The Intricacies of Cubanness :: Personal Narrative Writing

The Intricacies of Cubanness â€Å"Hey bro, en Hialeah me quedo,† I said to my friends Eddie Safille, Alex â€Å"G† Gonzalez and Orlie Castelblanco as we finished up our Cuban coffee while playing a game of dominos. Eddie, in an enthusiastic voice, answers, â€Å"You better believe I’m staying in Hialeah. This place is our home.† We all love Hialeah, as city in Miami-Dade County located a few miles from Miami city limits and is predominantly Cuban. Hialeah is one of the only cities in this country where we don’t feel like a minority. We cling to our Cuban culture like a python clings to its prey while it squeezes the life form its lungs with its muscular body. I feel a strong bond with my Cuban heritage, every time I play my bongos, every time the Salsa beat moves my feet across the floor like a hurricane taking a town by storm, or every time I drink some cafà © while playing dominos in the park or behind La Carreta restaurant. One of my favorite memories is of my friends and I playing a game of dominos at Bayfront Park downtown with Latin music in the background, feeling the ocean breeze brush against our faces, and seeing all the skyscrapers tower over us in a seemingly endless bundle of beauty and majesty. The city, with its sun-splashed avenues has treated the Cuban people with love and respect and has contributed to my pride in where I’m from. I like to think of my cultural heritage as a chocolate chip cookie. The dough of the cookie is an Americanized version of both Cuban and Lebanese cultures making up the majority of the cookie, while the chips are a mix of many cultures that have influenced me in smaller ways, such as my father’s Irish roots. The reason the Cuban and Lebanese cultures because the most predominate is mostly as a result of how I grew up. All my life I have lived with my parents, and my mother’s parents. Although both my Cuban and Lebanese influences have greatly impacted my life, my Cuban-American culture is without doubt the most influential of all. The first language I spoke was Spanish. Most of my friends are also of Cuban decent, and the city that I grew up in, Miami, is a strong hold of Cuban power in the United States.

Essay --

Junk Food Should Be Banned At All Outlets In The UAE More than 72 McDonald's restaurants in the United Arab Emirates itself, and over 29 KFCs, only goes to reflect the popularity of junk food all over the world. Food that is prepared and served quickly is termed as 'fast food'. Such type of food suits perfectly into the fast paced life of a working individual. There is nothing more than ready-made food that a hard-working professional living in the city away from family could ask for. However, those who are against junk food highlight the adverse effect that it has on our health. Despite all the debate about the advantages and disadvantages of fast food, the industry is flourishing. Is junk food good or bad? The most evident advantage of junk food is that it saves time, taste good, cheap, and you can eat it in few minutes, there is no need to wash dishes because it's comes with plastics or paper food, also you can eat them anywhere and even standing. There is nothing better than getting a ready meal. No matter how much the chefs praise the benefits of fresh food, at the end of a hard-working day, when one returns home all tired and hungry, a pizza or a burger can be enough to stop his hunger. Besides the time an individual has to spend in the kitchen, cooking a meal also requires one to make a trip to the supermarket to buy the ingredients for the dish. Then there is the added effort and time consumed in washing and peeling the vegetables. All this makes eating fast food score more preferably over cooking a meal for a busy individual. Besides time, cost saving gives fast food an edge over the meal prepared in the kitchen. If one lives alone, then it is cheaper to buy a meal at the supermarket instead of cooking it at home. Also c... ...re their experiences. However, the junk food centers are quickly eating into this quality time. This is especially true about youngsters for whom a junk food center is a good place to hang out with friends. Finally, in my opinion junk food must be banned in all outlets in the UAE, because junk food is not good at all as I wrote above, it makes people rely on the ready male and their health will be weak and also will increase their risk of being obese as their body will use the desired number of calories. In addition the women will forget how to cook and this will affect their relationship with their husbands and their children, this is a reason of divorce for the negligence of the wife. References:- †¢ http://www.albayan.ae/economy/1265974470599-2010-03-02-1.224419 †¢ http://healthmeup.com/photogallery-healthy-living/reasons-why-fast-food-is-bad-for-health/16239

Psychoanalytic Model Paper Essay

When we talk about Psychoanalytic theory the first name that comes to mind is Sigmund Freud. Even though they are other psychologists that contributed to psychoanalytic theory and its development, Sigmund Freud is known for being the founder of this theory. He is famous for his work on sexual bias of neurosis, his study of hysteria, childhood seduction controversy, and dream analysis, among other theories like id, ego, and superego. Psychoanalytic Theory is the theory of the unconscious mind, and the personality development. Another concept, that helped shape psychoanalysis, is the early ideas of psychopathology. Like any other theory, there is always criticism, and other psychologists that do not share the same view. In Freud’s case, he was criticized for his way of collecting and recording data from his sessions with patients. Also for his theory of women having penis envy, and that he focused on the past behaviors instead of paying attention to the patient’s goals, future hopes, and motivations. Psychoanalytic Theory focuses on the study of the unconscious and abnormal behavior. Three of the major influences of psychoanalysis were philosophical speculations about the unconscious, early ideas about psychopathology, and other evolutionary theory. The theory of the unconscious mind is that it is a big influence in our life whether we are sleeping or awake. Freud’s speculated that our actions were a manifestation of the unconscious consequence of childhood  experience or emotion. It was Fechner that used the analogy that the unconscious mind is like an iceberg. This analogy helped inspire some of Freud’s work so much that he even quoted Fechner is some of his writings. There were other psychologists before Freud that suggested the theory of the unconscious mind; however Freud claimed that he found a way to study it scientifically. According to Freud, the unconscious mind slips and exposes our true thoughts, desires, emotions and behavior in dreams. This is known as the Freudian slip. Psychopathology also had a great influence on the development of Psychoanalysis. The study of mental illness dates back to 2000BC. The Babylonians believed that mental illness was the cause of demon possession and that the only treatment was thru magic and prayer. The Hebrews also believed that the cure for mental illness was thru magic and prayer. They also believed that the cause of mental illness was the cause of sins. The great Greek philosophers believed that mental illness was the cause of the disorder of thought process. The treatment was the power of the healing word. In other words, they believed that therapy was the answer to mental illness. When Christianity became popular they convinced the people that mental illness was the result of the evil spirits sending us back to 2000BC mentality. The only difference is that the Christian Church believed that the only way to get rid of evil spirits and possessions was thru torture and execution. It wasn’t until the eighteen century that mental illness was considered as a behavioral problem. People displaying irrational behavior were sent to an asylum also known as the cemetery for the still breathing. This inspired other psychiatrists to find forms of treatment for the mentally ill. The Emmanuel Movement focused on talk therapy sessions. Elwood Worcester believed that psychological issues can be in some cases the cause of mental illness. The movement became so popular that when Freud came to the United Sates with the concept of psychoanalysis they welcomed him with opened arms. Sigmund Freud is believed to be the father of psychoanalytic theories. His research was based on his theories about the conscious and unconscious mind. He believed that our actions, emotions, and true thoughts are stored deep in our unconscious. He actually got inspired by Fechner’s analogy that the mind is like an iceberg. The part that is above water represents the conscious mind, and the part that is deep in the water is the unconscious mind. Freud strongly believed that our deepest desires were stored in the mind, and no divine power could change that  not even religion. He liked using the free association technique by letting his patients talk about whatever came to mind. Freud believed that by letting the patients express their thoughts they would uncover repressed memories that were the cause of their behavior. He noticed that his patients talked about childhood suppressed memories that involved sexual issues. At first he thought that his patient’s neurosis was caused by childhood trauma of sexual abuses. Later he suspected that they were fantasies that his patients were reporting and not the actual abuse. One of his theories is that all sons have a sexual attraction towards the mother and all girls towards the father. Freud published a paper talking about his theory of childhood seduction. This paper created so much controversy that some people were angry, and other had mixed emotions. Freud believed that sexual frustration was the cause of neurosis. He was actually obsessed with the subject because of sex because of the lack of sex in his life. By analyzing his dreams he realized that the unconscious mind can manifest thru dreams. Years later he published a book â€Å"The Interpretation of Dreams† (1900). Even though Sigmund Freud’s is considered the father of psychoanalysis it was Charles Darwin’s work that inspired Freud. Most of his views came from Darwin’s ideas on psychoanalysis like the meaning of dreams, the unconscious mind, sexual arousal, and even childhood development. Frank J. Sulloway was a recognized historian of science, and he found that Freud’s way of thinking  was inspired by Darwin. â€Å"What Sulloway did was to check the books in Freud’s personal library, where he found copies of Darwin’s works. Freud had read them all and had written notes in the margins.