End of Life Peace Without Pain Free Essays

End of Life: Peace without Pain Jacqueline R. Reviel Loyola University New Orleans End of Life Peace without Pain Pain management during end of life care is crucial to the comfort and peace of the patient and their family. â€Å"With better pain control, dying patients live longer and better. We will write a custom essay sample on End of Life Peace Without Pain or any similar topic only for you Order Now Pain shortens life. Relief of pain extends life† (Zerwekh et al. , 2006, p. 317). The nurse must educate about (a) disease pathology, (b) signs symptoms, (c) interventions, (d) medications, (e) alternative therapies, and (f) supportive care, related to end of life care. Pain management involves understanding the pharmacological issues, and management issues surrounding opioid drugs used for pain control. The identification of (a) nursing diagnosis, (b) implementation, and (c) education are essential in keeping the patient and family comfortable and at peace. Pathology, Signs and Symptoms End of life presents with specific pathology which can cause extreme pain and discomfort. The body’s organs begin to shut down as death approaches hypoventilation causes hypoxemia and hypercapnia in turn increasing the workload of the heart as it tries to oxygenate the vital organs. The kidneys and liver begin to fail and toxins begin to build up. The heart fails as it can’t keep up with the demand. Zerwekh (2006) lists specific signs and symptoms associated with death (a) reduced level of consciousness, (b) taking no fluids or only sips, (c) decreased urine output, (d) progressing coldness and mottling in legs and arms, (e) irregular labored breathing; periods of no breathing, and (f) the death rattle. Diagnosis Interventions Diagnoses related to end of life care are (a) Ineffective tissue perfusion, (b) Alteration in comfort, (c) Activity intolerance, (d) Impaired gas exchange; (e) Ineffective breathing patterns, and (f) Decreased cardiac output. Interventions are attached to each diagnosis and a plan of care is established for the patient. Interventions for alternation in comfort include (a) spiritual, (b) pharmacological, and (c) alternative methods. Ineffective tissue perfusion involves (a) positioning, (b) O2, and (c) fluid management. Activity intolerance is managed by pacing periods of activity with rest. Impaired gas exchange is managed by decreasing fluid shifts with medication. Ineffective airway clearance is helped by (a) positioning and (b) suctioning to clear the airway. Disturbed thought processes interventions are (a) reorient the patient, (b) supporting family, and (c) visitors at times when the patient is most alert. Interventions are tailored specially to the patient’s needs and their disease process. Pain management â€Å"Dying does not need to be painful† (Moynihan et al. , 2003 p. 401). Holistic pain management is crucial during end of life care. Terminally ill patients can have (a) physical, (b) spiritual and (c) emotional pain. Providing comfort is important in decreasing suffering. Emotional pain can be addressed by (a) laughter, (b) memories, and (c) touch. Spiritual pain can be helped with (a) prayer, (b) meditation, (c) talking, (d) listening, (e) pastoral care, and (f) providing the last rights. Physical pain is managed pharmacologically and with alternative comfort measures. Opioids are given to treat severe pain at the end of life. Parlow (2005) used nitrous oxide to control incident pain in terminally ill patients with positive results. Pharmacological issue related to pain management Pharmacological issues surrounding pain management are (a) issues of addiction under medication, (b) legal repercussions, (c) respiratory effects, and (d) side effects. Zerwekh (2006) sums up the fallacy of addiction by stating persons with addiction take their opioids to escape life, whereas persons with pain take their opioids to live life more fully. These issues and lack of knowledge often cause Physicians to under medicate during end of life care. The nurse needs to have full understanding of how opioids work and how to adjust the medications to control severe pain and break though pain without entering into (a) legal issues, (b) respiratory depression and (c) side effects. Complementary and alternative therapies Along with the pharmacological methods to keep the patient comfortable there are many alternative method the nurse can use and teach the family to assist with; giving the family the gift of caring for their loved one and feeling like they are helping. The patient also benefits from the touch and interaction from his or her loved ones. Therapies such as (a) massage, (b) therapeutic touch, (c) guided imagery, (d) aromatherapy, (e) hypnosis and (f) relaxation, are just a few alternative therapies used. Supportive nursing care Often when a family member is dying their loved ones do not know what to say or do and often feel helpless. While providing care for the patient the nurse engages the family in the care and breaks down the fear that they can’t touch the dying patient. The nurse encourages the family to (a) gather, (b) share, and (c) grieve. The family and patient are educated to end of life care so they know what to expect and can recognize it. By giving the family these skills it is a gift so the family has time to say