Create a job selection matrix Essay Example | Topics and Well Written Essays - 250 words

Create a job selection matrix - Essay Example In developing a job selection matrix, it is important for the team to analyse the required qualifications and job functions of the position at stake. The technical and performance job skills should be considered in addition to the general categories on applications. During an interview, it should be decided on about which skills must be observed from the candidates and hence organised into categories. Lastly, during the interview, to ensure the gaps that were not mentioned in the application are filled, the hiring team should structure the interview questions to deduce this information. Most importantly, in the job selection matrix, a numeric ranking system should be included for each prerequisite and interview question (Anon, 2010). The ranking may range from 1 to 5 with 5 being the highest. The selection criteria may however vary with respect to the job position with an opening. The candidate who exhibits the most favourable sheet in accordance to their application can then be offered the

Hank williams Sr Essay Example | Topics and Well Written Essays - 1250 words

Hank williams Sr - Essay Example He befriended music from the very start and the guitar given to him by his mother when he was eight years old, became his lifeline. Williams' childhood friend Rufus Payne (aka Tee Tot) taught him how to play the guitar and sing the blues. Hank Williams' home (now Hank Williams' Boyhood Home & Museum), surroundings and the initial hard family times influenced the style of his songs. Willing to take music as a career, Williams began performing around the Georgiana and Greenville areas of Alabama in his early teens. Forming a local band in Montgomery called the Drifting Cowboys, they became quite popular and the local radio station played their music regularly. Singing songs of the famous artists and his idol, Roy Acuff, the radio station dubbed him the Singing Kid. Lillie became the temporary manager for Williams and collected gate money, contracted and negotiated for gigs. Looking at the face of stardom, Williams contracted with alcoholism and turned intoxicated for his radio shows and eventually got fired due to his "habitual drunkenness". Audrey Mae Sheppard became Williams' manager and short time later in 1943, his wife. Although at the time Williams was a local hero, but he couldn't make it to big names yet. To get further in the limelight, the couple toured Nashville to meet with a songwriter/music publisher Fred Rose who was one of the heads of Acuff-Rose Publishing. Rose instantaneously liked Williams' songs and recorded two sessions for Sterling Records. This resulted in two singles, both hits. Seeing the success and potential in him, MGM Records signed a contract with him in early in 1947 and Rose became the Williams' manager and record producer. His first single with MGM, 'Move It On Over,' was instant hit and rose to the country Top Five charts. Songs released in 1948 like 'Honky Tonkin' and 'I'm a Long Gone Daddy' peaked in the charts too. Another huge success came in early in 1949 with 'Lovesick Blues,' which remained at number one for 16 weeks and crossing over into the pop Top 25. This song was performed at Grand Ole Opry and received a record six encores from the crowds. During this time, Williams and Audrey had their first child, Randall Hank in 1949. Soon afterwards, Williams gathered the guitarist Bob McNett, bassist Hillous Butrum, fiddler Jerry Rivers, and steel guitarist Don Helms to perform the most acclaimed versions of Drifting Cowboys. He and his band were earning handsomely and most of their shoes were sold out. In the early 1950s Williams made at least seven hits and most of them made it to the Top Five Charts. During these years, a different side of Hank Williams came to be known. He started to record some religious and spiritual records under the name of Luke the Drifter. The change of name was due to the fact that he thought that the dick jockeys and jukebox operators would not play his non-traditional songs and there spiritual songs would hurt his reputation as a country musician. Although the name was chosen to hide his identity, he couldn't cloak his voice. The next year Williams came back with more of the hits to please his fans. H e started taking parts in television shows and package tours to market him further. The music was going great with most songs of 1951 entering the top

Why is oil such an important resource in the region ( Middle East) Essay

Why is oil such an important resource in the region ( Middle East) - Essay Example The first step is to explore an area for the existence of oil. Once oil has been located, the commercial viability of the well, as it is commonly referred to, has to be ascertained. This depends on the quantity of oil that is available for extraction. Another factor is the quality of oil. Quality is determined by the percentage of sulphur and asphalt found in oil. On the basis of this content, oil is classified into three types. The best quality is known as light crude. This type of oil will be a golden brown in colour it will flow more easily and has low sulphur and asphalt content. Heavy crude, on the other hand will be thicker and dark in colour and its sulphur and asphalt content will be high. The third category, known as medium crude, has characteristics that fall between light and heavy crude. So the best quality oil is light crude, followed by medium, with heavy crude having the poorest quality. â€Å"Crude oil is a mixture of many substances, mainly compounds of carbon and h ydrogen, together with varying proportions of sulphur.† 1 The awareness of oil and its use has been in vogue even 2000 years ago. Its uses were limited mainly to cooking and lighting since technology was primitive in those days. Since drilling methods were not in existence at that time, only that oil which naturally came up to the surface due to pressure could be used. Commercial drilling using crude techniques started in the United States about 200 years ago. The pressure of oil was such that the pioneers in this field often found it difficult to stop the oil gushing out form the wells. But as time passed and modern drilling methods came into to being, exploration has become more efficient and less wasteful. From the beginning of the 20th century, oil was explored and extracted from many regions of the worlds. A majority of the oil companies operating were privately owned. These companies were able to

Employment responsibilities Essay Example for Free

Employment responsibilities Essay Understand employment responsibilities and rights in health, social care or children and young people’s settings. Outcome 1 know the statutory responsibilities and rights of employees and employers within own area of work 1 Health safety, minimum wage, working hours, equality 2 – Health Safety at Work Act 1974: An act put in place to look after the health, safety and welfare of people at work, for protecting others against risks to health or safety in connection with the activities of people at work. Equality Act 2010: This act legally protects people from discrimination in the workplace. Employment Rights Act 1996: This act explains what rights employees have in a place of work. For example, time off work, guaranteed wages, dismissal and redundancy. 3 – To protect employees against circumstances they may face in their working lives. Every person who works for an employer is protected from discrimination in the workplace, has the right to receive the national minimum wage, and to work no more than 48 hours per week unless they wish to. These employee rights apply regardless of whether the employee or worker is temporary, fixed-term or permanent, or how long they have worked for the employer. These laws provide rules and regulations that must be followed. 4 – Sources and types of information and advice available can be, speaking directly to managers, reading policies and procedures, looking on the internet (direct.gov.uk) , going to a citizen advice bureau or joining a union. Outcome 2 – understand agreed ways of working that protect own relationship with employer 1 – My contract of employment at Crown House covers the following : job title, probationary period, place of work, pay, deductions, hours of work,  overtime, time recording, short time working and lay off, annual holidays, public holidays, sick pay, alcohol and drug testing, pension, notice and garden leave. 2 – My payslip includes the following information: company name, department, payment method, payment period, payments, hours, rate, amount, deductions (PAYE tax, National Insurance, Pension), totals, week/month, date, department number, tax code, employee number, employee name and net total. 3 – If you have a grievance relating to your employment, you should in the first instance raise this with the manager. If the grievance cannot be settled informally, you must set out the grievance and the basis for it in writing and submit it to the Area Manager. 4- Personal information that must be kept up to date with own employer can include : change of name, marital status, change of address, any medical conditions that may affect work, any medication prescribed that may affect work and any altercations with the police must be admitted. 