†(Schultz, D 1969 pg293). Even though Freud contributed to the field of psychoanalysis there was criticism of his work. Some scholars believe that his work was reliable due to poor record keeping. â€Å"He did not make a verbatim transcript of each patient’s words but worked from notes made several hours after seeing the patient† (Schultz, D 1969 pg315). This means that his notes of the sessions with his  patients were compromised by his opinions and ideas. I can see way people would be concerned with his methods of data collection. There is a chance that he misunderstood what his patients were telling him. For example, when my husband and I have an argument there’s time when I misinterpreted what he said. My recollection of the argument is different from his recollection of the argument. In his case, it is important to have the most accurate information. Other scholars believed that he influenced the patient’s answers and only heard what he wanted to hear. â€Å"Examination of the actual cases referred to by Freud reveals not a single instance in which this was the case. There is no evidence that any patient ever told Freud she had been seduced by her father. This is nothing more than an inference on Freud’s part. (Kihlstorm, 1994, p.683)† (Schultz, D 1969, pg316). Concerns about the credibility of his work arose because of inconsistencies with his research, his notes, and the work he published. His work was limited to just a number of people and considered incomplete. There were other psychologists that also contributed to the development of Psychoanalysis. Carl Jung worked closely with Freud but after 1914, he developed the idea of analytical psychology. This was his own version of what psychoanalysis should be and opposed some of Freud’s work. Jung believed that what shape our personality are our goals, hopes and aspirations and not just childhood experiences like Freud suggested.  Personality can change with time. During our lifetime, we can experience several personalities depending on the experiences and the level of maturity. This means that you are not the same person you were in high school. As time passes you learn from your experiences and adapt to your environment as it changes. One of Jung’s theories is that the unconscious mind is formed by two levels. One is the personal level where all the memories, wishes, faint perceptions and suppressed memories are. The second form of unconscious is the collective unconscious this is where all the universal and  evolutionary experiences are. For example, the need and instinct to survive that gets passed on for generations. He also referred to this as archetypes of the collective unconscious. â€Å"We typically experience archetype in the form of emotions associated with significant life events such as birth, adolescence, marriage, and death or with reactions to stream danger.† (Schultz, D 1969, pg.327). He also suggested the theories of introversion and extraversion along with the types of functions and attitudes. Another psychologist, that also made a great contribution to psychoanalysis, was Alfred Adler. Like Jung, Adler did not share Freud’s views on the Oedipus complex. Adler was more interested in the conscious mind than the unconscious mind. He also believed that our plans for the future are the ones that influenced behavior and not the past experiences. Some of his theories are the creative power of the Self and that the order in which we are born matters. Karen Horney also contributed to the development of psychoanalysis. She had many disagreements with Freud’s theories except for the unconscious motivations. She did not share Freud’s view that women had penis envy; instead she suggested that man had womb envy. These psychologists helped developed psychoanalysis. They all brought interesting and exciting new ideas to the table. These theories helped shaped and develop psychoanalysis. Even though Sigmund  Freud is considered the father of psychoanalysis the one that pave the way for others to follow, in fact, it was Charles Darwin how inspired Freud theories. It was Darwin who paved the way for psychoanalysis, but Sigmund brought attention to it by claiming he found a scientific way to study the unconscious mind. Freud had many theories some were accepted by scholars, other theories were not. For example, Childhood seduction caused controversy, and some psychologists did not share his view of the Oedipus complex. Even his method of collecting data was criticized causing doubts about the credibility of his work. The one thing they did agree on  was of the existence of the unconscious mind and how it influenced a person’s thoughts, emotions, dreams, personality, and behaviors. Psychoanalysis began with just a philosophical speculation about the unconscious mind. Shaped by the early ideas about psych opathology and developed by evolutionary theories. References Schultz, D. (1969). A history of modern psychology (10e ed.). New York: Academic Cohen, T. (2003). Sigmund freud: The founder of psychoanalysis. School Library Journal, 49(9), 231. Retrieved from http://search.proquest.com/docview/211726954?accountid=458

Leadership revised

Answer to Question # 1 Sharon Daloz Parks, in his books entitled â€Å"Leadership Can Be Taught,† discussed leadership in an adaptive concept. Adaptive concept means that the word leader denotes to lead and in order to lead a group, you ought to be a procrastinator of time or think ahead of time. A person should have a view on what possible things might be encountered. Then think of the possible solutions for the upcoming problem. Anticipatory imagination is considering all the pros and cons of things. In adaptive leadership, it is believed that leadership can be learned. It deals with understanding and about behaviors and actions. It is not in any way an inherent trait. The adaptability of the organization depends on having a widespread leadership. The ideas should not only come from the people on the top, but it should come from people within the organization. Practicing adaptive leadership means making a holding environment where discussions of certain issues are kept safe. In addition, the adaptive leadership consulting is about understanding adaptive pressures and dynamics, and using those insights in creating successful changes. Adaptive leadership is a must in an organization because it paves the way for less problems to incur because in this process, the leader is futuristic, which considers the entire negative and positive things that will come their way.  As a mentor or guide, the leader has to be likened to an eagle which soars high and sees all things below. Leaders should have focused determination and an attitude for winning. Indeed, leadership is not a position but disposition. Answer to Question # 2 With regards to the to the character trait of embracing the negative, it is said that (a) Profit comes as a result of facing problems, so doing it is seen as a good thing, not a negative thing; and (2) The best way to solve a problem is not to have it to begin with. Embracing the negative means embracing problems. The person who is pessimistic or negative is a type of person who is always looking at the negative side of life. It seems that problem is bigger than the solution. Man in his struggle for existence need not grope in the dark but always look at the bright side of life. The dark side is the problem and the light side is the solution. As we face different challenges in our life, we must always think positive, never give up easily when trials comes our way and look at the brighter side of life. Always remember that in every problem, there is always a solution. The best way to do is to give up the negative, and learned to motivate and encourage yourself to think positively or be an optimistic. Thinking realistically and positively will become automatic in you as you go through your life. And the response to the problems when it comes to you the next time will be handled in a entirely a new way. It will then be easier for you to handle and face the next trials that will come to your life if you will become optimistic. It is indeed a long process and it will take some time for it to happen, but eventually, in the long run, it will happen. So it is better to start now on your journey to replace the negative thinking or being pessimistic with a positive thinking or being an optimistic. Profit comes as a result of facing the problems. Like David who faces Goliath, in our lives facing problems and trials will determine our strength and failure in life. Indeed life is a choice; we either choose life or death, problems or solutions, negative or positive. The rest is up to us. The best way to solve a problem is not to have it to begin with which means that in solving problems we need to look at the solution of the problem because in this way more concrete ideas will come our way. Keeping a positive attitude and not considering difficult things as problems would greatly help in attaining one’s goals. Sometimes when we have a problem, we keep on thinking that we have a problem and it is so hard to solve, how can I get over it? And in some cases, instead of solving the problem we engaged ourselves in drinking alcoholic beverages or taking prohibited drugs in order for us to forget that we have a problem. With these, we are not solving the problem. We keep on thinking about the problem not knowing that it will only aggravate the problem because emotionally we are affected by it. Instead of thinking about the problem on and on without doing something, we should face the problem, know what causes the problem and find the solutions. In every little problems that we encounter we must find solutions immediately, before it gets worse or become big that we cannot handle anymore. When we follow this kind of solving/handling the problem it will be easier for us to face the trials next time. If we continue with the way we do it the wrong way of solving the problem we will not gain something from it but if we start to face it now, and find solutions to the problem we will gain something from it and life would be easier. Answer to Question # 3 Three Essential/Necessary for Success: 1.   