Thursday, January 30, 2020

Knowledge Development in Nursing Essay Example for Free

Knowledge Development in Nursing Essay A philosophy of nursing should be all encompassing, with its foundation based upon core values and beliefs, while building upon experience. Medicine is often comprised of controversial ethical dilemmas where we must be advocates. In a study that examined the relationship between nurses and physicians it was determined that â€Å"Differences in values, communication, trust, and responsibilities can precipitate conflict between nurses and physicians over ethical components of care. (Corley MC 1998) Developing ones theoretical knowledge and learning how to apply it successfully into their clinical practice is part of the evolving process. The evolution that occurs over the course of a career can be empowering. Hence, it is important to develop positive nurse-physician relationships to bolster confidence and grow from those interactions. The importance of positive nurse-physician relationships has been widely acknowledged (Baggs, 1989; Baggs Schmitt, 1988; Eubanks, 1991; Fagin, 1992; Mechanic Aiken, 1982; Prescott Bowen 1985). Therefore, it is our obligation as professionals to mentor our peers, not only for ourselves, but our patients and families, as well. In an interesting illustration of self disclosure (Kim, H.S., 1999) a practitioner was able to identify the needs of a patient, but clearly had difficulty communicating the needs of the patient to the physician, although some of the difficulties appeared to be cultural in nature. The way we communicate with one another as practitioners, in addition to, how we collaborate and communicate with physicians has a direct impact on patient outcomes. As practitioners we are restricted in performing our jobs if we can not effectively collaborate with the physician. It is herein that the problem lies. The inexperienced or less assertive practitioner will often find it difficult to approach a physician when faced with perhaps the â€Å"Do Not Resuscitate† order that has yet to be signed. With that being said, approaching a family that needs to be educated on the implications of G-tube placement on their family member with prolonged intubatation and no signs of improvement can be daunting without interdisciplinary support. The more experienced practitioner’s clinical judgment is more easily verbalized  because he/she is comfortable in interdisciplinary collaboration, therefore the physician is more likely to involve them in the decision making process. For example in an ICU setting where often times the physician does not involve the practitioner in the decision making process or inform them when a decision has been made it generally creates one of three things. A. the nurse will continue to aggressively pursue the physician until an order is received B. resort to â€Å"slow codes†, or C. resuscitate all patients until told otherwise by the physician (Michael I Rauchman, BA). All of these things lead to negative outcomes for both the families and patients, and we as practitioners. â€Å"Future directions of the discipline are revealed when these linkages between philosophy, disciplinary goals, theory, and practice are strengthened† (McCurry, et al). It is for these reasons, we as practitioners must continually grow and develop through our experiences, always expanding our knowledge in the ever-changing profession we have chosen. Corley MC (1998). Ethical dimensions of nurse-physician relations in critical-care (The Nursing Clinics of North America) 1998 Jun; Vol. 33 (2), pp. 325-37. http://ehis.ebscohost.com.proxy.library.maryville.edu/ehost/detail?vid=19sid=78745a3b-d950-4ea0-890c-4ee4ab4c4b46%40sessionmgr112hid=101bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=cmedmAN=9624207 ISSN#0029-6465 MICHAEL I. RAUCHMAN, BA Medical student McGill University Montreal, PQ RABKIN MT. GILLERMAN G, RICE NR: Orders not to resuscitate. N Engi J Med I 976; 295: 364-366 http://www.ncbi.nlm.nih.gov.proxy.library.maryville.edu/pmc/articles/PMC1875656/pdf/canmedaj01406-0055.pdf Expertise in Nursing Practice Caring, Clinical Judgment, and Ethics

Wednesday, January 22, 2020

Graduation Speech -- Graduation Speech, Commencement Address

Well Class of 2012, we did it! We are graduating. All the hard work we have done to graduate has paid off. All the final exams, the many steps we've taken up and down Gadd High's halls, to the gym for practice, up to the cafeteria to connect with friends, down to the library, up to the playing fields -- they're all over. After today, our lives will be changed forever. Before that happens, let's take a look at the last four years of memories and even go back to those memories from our elementary and middle school years and collect them into a book; our own book, our book of life. If, some day, people could read our individual book, what would they learn from them? Have you ever read a book you just couldn't put down? A book that was so exciting and interesting that you couldn't wait to see what happened next. Our lives are like chapters in that type of book. Each chapter is unique and special in its own way. Our lives represent the most exciting book we'll ever read. In fact, we should hope that our book becomes more exciting and interesting with each new day, that we read faster a...