5 – Agreed ways of working includes policies and procedures, which may cover areas such as: Data protection – how confidential files relating to staff or service users are stored in cupboards where access is only given if needed. Conflict management – if there is any conflict between staff members this should be bought to the attention of the manager and he/she should try to resolve this professionally. Anti-discriminatory practise staff and service users will not be discriminated regardless of their age, gender, sexuality, religion, ethnic background or disability. Health and safety – staff should wear appropriate clothing, for example flat shoes and covered up. It is staffs responsibility to report any health and  safety issues they may come across, whether it be broken equipment or maintenance needed within the building. Equality and diversity – staff and service users must be treated equally but not all the same. Opportunities should not be missed just because somebody may need extra support to do something. For example, if a sensory room is upstairs and somebody cannot manage the stairs for whatever reason, help should be given (lift, stair lift) so that person can access the room. Outcome 3 – Understand how own role fits within the wider context of the sector 1 – My job description is to provide centred focused care to service users. To provide opportunities for service users to increase their knowledge and experience, to encourage them to maintain present skills and learn new ones, and to enable them to gain more control over their lives. To manage and minimise behaviours as best as possible. To ensure the four key principles of the ‘Valuing People’ document are adhered to at all times ‘Rights’ ‘Independence’ ‘Choice’ and ‘Inclusion’. General and administration duties. ** Important: this is not exhaustive and is subject to review in line with the changing needs of the unit and/or the needs of the service users. 2 Positive Negative Accessing community and participating in activities of enjoyment People may be at risk to themselves and others (staff, members of public) Gives the company a good name Service users not motivated, become lazy Improves service users development and remain stimulated Behaviours may be displayed often Keep service users safe Gives the company a bad reputation 3 – Other people in which staff need to communicate with will include, but  are not limited to, the following: Residential homes – to find out how the service user has been at home (behaviours, illness), let them of know of any lunch requirements (picnics, cooked lunch), ensure money is sent in for planned activities, make sure the service user is dressed appropriately for planned activities. Speech and Language Therapists – to assess, monitor and review a service users eating and swallowing if any problems have been noticed and reported, to offer help with communication aids and techniques. Mental health team – attend regular appointments with service users to see how they are, is medication working? Any new problems/obsessions? How mood has been? (agitated, confused, depressed) Any behaviour triggers? 4 – CQC are regulators for all health and social care services in Enlgand. A regulator is an organisation that checks services meet the government’s standards or rules about care. They also look after the rights of people who need extra support to stay safe. This includes people who are kept in care under a law called the Mental Health Act. The government’s standards cover all areas of care. These rules are about things like: respecting people and treating them in the way we all expect to be treated. making sure people receive the food and drink they need. giving people care in clean, safe buildings. managing services and having the right staff. CQC put care services on their register if they meet the standards, or act quickly if they do not. They continue to use different information to find out as much as they can about services. Information from the public about their experiences of care is very important to CQC. They also work with local groups and people who use services to find out what’s working well and what’s working badly in health and social care services in their area. Inspectors check services all over England to make sure they meet the rules for safe, effective, compassionate and high-quality care. Care services, and other organisations like the NHS, also give CQC information about certain things that happen. For example, they will check a service if more people are dying there than usual. They act quickly to stop unsafe services or bad ways of working. They say what needs to change and go back to check things are better. CQC can also fine people or companies, give  services a public warning, stop the service caring for any new people, stop a service caring for people while they find out what is happening and even shut services down. Outcome 4 – Understand career pathways available within own related sectors 1 – To be a care home manager you would need the following qualifications * at least two years’ senior management or supervisory experience in a relevant care setting within the past five years * a qualification appropriate to the care you will be providing, such as NVQ Level 4 in Health and Social Care, a degree in social work or nursing (with live registration) * a management qualification, such as NVQ Level 4 in Leadership and Management for Care Services (which replaces the Registered Managers Award (RMA)) or equivalent like a Diploma in Management Studies, or a Management NVQ Level 4 . To be a nurse you would need the following qualifications – around 5 GCSEs (or equivalent) of Grade C and above including English Literature or Language, Mathematics and a science subject. to take a nursing degree courses you will normally need at least 2 A-Level s or equivalent. all nurse training is done by universities. They offer nursing diplomas or degrees which take three years to complete. The diplomas however are being phased out and most universities are moving to degree only in September 2011 – all universities must move to degree only by September 2013 to work as a nurse in the United Kingdom you must be registered with the Nursing and Midwifery Council. The title Registered Nurse is only given to you when you have that registration. To be a social worker you would need the following qualifications – a three-year undergraduate degree or a two-year postgraduate degree in social work that is approved by the Health and Care Professions Council (HCPC). Many university courses are full-time, although some work-based routes with part-time study may also be available. You will typically need the following qualifications in order to study for an undergraduate degree in social work: five GCSEs (A-C) including English and maths  at least two A levels, or an equivalent qualification such as a BTEC National  Diploma or NVQ Level 3 in Health and Social Care. You should check entry requirements, as colleges and universities may accept alternatives like an Access to Higher Education or substantial relevant work experience (paid or voluntary). If you already have a degree, you could do a two-year postgraduate Masters degree in social work. †¨Ã¢â‚¬ ¨ When you apply for social work training, you should ideally already have some paid or voluntary experience in a social work or care setting. You will also need to pass background checks by the Disclosure and Barring Service (DBS). Previous convictions or cautions may not automatically prevent you from this type of work. 2 – In order to become a Deputy Manager of a day service such as Crown House, I would speak to my current manager and find out all the information I needed to know. I could also get in contact with the companies head office and if need be any training providers. 3 – The next steps in my career pathway are as follows Any refresher training to update my knowledge and remind me what I learnt last time, this will include NAPPI training. Attend first aid course and SOVA course annually Complete NVQ level 3 by December 2015 Mental health training by June 2016 Outcome 5 – Understand how issues of public concern may affect the image and delivery of services in the sector 1 – The following are cases where the public have raised concerns regarding issues within the care sector: Winterbourne View Baby P Ash Court Fiona Chisholm Orme House 2 – Abuse took place at Winterbourne View, a hospital for patients with learning disabilities and challenging behaviours in Gloucestershire. A Panorama investigation broadcast on television in 2011, exposed the physical and psychological abuse suffered by people with learning disabilities and challenging behaviour at the hospital. Local social services and the English national regulator (Care Quality Commission) had received various warnings but the mistreatment continued. One senior nurse reported his concerns to the management at Winterbourne View and to CQC, but his complaint was not taken up. The footage showed staff repeatedly assaulting and harshly restraining patients under chairs. Staff gave patients cold punishment showers, left one outside in near zero temperatures, and poured mouthwash into anothers eyes. They pulled patients hair and forced medication into patients mouths. Victims were shown screaming and shaking, and one patient was seen trying to jump out of a second floor window to escape the torment, and was then mocked by staff members. One patient was repeatedly poked in the eyes. A clinical psychologist who reviewed the footage described the abuse as torture. On 21 June 2011, 86 people and organisations wrote to the Prime Minister, David Cameron about the