Competencies Competencies means being confident in whatever undertakings we had. Competencies means we are fully equipped to do things because of all the necessary ingredients of trainings, experiences and capabilities are stored within us. Successful people are confident people. 2.   Alliance Builder Alliance builder means we are also a support group. We love networking, linkages and alliances with people who are also a builder like us. Builder means they help us to grow as a person in every aspect of our lives. The saying that no man is an island is a complement of this so called alliance builder. To be in allegiance with the right people is indeed a blessing. Successful people are building other lives or alliance builder. 3.    Character or Integrity Character or Integrity is very important aspects for success. Character or integrity is the totality your whole being. Talents, riches and material things can make us on the top but character will make us stay there. Truly character depicts the real you. Six Character Dimension: 1)   Gain the complete trust of the people they were leading and capture their full hearts and following The saying that, â€Å"follow the leader,† means that a true leader is worth following for. They gain the trust and confidence of his followers and believe in every word he says. And being a good leader we should also be a role model to our followers. 2)      See all of the realities that were right in front of them. They had blind spots regarding themselves, others, or even the markets, customers, projects, opportunities, or other external realities that kept them from reaching their goals.  Ã‚  A true leader is realistic for their weakness and strengths. Blind spots means, that they are open to correction and suggestion because they don’t see everything like an imperfect person. They have teachable spirit and a humble heart to learn more things for their completion as a person. They want to learn more in areas like marketing, customer relations, projects, opportunities or other external realities in life because leaders are good followers. 3) Work in a way that actually produced the outcomes that they should have produced, given their abilities and resources  Successful leaders are results driven and results oriented. They work in a way that their given abilities and talents were used and exercised and applied to the fullest. 4)   Deal with problem people, negative situations, obstacles, failures, setbacks, and losses.  Successful people are not afraid to work with all kinds of people and situations. They consider it as a challenge and transcend their own interest and give themselves to larger purposes, thus becoming part of a larger mission a test for their testimony and they are winners and not losers in facing any failures, setbacks, and losses. 5.   Create growth in their organization, their people, themselves, their profits, or their industry.  Successful people are part and parcel of growth in any organization and a contributing factor for the success of other people and the industry in general. 6)    Transcend their own interest and give themselves to larger purposes, thus becoming part of a larger mission  This character trait for success is broadminded. Successful leaders want to widen his territories, his field of interest and horizons. He wants to connect with best minds and believe in the saying that â€Å"Iron sharpens Iron† for the betterment of themselves and others. Indeed, for them learning never ends from cradle to grave. Learning is a never-ending process we should never stop striving to learn more. References: â€Å"Avoiding Pessimism May Be More Important than Being Optimistic.† 1998.Ohio State University. â€Å"Ethics is our Religion: Creative and Optimistic Thinking.† 2006. North Virginia Ethical Society. McGrath, H. Phd. â€Å"Teaching Students to Think Optimistically. Deakin University: Faculty Education. Parks, SD. 2005. â€Å"Leadership Can Be Taught.† Amazon.com â€Å"Positive Thinking: Practice this Stress Management Skill.† 2007. Mayo Foundation for Medical Education and Research (MFMER). â€Å"Tips on Giving Up Pessimistic Thinking Habit.† 2006. Liesnet. â€Å"What is Leadership?† 2007. Amazom.com         

Attachment Theory and Child Essay

An attachment is a two-way emotional bond in which people depend on each other for their sense of security. Although we forma attachments through out our lives, psychologists are particualry interested in the attachments formed between a child and his/her primary caregiver.1 This essay will examine the role of attachment in childhood and it’s subsequent formation of relationships. Most babies of mammals exhibit the same patterns as human infants; they seek proximity to the mother and react with anxeity on seperation from her, which is the essense pf attachment behaviour. John bowlby believed that attachment was an innate pattern and it helped infants to survive. Bowlby had observed how baby monkeys reacted with distress on sepearation from their mother for a brief period. The mother and baby both called for each other. This shows that attachment is essential for survival however, it can be argued that research relating to animals cannot be generalised to humans. Bowlby’s theory of attachment is that children have a biological need to attach to their main caregiver as attachment helps serve the purpose of survival. The emotional relationship provides the infant with a set of expectations about relationships which stays with the child throughout life; this is known as the internal working model, and is a pattern for relationships the child may have in the future. If the child experiences love and affection, he/she will come to see him/herself as worthy of love and attention. This is the child’s working model as Bowlby sees it. The working model will determine the child’s relationship with other people and the way the child sees him/herself in the future. On the other hand, if the child experiences neglect or rejectionthey may develop a working model that is based on denial rather than on reality. Such a working model may contribute negatively to the the mental health of the child and the quality of their relationships with others in the future. Mary Ainsworth was a US psychologist who operationalised Bowlby’s concept so that it could be tested empirically. She devised an experimental procedure called the stange situation, which resulted in the classificatin of attachment patterns. In the strange situation an observer shows the caregiver and child into a room and then leaves. The caregiver watches the child play and a stranger soon enters the room. The stranger sits silently at first then talks with the caregiver and then tries to interact with the child. The caregiver leaves the room. This is he first seperation between the caregiver and the child. While the caregiver is absent the stranger continues trying to interact with the child. The caregiver returns and is reunited withnthe child. The stranger then leaves the room and the caregiver follows leaving the child alone. This is the second seperation. The stranger enters the room and once again tries to interact with the child. The caregiver returns for a second reunion and the stranger leaves. The findings resulted in the classification of three attachment types discussed below. Attachment type A, avoidant, is when the child shows apparent indifference when the caregiver leaves the room, and avoids contact when the caregiver returns. The child is apparently not afraid of strangers. Mothers of type A children tend to be insensitive and do not seem interested in their child’s play. Attachment type B, securely attached, is when the child is upset when the caregiver leaves and is happy to see the caregiver return. The child is easily comforted by the caregiver. The mothers of type B children are very intersted in their child’s play and actively support and communicate with the child during play. Attachment type C, ambivalent is when the child is very upset when the caregiver leaves the room, however, the caregiver finds it difficult to sooth the child when they return. The child seeks comfort but at the same time rejects it. mothers of type C children are inconsistent in their reactions to their children. Ainsworth concluded that the primary caregiver’s behaviour determines the attachment type of the child. A sensitive primary caregiver leads to a securely attached child. Insecure attachment will lead to problems in later life. Jerome Kagan (1982) suggested that innate differences in children’s temperaments influence how the environment interacts with them. Another impact on attachment is the family circumstances that a child is part of. A childs socio-economic environment has a major impact on the attachment type the child has. If a family is hit by povery the child may not recieve the necessary support and this could lead to a change in the attachment type. A risk factor in the development of mental health seems to be a lack of formation of attachment to important people during childhood. According to Goldberg (2000), the method is a unique combination of experimental and clinical methods. He he finds it a well standardised procedure which allows for