. It is essential for clinicians to understand the epidemiology of all disorders a person is suffering from to ensure correct and effective treatment is received. Service delivery can be expected to improve with an increase in more knowledgeable clinical staff. Clini cians must be knowledgeable about possible interaction of the two disorders and how both can be treated, rather than just one. However, as long as stigma continues to surround the topic of mental health, there will continue to be hesitation by mentally ill individuals to seek treatment. As a society, we must take the necessary steps and encourage help seeking by those suffering from a mental illness.   References Levin BL, Hennessy KD, Petrila J (Eds.).Mental Health Services: A Public Health  Perspective, Third Edition.New York: Oxford University Press; 2010. Falk D, Yi H, Hiller-Sturmhofel S. An epidemiologic analysis of co-occurring alcohol and  drug use and disorders. Alcohol Research Health. 2008; 31(2): 100-110. National Institute of Mental Health. Available online at  http://www.nimh.nih.gov/health/topics/depression/index.shtml. Accessed February 19 2014. National Institute on Alcohol Abuse and Alcoholism. Available online at  http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics. Accessed February 19 2014. Conner KR, Pinquart M, Gamble SA. Meta analysis of depression and substance use among  individuals with alcohol use disorders. Journal of Substance Abuse Treatment. 2009; 37: 127-137. Riper H, Andersson G, Hunter SB, et al. Treatment of comorbid alcohol use disorders and  depression with cognitive-behavioural therapy and motivational interviewing: a meta-analysis. Addiction. 2013; 109: 394–406. Green AI, Noordsy DL, Brunette MF, et al. Substance abuse and schizophrenia:  Pharmacotherapeutic intervention. Journal of Substance Abuse Treatment. 2008; 34: 61– 71. National Institute of Mental Health. Available online at  http://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml. Accessed February 19 2014. QUESTION #3 Is Mental Health a Public Health Issue? Among U.S. adults age 18 years and older, an estimated 26 percent suffer from a diagnosable mental disorder each year, and for young adults, mental disorders are the leading cause of disability.1 Mental illness also bears a heavy burned on the global economy. The WHO estimates that 14% of the global disease burden is attributable to mental illness.2 Among the twenty most significant causes of disease burden worldwide are depression (3rd), alcohol use disorder (7th), bipolar disorder (12th), schizophrenia (14th), and substance abuse disorders (20th).2 Compared to all health expenditures, mental health and substance abuse expenditures have been decreasing since 1986, and are estimated to account for 6.9% of the nation’s health care expenditures in 2014.3 Mental illness increases the risk of developing a physical illness, communicable and non-communicable disease, and intentional and unintentional injury.2 To decrease prevalence of mental illness and its adverse effects on overall health of individuals, it is necessary to integrate mental health service delivery into the nation’s public health system. The public health system encompasses a broad array of topics, which creates opportunities for integration of mental health services through community education, epidemiologic surveys, health screening and assessment, ensuring adequate access to care, identifying risk factors and determinants of health, focusing on prevention and early intervention, and promoting sharing of information among health care providers.3 Traditionally, mental and physical health have been treated in two separate service delivery systems. However, majority of adults diagnosed with a mental disorder to not seek treatment, and those who do, seek treatment within the primary care sector, rather than a specialty behavioral health care sector.3 Integration of the mental and physical service delivery systems leads to better health outcomes in primary care, home health care, and long-term care setting, as well as increased mental health care access, rates of treatment, improved treatment adherence, enhanced clinical and functional outcomes, and greater cost-effectiveness.3 Among older adults suffering from depression, integration of physical and mental health services has shown a decrease in health care dollars spent on care, improved survival, and improved quality of life.1Among individuals suffering from substance abuse disorders, integrated care leads to lower â€Å"hospitalization rates, inpatient days, emergency room u se, and medical costs.†3 One example of an integrated health care delivery system is the Veterans Health Administration, the nation’s largest integrated health care system. Zeiss identified five key reasons for this integration. First, patients prefer to receive mental health care in the same setting as primary care, as they are most familiar and comfortable with their primary care provider.4 Second, primary care providers often fail to diagnose or misdiagnose a mental illness, especially in older patients who may have other health conditions.4 Integrating care can increase detection and accuracy of diagnosis. Third, patients are more likely to seek treatment for a mental illness when a diagnosis is determined in primary care and when care is available in the primary care setting.4 Of importance is the difficulty of primary care referral to mental health providers.4 Studies have shown an astounding 75% of patients fail to follow through with the referral and therefore do not get the mental health trea tment, whereas 90% receive treatment when it is provided by the primary care provider.4 Fourth, integrated care allows for information sharing among providers. Of highest importance is information relating to the patient’s diagnosis and treatment options. It allows both health providers to provide ongoing care and treatment to the patient, without overlap of information, or exchange of misinformation among the providers. Fifth, screening for mental illness in the primary care setting may lead to reduction in the stigmatization of mental illness as it will be viewed as one of many steps of a health assessment provided to all primary care patients.4 These findings have been echoed through other studies, as we have learned throughout the course of the semester. Implications for Behavioral Health Mental illness affects a significant proportion of the U.S. population and the importance of efficient treatment cannot be understated. Integrating mental health services into the traditional public health delivery system and increasing collaboration and information sharing among providers of different disciplines is a key aspect of delivering holistic care. Through course lectures, reading assignments, and videos, we have learned that populations at higher risk of developing a mental illness are more likely to delay treatment, or not seek treatment at all, receive lower quality care, and have higher rates of co-occurring illness and morbidity. The traditional health care model emphasizes preventive care and early treatment, which must be a primary focus for mental health services as well, in order to keep the population healthy, lower the prevalence of mental illness, and maintain an affordable health care system. The number of mental health facilities and organizations providing me ntal health services and treatment has decreased from 3,942 in 1990 to 3,130 in 2008,1 thus the need for integration is essential. In order to create a holistic healthcare system, we must break down the existing barriers between the mental and physical health care delivery sectors. References Levin BL. Week #3 Lecture: Mental Health Systems.2014. 1-11. Levin BL. Week #2 Lecture: Epidemiologic, Historical, Legislative Perspectives.2014: 4-  15. Levin BL, Hennessy KD, Petrila J (Eds.).Mental Health Services: A Public Health  Perspective, Third Edition.New York: Oxford University Press; 2010. Zeiss AM, Karlin BE. Integrating mental health and primary care services in the Department of  Veterans Affairs health care system. Journal of Clinical Psychology in Medical Settings. 2008; 15:73–78.