goodbye and to spend the last days in peace not in fear and chaos. The nurse manages symptoms so the patient and the family can concentrate on each other. O’Brien (2011) stated one of the best ways of providing spiritual support in this situation is to allow the patient and family to verbalize their feelings; for the dying person â€Å"one of the greatest spiritual gifts† a nurse can give is to listen (Burns, 1991, p. 1). Patient Family education Education gives the patient and the family great power and strength to face the path ahead and not be fearful of the process. Discussion around key information such as (a) the patient’s wishes, (b) spiritual care, (c) visitation, (d) pain control, (e) disease process, (f) multi organ failure, (g) specific signs and symptoms, (h) interventio ns that can be provided, (i) interventions the patient may not want, (j) comfort care, and (k) funeral arrangements, must take place with the patient and their family. Patients may believe that pain is to be expected and education informing them that comfort will bring them quality time to spend with their loved ones and to not suffer in silences is vital. Encouraging the family to (a) hold their love ones hand, (b) stroke hair, (c) massage, and (d) talk to them until they take their last breath, is all education the nurse encourages. The nurses’ role is to (a) support, (b) pray and (c) answer question that might arise. Conclusion Caring for patients as they die involves (a) a great deal of knowledge, (b) compassion, and (c) caring, on the nurse’s part. Effective pain management decreases suffering in the terminally ill patient and can make all the difference in how the patient arrives at the end of life. The nurse must be versed and comfortable with the many issues surrounding end of life care so she or he can advocate for the needs of the patient and their family. The nurse’s role in (a) educating, (b) providing spiritual care, and (c) physiological care, to the patient and their family during this very important and stressful time plays a huge part in the comfort and peace that they experience as they journey down the path of loss and grieving. References Moynihan, T. J. (2003). Use of opioids in the treatment os severe pain in terminally ill patients-Dying should not be painful. Mayo Clin Proc. , 1397-1401. O’Brien, M. E. (2011). Spirituality in nursing: Standing on holy ground. Sudbury, MA: Jones ; Barlett Learning. Parlow, J. L. (2005). Self-administered nitrous oxide for the management of incident pain in the terminally ill patient: A blind case series. Palliative Medicine, 19: 3-8. Zerwekh, J. V. (2006). Nursing care at the end of life: Palliative care for patients and families. Philadelphia, PA: F. A. Davis Company. LOYOLA UNIVERSITY NEW ORLEANS NURS 384: End-of-Life Issues Paper Student: _Jackie Reviel__________________________Semester:_Fall__Year:_2011__ Directions: The purpose of this paper is to examine end-of-life issues. Write a 4-5 page paper on one of the topics that are suggested in your syllabus. Focus the paper on the care of the terminally-ill patient; education of patient and family, and supportive nursing care. Use ast least 4 references (current text and articles) for this assignment and format paper in APA style. Criteria: End-of-Life Issues Paper| Max. Points| Score| 1. Describes terminal Illness. Include pathology and signs and symptoms| 15| | 2. Identify palliative care/interventions associated with illness| 15| | 3. Address pharmacological issues related to terminal illness| 10| | 4. Address complementary and alternative therapies | 15| | 5. Describe supportive nursing care related to terminal Illness. | 15| | 6. Discuss at least 5 nursing diagnosis taken from those listed in the North American Diagnosis Association. 15| | 7. Provide key information to be discussed with patients ; families on terminal illness. | 15| | Total Comments: Faculty Signature: _______________________________Date:_______________________ LOYOLA UNIVERSITY NEW ORLEANS Evaluation of Communication Skills Student: ________________________________Semester: ____Year: _____ Skill in communication is defined as the ability to: (a) effectively express ideas through a variety of media, (b) use communication technology to enhance personal and professional functioning, and (c) use the group process for the purpose of achieving common goals. Note: Your grade on Communication Skills will comprise 10% of your final course grade. You will be rated using a scale of 0-10, where â€Å"0† indicates no credit and â€Å"10† indicates maximum credit for the item indicated. | Writing Criteria: Nursing Research Critique Paper | Score| 1. Use appropriate language and erminology. | | 2. Use correct sentence structure and paragraphing. | | 3. Use correct grammar, spelling, and punctuation. | | 4. Demonstrate knowledge of relevant content areas. | | 5. Express ideas clearly and convincingly. | | 6. Organize ideas logically. | | 7. Use APA format correctly. | | 8. Overall effectiveness of the written work in meeting identified goals. | | Communication Skills: Pt s earned (_____)/ 80 pts = _____% Letter Grade:____ Percent of Final Course Grade: [Pts earned (____)/ 80 pts =___%] X 10 = ____% Comments: Faculty Signature:____________________________________Date:______________ How to cite End of Life Peace Without Pain, Essays