revelations, We are aware of the various actions currently being taken within and outside government – such as the DH review and CQC internal inquiry. We hope to make submissions to those both individually and collectively. However, on their own these will not be enough and a clear programme is needed to achieve change. The prime minister responded saying he was â€Å"appalled† at the â€Å"catalogue of abuses† Panorama uncovered. In June 2011 the Association of Supported Living issued a press statement, which was followed up in writing to every member of parliament in the United Kingdom, calling for community based supported living services to replace institutional services for people with learning disabilities. The Daily Mail said Without the investigation by the BBCs Panorama, given huge coverage in the Mail, the abuse of patients at Winterbourne View might be continuing to this day. As it is, the secure hospital and two other care  homes have been shut down, 11 guilty staff have been brought to justice – and a devastating report now exposes the serial failings of the local NHS, police and health watchdogs. For the past year, the Leveson Inquiry has focused relentlessly on the failings of the media. Never let it be forgotten how much this country owes, in the fight against cruelty and corruption, to its free Press. The Daily Telegraph said, It is impossible to read the details of what went on at Winterbourne View, a care home for the severely disabled in Gloucestershire, without feeling repelled. In the wake of an exposà © from the BBCs Panorama, 11 members of staff were convicted of almost 40 charges of neglect and ill treatment of those in their care. The national regulator, the CQC did a nationwide check on facilities owned by the same company, Castlebeck Care – as a result three more institutions have been closed. The CQC reported a systemic failure to protect people or to investigate allegations of abuse and said that Castlebeck Care had misled the health watchdog. The CQC also inspected 132 similar institutions and a Serious Case Review was commissioned. The head of the Care Quality Commission resigned ahead of a critical government report, a report in which Winterbourne View was cited. Mencap published a report warning that similar abuse could be going on elsewhere and calling for the closure of all large institutions far from peoples families. Eleven people pleaded guilty to criminal offences of neglect or abuse as a result of evidence from Undercover Care and six of them were jailed. Immediately after the eleventh person pleaded guilty, the Serious Case Review was published, revealing hundreds of previous incidents at the hospital and missed warnings. 3 The public seems to have lost faith in such regulators and companies as this has been reocurring for a number of years. The media have issued a lot of publicity stating how care companies, social services and regulators have let the victims down by simply not taking these cases seriously enough and ensuring the well-being and standards are being met. The public may feel  reluctant to use the care services to look after their family members. These issues also give the care sector a bad reputation. 4 – Recent changes in service delivery which have affected own area of work includes staff being supervised and appraised on a regular basis, changes to medication being administered, NAPPI training to prevent forceful restraining, ensuring incident/accident forms are completed correctly and signed by witnesses if needed and up to date training, policies and procedures.

Reflection coaching

Reflection coaching Reflection is defined by Stenhouse 1975 p144 as ‘a capacity for autonomous professional self-development through systematic self-study. Discuss how a coach utilises reflective practise to enhance their coaching performance Reflection is used to improve coaching performance through a variety of ways. Kidman (2001: 50) describes reflection as â€Å"a particularly significant part of empowerment whereby coaches themselves take ownership of their learning and decision making†. The coach is therefore very active in gaining information which could be beneficial to them. Dewey (1919: 3) describes reflection as â€Å"turning a subject over in the mind and giving it a serious and consecutive consideration†. By analysing information repeatedly and seriously, in depth knowledge is gained from it. *(DANS)*Pollard (2002) believes that â€Å"‘Reflective teaching is applied in cyclical or spiralling process, in which teachers monitor, evaluate and revise their own practice continually.† By being dedicated in analysing oneself, analysing others is possible. A slightly different concept of reflection is introduced by Schon. The notion of, ‘reflection in action. Schon (1983; 50) â€Å"Athletes think about what they are doing, sometimes even while doing it†. Expanding on this Schon highlights phrases like, ‘Keep your wits about you and ‘thinking on your feet. Schons belief here is in game reflection is natural and beneficial. Gilbert and Trudel (2001) believe Schons idea as a â€Å"separate type of reflection†. They also offer a different type of reflection which they call â€Å"retrospective reflection-on-action† which is further described as â€Å"that which occurs outside the action-present†. Their belief is that coaches reflect on concerns in between practise sessions and that reflection â€Å"still occurs within the action-present, but not in the midst of activity†. So they firmly believe that reflection-on-action is totally different to reflection-in-action. Gilbert and Trudel (2001) consider reflection to utilise â€Å"a conceptual framework to understand how coaches draw on experience when learning to coach† Ghaye and Lillyman (2000) bring forward the idea that the core of reflection is carried out in a series of ‘frames. Role framing was the coaches role executed correct? Value framing examining if there was value-positions present? Temporal framing was the order of actions correct? Parallel process framing could the end result varied? Problem framing were problems noticed effectively? These frames provide a practical way of analysing sport practises. Reflective practise can provide an efficient apparatus for monitoring and assessment of athletes. Dewey (1916) who is considered heavily to be the ‘founder of reflection, gives three attributes which are needed in order to participate in reflective practise. Open-mindedness, described as â€Å"an active desire to listen to more sides than one, to give heed to facts from whatever source they come and to give full attention to alternative possibilities†. Whole-heartedness, which is being â€Å"absorbed in an interest†. Responsibility is also needed as consequences are accepted therefore â€Å"securing integrity in ones beliefs†. Deweys beliefs have stood strong for eighty years and still provide modern coaches with a basic outlook on what is needed to be an effective reflective coach. Methods of using reflective practise There are a few ways in which reflective practise is put into action. By using a variety of methods coaches can expand from the basics and look more in detail depending on the type of information that is required. Video analysis is one method used in order to aid reflective practise. A coach can record a session and therefore have exact details of what actions are taken. This allows for precise analysis in which athletes can also see themselves and what they could improve on. McKernan was a firm believer in video recording to aid coaching: ‘†¦might use a video recorder to trap teaching performance as evidence or ‘data to be analysed. More importantly, such a film becomes a critical documentary for reflecting on practice†¦research can be undertaken by reactive methods such as observers, questionnaires, interviews, dialogue journals or through such non-reactive techniques as case studies, field notes, logs, diaries anecdotal records, document analysis, shadow studies. McKernan (1996)(DANS) Using other coaches is one way reflective practise can be more reliable and efficient. Analysis speed is increased as more coaches can observe and acknowledge similar issues that arise and whilst opinions may be divided, an overview of general problems can be addressed more easily. This view is backed up by Gould, Giannani, Krane, Hodge (1990) â€Å"development of craft knowledge which can be fostered through the realms of practical experience and interaction with other coaches.† Using a cognitive based style, reflection can take place through demonstration. Coaches need to reflect on how demonstrations of skills are executed and the coach must ensure that when a learner is receiving a demonstration that it is of adequate quality for the athlete to learn and progress using reflection. Demonstrations Coaching points and ‘logs are a very basic and fundamental way of reflecting on a performer. By making key observations during a practise and after, a coach can identify the problem areas. The more experienced the coach the more this basic method is effective and less need for the more advanced methods. This kind of feedback is usually Benefits to using reflective practise â€Å"by reflecting on practise a coach may expose his or her perceptions and beliefs to evaluation, creating a heightened sense of self awareness, which in turn my lead to a certain openness to new ideas† (Hellison and Templin 1991: 9) Reflective practise can increase ability in perception and creativity. This is due to the self improvement the coach must make themselves but are rewarded through these attributes. These attributes could then be passed onto the learner and thus bridging a gap between coach and learner.