cochlear implants Essay -- essays research papers fc

Cochlear Implants   Ã‚  Ã‚  Ã‚  Ã‚  A cochlear implant is an electronic device that restores hearing for people anywhere from hard of hearing to the profoundly deaf. The cochlear implant is surgically implanted under the skin behind the ear. The surgeon puts the electrode array inside the inner ear and than inside the cochlea. The implant works by a device outside the ear, which rests on the skin behind the ear. It is held upright by a magnet and is also connected by a lead to a sound professor.   Ã‚  Ã‚  Ã‚  Ã‚  What happens when you get a cochlear implant? First, you are given an injection to make you fall asleep. Once youà ¢Ã¢â€š ¬Ã¢â€ž ¢re asleep the hair behind your ear is shaved off. Then you have the operation tat usually lasts from 2-4 hours. The doctor cuts behind your ear and puts the implant into the bone right there. Next he places an electrical array the curls inside your cochlea. When you wake up you are sent home for a few days to rest. After you are all rested you go to an audiologist to get the sound professor programmed. The sound professor is a main part is allowing you to hear when you have a cochlear implant and when ità ¢Ã¢â€š ¬Ã¢â€ž ¢s not in, you wonà ¢Ã¢â€š ¬Ã¢â€ž ¢t hear anything. Once the sound professor is programmed you with be able to hear. The cochlear implant uses a much different method to enable a person to hear opposed to a normal hearing ear. The cochlear implant has five parts; a microphone, sound processor, head piece, implant and hearing nerve. The...