Tuesday, January 14, 2020

New Media Technology Essay

Tim Berners-Lee, the creator of the worldwide web, initially intended his invention to be a haven of collaboration where people could share their knowledge (Gauntlett 2009:39). Although the prospect of such public journalism corresponded with democratic and egalitarian principles, journalists took this idea with a pinch of salt. This was almost 20 years ago, before the information highway had, for better or for worse, stretched its limbs across the globe. Today, the new media has redefined both journalism and self expression in conflicting ways that leave an individual wondering at the veracity of digital information. In the last decade, internet has gone through an explosive growth and diversification. No one could have foreseen how the internet would pervade our lives and transform the very notion of being part of a society. It has provided the ultimate freedom of the new age: a single blogger can speak to the entire world, a concept virtually impossible two decades ago. However, with this flourishing and unbound growth, the internet brings a unique set of predicaments and dilemmas. The most profound and relevant of such problems is the age-old clash of a person’s right of self-expression with the hazards of misinformation of the whole society. Whether this deceit comes about due to ignorance or design is irrelevant; in a society that promotes freedom of speech, misinformation is bound to occur on both grounds. While conferring infinite freedom to the common person, this means of self-expression comes with the acrid realization that words from a layman, presented as the predominating views of his community, are not necessarily a blessing. The news on the new media of today is more about gossip and entertainment then first-rate journalism. Since when did journalism begin to cater to the ever-growing need of the populace to be entertained? In an interview to BBC World News America, Ted Koppel, former Nightline presenter, criticized the digital journalist of today for being a mere supplier for consumers (Whitlock 2010). The commercial expansion of new media and ever-growing competition in the free market means that journalists have to write what sells; or rather, gets the most â€Å"hits† on a website. How did we come to a situation where the populace demands not to be informed, but to be perpetually entertained? Discussing news on the television, Daya Kishan Thussu (2007: 9) states: â€Å"There is a concern that too much news is creating an information overload, contributing to a structural erosion of the public sphere in the Habermasian sense, where the viewer, bombarded with visuals, is unable to differentiate between public information and corporate propaganda. † If that is true regarding television news, it most definitely holds water concerning internet news. The gargantuan flow of information, most of which lacks in credibility, is bombarded on any user who wades through the mire of pop up advertisements, banners, and mass e-mailing. Although, these devices are some of the tools used in the race to get more traffic on ones website, the capitalist agenda is far from being the most unfavorable feature of journalism. It is the ubiquitous use of new media, especially by the youth that yields the most detrimental effects. The frivolous writing that is spilt across the new media today may be the first literature some of us encounter, and draw heavily from. However, there have been examples of the internet doing its job where other media have failed. Earlier this year, on January 12th, an earthquake hit the Caribbean island of Haiti. All landlines and mobile connections were suspended. The production team of the news program Sunrise at Sky News, London, was finding it difficult to channel in the first reports from the disaster-struck area. It was to be a young member of their team, Emily Purser, who used Twitter and instant messaging via Google and Skype, to secure the first reports of the incident (Elward 2010). Another, much publicized affair was the use of Twitter by the political opposition in Iran to protest the presidential elections. The protestants took to all sorts of media, but the loudest dissent was voiced, surprisingly, through microblogging. This medium proved to be fast, portable, and most importantly very difficult to contain. Ironically, this very accessibility makes the medium too erratic, unreliable, and mundane to be of any journalistic value (Grossman 2009). An obvious embodiment of the debate between free speech and quality journalism is Wikipedia. This resource epitomizes the â€Å"by the people, for the people† ideology, but this trait alone does not give it any credibility whatsoever, at least not in academic circles. A former editor-in-chief of Encyclopedia Britannica compared Wikipedia to a â€Å"public toilet†, accusing it of delivering information that has no authenticity (Shirky 2006). On the other hand, notions that anything that appears in print media will always be more accurate than digital information are absurd. What Wikipedia envisions is the process through which one can witness the knowledge of its users evolving and perfecting itself through countless revisions (Shirky 2006). The trump card in the argument for Wikipedia comes from a comparison of veracity of data between itself and Britannica; the scientific journal Nature declares them to be of similar accuracy (Giles 2005:900). This collaboration is a sign for those who think people are becoming ever more antisocial and misanthropic, for this is a global effort in creating something for the benefit of all and no monetary gain (Gauntlett 2009:42) . Patricia Wallace, in her book, The Psychology of the Internet writes about how free flow of information can be used to cultivate critical and analytical thinking amongst students who access it (1999:245). Nevertheless, the fact remains that the new media is losing credibility day by day. Although, the global sharing of information and its revision by collaboration is a noble idea, public journalism makes it exceedingly difficult to acquire accurate information; and to accept the new media as a genuine journalistic medium. BIBLIOGRAPHY Gauntlet, David. (2009). Case Study: Wikipedia. Eds. Creeber, G & Martin, R. Digital Cultures. Maidenhead: McGraw-Hill. Thussu, Daya Kishan. (2007). News as Entertainment: The Rise of Global Infotainment. London: SAGE Publications. Wallace, Patricia. (1999). The Psychology of The Internet. Cambridge: Cambridge University Press. Shirky, Clay. Interviewed on Imagine, BBC1, UK (aired 5th December 2006) Giles, Jim. (2005). Internet encyclopedias go head to head, Nature, 438:900. www. nature. com/nature/journal/v438/n7070/full/438900a. html (5th May, 2010) Grossman, Lev. (2009). Iran Protests: Twitter, the Medium of the Movement. Time. http://www. time. com/time/world/article/0,8599,1905125,00. html (5th May, 2010) Whitlock, Scott. (2010). Ted Koppel Slams Undisciplined Internet Journalism. NewsBusters. http://newsbusters. org/blogs/scott-whitlock/2010/04/13/ted-koppel-slams-undisciplined-internet-journalism-longs-good-old-da (5th May, 2010) Elward, David. (2010) Work of a trainee newspaper journalist. (5th May, 2010) http://davidelward. com/2010/03/09/the-digital-revolution-need-not-sound-the-death-knell-for-good-journalism/