(BOOK) (PDF)Anderson, Knowles and Gilbourne (2004) state that â€Å"reflective practice is the latest topical strategic method that could help sports coaches explore their decisions and experiences, aiding them to make sense of the situation and directly influence the learning process.† This is clear that reflective practise can be used in order to help sports coaches. It is also considered one of the more modern uses of coaching in order to achieve higher ability in a more demanding results driven environment. â€Å"Indeed, to maximise learning, critical reflection is the core difference between whether an individual repeats the same experience time and time again or learns from the experience in such a way that the individual is cognitively or affectively changed† (Boyde and Fales, 1983).(PDF) By using reflective practise Boyde and Fales suggest that there is a high chance of learning and developing skills rather than just repeating an experience with no eventual gain. They believe reflection is essential to this as without it there would be no way an individual would know if improvement took place or not. â€Å"if a coach takes the opportunity to understand the consequences, both positive and negative, of the decisions made during a training session, they are better able to rationalise their decisions when under pressure† (Kidman, 2001).(PDF) Kidman here links this in with Schons ‘refelction in action. This is necessary in high tempo environments and is vital in gaining a better decision making process. Whilst reflection is important before and during training or match environments, only ‘reflection in action can gain quick and often needed information to make decisions. â€Å"reflection is thought to have a potent role in helping to bridge the gap between education and knowledge that is generated through practice† (Ghaye Ghaye, 1998).(PDF) Making coaches acknowledge their achievements is possible via reflection as it is a conscious and active way of fortifying the positives and negatives of individual and group practise. Difficulties in using reflective practise Whilst there is lots of evidence to strengthen the idea that reflective coaching is a useful practise, there are certainly problems that need addressing and limitations which clearly show it is not a full proof method even when applied properly. Crum (1995) â€Å"If a practitioner holds a ‘training-of-the-physical view of coaching and believes his or her role is only to improve fitness and adopt a technical/utilitarian approach, then becoming a coach who reflects in depth is not going to be paramount†. Whilst reflective practise does have its place, it would seem that it is limited. Some areas such as social negotiation and mentality may be difficult to improve through reflection practise but in many environments that reflective practise is used these are vital skills. Playing in high tempo and contact sports require both of these skills in abundance and gaining it through the individual is the most logical approach but if reflective practise is used then the coach is providing the information and techniques which arent transferable to individuals in these areas. â€Å"As many coaches will testify, written reflection, usually in the form of ‘logs, are frequently sanitised to deliver what is deemed as being necessary knowledge, thus being corralled into conformity (Chesterfield, Jones, Mitchell, 2007), possibly stifling coach creativity.†(PDF) Whilst Hellison and Templin believe in reflection in opening creativity, the basic form of a ‘log could be evidence that reflection does hinder creativity. Conformity is compliance with what already exists, if coaches comply to current practises such as ‘logs then there is no space for new practises to be introduced and composed. (PDF)Johns (1995) argued that â€Å"reflective practice is profoundly difficult, and it is therefore necessary to have a detailed model that guides and supports coaches.† Reflection does require many skills and outside opinions to be useful. There is a certain amount of complexity that comes with reflecting before, during and after sessions. Gibbs six-staged cyclical model for example is a complex calculated formula designed to give detailed analysis and evaluation. Whilst this could be beneficial it is only useful to coaches with prior experience or high ability levels. So as a general overall practise reflection can be difficult. â€Å"Trust is a vital part of a reflective conversation and, according to Maister, Green, Galford (2002), trust is a two-way relationship where people can be honest and respect each others openness. Without a real trusting relationship with significant others (e.g. a tutor, mentor, supervisor, coach) personal reflections may stay ‘safe and predictable and the real issues may go unresolved.†(PDF) Social dynamic in any relationship is extremely important. The relationship between coach and athlete is as open to flux as every other relationship. Trust is vitally important and is open to change to high and low levels. If trust is broken then coach performance or athlete obedience could drop. Reflection here is then a problem if not enough trust is spread and responsibility fall onto other people to provide strength in connecting and creativity in avoiding playing the ‘safe option which could potentially break trust. Conclusion To conclude, I believe that reflection is a very useful practise for coaches to undertake in developing athletes. Reflection can take place before, during and after which makes it very flexible and adaptable to a variety of environments. The coach does however need a certain level of ability in order to reflect appropriately and constructively. Detail is paramount and a coach analysing a level too high above them will struggle using reflection. I personally believe that the best method of reflection is video analysis. I think this because it gives an exact recollection of technical display and thanks to modern technology is available at a wide range of levels. It is, however, important that a coach doesnt rely on one method such as video analysis. During a competition or quick based environment it may not be possible to use this method and therefore a variety of reflective methods should be learnt and applied by coaches. This will make them more rounded and adaptable to their environment. One thing that I found intriguing was the amount of reflection that the coach must put on themselves. This ‘self reflection is vital as if this isnt carried out coaches methods may stagnate or accurate analysis and therefore feedback for the athlete cannot be attained thus making the practise useless. coach needs adaptable refelective ability, depending on the athletes, age, gender, ability etc†¦.. To sum up †¦Ã¢â‚¬ ¦.states and defines refelction very clearly â€Å"†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦..†

GENDER ROLES IN LITERATURE :: essays research papers

Many people think that boys in our culture today are brought up to define their identities through heroic individualism and competition, particularly through separation from home, friends, and family in an outdoors world of work and doing. Girls, on the other hand, are brought up to define their identities through connection, cooperation, self-sacrifice, domesticity, and community in an indoor world of love and caring. This view of different male and female roles can be seen throughout children’s literature. Treasure Island and The Secret Garden are two novels that are an excellent portrayal of the narrative pattern of â€Å"boy and girl† books. When thinking of books that seem to be written specifically for young boys, Treasure Island is a book that comes to many minds. Treasure Island is the epic tale of thrill seeking and adventure. Stevenson’s main character is a small boy, Jim, who gets to go away from his mother and embark on a trip across the ocean. There are sea fearing pirates, sword fight, and bloody killings. These are typically things that interest boys. Stevenson also follows the literary pattern described by Perry Nodelman in his book, The Pleasures of Children’s Literature. He describes that many novels written by men follow a pattern when it comes to the plot of their stories. â€Å"There is an unified action that rises toward a climax and then quickly comes to an end† (Nodelman 124). Treasure Island follows this pattern. The novel moves towards the climax of finding the treasure and then ends quickly without too great of detail with how the treasure money is spent or what happens in the character’s lives. In many ways, Treasure Island exemplifies the narrative patterns of a â€Å"boy book.† On the opposite end of the spectrum, The Secret Garden seems to be written for girls. The Secret Garden’s main character is a young, orphaned girl named Mary. The story focuses on Mary finding friends, becoming a better person, and a family coming together at last. Frances Burnett seems to follow two literary patterns described by Nodleman. The first is that she seems to write more about domestic events rather than adventures. Although the garden is an adventure for Mary, planting, weeding, and tending to the garden are chores that many would associate with women. The other literary pattern she follows is how the plot is laid out. Nodelman describes plots of novels written by woman as having many less-intense climaxes rather than one.