natural interactions. Lamb (1985) claims that this widely used methodology is highly artificial and extrememly limited in terms of the amount of information gathered, and that it fails to take into account the mother’s behaviour. Marrone (1998) finds that although the strange situation has been criticized for being stressful-and therefore unethical- it is modelled on normal everyday circumstances when the caregiver must leave the infant for brief periods of timein different circumstances. However, it can be argued that exposing children to stress in experimental situations can be very different to everyday life. Van ijzendoorn and Kroonenberg (1988) carried out a major review of 32 world wide studies, involving eight countries and over 2000 infants. They found that there are differences within cultures in the distribution of types A,B and C. For example, Japanese studies showed complete absence of type A, but a high proportion of type C. There sems to be a pattern of cross-cultural differences, so that type B is the most common cross-culturally. Type A is reletively more common in Western European countries, and type C is reletively more common in Japan. He differences has been associated with differences in child-rearing. The results of these studies indicated that if we want valid interpretations of the strange situaton in a cross-cultural setting, we need to have good knowlege about child rearing. The cross-cultural validity of the strange situation methods of assesing attachment and the meaning of the classification classifications themselves has been questioned. The meaning of the strange situation has been challenged, in that it focuses on o the measurement of the attachment in terms of the infants reaction to the seperation and the subsequent reunion with the caregiver. It does not take into account that the meaning of seperation may differ across cultures. Japanese children are rarely seperated from their primary caregivers and so the seperation may be a very unusual situation for the child. this may mean something completely different to Japanese mothers and children than to American infants and mothers. Bowlby’s internal working model assumes that although the model can be modified, it remains relative;y stable throughout the lifespan. Hazen and Shaver (1987) were one of the first researchers to explore Bowlby’s attachment theory in relation to adult romantic relationships. They found the attachment theory a valuable perspective on adult love because it could explain both positive and negative emotions. Hazen and Shaver translated Ainsworth’s three attachment styles to make them suitable for adult relationships. Then they devised a â€Å"love quiz† in a local newspaper and ask respondents to indicate which of the three patterns best described their feelings toward romantic relationships. A self selected sample of 620 people, aged 14-82 years, responded to the love quiz. The mean age was 36 years. There were 205 males and 415vfemales. A second study used a sample of 108 college students. The researchers found that 60% of the respondants showed a secure attachment style and 20% showed the anxious ambivalent pattern, and 20% showed the anxious avoident pattern. The research also asked the respondents to describe their parent’s parenting style. People who were seecurely attached had said their parents were responsive and attentive, people who were anxious-ambivalant had rejecting and inattentive parent. Hazen and Shaver theorised that romantic love shares important similarities with early attachment relationships. They also found that differences in adult attachment wre related to how people felt about themselves. Although the researchers found some correlation between parenting style and attachment paterns, they went against drawing too many conclusions as this would be deterministic. In fact, it seems that as people get older, they are more likely to to be able to develop their own outlook and approach to life. The study was ased on a self selected sample and can therefore not be representative. Self report data is not always reliable, and since the study was carried out in the western world it cannot be generalised to everybody across different cultures. It can be seen through the strange situation that majority of infants are likely to develop an attachment type B, although, it is largely dependant on factors such as temperment, socio-economic factors, and parent styles. In addition, it can also be seen that the attachment style developed as a child can have a large impact on the attachment style involved in the formation of subsequent parent relationships.

A needs orientated approach to care

This will be discussed in detail providing evidence of strengths and weaknesses of the model. The nursing process that will be discussed will be APIE which is assess, plan, implement and evaluate. A nursing process is a systematic approach which focuses on each patient as an individual ensuring that the patients holistic needs are taken into consideration. These include physical, social, psychological, cultural and environmental factors. . The nursing process is a problem solving framework for planning and delivering nursing care to patients and their families (Atkinson and Murray 1995). When used collaboratively the nursing model and the nursing process should provide a plan of care that considers the patient holistically rather than just focusing on their medical diagnosis (Moseby’s 2009). It will also discuss an example of a care plan done for a fictional patient and evaluate and discuss how the nursing plan and the nursing process have created a plan of care and how effect ive this was or was not. Care planning is a highly skilled process used in all healthcare settings which aims to ensure that the best possible care is given to each patient. The Nursing and Midwifery council state that care planning is only to be undertaken by qualified staff or by students under supervision. The Department of health (2009) says that â€Å"Personalized care planning is about addressing an individual’s full range of needs, taking into account their health, personal, social, economic, educational, mental health, ethinic and cultural background and circumstances† with the aim of returning the patient to their previous state before they became ill and were hospitalized considering all of these needs to provide patient centered care. It recognizes that there are other issues in addition to medical needs that can impact on a person’s total health and well being’.It provides a written record accessible to all health professionals where all nursing interventions can be d ocumented. Care planning is extremely important as it enables all staff involved in the care to have access to relevant information about the patients current medical problems and how this affecting them in relation to the 12 activities of living as well as any previous medical history. Barrett et al (2009) state that taking care of an individuals needs is a professional, legal and ethical requirement. There are many different nursing models all of which have strengths and weaknesses and its up to the nurse to choose the right one for individual patient, the model which is used will vary between different speciailties depending on which is more relevant to the patient and their illness and needs. Although a vast majority of hospitals now use pre-printed care plans it is important to remember that not all the questions on them will be relevant to all patients. An example of this would be that activity of breathing may not have any impact on a healthy young adult be would be a major f actor for an elderly man with COPD. There are four stages to the nursing process which are Assess, plan, implement and evaluate (APIE) but Barrett et al state that there should be six stages to include systematic nursing diagnosis and recheck (ASPIRE) as although they are included in the nursing process they are not separate stages and could be overlooked.(Barrett et al 2009). It is important that a nursing process is used and it is set out in a logical order, the way in that the nurse would think this helps minimize omissions or mistakes. Roper, Logan and Tierney model of nursing suggests that there are five interrelated concepts which need to be taken into consideration when planning and implementing care which are activities of living, lifespan, dependence/independence continuum, factors influencing activities of living and individuality in living (Roper, Logan and Tierney 2008). Assessment Assessment is fundamental to gaining all the information required about the patient in order to give the best possible care. â€Å"Assessment is extremely important because it provides the scientific basis for a complete nursing care plan† (Moseby’s 2009). The initial assessment untaken by nurses is to gather information regarding the patients needs but this is only the beginning of assessing as the holistic needs of the patient including physical, physiological, spiritual, social, economic and environmental needs to be taken into consideration in order to deliver appropriate individualized care (Roper, Logan and Tierney 2008). When using the 12 activities of living (ALs) for assessment it gives a list a basic information required but must not just be used as a list as the patient will respond better to questions asked in an informal manner and when just part of the general conversation. RLT (2008) state that although every AL is important some are more important than o ther and this can vary between patients. It is important for nurses to obtain appropriate information through both verbal and non-verbal conversation patients are more likely to give correct information but without jumping to conclusions or putting words into their mouths. ‘Assessment is the cornerstone on which a patients care is planned, implemented and evaluated (RLT 2008). â€Å"Poor or incomplete assessment subsequently leads to poor care planning and implementation of the care plan† (Sutcliffe 1990). Information can be gained from the