Jean-Paul Sartre Essay -- Biography Biographies Philosophers Essays

Jean-Paul Sartre Jean-Paul Sartre was an existentialist philosopher. The questions of his philosophy often come out in his readings. Existentialism questions why we exist. Existentialists deny the existence of God. Existentialist writers such as Kafka and Sartre often use prisons and solitary confinement to tell their stories. Often, neither the reader nor the protagonist is aware of what crime has been committed. Jean-Paul Sartre’s â€Å"The Wall† reflects his philosophy and personal experiences. He worked for the French resistance and was imprisoned by the Germans during WWII. The story takes place during the Spanish Civil War in an old hospital being used by the Spanish Fascist’s to house prisoners. â€Å"The Wall† is told from a first person, stream of consciousness point-of-view, and uses existentialist philosophy, to illuminate the follies of totalitarian governments like Fascism, and Nazism. Like most existentialist writers, Sartre chooses to tell the story of â€Å"The Wall† form the first person stream-of-consciousness point-of-view. We get dialogue from other characters, but the dialogue is filtered through the mind and thoughts of Pablo. The terror in the story slowly unfolds from Pablo’s mind. In the beginning, Sartre only gives us a hint of terror. The reality of the situation has not yet set into Pablo’s mind: They pushed us into a big white room and I began to blink because the light hurt my eyes. Then I saw a table and four men behind the table, civilians, looking over the papers. They had bunched another group of prisoners in the back and we had to cross the whole room to join them. There were several I knew and some others who must have been foreigners. The two in front of me were blond with round skulls; they looked alike. I supposed they were French. The smaller one kept hitching up his pants; nerves. (7) The emphasis on the â€Å"round skull† foreshadows a scene that later brings terror into greater effect. Tom tells Pablo while they are waiting to be executed, that they aim for the eyes and head to disfigure your face. The emphasis on the perfect round skulls in the first paragraph draws attention to faces and heads. â€Å"The smaller one hitching up his nerves,† tell us from the beginning that Pablo should be nervous himself. Pablo knows he is in trouble at the beginning. He just does not realize the amount yet. ... ...out truth or a person’s innocence. Juan is guilty of know crime and is put to death. Garcia who Pablo meets in the courtyard after he gives his false testimony, â€Å"had nothing to do with politics† (36). When asked why he was arrested, Garica responds â€Å"They arrest everybody who doesn’t think the way they do†(36). The Nazi’s and the Fascist’s used mental torture and the threat of terror to get people to question their own existence, their own sanity. They do not think, they just take orders and obey. Therefore, it is perfectly ironic that Pablo sends them to a place devoid of reason or thought. The further irony is that Gris is hiding in the graveyard in the gravediggers’ shack and is killed in a gunfight. Pablo says after learning of Gris’s death, â€Å"everything began to spin and I found myself siting on the ground: I laughed so hard I cried† (37). Pablo laughs until he cries because he realizes he never will understand why one man dies and another lives. In spite of all his thinking and mental anguish over the question, every answer he discovers leads back to Descartes; the only part of his existence he can not question is the one truth, â€Å"I think, therefore I am."

Example of a perception paragraph Essay

I am discussing the wealth inequality about hos its being distributed. Distribution of wealth is one of the main problems we have in our society, and it depends on the outcome of people in the environment. I am looking at the perception, status, charity and imperialism of how the world is and can be. First, I will discuss status and Imperialism. Imperialism, as defined by the dictionary of geography, is ‘an unequal human and territorial relationship, usually in the form of an empire, based on ideas of superiority and practices of dominance, and involving the extension of authority and control of one state or people over another. The people in power have unlimited authority because they have all the money they control the less privileged ones with less money. The perception of people about the environment on wealth distribution is one of the problems that deprives the community from improving. Charity is the practice of benevolent giving and caring. It is desirable that the earth should be peopled, governed, and developed, as far as possible, by the races which can do this work best. This are the people in high status that can make the community a better place. The focus of my paper is to discuss about how wealth should be distributed. There is no real answer to should wealth be evenly distributed or distributed according to class and status?. I picked this topic because of my experience have had with wealth in my family. I personally believe wealth should be evenly distributed. If it is evenly distributed, everybody is going to have equal opportunity in life.

