Effective Communication and Health Literacy for Orientation

Question: Discuss about theEffective Communication and Health Literacy for Orientation. Answer: Topic: The importance of effective communication and health literacy in a culturally safe healthcare environment Target audience: An orientation session for new staff in the workplace. Type of interaction with the audience: During the presentation, both verbal and non-verbal cues will be used. Specifically, tonal variation and body language will be used. In the course of the presentation, the audience will be allowed to ask questions and offer contributions where necessary. In addition, examples will be used to ensure the audience understands the concepts that will be presented. The audience will also be asked to answer certain questions to make the presentation more interactive. The presentation will use existing literature and health models to enhance the understanding of the concepts. The REDE model will be used to illustrate the elements of effective communication. Further, the cultural practice program for the Aboriginal and Torres Strait Islander will be used to discuss the importance of effective communication in a culturally safe environment. Nutbeam model of health literacy will be illustrated in the presentation and importance of health literacy in the culturally safe environment will be discussed. Effective communication is the process of sharing thoughts, information and feeling among individuals through speech, writing or body language. The presentation highlights the main elements of effective communication. Effective communication assists vulnerable patients to understand and make appropriate decisions about their treatment and care (Bramhall, 2014). Nevertheless, effective communication requires pertinent interpersonal skills, self-awareness, and awareness of others. In the past, communication has been viewed as a tool for healthcare providers alone. Patients and healthcare providers should understand and develop effective communication skills to facilitate and enhance the quality of healthcare. Further, the presentation discusses the barriers to effective communication in healthcare settings. Based on this view, patients, caregivers, and healthcare professionals should overcome the barriers to effective communication. For patients and carers, the barriers to effective co mmunication are the lack of privacy, being weak, difficulty explaining feelings and blockage of communication cues by healthcare providers (Neese, 2015). On the other hand, the blocks to effective communication for medical professionals are inadequate time, high workload, lack of support, emotion barriers and distress (Bramhall, 2014). The patients and nurses should always adhere to the principles of effective communication. Communication is perceived as a transaction as well as message creation. The process of communication should ensure patient satisfaction and protect the health professional (Frenkel Cohen, 2014). Both the nurse and patient should understand that communication is unidirectional meaning that any of these parties can initiate the communication process. The use of certain technical terms might block the communication process because the patient can misinterpret technical terms (Kourkouta Papathanasiou, 2014). The REDE model can be used to achieve effective communication in a healthcare setting. Primarily, the REDE model promotes relationship-centred communication to improve the quality of care. This model optimises personal connections is several stages of relationship including establishment, development, and engagement (Windover, Boissy, Rice, Gilligan, Velez, Merlino, 2014). The presentation discusses these elements of REDE model. Establishing a relationship This stage proposes the creation of an enabling and supportive environment where there are collaboration and trust. Healthcare professionals should focus on building an emotional bank with their patients and carers. Respect should be promoted in this phase because it is the first encounter. Healthcare professionals should set the design of care collaboratively even though it might be time-consuming. They should also introduce electronic health record to enhance patient care. Lastly, the provider should demonstrate empathy, which is the capacity to acknowledge and understand the situation of others (Windover, Boissy, Rice, Gilligan, Velez, Merlino, 2014). Developing the relationship After the initial step, the relationship continues evolving and growing. Healthcare professionals should attempt to know the patient and understand their critical signs in a biopsychosocial context. They should listen reflectively as the patient narrates their feelings and thoughts. In this case, the nurse should attempt to obtain the history of present illness (HPI). The importance of provider-patient communication has been extensively documented in the recent literature (Cheng, Bridges, Yiu, McGrath, 2015). Engaging the relationship The main elements of this stage are patient education and treatment. As the healthcare professional continues to offer treatment, they should also enhance the patients knowledge. Education aims to obtain consent, enhance patient self-efficacy, treatment adherence and self-care of chronic health conditions (Windover, Boissy, Rice, Gilligan, Velez, Merlino, 2014). The healthcare professional should share the diagnosis with the patient, involve the patient in designing a treatment plan, and dialogue throughout the process of delivering care. The presentation will further discuss the meaning of effective communication and its significance in healthcare. Effective communication in a culturally safe environment is very important. Recent studies have found that good communication improves patients emotional health as well as symptoms resolution (Leonard, 2017). In addition, effective communication enhances several physiological measures including like blood pressure and reduces reported pain. Effective communication increases the chances of developing a mutually positive and advantageous relationship between the healthcare provider and the patient. Additionally, effective communication increases the level of confidence and self-empowerment for the patient because they understand their diagnosis and treatment. In most instances, communication reduces the issues of