Care Plan

Palliative care would allow the client to receive a combined and holistic approach for medications, equipment, unseeing, and symptom treatment all fascinated through one program. The community health nurse needs to be careful not to impose ones own perception about quality of life upon the client. With the experience of having helped both of my parents through the dying process, I know that it is important to separate my own experience and perceptions from those of my client. Just as each person takes on life with a different philosophy, so it goes with the dying process.The nurse must not assume that the patient's priorities are the same as his or hers. Open communication regarding the patient's wants and needs must be initiated. Though not all patients have had the time or skills to know how to deal with a terminal illness, one of the most important Jobs of the nurse is to connect the patient to the proper resources needed for navigating through the various aspects and stages of th eir disease process, and to do so without Judgment or bias. B. Many terminally ill patients begin to navigate through the stages of grief as outlined by Elisabeth Kibble-Ross.While caring for this client with a lingering terminal illness such as cancer, my first strategy would be to keep the lines of communication open, managing the patient's emotional and spiritual needs and outlining the stages of grief as the client progresses through them. By initiating a good line of communication, one can recognize and guide both Mr.. And Mrs.. Thomas through denial, anger, bargaining, depression and acceptance (Kibble-Ross). It will be easier to better manage Mrs.. Thomas' physical needs if her psychological social needs have been addressed.My second strategy in helping to improve the quality of life for Mrs.. Thomas and her husband would be to manage Mrs.; Thomas' comfort. Working carefully with a palliative or hospice team to manage the physical discomforts of the tangent's illness, can gre atly increase quality of life. This is often a critical area of educating the patient on pain control. Patients are often afraid to take pain medications, and therapeutic communication is likely to be necessary. Monsoon). My third strategy would be to set up an interdisciplinary palliative care team to to manage the health of Mrs..Thomas. Terminal illness can be overwhelming for a family, where likely there are other factors – be it financial, familial, psychological, and no one person can manage it all. By working with the family to institute a good team or care, the burden can be lifted off the family and this will ideally allow them to care for their loved one without becoming burdened or overwhelmed. It is important to consult the family regarding any spiritual support that they would feel comforting. Is there a minister or spiritual guide currently in their life?If not, would they be open too visit from someone that is akin to their spiritual values? These are questions that should be carefully addressed. C. Nursing Care Plan for Mrs.. Thomas Assessment: Mrs.. Thomas is a 56 year-old female with a history of breast cancer. Mrs.. Thomas is aired with two grown sons, aged 28 and 30 both of which live out of state. Mrs.. Thomas has a strong familial history of braes cancer and one year ago, was treated for a malignant mass in her right breast.After a right mastectomy, chemotherapy and radiation six months ago, the cancer has now returned with subsequent right sided mastectomy, chemotherapy and radiation. The cancer has now metastasis's to the lungs and the prognosis is now deemed to be â€Å"poor† with â€Å"palliative care now being recommended†. (Task 2). Diagnosis Number One: Acute Pain related to incision secondary to surgical intervention as evidenced by tangent's visible discomfort/crying in bed, pallor, respirations, blood pressure and a report of 8/10 pain. Goal 1.Patient will verbalize a pain rating of 4 or less on a scale of 10 with each assessment. 2. Pain control as evidenced by patient demonstrating ability to use analgesics appropriately, use alternative non-analgesic relief, reported pain to be mild, relaxed body language, vital signs returning to normal Plan 1. Analgesic pain medication as prescribed by physician (Swearing) 2. Use of diversionary and or strategies to assist with pain (SHE Nursing Care Plan Guide) 3. Assist patient with positioning for comfort Implement .Evaluated effect of medication, utilize pain scale 2. Assessed effectiveness of diversionary strategies (SHE Nursing Care Plan Guide) 3. Assisted with position changes Diagnosis Number Two: Activity Intolerance related to generalized weakness as evidenced by increasing fatigue Goal 1. The nurse will help fascinate a physical therapist to help with mobility 2.. Will ambulate IX around block daily Patient 3.. Patient will fully participate in Tall's within physical limitations without dizziness or change in vital signs by 8/1/14 1 .Ass ess patient's level of mobility, educate within patient's capability 2. Assess nutritional status. Adequate energy reserves are required for activity. (Swearing) 3. Ambulate patient XX a day 1. Educated patient on benefits of mobility and the proper body mechanics for mobility 2. Encourage nutrition prior to activity and the proper body mechanics for mobility Monsoon) 3. Ambulated patient XX daily Diagnosis Number 3: Ineffective Coping related to financial burden and emotional impact of diagnosis on family as evidenced by patient's increasing isolation 1.Set up a quality interdisciplinary team incorporating counseling services for the family 2. Patient will demonstrate problem solving techniques Monsoon) 3. Patient ill verbalize acceptance of diagnosis 1. Patient will utilize available support systems and work with counselor for socio psych issues 2. Assist client to identify priorities and attainable goals as he/she starts to plan for necessary lifestyle and role changes 3. Perform actions to facilitate the grieving process (Elsevier) 1. Patient met with counseling services 2. Patient identified priorities and set goals 3.Patient demonstrated knowledge of the 5 stages of grief and how to work through them In order to optimize Mrs.. Thomas functional ability, the care team should strive for all three of the goals in her plan of care to be met. First of all, her pain needs to be managed so that manipulation can be successful, without discomfort. It is quite common for patients to be concerned about becoming addicted to pain medication as in the case of Mrs.. Thomas. Addiction is â€Å"psychological dependence† on a drug and is not the same as tolerance or physical dependence, according to Oncologist, DRP.Gary Johansson who states that â€Å"In fact, addiction is rare when avoids are used for pain relief†. With proper education and regularly scheduled pain medication, Mrs.. Thomas should be much more comfortable and able to manage other areas of he r life more successfully. Once Mrs.. Thomas' pain is under control, she will be able to work through many of the stresses that have mounted since her diagnosis. As Mrs.. Thomas disease progresses, there will come a time when she will no longer be able to care for herself. A new Plan of Care should be created and ready to transition to at that time.At this time the interdisciplinary team should consist of a hospice care which is generally implemented when a patient has less than 6 months to live. When hospice is begun, all care is transferred to the hospice team. New orders for care, medication, equipment will be set up and time is given to the family or supporting both the patient and their loved ones. Care will focus on making the most out of the time they have left, â€Å"without some of the negative side-effects that life prolonging treatments can have†. Monsoon).Most hospice patients can attain a level of comfort that allows them to â€Å"concentrate on the emotional and practical issues of dying†. Willet-Legislations). Mr.. Thomas is carrying a big physical and emotional burden during his wife's terminal illness. The Thomas family's case is complicated by Mr.. Thomas' chronic depression and high stress occupation. As Mrs.. Thomas' needs escalate and change, so do the needs of the Mr.. Thomas. By facilitating psychological help for Mr.. Thomas, the care team is in turn helping Mrs.. Thomas by easing her worries about her spouse.Patients and families need support, guidance, and encouragement