An artwork is foremost a reflection and expression

It has been essentially argued since time immemorial of how an artwork is foremost a reflection and expression of the deeper emotions and values of an artist, which may sometimes be unfortunately suppressed in the artist’s life or unintentionally implied in the artwork. For that matter, any artwork is perhaps considered an artist’s personal drama set in a creative manner of expression. Sophie Treadwell’s play, Machinal, and T.S. Eliot’s poem, The Love Song of J. Alfred   Prufrock, are be fitting examples of modern human drama relatively framed in a dark, lonesome, and tragic milieu of love, death, age, solitude, and despair in the twentieth century. In Eliot’s poem, the narrator or speaker in his poem is a contemporary man who feels secluded brought by the fear of aging, and who is indecisive to act upon his crisis on love for a woman. The speaker Prufrock is rather an epitome of despair, frustration, and helplessness of the modern man toward a personal crisis. Prufrock positions himself as a symbol of disillusionment and dismay for failing to overcome his human weaknesses. What makes the poem or the speaker tragic is that his insecurity on a lot of things is holding his happiness in life and love. He remains to be brooding, dark, lonesome and awaits death in no time. Eliot has always been a difficult read, and this quality of writing has put him in the level of other literary masters. For a non-Eliot reader, the poem may initially seem confusing to understand. However, the speaker Prufrock has been endowed by Eliot the style of repeating particular phrases and going back to his main sentiment while the poem develops into a whole new set of ideas. This style is reassuring the reader that he can understand the deeper emotions of the speaker as he slowly reads through it. On one hand, this repetition may also show the speaker’s inability to communicate well with the society, and he needs to repeat words such as vision and revision to be clearly understood. Eliot possesses an ironic manner of writing that is very well implied on how Prufrock talks about his love for a woman but is coward enough to open up his feelings and of how he even contradictorily speaks of time as he would sense the urgency to capture life and love in his hands before old age and death take him away, but would also set it aside and reveal that there is still time to catch up on things. The first two similar characteristics or qualities of Treadwell’s play with Eliot’s poem are the twentieth century setting and powerful themes of death and despair, even though the former’s work is based on a sensational real murder case and the latter is more of a personal struggle brought about by aging. Machinal is also similar with Prufrock’s written image of pessimism and depression for things that they are incapable of having, but both end in different resolutions. Machinal’s main character, Helen, is unhappily married to a vicious man and yet happily having an extra-marital affair with a younger man. But, Helen being incapable of loving the younger man in the most proper ways as dictated by society’s conventions, murders her husband and releases herself from the wretched married life. In the case of Prufrock, he remains attached to his fears of opening up to his love and to the society. Machinal is as powerful and intense as Prufrock in its presentation of despair over love. Machinal is desperately consumed with two kinds of love as previously stated. What makes Helen a tragic hero like Prufrock is their disparate heroism takes them not into the world of admiration, but into a world of utmost dismay and desperation – theirs is a tragic presentation of surrender to an inescapable human obstacle of frustrating emotions. Treadwell is capable of repetitive rhythm like a strange poem – a quite tricky concept like Eliot – yet incorporated the theatrical lingo of any expressionistic writing during the twentieth century. To say expressionistic is to only define the attributes of human emotions, not necessarily placing it into an approach of realism. But, moreover, Machinal is an engaging, dark display of human wickedness doomed like Prufrock’s love song. Works Cited Treadwell, Sophie. Machinal (Royal National Theatre). London: Nick Hern Books, 1995. â€Å"T. S. Eliot: The Love Song of J. Alfred Prufrock.†