misunderstanding and errors linked to diagnosis, treatment and medication administration. The cases of medication non-adherence can also be reduced through good com munication. Communication further improves the level of respect and reputation between the nurse and the patient (Cultural.org, 2012). Health literacy can be perceived as the capacity to access, comprehend, analyse and convey information as a way to enhance, sustain and promote health in various settings (Medibankhealth, 2018). The presentation discusses how health literacy is defined in Australia and its association with healthcare delivery. In Australia, health literacy is defined as the skills and knowledge needed to comprehend and apply information associated with health issues like disease prevention and management, drugs and alcohol, accident prevention, and first aid. Health literacy can also be viewed as the ability to understand and use health information to improve the delivery of healthcare and make suitable health decisions (Lambert, et al., 2014). Low level of health literacy often occurs in vulnerable communities and it is associated with socially disadvantaged populations. Poverty and low education attainment are important predictors of health literacy level. Traditionally, health literacy concentrate d on health care services and had a finite concentration on the capacity to address words and numbers in medical contexts. Over the last few years, the idea of health literacy has evolved significantly to include the aspects of reading and acting on written health information (Van den Broucke, 2014). Health literacy is an important determinant of public health and determines the outcomes of patients across different healthcare settings. Low health literacy is not only an issue of the minorities because it even exists in the majority populations. The presentation discusses the Nutbeam model of health literacy. The Nutbeams model of health literacy consists of three levels including functional literacy, interactive health literacy, and critical health literacy (Nutbeam, 2015). Functional literacy is the capacity to use common literacy skills to address issues associated with health such as reading medication labels. This kind of literacy is applied mainly in clinical settings where information is conveyed to patients. In case a patient has poor functional health literacy skills, they might be unable to read prescription and written materials. On the other hand, interactive literacy emphasizes the development of cognitive skills as well as the capacity to operate in social environments (Mitchell Begoray, 2014). Interactive literacy depends on a sturdy foundation of the first level, which is functional health literacy. At this level, patients develop the ability to analyze message effectively and interact with others in the env ironment. Critical literacy depends on the other level of health literacy including functional and interactive literacy. Individuals who are at this level of health literacy can facilitate community development. Besides, persons at this level of health literacy can analyse health problems, determine the challenges and benefits of each aspect. The presentation will highlight the benefits of health literacy. Health literacy is essential in a culturally safe environment due to various factors. Undeniably, low health literacy is linked to poor health knowledge, poor health status, high mortality, high rates of hospitalisation and high costs of care. Nutbeam model insinuates that health literacy can act as a strategy for empowerment. Based on the model, health literacy allows an individual to seek, access and analyse health information (Lowell, Schmitt, Ah Chin, Connors, 2014). Health literacy enhances the appropriate use of medication and subsequent outcomes. Patients with high health literacy can use medication appropriately, which improves the outcome of their symptoms (Fincham, 2013). Additionally, health literacy increases the involvement of patients in medical decision-making. High order competence is positively associated with greater involvement in making decisions about medications (Brabers, Rademakers, Groenewegen, van Dijk, de Jong, 2017). Health literacy is even important for patients diagnosed with chronic health conditions. Health literacy allows patents diagnosed with chronic health conditions to access information, and apply appropriate skills to manage their condition (Poureslami, Nimmon, Rootman, Fitzgerald, 2016). In a culturally safe environment, health literacy allows the nurses to apply promote health based on the culture. The healthcare providers can address the needs of consumers in culturally diverse populations. Furthermore, health literacy integrates with effective communication to ensure the needs of the health consumers are met effectively. Word count: Rationale 1500 Presentation 250 Total - 1750 References Brabers, A. E., Rademakers, J. J., Groenewegen, P. P., van Dijk, L., de Jong, J. D. (2017). What role does health literacy play in patients' involvement in medical decision-making? PloS one , 12 (3), e0173316. Bramhall, E. (2014). Effective communication skills in nursing practice. Nursing Standard , 29 (14), 53-59. Cheng, B. S., Bridges, S. M., Yiu, C., McGrath, C. (2015). A review of communication models and frameworks in a healthcare context. Dental update , 42 (2), 185-193. Cultural.org. (2012). Communicating effectively with Aboriginal and Torres Strait Islanderpeople. Retrieved 4 16, 2018, from https://www.cultura.org.au/sites/default/files/2017-02/Communicating%20effectively%20with%20Aboriginal%20and%20Torres%20Strait%20Islander%20people_1.pdf Fincham, J. E. (2013). The public health importance of improving health literacy. American journal of pharmaceutical education , 77 (3), 41. Frenkel, M., Cohen, L. (2014). Effective Communication About the Use of Complementary and Integrative Medicine in Cancer Care. J Altern Complement Med , 20 (1), 12-18. Kourkouta, L., Papathanasiou, I. V. (2014). Communication in nursing practice. Materia socio-medica , 26 (1), 65-67. Lambert, M., Luke, J., Downey, B., Crengle, S., Kelaher, M., Reid, S., et al. (2014). Health literacy: health professionals understandings and their perceptions of barriers that Indigenous patients encounter. BMC health services research , 14 (1), 614. Leonard, P. (2017). Exploring ways to