to begin planning for many decisions. Many spouses are weighted with concern about the patients' comfort and impending death as well as every day problems. â€Å"This is an emotionally intense, exhausting, and singular experience, set in a world apart from everyday life patterns†. (Siegel). Mr.. Thomas needs to be reminded that in order to help care and be emotionally supportive to his wife, he needs to take care of himself. Medication reminders and grief support should be set up for Mr.. Thomas.Therapeutic conversation and guidance can make all the difference for the significant other off terminal patient. In addition, Mr.. Thomas needs respite care so that he can be fully present while caring for his wife. Mr.. Thomas should be encouraged to take a walk, a nap, or a restorative A care plan for Mr.. Thomas could be initiated with a nursing diagnosis of: Risk for Caregiver Role Strain. (SHE). Goal: Spouse will report low or no feelings of burden or distress by 8/01/14, measured by relief stated by spouse. Plan: Encourage the caregiver to talk about feelings, concerns, uncertainties, and fears. Care Plan Transition Nursing Process Discussion Group 3 Case Study Michael Martinez Is a 24-year-old Marine who was Involved In a motor vehicle accident (MBA) while on leave. His face hit the dashboard, resulting in a fracture of the mandible. Yesterday, he underwent a surgical incommensurable fixation, (wiring of the Jaw) for stabilization of the fracture. As a result of this surgery, he is unable to open his mouth and is limited to a liquid diet. The restricted diet will be necessary for 4 to 5 weeks until the fracture heals. One day post pop, his vital signs are 120/76, T-99. 2, P-82, and R- 20.After medication, is pain level is 3/10. With the exception of facial bruising, his appearance is within normal Limits, Steps of the Nursing Process Patient Information Assessment Objective and subjective data will be entered here. The database presented In the case study will be used. Data is collected and verified from the primary (apt. ) and the secondary (family, friends, health professionals, an d medical record). Analysis of this data provides the basis for development of the remaining steps in the nursing process. Subjective: Patient expresses disinterest in a liquid only diet Objective: wired Jaw Liquid diet Nursing DiagnosisAfter analyzing the assessment data, formulate a priority nursing diagnosis. Remember, a nursing diagnosis is a statement describing the patient's actual or potential response to a health problem that the nurse Is licensed and competent to treat. An actual diagnosis Is written In three parts: diagnostic label (problem) related to_ as evidenced/exhibited by_. A risk diagnosis is written in two parts: Risk for (diagnostic label) _ related to Nutrition: less than body requirements related to Inability to eat solid foods as evidenced by liquid diet post-surgery Planning Goals: Now is the time set patient centered goals.Here you will develop expected selection of interventions based on six important factors outlined in your text. Please write the interven tions you select below in implementation. Patient will be free of signs of malnutrition post dinner time each shift Implementation Here is where the nurse will carry out the plan of care. Then continue data collection and modify the plan of care as needed and document care provided. What nursing interventions will you provide to enhance patient outcomes? Assess patient's weight every shift Calculate bowel sounds Evaluate total daily food intake Provide high calorie, nutrient-rich dietary supplementsEvaluation The purpose of evaluation is to support the effectiveness of nursing practice which is patient-centered and patient-driven. This phase measures the patient's response to nursing interventions and progress towards achieving goals using five elements listed in the text. Did you achieve the goal for this nursing diagnosis? Will you continue the plan of care, revise the plan of care, or discontinue? Reassess patient's lab value daily for signs of malnutrition. If malnourished call health care provider for further orders Patient will weight within 10% of normal body weight every morning Care Plan A. Our client, Mrs.. Thomas has been given the unfortunate diagnosis of metastasis breast cancer. When considering the current and future needs of this client, significant thought and planning must be directed toward the client's level of well being. In the case off terminally ill patient, it is important to help facilitate a high quality of life that encompasses both physical and psychological health. I would recommend initiating palliative care for Mrs.. Thomas.Palliative care would allow the client to receive a combined and holistic approach for medications, equipment, unseeing, and symptom treatment all fascinated through one program. The community health nurse needs to be careful not to impose ones own perception about quality of life upon the client. With the experience of having helped both of my parents through the dying process, I know that it is important to separate my own experience and perceptions from those of my client. Just as each person takes on life with a differen t philosophy, so it goes with the dying process.The nurse must not assume that the patient's priorities are the same as his or hers. Open communication regarding the patient's wants and needs must be initiated. Though not all patients have had the time or skills to know how to deal with a terminal illness, one of the most important Jobs of the nurse is to connect the patient to the proper resources needed for navigating through the various aspects and stages of their disease process, and to do so without Judgment or bias. B. Many terminally ill patients begin to navigate through the stages of grief as outlined by Elisabeth Kibble-Ross.While caring for this client with a lingering terminal illness such as cancer, my first strategy would be to keep the lines of communication open, managing the patient's emotional and spiritual needs and outlining the stages of grief as the client progresses through them. By initiating a good line of communication, one can recognize and guide both Mr.. And Mrs.. Thomas through denial, anger, bargaining, depression and acceptance (Kibble-Ross). It will be easier to better manage Mrs.. Thomas' physical needs if her psychological social needs have been addressed.My second strategy in helping to improve the quality of life for Mrs.. Thomas and her husband would be to manage Mrs.; Thomas' comfort. Working carefully with a palliative or hospice team to manage the physical discomforts of the tangent's illness, can greatly increase quality of life. This is often a critical area of educating the patient on pain control. Patients are often afraid to take pain medications, and therapeutic communication is likely to be necessary. Monsoon). My third strategy would be to set up an interdisciplinary palliative care team to to manage the health of Mrs..Thomas. Terminal illness can be overwhelming for a family, where likely there are other factors – be it financial, familial, psychological, and no one person can manage it all. By working w ith the family to institute a good team or care, the burden can be lifted off the family and this will ideally allow them to care for their loved one without becoming burdened or overwhelmed. It is important to consult the family regarding any spiritual support that they would feel comforting. Is there a minister or spiritual guide currently in their life?If not, would they be open too visit from someone that is akin to their spiritual values? These are questions that should be carefully addressed. C. Nursing Care Plan for Mrs.. Thomas Assessment: Mrs.. Thomas is a 56 year-old female with a history of breast cancer. Mrs.. Thomas is aired with two grown sons, aged 28 and 30 both of which live out of state. Mrs.. Thomas has a strong familial history of braes cancer and one year ago, was treated for a malignant mass in her right breast.After a right mastectomy, chemotherapy and radiation six months ago, the cancer has now returned with subsequent right sided mastectomy, chemotherapy an d radiation. The cancer has now metastasis's to the lungs and the prognosis is now deemed to be â€Å"poor† with â€Å"palliative care now being recommended†. (Task 2). Diagnosis Number One: Acute Pain related to incision secondary to surgical intervention as evidenced by tangent's visible discomfort/crying in bed, pallor, respirations, blood pressure and a report of 8/10 pain. Goal 1.Patient will verbalize a pain rating of 4 or less on a scale of 10 with each assessment. 