patient, the patients family and friends as well as any health records (Peate I, 2010) During this process of gathering information it is important to find out what the patient can do as well as what they cant. , McCormack, Manley and Garbett (2004) state that gathering the information requires a certain kind of relationship between the nurse and the patient and nurses need to be able to communicate effectively in order to be able to build this relationship. A full assessment needs to consider how the patient was before they became ill or hospitalized in relation to their medical diagnosis as well as how the patient was dealing with it, how they are now, what is the change or difference if any, do they know what is causing the change, what if anything they are doing about it, do they have any resources now or have they have in the past to deal with the problem (barrett et al). RLT (2008) state that there are 5 factors that influence the 12 activities of living which are biological, psychological, sociocultural, environmental and politicoeconomic, these may not all hav e an effect on each patient but all need to be taken into consideration.The more information gained in the assessment process the easier the other steps will follow. RLT (2008) suggest that assessing is a continuous process and that further information will be obtained through observations and within the course of nursing the patient. At the end of the initial assessment the nurse should to identify the problems that the patient has. There are limitations to using a nursing process which are the 12 als are often used as a list as part of a core care plan and are not always individualized Walsh (1998) argues that the 12 activities of living may just be used as a list which could result in vital information being missed which could be detrimental to the patient. The Nursing and Midwifery Council (NMC 2008) states a nurse is personally and professionally accountable for actions and omissions in practice and any decisions made must always be justifiable. There are many benefits to using a nursing process it is patient centered and enables individualized care for each patient. It also gives patients input into their own care and gives them a greater sense of control it is outcome focused using subjective and objective information which helps and encourages evaluation of the care given. It also minimizes any errors and omissions. When I carried out the assessing stage on mabel I did this using the 12 activities of living as suggested by Roper et al (2008) but this was used too much like a checklist. I didn’t gather enough information in order to be able to do the best plan of care possible for her although I don’t feel this could have been detrimental to the care she received it needed more information than I had. I also found it difficult deciding which information should go where so I endened up repeating information in more than one of the 12 als, Which although this wouldn’t have made a difference to the planning of the care plan there was too much irrelevant information which could mean that it wasn’t read thoroughly just skimmed over as it would take too much time. As I am inexperienced in doing this I realized when writing the care plan that there were many questions that I didn’t ask so there where many parts that could not be filled in. I also didn’t gather e nough objective data for certain parts so I didn’t have any evidence that the care had worked or how effective it had been. This is where Barrett et al (2009) state that there should be a systematic nursing diagnosis where nurses establish a nursing diagnosis rather than just a medical diagnosis. This is where the holistic needs of a patient are taken into consideration. Although nursing diagnosis differs from a medical diagnosis the two do interlink but a nursing diagnosis considers the physical, psychological and spiritual aspects of the medical diagnosis and problems that may arise from these. Another part of the systematic nursing diagnosis is to provide baselines to state where the patients are at at the present time so that a needs statement can be written in conjunction with the patient in terminology that they can understand(Barrett et al 2009). Planning The next stage of the nursing process is planning this is where all the information gained in the assessment part to plan the care of the patient. The planning stage of the process is where achievable goals need to be made through discussion with care givers and the patient or the patients representative. These goals need to contain both subjective goals and objective goals in order for them to be measurable and evaluated. The plan of care is to solve the actual problems the patient has and to prevent potential problems from becoming actual ones. It also aims to help the patient cope with their illness in a positive way and to make them as comfortable and pain free as possible (RLT 2008). Planning needs to be totally individualized and patient centered they need to feel they have a voice and part of the team. The more information gathered in assessment the easier the plan of care will be. The main objective of a nursing plan is to ‘provide the information on which systematic, i ndividualized nursing can be based and individualized nursing can be based and implemented by any nurse’ (RLT 2008). Through a detailed individualized plan of care any nurse caring for a particular patient should be able to see exactly what is required of them as all the information will be recorded in the care plan. The NMC (2008) says that nursing interventions need to be specific for that particular patient, based on best evidence, measurable and achievable. There are many different criteria for setting goals just one of these is PRODUCT which stands for, Patient centered, recordable, observable and measurable, directive, understandable and clear, credible and time related. This is just meant as a way of helping nurses to set goals (Barrett et al 2009). When planning care a great emphasis needs to be based on the dependence/independence continuum which will have been established in the assessment phase. The care to be given will encourage the patient to get back to as rea sonably possible or as close to where they were on the continuum as they were before they were admitted to hospital. Planning also needs to take into account the resources available to implement the care as they need to ensure that the care they are planning is achievable and will not be compromised by lack of resources or a shortage of nursing staff (Roper et al 2008). When I did a plan of care for mabel it quickly became evident how inexperienced I was. I didn’t gather enough information in the assessing period to be able to do an effective plan of care. I also didn’t know how achievable the goals where as I wasn’t aware of how long they would take to improve or if they where achievable or not, I also found it difficult determine which problems were interrelated and as a result tried to link anxiety in with another problem when in fact it was a problem on its own. I was able to write the needs statements effectively that were not long but on a couple of these the influencing factors were missed out which would be necessary when providing holistic care. Planning care for a patient requires a great deal of knowledge in the chosen specialty which is why it must be carried out by a qualified member of staff or a student under supervision. Implementation Implementation is the next part of the nursing process and where all the goals which were set in the planning stage are put into motion and the goals can start to be achieved through nursing and medical interventions. The main component of the implementation stage is the delivery of the care to the patient. This is done with nursing staff, the multidisciplinary team members involved in the patients care such as doctor, dieticians and physiotherapists and the patient themselves in order for the patient to be able to return to how they were previously before they were admitted to hospital. The plan of care will be specific to the particular patient and will focus on the biopsychosocial aspects of the patient (Marriner 1983).Implementation provides great emphasis on individualized care which is why it is important to establish in the previous phases where they are on the dependence/independence continuum and what they are able to do now and what they were able to do before. Individualis ed care is associated with how the patient did things before such as how the person carries out the ALs and how often they carry these out. An example of this would be when carrying out the AL of personal cleansing and dressing to individualise the care it would be necessary to have determined in the assessing stage how the patient usually did this and how often it wouldn’t be individualized if in the care plan it was stated that they got a shower every morning if at home they only did this once a week. Core care plans may be used in certain situations this can provide a greater level of care as potential problems can be foreseen if related to a certain problem on the other hand it is also important not to standardize care as patients react differently to different illnesses and treatment. (Faulkner A, 2000). The NMC (2008) state that nurses are required to ‘Make the care of people your first concern, treating them as individuals and respecting their dignity’. In order to deal with certain problems or situations people often develop coping strategies which can be either adaptive or maladaptive. Adaptive coping strategies are usually helpful to the patient whereas maladaptive ones could be detrimental to their health such as smoking or drinking, the patient may feel this helps them to deal with a present situation but it is actually causing them harm. Patients need to be discouraged from using maladaptive coping strategies this could be done by introducing them to adaptive coping strategies and encouraging them to change their maladaptive ones into adaptive ones. Diamond (2008) states that there are also legal and ethical issues when it comes to implementing care as consent needs to be gained before any care is implemented and if this is not given the care cannot be given this will obviously have an effect on how effective the care has been when evaluating the care. The Nursing and Midwifery Council (NMC) state in section 3 of the code of c onduct ‘you must obtain consent before you give any treatment or care’ (2002). During the implementation of Mabel I found that although I was able to implement the care effectively I hadn’t recognized all of the nursing interventions needed to provide holistic care and I wasn’t fully aware of timescales of the planned care. I feel I also needed to research further into Mabel’s problems in order to gain the appropriate knowledge to provide the best care available as this would ensure that are the interventions are evidence based and best practice (NMC 2008). Barrett et el (2008) state that this is where recheck should take place which would enable the health care provider to establish how effective the plan of care is before the treatment ends this would enable them to re-evaluate the plan of care while the treatment is still ongoing and adjust the goals accordingly. Evaluation Evaluation is where the care that has been given can be assessed to evaluate the care given and whether it has worked or not. Chalmers (1986) describe that it is an ongoing and continuous process and also occurs at timed points in a formal setting. Roper et al (2000) say that evaluating care also provides a basis for ongoing assessment, planning and evaluation. There are two different parts to evaluation summative evaluation and formative evaluation. Formative evaluation is done with the patient taking into account whether they feel the care given has worked when done with consideration of the dependence/independence continuum information regarding the patients previous place on the dependence/independence continuum can be obtained from the patient, their friends and relatives as well as other health care professionals in the multidisciplinary team involved in the care of the patient. Summative evaluation is when the holistic view of the patient is taken into consideration how they feel about the treatment, whether they felt that the goals were achievable. It so where all the measureable data stated in the baselines and data received after this time are analyzed to show how effective or not the treatment has been. When evaluating care consideration needs to be given to the influencing factors such as biological factors as the bodies physical ability varies according to age the physical ability of an older person is generally less efficient, therefore therefore the plan of care needs to take this into consideration so that when the evaluation takes place it its hoped to have been effective. A nurse needs to evaluate her patient’s status regularly for some patients this will be just once a day but for others it will be much more frequent depending on their illness and healthcare status. RLT (2008) says that evaluation must be individual to the specific patient and not just a standard goal that is related to a specific problem. If goals haven’t been achieved then it is up to the nursing staff to determine why. Maybe the goals set weren’t measureable or achievable. Parsley and Corrigan (1999) say that if goals haven’t been measureable or achievable then new goals need t o be set. It could also be that the nursing interventions were not successful in which case new interventions should be set. Through my evaluation of Mabel it was evident that I did not require all the information to do a comprehensive plan of care. Although I did set baselines which meant I could compare data I wasn’t experienced enough to set goals to the correct timeframe I also didn’t obtain enough measureable information in certain problems to be fully able to assess how effective or ineffective the care had been. Had I had more experience I feel that the evaluation wouldn’t be a problem. Evaluation requires checking and rechecking in order to see the effectiveness of the care delivered. It requires knowledge and expertise to be able to effectively evaluate and amend the goals and interventions set as necessary. The whole care planning process took me a long time and I still was not very good at certain aspects of it. When setting goals a lot of detailed information is required in order for the plan of care to be effective so I can now understand why it is necessary for a trained member of staff to carry out the task. Conclusion This assignment has shown that when used together the nursing process and the nursing model provide a good basis to providing care. It sets out a systematic approach to providing care. Care needs to be set out in a way that both the nurse and the patient know exactly what is happening as well as any other health care professional in the multidisciplinary team providing care for the patient. It has also shown that involving patients in their care enables them to feel they are part of the team and are more likely to help themselves with their care. Reference list Sutcliffe E 1990, Reviewing the process progress. A critical review of literature on the nursing process. Senior Nurse, 10(a), 9-13. Applying the Roper-Logan-Tierney model in practice 2008 Elsevier ltd. Roper N, Logan W, Tierney J (2008) The Roper Logan Tierney model of nursing, Churchill Livingstone:London. Dimond, B. (2008) Legal Aspects of Nursing, 4th ed. Harlow: Pearson Education. Barrett D, Wilson B, Woolands A (2009) Care planning a guide for nurses: Pearson, Essex. Faulkner A (2000) Nursing The reflective approach to adult nursing. Stanley Thornes: Cheltenham. Peate I (2010) Nursing care and the activities of living 2nd ed. Wiley-Blackwell: West Sussex. Yura H, Walsh M (1983) The nursing process: Assessment, Planning, Implementing, Evaluating. Appleton Century: Crofts Norfolk. Cook S (1995) The merits of individualized measures within routine clinical practice. . http://www.dh.gov.uk/en/Healthcare/Longtermconditions/DH_093359(2009) (29/04/11 Alfaro R (2002), Applying the nursing process: Promoting collaborative care 5th ed. Lippincott: London. Moseby’s Medical Dictionary (2009), 8th ed, Elsevier. http://www.nmc-uk.org/Nurses-and-midwives/Advice-by-topic/A/Advice/Accountability/[Date Accessed 11/04/2011]. McCormack B, Manley K and Garbett R (2004) Practice Development in Nursing, Blackwell Publishing, Oxford. Atkinson L Murray E, (1995), Clinical guide to care planning, McGraw, Oxford. NMC (2002), The NMC code of professional conduct, Nursing and Midwifery Council Publications A needs orientated approach to care This will be discussed in detail providing evidence of strengths and weaknesses of the model. The nursing process that will be discussed will be APIE which is assess, plan, implement and evaluate. A nursing process is a systematic approach which focuses on each patient as an individual ensuring that the patients holistic needs are taken into consideration. These include physical, social, psychological, cultural and environmental factors. . The nursing process is a problem solving framework for planning and delivering nursing care to patients and their families (Atkinson and Murray 1995). When used collaboratively the nursing model and the nursing process should provide a plan of care that considers the patient holistically rather than just focusing on their medical diagnosis (Moseby’s 2009). It will also discuss an example of a care plan done for a fictional patient and evaluate and discuss how the nursing plan and the nursing process have created a plan of care and how effect ive this was or was not. Care planning is a highly skilled process used in all healthcare settings which aims to ensure that the best possible care is given to each patient. The Nursing and Midwifery council state that care planning is only to be undertaken by qualified staff or by students under supervision. The Department of health (2009) says that â€Å"Personalized care planning is about addressing an individual’s full range of needs, taking into account their health, personal, social, economic, educational, mental health, ethinic and cultural background and circumstances† with the aim of returning the patient to their previous state before they became ill and were hospitalized considering all of these needs to provide patient centered care. It recognizes that there are other issues in addition to medical needs that can impact on a person’s total health and well being’.It provides a written record accessible to all health professionals where all nursing interventions can be d ocumented. Care planning is extremely important as it enables all staff involved in the care to have access to relevant information about the patients current medical problems and how this affecting them in relation to the 12 activities of living as well as any previous medical history. Barrett et al (2009) state that taking care of an individuals needs is a professional, legal and ethical requirement. There are many different nursing models all of which have strengths and weaknesses and its up to the nurse to choose the right one for individual patient, the model which is used will vary between different speciailties depending on which is more relevant to the patient and their illness and needs. Although a vast majority of hospitals now use pre-printed care plans it is important to remember that not all the questions on them will be relevant to all patients. An example of this would be that activity of breathing may not have any impact on a healthy young adult be would be a major f actor for an elderly man with COPD. There are four stages to the nursing process which are Assess, plan, implement and evaluate (APIE) but Barrett et al state that there should be six stages to include systematic nursing diagnosis and recheck (ASPIRE) as although they are included in the nursing process they are not separate stages and could be overlooked.