manage healthcare professionalpatient communication issues. Support Care Cancer , 25 (Suppl 1), 7-9. Lowell, A., Schmitt, D., Ah Chin, W., Connors, C. (2014). Provider Health Literacy, cultural and communication competence: towards an integrated approach in the. Northern Territory. Medibankhealth. (2018). Health Literacy Implications of Australia. Retrieved 4 16, 2018, from https://www.medibankhealth.com.au/files/editor_upload/File/Medibank%20Health%20Literacy%20Implications%20for%20Australia%20Summary%20Report.pdf Mitchell, B., Begoray, D. L. (2014). Electronic Personal Health Records that Promote Self-management in Chronic Illness. The Online Journal of Issues in Nursing , 15 (3). Neese, B. (2015). Effective Communication in Nursing: Theory and Best Practices. Retrieved 4 16, 2018, from https://online.seu.edu/effective-communication-in-nursing/ Nutbeam, D. (2015). Defining, measuring and improving health literacy. HEP , 42 (4), 450-456. Poureslami, I., Nimmon, L., Rootman, I., Fitzgerald, M. J. (2016). Health literacy and chronic disease management: drawing from expert knowledge to set an agenda. Health promotion international , 32 (4), 743-754. Van den Broucke, S. (2014). Health literacy: a critical concept for public health. Arch Public Health , 72 (1), 10. Windover, A. K., Boissy, A., Rice, T., Gilligan, T., Velez, V. J., Merlino, J. (2014). The REDE model of healthcare communication: optimizing relationship as a therapeutic agent. Journal of patient experience , 1 (1), 8-13.

Promoting Mental Health Essay Example

Promoting Mental Health Essay The aim of this assignment will be to demonstrate my interventions designed to promote mental health and well being using current national and local policies and campaigns in relation to the patient’s identified needs as well as evidence based therapeutic interventions. Finally I will evaluate my package reflecting on its success or failure. In order to gain a better understanding of mental health promotion, it is important to gain a definition of promoting mental health. Rosie Winterton (2006) quotes ‘Mental health promotion is key to changing attitudes about mental health across society. The National framework for mental health (DOH 1999) implemented national standards and service models for promoting mental health. Rosie Winterton (2006) continues ‘the National Service Framework for mental health.. outlines the need for the promotion of mental health for whole communities in schools, the workplace and neighbourhoods, as well as combating the discrimination against individuals and groups with mental health problems, and promoting their social inclusion. As a nurse, I have a duty of care NMC (2008) to support and promote patients recovery so that he/she can be a productive member of society without feelings of feeling socially excluded. The client chosen will be called Elizabeth* for the purpose of this assignment in line with the Nursing and Midwifery Council (NMC 2008) Code of professional Conduct and Data Protection Act (1998) which require health care professionals to protect and maintain their clients confidentiality. We will write a custom essay sample on Promoting Mental Health specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Promoting Mental Health specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Promoting Mental Health specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Elizabeth is a 38 year old woman who originates from Didsbury. Elizabeth is currently an inpatient on an adult psychiatric ward. Elizabeth was referred on recommendations from her Drugs Misuse worker. Elizabeth presented with signs of self neglect, low self esteem, feeling faint, disorientated, anxiety, irritability and aggression amongst others. Elizabeth has recently separated from her husband with whom she had no children. This was due to her cannabis addiction; this caused problems between Elizabeth and her husband mentally, emotionally and financially. Elizabeth is now living with her mother, having accumulated debts to dealers, led to Elizabeth’s low mood and admission. During the initial interview Elizabeth claimed she had been dependant on cannabis since the age of 14. She had been admitted onto the ward for a detoxification from drugs on the recommendation from her Drug Worker and husband who felt her drug taking was affecting her mental health. It is my duty to work in partnership with Elizabeth, to make her feel in control of her life and to successfully recover her from her drug dependence in accordance with the National Service Framework (NSF 1999) standard 1 which states, ‘health and social services should combat discrimination against individuals and groups with mental health problems, and promote their social inclusion’. To promote Elizabeth’s mental health I will need to assess her needs. ‘A need is a problem or barrier that makes people or communities less healthy than they can be.. or interferes with optimum health’ Bradshaw (1972). The nursing care begins with a comprehensive, systematic and accurate assessment. (Shives 2005). It would be vital to gain as much information as possible from Elizabeth and any other relevant sources in order to evaluate Elizabeth needs. (Barker 2003) state’s ‘collections of relevant information.. contributes to an overall evaluation’. This information would assist me in formulating a psycho-educational package. I prioritised her needs in identifying and implementing care using Specific, Measurable, Achievable, Realistic and Time framed’. (SMART) model DOH (2001). I introduced myself to Elizabeth as her Nurse. It is important to establish a therapeutic and understanding relationship with Elizabeth in order for recovery to take place. This can be achieved through communication. Communication is the key to gaining trust in any relationship. The DOH highlighted ‘Communication is a fundamental aspect of any relationship’. (DOH 1994). The assessment interview was conducted in an isolated room to avoid distractions that may threaten confidentiality and interfere with the effective listening, privacy and dignity of the client, (NMC 2008). I explained to Elizabeth that any information gathered from her would be shared with other health care professionals involved in her care without breaching her confidentiality in compliance to the (NMC 2008) and the (Caldicott Report 1997) unless it was