2. Pain control as evidenced by patient demonstrating ability to use analgesics appropriately, use alternative non-analgesic relief, reported pain to be mild, relaxed body language, vital signs returning to normal Plan 1. Analgesic pain medication as prescribed by physician (Swearing) 2. Use of diversionary and or strategies to assist with pain (SHE Nursing Care Plan Guide) 3. Assist patient with positioning for comfort Implement .Evaluated effect of medication, utilize pain scale 2. Assessed effectiv eness of diversionary strategies (SHE Nursing Care Plan Guide) 3. Assisted with position changes Diagnosis Number Two: Activity Intolerance related to generalized weakness as evidenced by increasing fatigue Goal 1. The nurse will help fascinate a physical therapist to help with mobility 2.. Will ambulate IX around block daily Patient 3.. Patient will fully participate in Tall's within physical limitations without dizziness or change in vital signs by 8/1/14 1 .Assess patient's level of mobility, educate within patient's capability 2. Assess nutritional status. Adequate energy reserves are required for activity. (Swearing) 3. Ambulate patient XX a day 1. Educated patient on benefits of mobility and the proper body mechanics for mobility 2. Encourage nutrition prior to activity and the proper body mechanics for mobility Monsoon) 3. Ambulated patient XX daily Diagnosis Number 3: Ineffective Coping related to financial burden and emotional impact of diagnosis on family as evidenced by p atient's increasing isolation 1.Set up a quality interdisciplinary team incorporating counseling services for the family 2. Patient will demonstrate problem solving techniques Monsoon) 3. Patient ill verbalize acceptance of diagnosis 1. Patient will utilize available support systems and work with counselor for socio psych issues 2. Assist client to identify priorities and attainable goals as he/she starts to plan for necessary lifestyle and role changes 3. Perform actions to facilitate the grieving process (Elsevier) 1. Patient met with counseling services 2. Patient identified priorities and set goals 3.Patient demonstrated knowledge of the 5 stages of grief and how to work through them In order to optimize Mrs.. Thomas functional ability, the care team should strive for all three of the goals in her plan of care to be met. First of all, her pain needs to be managed so that manipulation can be successful, without discomfort. It is quite common for patients to be concerned about bec oming addicted to pain medication as in the case of Mrs.. Thomas. Addiction is â€Å"psychological dependence† on a drug and is not the same as tolerance or physical dependence, according to Oncologist, Dry.Gary Johansson who states that â€Å"In fact, addiction is rare when avoids are used for pain relief†. With proper education and regularly scheduled pain medication, Mrs.. Thomas should be much more comfortable and able to manage other areas of her life more successfully. Once Mrs.. Thomas' pain is under control, she will be able to work through many of the stresses that have mounted since her diagnosis. As Mrs.. Thomas disease progresses, there will come a time when she will no longer be able to care for herself. A new Plan of Care should be created and ready to transition to at that time.At this time the interdisciplinary team should consist of a hospice care which is generally implemented when a patient has less than 6 months to live. When hospice is begun, all c are is transferred to the hospice team. New orders for care, medication, equipment will be set up and time is given to the family or supporting both the patient and their loved ones. Care will focus on making the most out of the time they have left, â€Å"without some of the negative side-effects that life prolonging treatments can have†. Monsoon).Most hospice patients can attain a level of comfort that allows them to â€Å"concentrate on the emotional and practical issues of dying†. Willet-Legislations). Mr.. Thomas is carrying a big physical and emotional burden during his wife's terminal illness. The Thomas family's case is complicated by Mr.. Thomas' chronic depression and high stress occupation. As Mrs.. Thomas' needs escalate and change, so do the needs of the Mr.. Thomas. By facilitating psychological help for Mr.. Thomas, the care team is in turn helping Mrs.. Thomas by easing her worries about her spouse.Patients and families need support, guidance, and encour agement to begin planning for many decisions. Many spouses are weighted with concern about the patients' comfort and impending death as well as every day problems. â€Å"This is an emotionally intense, exhausting, and singular experience, set in a world apart from everyday life patterns†. (Siegel). Mr.. Thomas needs to be reminded that in order to help care and be emotionally supportive to his wife, he needs to take care of himself. Medication reminders and grief support should be set up for Mr.. Thomas.Therapeutic conversation and guidance can make all the difference for the significant other off terminal patient. In addition, Mr.. Thomas needs respite care so that he can be fully present while caring for his wife. Mr.. Thomas should be encouraged to take a walk, a nap, or a restorative A care plan for Mr.. Thomas could be initiated with a nursing diagnosis of: Risk for Caregiver Role Strain. (SHE). Goal: Spouse will report low or no feelings of burden or distress by 8/01/14 , measured by relief stated by spouse. Plan: Encourage the caregiver to talk about feelings, concerns, uncertainties, and fears.Acknowledge the frustration associated with caregiver responsibilities. Initiate counseling. 2. Help the caregiver problem solve to meet his needs. 3. Set up medication reminders for psychological medications. Implement: 1. Patient openly discusses concerns, uncertainties and fears (SHE). Patient acknowledges frustrations associated with his caregiver responsibilities. Patient attends counseling. 2. Patient participates in problem solving to meet his needs. 3. Patient follows medication reminders and takes medications for his depression. Care Plan A. Our client, Mrs.. Thomas has been given the unfortunate diagnosis of metastasis breast cancer. When considering the current and future needs of this client, significant thought and planning must be directed toward the client's level of well being. In the case off terminally ill patient, it is important to help facilitate a high quality of life that encompasses both physical and psychological health. I would recommend initiating palliative care for Mrs.. Thomas.Palliative care would allow the client to receive a combined and holistic approach for medications, equipment, unseeing, and symptom treatment all fascinated through one program. The community health nurse needs to be careful not to impose ones own perception about quality of life upon the client. With the experience of having helped both of my parents through the dying process, I know that it is important to separate my own experience and perceptions from those of my client. Just as each person takes on life with a differen t philosophy, so it goes with the dying process.The nurse must not assume that the patient's priorities are the same as his or hers. Open communication regarding the patient's wants and needs must be initiated. Though not all patients have had the time or skills to know how to deal with a terminal illness, one of the most important Jobs of the nurse is to connect the patient to the proper resources needed for navigating through the various aspects and stages of their disease process, and to do so without Judgment or bias. B. Many terminally ill patients begin to navigate through the stages of grief as outlined by Elisabeth Kibble-Ross.While caring for this client with a lingering terminal illness such as cancer, my first strategy would be to keep the lines of communication open, managing the patient's emotional and spiritual needs and outlining the stages of grief as the client progresses through them. By initiating a good line of communication, one can recognize and guide both Mr.. And Mrs.. Thomas through denial, anger, bargaining, depression and acceptance (Kibble-Ross). It will be easier to