(Barrett et al 2009). It is important that a nursing process is used and it is set out in a logical order, the way in that the nurse would think this helps minimize omissions or mistakes. Roper, Logan and Tierney model of nursing suggests that there are five interrelated concepts which need to be taken into consideration when planning and implementing care which are activities of living, lifespan, dependence/independence continuum, factors influencing activities of living and individuality in living (Roper, Logan and Tierney 2008). Assessment Assessment is fundamental to gaining all the information required about the patient in order to give the best possible care. â€Å"Assessment is extremely important because it provides the scientific basis for a complete nursing care plan† (Moseby’s 2009). The initial assessment untaken by nurses is to gather information regarding the patients needs but this is only the beginning of assessing as the holistic needs of the patient including physical, physiological, spiritual, social, economic and environmental needs to be taken into consideration in order to deliver appropriate individualized care (Roper, Logan and Tierney 2008). When using the 12 activities of living (ALs) for assessment it gives a list a basic information required but must not just be used as a list as the patient will respond better to questions asked in an informal manner and when just part of the general conversation. RLT (2008) state that although every AL is important some are more important than o ther and this can vary between patients. It is important for nurses to obtain appropriate information through both verbal and non-verbal conversation patients are more likely to give correct information but without jumping to conclusions or putting words into their mouths. ‘Assessment is the cornerstone on which a patients care is planned, implemented and evaluated (RLT 2008). â€Å"Poor or incomplete assessment subsequently leads to poor care planning and implementation of the care plan† (Sutcliffe 1990). Information can be gained from the patient, the patients family and friends as well as any health records (Peate I, 2010) During this process of gathering information it is important to find out what the patient can do as well as what they cant. , McCormack, Manley and Garbett (2004) state that gathering the information requires a certain kind of relationship between the nurse and the patient and nurses need to be able to communicate effectively in order to be able to build this relationship. A full assessment needs to consider how the patient was before they became ill or hospitalized in relation to their medical diagnosis as well as how the patient was dealing with it, how they are now, what is the change or difference if any, do they know what is causing the change, what if anything they are doing about it, do they have any resources now or have they have in the past to deal with the problem (barrett et al). RLT (2008) state that there are 5 factors that influence the 12 activities of living which are biological, psychological, sociocultural, environmental and politicoeconomic, these may not all hav e an effect on each patient but all need to be taken into consideration.The more information gained in the assessment process the easier the other steps will follow. RLT (2008) suggest that assessing is a continuous process and that further information will be obtained through observations and within the course of nursing the patient. At the end of the initial assessment the nurse should to identify the problems that the patient has. There are limitations to using a nursing process which are the 12 als are often used as a list as part of a core care plan and are not always individualized Walsh (1998) argues that the 12 activities of living may just be used as a list which could result in vital information being missed which could be detrimental to the patient. The Nursing and Midwifery Council (NMC 2008) states a nurse is personally and professionally accountable for actions and omissions in practice and any decisions made must always be justifiable. There are many benefits to using a nursing process it is patient centered and enables individualized care for each patient. It also gives patients input into their own care and gives them a greater sense of control it is outcome focused using subjective and objective information which helps and encourages evaluation of the care given. It also minimizes any errors and omissions. When I carried out the assessing stage on mabel I did this using the 12 activities of living as suggested by Roper et al (2008) but this was used too much like a checklist. I didn’t gather enough information in order to be able to do the best plan of care possible for her although I don’t feel this could have been detrimental to the care she received it needed more information than I had. I also found it difficult deciding which information should go where so I endened up repeating information in more than one of the 12 als, Which although this wouldn’t have made a difference to the planning of the care plan there was too much irrelevant information which could mean that it wasn’t read thoroughly just skimmed over as it would take too much time. As I am inexperienced in doing this I realized when writing the care plan that there were many questions that I didn’t ask so there where many parts that could not be filled in. I also didn’t gather e nough objective data for certain parts so I didn’t have any evidence that the care had worked or how effective it had been. This is where Barrett et al (2009) state that there should be a systematic nursing diagnosis where nurses establish a nursing diagnosis rather than just a medical diagnosis. This is where the holistic needs of a patient are taken into consideration. Although nursing diagnosis differs from a medical diagnosis the two do interlink but a nursing diagnosis considers the physical, psychological and spiritual aspects of the medical diagnosis and problems that may arise from these. Another part of the systematic nursing diagnosis is to provide baselines to state where the patients are at at the present time so that a needs statement can be written in conjunction with the patient in terminology that they can understand(Barrett et al 2009). Planning The next stage of the nursing process is planning this is where all the information gained in the assessment part to plan the care of the patient. The planning stage of the process is where achievable goals need to be made through discussion with care givers and the patient or the patients representative. These goals need to contain both subjective goals and objective goals in order for them to be measurable and evaluated. The plan of care is to solve the actual problems the patient has and to prevent potential problems from becoming actual ones. It also aims to help the patient cope with their illness in a positive way and to make them as comfortable and pain free as possible (RLT 2008). Planning needs to be totally individualized and patient centered they need to feel they have a voice and part of the team. The more information gathered in assessment the easier the plan of care will be. The main objective of a nursing plan is to ‘provide the information on which systematic, i ndividualized nursing can be based and individualized nursing can be based and implemented by any nurse’ (RLT 2008). Through a detailed individualized plan of care any nurse caring for a particular patient should be able to see exactly what is required of them as all the information will be recorded in the care plan. The NMC (2008) says that nursing interventions need to be specific for that particular patient, based on best evidence, measurable and achievable. There are many different criteria for setting goals just one of these is PRODUCT which stands for, Patient centered, recordable, observable and measurable, directive, understandable and clear, credible and time related. This is just meant as a way of helping nurses to set goals (Barrett et al 2009). When planning care a great emphasis needs to be based on the dependence/independence continuum which will have been established in the assessment phase. The care to be given will encourage the patient to get back to as rea sonably possible or as close to where they were on the continuum as they were before they were admitted to hospital. Planning also needs to take into account the resources available to implement the care as they need to ensure that the care they are planning is achievable and will not be compromised by lack of resources or a shortage of nursing staff (Roper et al 2008). When I did a plan of care for mabel it quickly became evident how inexperienced I was. I didn’t gather enough information in the assessing period to be able to do an effective plan of care. I also didn’t know how achievable the goals where as I wasn’t aware of how long they would take to improve or if they where achievable or not, I also found it difficult determine which problems were interrelated and as a result tried to link anxiety in with another problem when in fact it was a problem on its own. I was able to write the needs statements effectively that were not long but on a couple of these the influencing factors were missed out which would be necessary when providing holistic care. Planning care for a patient requires a great deal of knowledge in the chosen specialty which is why it must be carried out by a qualified member of staff or a student under supervision. Implementation Implementation is the next part of the nursing process and where all the goals which were set in the planning stage are put into motion and the goals can start to be achieved through nursing and medical interventions. The main component of the implementation stage is the delivery of the care to the patient. This is done with nursing staff, the multidisciplinary team members involved in the patients care such as doctor, dieticians and physiotherapists and the patient themselves in order for the patient to be able to return to how they were previously