required by the law. Elizabeth’s response was very responsible saying she understood and was willing to co-operate. I continued to engage with Elizabeth using my interpersonal skills; listening, attentiveness, assertiveness, humour, self disclosure and my body language, (Riley 2008). Without these skills I would not have been able to attain the information required to understand her difficulties and formulating sessions. During our initial session, Elizabeth was very open with me about her cannabis use and personal life. Elizabeth explained how cannabis had changed her and destroyed her marriage. Elizabeth expressed her desire of detoxification, to stay clean and to gain employment. Elizabeth explained how her cannabis use had started off in her young teens where smoking cannabis was seen as ‘being cool’. Elizabeth also explained that it had started to affect her mentally in her late 20’s. I assured Elizabeth that her detoxification would be a tough process for her but as a Nurse I will support her. According to Murray et al (2004) ‘Cannabis use alone does not cause psychosis, but it is one of the things that may contribute to its development; therefore, using cannabis increases the risk. Alongside this drugs.. cause a massive surge of dopamine to be released and this extra dopamine leads to the sensation of pleasure, (Creek and Lougher 2008). This contributes to Elizabeth’s low mood since dopamine receptor sites have been either reduced or shut down. Elizabeth and I both agreed to use Cognitive Behaviour Therapy to correct distorted conceptualizations and dysfunctional beliefs underlying her illness. CBT is the only psychological treatment in chronic psychosis with proven durability at short-term follow-up (Gould et al, 2001). Cognitive behavior therapy takes into account not only the symptoms of the illness but also the impact the illness on the individual such as isolation from family and friends, damage to social and working relationships, depression and increased risk of self harm. I discussed CBT in depth with Elizabeth and allowed her to have literature on the subject which she could refer to in her own time. Elizabeth was experiencing hallucinations, I explained how reality testing worked and belief modification. ‘Milton et al. (1987) suggested that belief modification and reality testing are effective strategies in reducing the conviction associated with delusional beliefs. This involves helping clients to question the evidence underlying their beliefs and to set up behavioural experiments to test the reality of the evidence for their beliefs (Chadwick amp; Lowe, 1990). Elizabeth was willing to use CBT and later realised the voices were not real. Alongside this with all the information gathered Elizabeth was prepared to assume the role of a self-therapist, (Williams, 2004). During the next weeks of Elizabeth’s treatment I was able to continue my assessment. Elizabeth portrayed irritability, self neglect, poor concentration, agitation and lack of sleep. Elizabeth’s symptoms continued and she also expressed thoughts about staff, which were out to hurt her and hated her. I reassured Elizabeth that her thoughts were not reality using CBT reality testing. I also asked her to ask the staff she accused whether they expressed these thoughts about her. Although this was difficult as Elizabeth’s symptoms grew she became adamant that they hated her. It takes time to change and many individuals like Elizabeth, no matter what the change, are not successful on their first attempt stated by Prochaska and Di Climente (1998). My interaction with Elizabeth was positive, through me engaging her in decision making and allowing her to be involved in her care, this allowed us to build a therapeutic relationship. Elizabeth was able to open up to me and share her feelings with me, she expressed how important it was for her detoxify and to rebuild her life. Elizabeth began to show some insight into her illness in the second session. Elizabeth realised her problematic behaviour and expressed a desire to change. I used motivation enhancement therapy encouraging her desire to change. Elizabeth was a voluntary patient in the hospital and claimed she had no desire to leave until the drug detoxification had taken place. I made positive comments regarding this and encouraged Elizabeth. Elizabeth expressed that she felt better within her mental state, I had noticed this too as she had been more engaging with myself and other staff with whom previously she didn’t. Elizabeth said she was grateful towards me and the nursing team for listening and helping her. She also felt as though she was being treated as an individual whose dignity was respected rather than drug addict in compliance with the NMC (2008). Elizabeth expressed her desire to build her life again with her family including her husband and her mother. I asked her to use this as an inspiration and to act on this thought positively. I also asked Elizabeth to elaborate on this thought; we looked at positive and negative outcomes that could happen so Elizabeth was ready to deal with them if they arose. My role as a nurse was to act as a witness and a facilitator to Elizabeth’s battles. Elizabeth expressed her desire to get involved with the groups that took place within the ward with the Occupational Therapist. I encouraged her to join the groups and pointed out there was a gardening group who worked on the hospital garden. I remember from an earlier session that Elizabeth had expressed a passion for gardening. Elizabeth agreed to attend the group, she later expressed that she had made friends with a lady from another ward in the group. This was promoting her mental health and also boosting her social skills. Elizabeth’s food intake was poor; she claimed she did not like the hospital food and that it made her feel sick. I discussed with the multi disciplinary team and we agreed to commence sessions with the Occupational Therapist with whom she was already working with to start cooking sessions. This would allow the O. T to assess Elizabeth’s skills and to assist her with activities of daily living. Alongside this Elizabeth would be able to cook, prepare and eat the foods she liked. This would boost Elizabeth’s confidence and avoid relapse. Relapse prevention is a self management programme designed to enhance the maintenance phase in the model of