better manage Mrs.. Thomas' physical needs if her psychological social needs have been addressed.My second strategy in helping to improve the quality of life for Mrs.. Thomas and her husband would be to manage Mrs.; Thomas' comfort. Working carefully with a palliative or hospice team to manage the physical discomforts of the tangent's illness, can greatly increase quality of life. This is often a critical area of educating the patient on pain control. Patients are often afraid to take pain medications, and therapeutic communication is likely to be necessary. Monsoon). My third strategy would be to set up an interdisciplinary palliative care team to to manage the health of Mrs..Thomas. Terminal illness can be overwhelming for a family, where likely there are other factors – be it financial, familial, psychological, and no one person can manage it all. By working w ith the family to institute a good team or care, the burden can be lifted off the family and this will ideally allow them to care for their loved one without becoming burdened or overwhelmed. It is important to consult the family regarding any spiritual support that they would feel comforting. Is there a minister or spiritual guide currently in their life?If not, would they be open too visit from someone that is akin to their spiritual values? These are questions that should be carefully addressed. C. Nursing Care Plan for Mrs.. Thomas Assessment: Mrs.. Thomas is a 56 year-old female with a history of breast cancer. Mrs.. Thomas is aired with two grown sons, aged 28 and 30 both of which live out of state. Mrs.. Thomas has a strong familial history of braes cancer and one year ago, was treated for a malignant mass in her right breast.After a right mastectomy, chemotherapy and radiation six months ago, the cancer has now returned with subsequent right sided mastectomy, chemotherapy an d radiation. The cancer has now metastasis's to the lungs and the prognosis is now deemed to be â€Å"poor† with â€Å"palliative care now being recommended†. (Task 2). Diagnosis Number One: Acute Pain related to incision secondary to surgical intervention as evidenced by tangent's visible discomfort/crying in bed, pallor, respirations, blood pressure and a report of 8/10 pain. Goal 1.Patient will verbalize a pain rating of 4 or less on a scale of 10 with each assessment. 2. Pain control as evidenced by patient demonstrating ability to use analgesics appropriately, use alternative non-analgesic relief, reported pain to be mild, relaxed body language, vital signs returning to normal Plan 1. Analgesic pain medication as prescribed by physician (Swearing) 2. Use of diversionary and or strategies to assist with pain (SHE Nursing Care Plan Guide) 3. Assist patient with positioning for comfort Implement .Evaluated effect of medication, utilize pain scale 2. Assessed effectiv eness of diversionary strategies (SHE Nursing Care Plan Guide) 3. Assisted with position changes Diagnosis Number Two: Activity Intolerance related to generalized weakness as evidenced by increasing fatigue Goal 1. The nurse will help fascinate a physical therapist to help with mobility 2.. Will ambulate IX around block daily Patient 3.. Patient will fully participate in Tall's within physical limitations without dizziness or change in vital signs by 8/1/14 1 .Assess patient's level of mobility, educate within patient's capability 2. Assess nutritional status. Adequate energy reserves are required for activity. (Swearing) 3. Ambulate patient XX a day 1. Educated patient on benefits of mobility and the proper body mechanics for mobility 2. Encourage nutrition prior to activity and the proper body mechanics for mobility Monsoon) 3. Ambulated patient XX daily Diagnosis Number 3: Ineffective Coping related to financial burden and emotional impact of diagnosis on family as evidenced by p atient's increasing isolation 1.Set up a quality interdisciplinary team incorporating counseling services for the family 2. Patient will demonstrate problem solving techniques Monsoon) 3. Patient ill verbalize acceptance of diagnosis 1. Patient will utilize available support systems and work with counselor for socio psych issues 2. Assist client to identify priorities and attainable goals as he/she starts to plan for necessary lifestyle and role changes 3. Perform actions to facilitate the grieving process (Elsevier) 1. Patient met with counseling services 2. Patient identified priorities and set goals 3.Patient demonstrated knowledge of the 5 stages of grief and how to work through them In order to optimize Mrs.. Thomas functional ability, the care team should strive for all three of the goals in her plan of care to be met. First of all, her pain needs to be managed so that manipulation can be successful, without discomfort. It is quite common for patients to be concerned about bec oming addicted to pain medication as in the case of Mrs.. Thomas. Addiction is â€Å"psychological dependence† on a drug and is not the same as tolerance or physical dependence, according to Oncologist, Dry.Gary Johansson who states that â€Å"In fact, addiction is rare when avoids are used for pain relief†. With proper education and regularly scheduled pain medication, Mrs.. Thomas should be much more comfortable and able to manage other areas of her life more successfully. Once Mrs.. Thomas' pain is under control, she will be able to work through many of the stresses that have mounted since her diagnosis. As Mrs.. Thomas disease progresses, there will come a time when she will no longer be able to care for herself. A new Plan of Care should be created and ready to transition to at that time.At this time the interdisciplinary team should consist of a hospice care which is generally implemented when a patient has less than 6 months to live. When hospice is begun, all c are is transferred to the hospice team. New orders for care, medication, equipment will be set up and time is given to the family or supporting both the patient and their loved ones. Care will focus on making the most out of the time they have left, â€Å"without some of the negative side-effects that life prolonging treatments can have†. Monsoon).Most hospice patients can attain a level of comfort that allows them to â€Å"concentrate on the emotional and practical issues of dying†. Willet-Legislations). Mr.. Thomas is carrying a big physical and emotional burden during his wife's terminal illness. The Thomas family's case is complicated by Mr.. Thomas' chronic depression and high stress occupation. As Mrs.. Thomas' needs escalate and change, so do the needs of the Mr.. Thomas. By facilitating psychological help for Mr.. Thomas, the care team is in turn helping Mrs.. Thomas by easing her worries about her spouse.Patients and families need support, guidance, and encour agement to begin planning for many decisions. Many spouses are weighted with concern about the patients' comfort and impending death as well as every day problems. â€Å"This is an emotionally intense, exhausting, and singular experience, set in a world apart from everyday life patterns†. (Siegel). Mr.. Thomas needs to be reminded that in order to help care and be emotionally supportive to his wife, he needs to take care of himself. Medication reminders and grief support should be set up for Mr.. Thomas.Therapeutic conversation and guidance can make all the difference for the significant other off terminal patient. In addition, Mr.. Thomas needs respite care so that he can be fully present while caring for his wife. Mr.. Thomas should be encouraged to take a walk, a nap, or a restorative A care plan for Mr.. Thomas could be initiated with a nursing diagnosis of: Risk for Caregiver Role Strain. (SHE). Goal: Spouse will report low or no feelings of burden or distress by 8/01/14 , measured by relief stated by spouse. Plan: Encourage the caregiver to talk about feelings, concerns, uncertainties, and fears.Acknowledge the frustration associated with caregiver responsibilities. Initiate counseling. 2. Help the caregiver problem solve to meet his needs. 3. Set up medication reminders for psychological medications. Implement: 1. Patient openly discusses concerns, uncertainties and fears (SHE). Patient acknowledges frustrations associated with his caregiver responsibilities. Patient attends counseling. 2. Patient participates in problem solving to meet his needs. 3. Patient follows medication reminders and takes medications for his depression.