Monday, January 6, 2020

The Hypothesis That Increased Glucagon Like Peptide

VII. Current Research A. Study by Mayo Clinic, Rochester, Minnesota (Adrian Vella, M.D. Principal Investigator) 1. Studied the hypothesis that increased glucagon-like peptide 1 (GLP-1) secretion explains the improvement in insulin secretion after Roux-en-Y Gastric Bypass (RYGB) Surgery (therapeutic long-term treatment for patients with morbid obesity and type 2 diabetes mellitus) a) â€Å"The overall metagenomic RYGB-induced shift was characterized by a reduction of Firmicutes and Bacteroidetes and an increase of Proteobacteria . . . Highly correlated species [of bacterium] were assembled into two common components. Component 1 consisted of species that were mainly associated with BMI and C-reactive protein. This component was characterized by†¦show more content†¦C. Newcastle University Study 1. Researchers conducted a study where patients did 90 second intervals of intense exercise (cycling) and observed the effects it had on the heart. It â€Å"improved cardiac structure and heart function, particularly the left ventricle, which is altered by the development of type 2 diabetes† as well as helped with maintaining a normal blood sugar level (Wood 2). D. Various studies with Vitamin D Experimentation 1. Study D2d, principal investigator Anastassios G. Pittas, M.S., M.D., large scale clinical trial funded by NIH a) Investigation of whether vitamin D supplementation helps prevent or delay type 2 diabetes in pre-diabetic adults (The D2d Study is Underway 1). 2. Another study researched whether vitamin D was a predictor of all-cause and cardiovascular mortality and risk of progression to micro- or macroalbuminuria in type 2 diabetic patients. a) The study concluded that â€Å"severe vitamin D deficiency predicts increased risk of all-cause and cardiovascular mortality, independent of UAER and conventional cardiovascular risk factors. Whether vitamin D substitution improves prognosis remains to be investigated† (Vitamin D levels and mortality in type 2 diabetes 1). b) Study was conducted in 2010 but Vitamin D is still being investigated as a possible factor in prevention/controlling of diabetes today. E.