change, Miller and Rollnick (2002). It can be defined as a wide range of strategies to prevent relapse in the field of addictive behaviour with the emphasis on self management and the techniques and strategies aimed at enhancing maintenance of habit of change, (Creek and Lougher 2008). Through motivational interview, Elizabeth recovered some of her coping strategies in situations that could lead to relapse. Researchers have shown that the people who are aware of potential relapse situations and use specific strategies can effectively reduce the risk of relapse. (Kirby et al 1995). Elizabeth’s mental health and well being was also promoted using the Humanistic approach. Humanism emphasises the study of the whole person (Aanstoos et al 2000). This concentrates on Elizabeth’s behaviour from her point of view and allows Elizabeth to analysis her behaviour. This also promotes empathy. However it is unarguable whether Elizabeth’s behaviour is connected to her inner feelings and self image, (Clay 2002). Using open questions with Elizabeth, unstructured interviews and diary accounts, allows Elizabeth to have insight into her illness and promote her mental health and well being. The humanistic approach offers new set’s of values for approaching an understanding of human nature and their condition. This offers expanded horizons of methods of inquiry in the study of human behaviour and needs. The information gathered from Elizabeth from using the humanism approach gave insight and more holistic information in her problems; she was also involved in making decisions to meet her needs and kept a diary account to see if she was meeting these needs. The humanism approach helped Elizabeth’s mental health and well being as suggested by Maslow’s hierarchy of need as the baseline (Maslow 1954). The final session between me and Elizabeth was on motivation. Motivational strategies are used to increase commitment to change and boost motivation. It is a relatively simple, transparent and supportive talk therapy based on the principles of cognitive behaviour therapy, (Bundy 2004). A great deal of commitment and effort is required by me and Elizabeth in CBT. It is important for the Elizabeth to give me feedback, both positive and negative, at each session. This allows me to alter the speed, style, and content of future sessions in order to meet the specific needs of Elizabeth. Motivational interviewing assisted Elizabeth in identifying and measuring her emotional reactions to problems she has faced, to also identify how her thoughts and feelings interact to produce the patterns in behaviour and to challenge this thought process. Alongside this i had to fully utilize my listening skills to ensure engagement between me and Elizabeth. This gave Elizabeth the opportunity to express herself and feel valued with my attention. I also expressed empathy by using eye contact that made her feel comfortable with myself. I used phrases like ’I understand’ and ‘I can see you feel strongly about that’ as suggested by Riley (2008). I also waited until Elizabeth had finished what she was saying, avoiding interruption allowed Elizabeth to continue with what she was saying. The National Services Framework (DOH 1999) Standard one states ‘Individuals who misuse alcohol or drugs are at a significantly increased risk of suicide’. The standard one puts mental health promotion as their main goal. Individuals like Elizabeth have stigma attached to them because of the discrimination and social exclusion they face. In order to tackle this, educating the public on mental and drug and alcohol related issues would gain mental health promotion. The NSF standard one allows opportunities for promotion in mental health such as employment, housing, education, benefits to reduce discrimination against individuals with mental health problems. Mental Health prevention is important in psychiatric nursing care. (Caplan 1964). Promotion of mental health is divided into three levels. 1. Primary – lowering mental disorders or reducing the rate at which new cases of disorders occur. By using Motivational Interviewing Elizabeth was able to understand her thought process which was linked to her behaviour, thus reducing the rate at which the incidences of mental disorders occur. 2. Secondary prevention would involve reducing the prevalence of mental disorder by reducing the number of existing cases. This involves finding, screening and effective treatments. By Elizabeth committing herself to treatment and detoxification, has allowed us to treat her and reduce the number of existing cases. 3. Tertiary prevention allows activities to reduce the severity of mental disorders and associated disability through rehabilitative activities. Elizabeth found Gardening relaxed her mental state and reduced the severity of her mental disorder. Elizabeth showed determination and improvement with her treatment. This allowed me and the multidisciplinary team to start working with her for her life after discharge. Employment opportunities and help with housing will be in place for Elizabeth’s discharge. This plan allows Elizabeth to see discharge and abstinence from drugs as a reality. The National Treatment Agency for Substance Misuse have published many documents to assist with recovery from substance misuse. The NTA works in partnership with national, regional and local agencies to develop standards for treatment and that there are local accessible services to support drug users. The ‘Making it Happen’ (DOH 2001) document states that mental health promotion helps to improve physical health, enhance social inclusion and participation. By assisting Elizabeth through her treatment, allowed Elizabeth to become part of the society again. By reducing the stigma and discrimination associated with mental health problems. This strengthens the capacity of communities to support social inclusion. Elizabeth was able to follow the treatment programme designed for her to allow her to recover from drugs and to stay abstinence from them. However it is vital for Elizabeth to continue this treatment whilst in the community to promote recovery and avoid relapse. I discussed with Elizabeth possible triggers that may trigger a relapse or become weak. Elizabeth shared with me that her brother was also a cannabis user. I expressed that Elizabeth could educate her brother with the knowledge