before they were admitted to hospital. The plan of care will be specific to the particular patient and will focus on the biopsychosocial aspects of the patient (Marriner 1983).Implementation provides great emphasis on individualized care which is why it is important to establish in the previous phases where they are on the dependence/independence continuum and what they are able to do now and what they were able to do before. Individualis ed care is associated with how the patient did things before such as how the person carries out the ALs and how often they carry these out. An example of this would be when carrying out the AL of personal cleansing and dressing to individualise the care it would be necessary to have determined in the assessing stage how the patient usually did this and how often it wouldn’t be individualized if in the care plan it was stated that they got a shower every morning if at home they only did this once a week. Core care plans may be used in certain situations this can provide a greater level of care as potential problems can be foreseen if related to a certain problem on the other hand it is also important not to standardize care as patients react differently to different illnesses and treatment. (Faulkner A, 2000). The NMC (2008) state that nurses are required to ‘Make the care of people your first concern, treating them as individuals and respecting their dignity’. In order to deal with certain problems or situations people often develop coping strategies which can be either adaptive or maladaptive. Adaptive coping strategies are usually helpful to the patient whereas maladaptive ones could be detrimental to their health such as smoking or drinking, the patient may feel this helps them to deal with a present situation but it is actually causing them harm. Patients need to be discouraged from using maladaptive coping strategies this could be done by introducing them to adaptive coping strategies and encouraging them to change their maladaptive ones into adaptive ones. Diamond (2008) states that there are also legal and ethical issues when it comes to implementing care as consent needs to be gained before any care is implemented and if this is not given the care cannot be given this will obviously have an effect on how effective the care has been when evaluating the care. The Nursing and Midwifery Council (NMC) state in section 3 of the code of c onduct ‘you must obtain consent before you give any treatment or care’ (2002). During the implementation of Mabel I found that although I was able to implement the care effectively I hadn’t recognized all of the nursing interventions needed to provide holistic care and I wasn’t fully aware of timescales of the planned care. I feel I also needed to research further into Mabel’s problems in order to gain the appropriate knowledge to provide the best care available as this would ensure that are the interventions are evidence based and best practice (NMC 2008). Barrett et el (2008) state that this is where recheck should take place which would enable the health care provider to establish how effective the plan of care is before the treatment ends this would enable them to re-evaluate the plan of care while the treatment is still ongoing and adjust the goals accordingly. Evaluation Evaluation is where the care that has been given can be assessed to evaluate the care given and whether it has worked or not. Chalmers (1986) describe that it is an ongoing and continuous process and also occurs at timed points in a formal setting. Roper et al (2000) say that evaluating care also provides a basis for ongoing assessment, planning and evaluation. There are two different parts to evaluation summative evaluation and formative evaluation. Formative evaluation is done with the patient taking into account whether they feel the care given has worked when done with consideration of the dependence/independence continuum information regarding the patients previous place on the dependence/independence continuum can be obtained from the patient, their friends and relatives as well as other health care professionals in the multidisciplinary team involved in the care of the patient. Summative evaluation is when the holistic view of the patient is taken into consideration how they feel about the treatment, whether they felt that the goals were achievable. It so where all the measureable data stated in the baselines and data received after this time are analyzed to show how effective or not the treatment has been. When evaluating care consideration needs to be given to the influencing factors such as biological factors as the bodies physical ability varies according to age the physical ability of an older person is generally less efficient, therefore therefore the plan of care needs to take this into consideration so that when the evaluation takes place it its hoped to have been effective. A nurse needs to evaluate her patient’s status regularly for some patients this will be just once a day but for others it will be much more frequent depending on their illness and healthcare status. RLT (2008) says that evaluation must be individual to the specific patient and not just a standard goal that is related to a specific problem. If goals haven’t been achieved then it is up to the nursing staff to determine why. Maybe the goals set weren’t measureable or achievable. Parsley and Corrigan (1999) say that if goals haven’t been measureable or achievable then new goals need t o be set. It could also be that the nursing interventions were not successful in which case new interventions should be set. Through my evaluation of Mabel it was evident that I did not require all the information to do a comprehensive plan of care. Although I did set baselines which meant I could compare data I wasn’t experienced enough to set goals to the correct timeframe I also didn’t obtain enough measureable information in certain problems to be fully able to assess how effective or ineffective the care had been. Had I had more experience I feel that the evaluation wouldn’t be a problem. Evaluation requires checking and rechecking in order to see the effectiveness of the care delivered. It requires knowledge and expertise to be able to effectively evaluate and amend the goals and interventions set as necessary. The whole care planning process took me a long time and I still was not very good at certain aspects of it. When setting goals a lot of detailed information is required in order for the plan of care to be effective so I can now understand why it is necessary for a trained member of staff to carry out the task. Conclusion This assignment has shown that when used together the nursing process and the nursing model provide a good basis to providing care. It sets out a systematic approach to providing care. Care needs to be set out in a way that both the nurse and the patient know exactly what is happening as well as any other health care professional in the multidisciplinary team providing care for the patient. It has also shown that involving patients in their care enables them to feel they are part of the team and are more likely to help themselves with their care. Reference list Sutcliffe E 1990, Reviewing the process progress. A critical review of literature on the nursing process. Senior Nurse, 10(a), 9-13. Applying the Roper-Logan-Tierney model in practice 2008 Elsevier ltd. Roper N, Logan W, Tierney J (2008) The Roper Logan Tierney model of nursing, Churchill Livingstone:London. Dimond, B. (2008) Legal Aspects of Nursing, 4th ed. Harlow: Pearson Education. Barrett D, Wilson B, Woolands A (2009) Care planning a guide for nurses: Pearson, Essex. Faulkner A (2000) Nursing The reflective approach to adult nursing. Stanley Thornes: Cheltenham. Peate I (2010) Nursing care and the activities of living 2nd ed. Wiley-Blackwell: West Sussex. Yura H, Walsh M (1983) The nursing process: Assessment, Planning, Implementing, Evaluating. Appleton Century: Crofts Norfolk. Cook S (1995) The merits of individualized measures within routine clinical practice. . http://www.dh.gov.uk/en/Healthcare/Longtermconditions/DH_093359(2009) (29/04/11 Alfaro R (2002), Applying the nursing process: Promoting collaborative care 5th ed. Lippincott: London. Moseby’s Medical Dictionary (2009), 8th ed, Elsevier. http://www.nmc-uk.org/Nurses-and-midwives/Advice-by-topic/A/Advice/Accountability/[Date Accessed 11/04/2011]. McCormack B, Manley K and Garbett R (2004) Practice Development in Nursing, Blackwell Publishing, Oxford. Atkinson L Murray E, (1995), Clinical guide to care planning, McGraw, Oxford. NMC (2002), The NMC code of professional conduct, Nursing and Midwifery Council Publications

Process and production improvement Essay Example | Topics and Well Written Essays - 500 words

Process and production improvement - Essay Example Besides main course, DH kitchen offers a variety of desserts, salads, side orders, and ice creams along with plenty of beverages like tea, coffee, cardamom tea, and drinks. The increased number of food and cash counters has eased the difficulties of increased student body and caters significantly more people than before. However, there are many aspects of DH, which needs improvement. First, the temperature turns to discomforting degrees at times. Specifically during summers, it gets more suffocating with a huge number of people around and lesser ventilation. Second, the cash counters are located in one centre aisle, receiving people from five counters simultaneously. This results in huge crowd and delay leading to agonized public at both sides of the counter. In addition, DH has been one outlet, which is affordable for all classes: NOPs, janitors, middle-class, or elite rich, everyone can afford. However, the recent 25% increase in prices of all food items have led to great hues and cry in the entire student body whose parents are already fighting with inflation to pay for the expensive tuition of their children. In addition, the quality and taste of the food has always been a great debate at Harvard.