she now shared about the drug and the problems it poses. I also advised Elizabeth to advise her brother on the help she received from her local Drug and Alcohol team. This may help her brother to seek help for his own addiction and allow Elizabeth not to be influenced by her brother. I was impressed by Elizabeth’s determination she had shown me throughout her treatment and her consistency of hard work. I advised Elizabeth to join a local support group to remove the stigma on drug users, to boost her confidence within her community and to socialize. In order for this mental health promotion to be a success ongoing assessment of Elizabeth was necessary. This allowed Elizabeth to become engaged with the interventions proposed and to express her own concerns. Although Elizabeth’s behaviour was monitored Elizabeth felt able to approach me and express that she had noticed changed in her behaviour via using the motivational interviewing skills, the demonstration of care and concern by the nursing team and her desire to achieve her goal of regaining relationships with her family. The package that was created for Elizabeth allowed her to promote her health and well being in many ways, building her confidence with the nursing team, allowing her to socialize with other patients from other wards in her Occupational Therapy groups/activities, building her knowledge on her treatment allowing her to be in control and to make decisions. Elizabeth was able to analyze her behaviour through keeping a diary. Elizabeth was able to advise other patients through her experience of the detoxification. Elizabeth turned into a confident young woman allowing her to build her broken life into success with her family and gaining voluntary employment with her local Drug and Alcohol team where she advised drug users on the experience of her detoxification programme.

Ethical Argument Essay Samples - Choose The Best

Ethical Argument Essay Samples - Choose The BestIn a world of endless competition among students, writing an ethical argument essay has become more essential than ever. Not only will your grades suffer but the grade you receive may not even be based on the writing you have done. You are competing with thousands of other students for available funding, for jobs and for admission to top universities. This competition will determine who gets to graduate.The amount of time you spend on an essay is not really a matter of importance. It all depends on what you decide to put on paper. One of the fastest ways to get yourself labeled as a quitter is to submit a paper which gives little value to what you spent the time on. This is not going to do you any good. You will lose out on students who would want to read your work in favor of one who would want to ignore it.These days, ethical argument essay samples can be found online. You may find that these essays are the fastest way to get accepted into a school. The main reason for this is that most universities consider the essay an application rather than a research paper.So if you want a persuasive essay to add to your resume, then you need to have it written by professionals. As mentioned earlier, the admissions committees are only looking for the most persuasive arguments. You may be able to raise your GPA to a respectable level, but this will not be possible without using ethical argument essay samples.These essays are commonly written by professors or instructors who take pride in teaching and this can be why ethical argument essay samples are written so well. They have the ability to communicate ideas clearly to students. They also have experience and expertise. When a student wants to write a persuasive essay, then they should only use what a professor or an instructor has already used.Also, if you are going to create an essay on the same topic, you will not have to write multiple essays. Just use the essays that th e professor has already given. Your final score will be based on how well you have written the essay. If you find that the professor or teacher has given you a compelling argument, then that is the best way to make your mark.There are ethical argument essay samples available for everyone to choose from. The cost to create one is very low. What is more important is the fact that the essays are extremely powerful. As long as you stick to the rules and stick to the standards of the subject, then you should be able to pass.

Maoist China essays

Maoist China essays The Cultural Revolution is one of the biggest historical events in China. The history of this event is amazingly captured in the documentary the morning Sun. In 1964 the communist party celebrated its fifteenth birthday and the idea of a classless society was enacted. One main idea emphasized by the party was that the glorious life is the one dedicated to the cause and the feeling of pride and power through the youths of china. Everyone joined in fear of being left out; to be excluded was seen as to be left with no real purpose in life. The party used a specific western book to influence youths. It was dubbed into Chinese and was put into print it was The Gadfly. In the book it tells of a man who has looses his faith in god and follows the revolution of his country, this thus became an important book that the party used for their teachings. On October sixteenth the first Chinese atomic bomb was exploded, a feeling of pride swept the nation later they exploded a strong Atomic Bomb calling it their spirit bomb and using it for propaganda purposes. In 1958 the Mao and his party leadership made a great leap into classlessness society. Steel work, collective farms were built. In the summer of 1959 the excess was seen as success but by spring 1962 famine struck china. Mao took some blame for the wide spread famine but blamed it mostly on his advisors. By 1964 the revolution in the arts were expanding. The east is red represented a new proletarian art. Responsibilities were put on the youth to change the world . Ideas of revolutionary idealism and romance hit hard by the Gad Fly would change views. In November 1965 the Cultural Revolution was almost reaching it climax. By 1966 Mao used the excuse of insiders are trying to take down China thus a lot of people were blacklisted. Mao had complete power his thoughts and words were everything. The Red Guard was formed by a bunch of yout...

Biography of Clementine Churchill

Biography of Clementine Churchill Born Clementine Ogilvy Hozier, Clementine Churchill (April 1, 1885 – December 12, 1977) was a British noblewoman and the wife of prime minister Winston Churchill. Although she lived a relatively quiet life, she was honored in later life with a Dame Grand Cross and a life peerage in her own right. Fast Facts: Clementine Churchill Full Name:  Clementine Ogilvy Spencer-Churchill, Baroness Spencer-ChurchillBorn: April 1, 1885 in London, EnglandDied: December 12, 1977 in London, EnglandKnown For: Born to a minor noble family, Clementine Churchill came to prominence as the wife of prime minister Winston Churchill, receiving several honors in her own right for her charity work.Spouse: Winston Churchill (m. 1908-1965)Children: Diana (1909-1963), Randolph (1911-1968), Sarah (1914-1982), Marigold (1918-1921), Mary (1922-2014) Early Life and Family Officially, Clementine Churchill was the daughter of Sir Henry Hozier and his wife, Lady Blanche Hozier, who was a daughter of David Ogilvy, 10th Earl of Airlie. However, Lady Blanche was infamous for her many affairs. She reportedly claimed that Churchill’s real father was Capt. William George Bay Middleton, a horseman and equerry to Earl Spencer, while others believe that Sir Henry was totally infertile and that all of her children were actually fathered by her brother-in-law Algernon Bertram Freeman-Mitford, Baron Redesdale. Churchill’s parents divorced when she was six, in 1891, due in large part to both of their ongoing and numerous affairs. When she was fourteen, her mother moved the family to Dieppe, a town off the coast in northern France. Their idyllic time there was cut tragically short, though, within a year, when the eldest daughter, Kitty, fell ill with typhoid fever. Churchill and her sister Nellie were sent away to Scotland for their safety, and Kitty died in 1900. 1908: Clementine Ogilvy Hozier before her marriage to Sir Winston Churchill.   Hulton Archive / Getty Images As a girl, Churchill began her education at home under the care of a governess, as many girls of her social class did. Afterwards, she attended the Berkhamsted School for Girls  in Hertfordshire, England. She became secretly engaged- two separate times- to Sir Sidney Peel, a grandson of Queen Victoria’s famous prime minister Sir Robert Peel; Peel was fifteen years her senior and the relationship never worked out. Marriage to Winston Churchill In 1904, Clementine and Winston Churchill first met at a ball held by mutual acquaintances, the Earl and Countess of Crewe. It would be another four years before their paths crossed again, when they were seated next to each other at a dinner party held by a distant cousin of Clementine’s. They developed a rapport very quickly and continued seeing each other and corresponding over the next several months, and by August 1908, they were engaged. Only one month later, on September 12, 1908, the Churchills were married in St. Margarets, Westminster. They took their honeymoon in Baveno, Venice, and Moravia, then returned home to settle down in London. Within a year, they welcomed their first child, their daughter Diana. In total, the couple had five children: Diana, Randolph, Sarah, Marigold, and Mary; all but Marigold survived to adulthood. British statesman Winston Churchill (1874 - 1965) his wife Clementine (1885 - 1977) and their daughter Sarah, leaving for an appointment at Buckingham Palace, 11th May 1933.   Keystone / Getty Images Wars and Between Wars During World War I, Clementine Churchill organized canteens for munitions workers, working with the Young Mens Christian Association of the North East Metropolitan Area of London. This assistance to the war effort earned her an appointment as a Commander of the Order of the British Empire (CBE) in 1918. In the 1930s, Churchill spent some time traveling without her husband. She traveled on Baron Moyne’s yacht on an island cruise. There were rumors that she had an affair with a younger man, art dealer Terence Philip, but they were never confirmed; there were also rumors that Philip was gay. Her trip with the Moynes ended abruptly after an incident in which another guest insulted Winston and the Moynes failed to smooth things over. Winston Churchill became prime minister in 1940, as World War II was breaking out. During the war years, Clementine Churchill again took on roles in aid societies, now with a much higher profile as the wife of the prime minister. She was the chairman of the Red Cross Aid to Russia Fund, the president of the Young Womens Christian Association War Time Appeal, and the chairman of Maternity Hospital for the Wives of Officers. Clementine Churchill surveys a graph of her Aid to Russia Fund in 1944. J. Wilds / Getty Images She was honored again for her efforts, and this time, she was not only honored in her own country. During a tour of Russia at the end of the war, she was awarded a Soviet honor, the Order of the Red Banner of Labour. Back home, in 1946, she was appointed a Dame Grand Cross of the Order of the British Empire, and her formal title became Dame Clementine Churchill GBE. Over the years, she also received several honorary degrees from the University of Glasgow, the University of Bristol, and Oxford. Widowhood and Later Years In 1965, Winston Churchill died at the age of 90, leaving Clementine as a widow after 56 years of marriage. That year, she was created a life peer, with the title Baroness Spencer-Churchill, of Chartwell in the County of Kent. She remained independent from major party affiliations, but ultimately, her declining health (particularly hearing loss) prevented her from having much of a presence in Parliament. Her two oldest children both predeceased her: Diana in 1963, and Randolph in 1968. Churchill’s final years were marred by financial difficulties, and she had to sell some of her husband’s paintings. On December 12, 1977, Clementine Churchill died at age 92 after suffering a heart attack. She was buried alongside her husband and children at St. Martins Church, Bladon in Oxfordshire. Sources Blakemore, Erin. â€Å"Meet the Woman Behind Winston Churchill.† History, 5 December 2017, https://www.history.com/news/meet-the-woman-behind-winston-churchill.Purnell, Sonia. First Lady: The Private Wars of Clementine Churchill. Aurum Press Limited, 2015.Soames, Mary. Clementine Churchill. Doubleday, 2002.

The Impact of Tourism on Indigenous Communities Essay

The Impact of Tourism on Indigenous Communities - Essay Example However in the mass tourism trade, large hotels are built, theme parks are developed, etc, all of which can impact the people who usually live in the areas, this can increase or decrease employment, and they can affect the development of the land. For example, as according to the Austrian Preparatory Conference for the International Year of Ecotourism (APCIYE), 2001, the development of national parks, such as the Lake Rara National Park in Nepal. This resulted in the replacement of four hundred villagers, the Chhetri people, from their native land. This movement was fueled by tourism and the people who are the land’s natural inhabitants did not have right to say no. However, in Ecuador, the Tambopata reserve integrates the people who inhabit the forests and the forest area itself for outsiders to observe. The main problems of this type of commercial tourism, by creating the national park, this creates new incentives for individuals to move into the areas, cut down more of the land, or claim status to live. Furthermore, creating a park creates a dilemma of what should and should not be included as concluded by APCIYE, 2001. The impact of tourism on indigenous communities can often be destructive because tribal and minority groups in developing countries are often targeted as objects to be looked at instead of people (Neale 1999). For example, according to WTO, 2005, for the people in Masai in Kenya, who live near safari parks, the natives themselves have not benefited from the tourists themselves. The Masai were presented as part of the â€Å"safari’ package and tourists were invited to observe their lifestyle, which many anthropologists refer to as â€Å"staged authenticity,† where people expect to see the exotic, remote, and new, given they have travelled a long distance (Forsyth 2002). Though it doesn’t necessarily mean that the people visiting are causing harm to the natives, however, it can increase the barriers between the minority and majority groups who live in the country as a whole.  Ã‚  

Court case Essay Example | Topics and Well Written Essays - 500 words

Court case - Essay Example On 26th October 2010 the accused was arrested again and jailed on several charges, namely: Grand Larceny on the 2nd and 8th of June, breaking and entering with intent on 8th June, credit card theft on 22nd January and receipt of stolen property on 18th June. Pre-sentence report was ordered on 12th November. Evidence for the preceding charges was submitted on 14th December and a true bill was issued by the Grand Jury. A review of all the charges and the case was made on 21st December and a trial was scheduled for 22nd February 2011. The case was postponed again and set on 28th March. The judicial body deciding on the case was the County Circuit Court Criminal Division. The accused was facing 30 years for 7 counts of grand larceny, 2 counts of receipt of stolen property, 1 count of credit card theft and 1 count of breaking and entering with intent to commit other misdemeanors. On top of this, the accused was already serving probation for driving under influence. Accused was ordered to pay restitution in the amount of $29,328.15. Due to the number of evidence and witnesses, the accused plead guilty. Consequently, the sentence was reduced to 2 years and 8 months with supervised probation for 5 years succeeding release from prison. Because the accused had committed the same crime several times, it is the victims’ opinion that the offender did not deserve the plea bargain and subsequent reduction in prison term. Although I do not share the victims’ feeling of unfairness, I found a couple of things surprising. First is the offer for plea bargain. The accused committed seven (7) similar offenses in a span of six (6) months. Obviously, any feeling of remorse is doubtful as he seems to jump into one offense after another. Leniency in prison term does not seem to be appropriate. Secondly, I wonder about the chronological aspect of the arrests made. The first arrest was made for offenses on 15th March, 18th