Love as a Theme Expressed in Three Poems free essay sample

This paper looks at how three authors use love in different poems, including Robert Brownings Porphyrias Lover, A. E. Housmans `When I Was One and Twenty,` and Thomas Hardys Neutral Tones. For hundreds of years, people have used poetry to express their attitudes towards something or someone. In these centuries, the most common use for poetry is to express feelings of love. Through poetry, a person can say so much more than trying to verbally express his or her feelings. Also, this persons identity does not need to be known if a nervousness is present about telling that special someone these feelings. This person may write an original poem if he or she feels able to do so, or, as others would chose to do, it is common to have another person write a poem that best conveys the feelings of one towards another. Poems may have changed their styles over the course of these generations, but the basic love poetry still remains, charming the hearts of millions of people. We will write a custom essay sample on Love as a Theme Expressed in Three Poems or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Along with love poems are the break-up poems that people dread receiving. The poems Porphyrias Lover, When I was One and Twenty, and Neutral Tones each convey this idea.

Free Essays on Fire And Ice By Frost

â€Å"Fire and Ice† In Robert Frost’s poem â€Å"Fire and Ice† the main theme is the final destruction of the earth. Many people speculate how the world will come to an end. Frost compares the destructive forces of fire and ice and gives the reader insight into Frost’s own experiences and thoughts of entire destruction. At the very beginning of the poem, Frost literally offers two possibilities for the end of the world. â€Å"Some say the world will end in fire, / Some say in ice.† (l. 1-2). People have wondered for years as to how the world will be destroyed. Most believe the Bible that the world will end in fire. Others favor the view of another Ice Age caused from a meteor hitting earth. Beyond the literal reference, Frost also leads the reader to observe the downfall of mankind. In the next two lines Frost tells the reader what he has experienced. He concurs with â€Å"those who favor fire† (l. 4). Frost relates the detrimental fire to desire. He believes that desire will ultimately bring about the end. This relation suggests that desire, or lust, greed and want, when used negatively bring about one’s downfall and could certainly bring about the downfall of an entire planet. Frost next contrasts the relation of fire and desire with that of ice and hatred. â€Å"But if it had to perish twice, I think I know enough of hate To say that for destruction ice Is also great And would suffice.† (l. 5-9). Frost is saying that if the world must be destroyed a second time that he would want it to end with damaging ice to show what hate would be like. Frost relates ice to the hatred throughout the world. He has seen enough hate to consummate world wide death. Ice surrounds objects and causes them to crack or break from the pressure; much like hatred does to an individual. Hate gets into one’s very soul and forces out all the good, eventually eating away the core of one’s being. Therefore... Free Essays on Fire And Ice By Frost Free Essays on Fire And Ice By Frost â€Å"Fire and Ice† In Robert Frost’s poem â€Å"Fire and Ice† the main theme is the final destruction of the earth. Many people speculate how the world will come to an end. Frost compares the destructive forces of fire and ice and gives the reader insight into Frost’s own experiences and thoughts of entire destruction. At the very beginning of the poem, Frost literally offers two possibilities for the end of the world. â€Å"Some say the world will end in fire, / Some say in ice.† (l. 1-2). People have wondered for years as to how the world will be destroyed. Most believe the Bible that the world will end in fire. Others favor the view of another Ice Age caused from a meteor hitting earth. Beyond the literal reference, Frost also leads the reader to observe the downfall of mankind. In the next two lines Frost tells the reader what he has experienced. He concurs with â€Å"those who favor fire† (l. 4). Frost relates the detrimental fire to desire. He believes that desire will ultimately bring about the end. This relation suggests that desire, or lust, greed and want, when used negatively bring about one’s downfall and could certainly bring about the downfall of an entire planet. Frost next contrasts the relation of fire and desire with that of ice and hatred. â€Å"But if it had to perish twice, I think I know enough of hate To say that for destruction ice Is also great And would suffice.† (l. 5-9). Frost is saying that if the world must be destroyed a second time that he would want it to end with damaging ice to show what hate would be like. Frost relates ice to the hatred throughout the world. He has seen enough hate to consummate world wide death. Ice surrounds objects and causes them to crack or break from the pressure; much like hatred does to an individual. Hate gets into one’s very soul and forces out all the good, eventually eating away the core of one’s being. Therefore...

French Introductions, or Les Présentations

French Introductions, or Les Prà ©sentations When you meet French speakers, you need to know how to introduce yourself and what to say when you are introduced.  French can be a bit tricky when introducing yourself or others depending on whether you know the person to whom you are making the introduction(s) or even if you have had any contact with the person. In French, those circumstances all require different introductions. Basic Introductions French uses the verb  se prà ©senter, not  introduire,  meaning to introduce something into something else, which translates into English as to insert. The most basic introduction in French, then, would be: Je me prà ©sente. Let me introduce myself. Using s’appeler is the common way of introducing yourself in French. Don’t think of it as â€Å"to name oneself† because it will only confuse you. Think of it in the context of introducing your name to someone, and link the French words to that context instead of applying a literal translation, as in: Je m​appelle...   My name is... Use je suis with people who already know your name, such as those  you have already talked to on the phone or by mail but never met in person, as in: Je suis...   I am... If you dont know the person or have never spoken to him on the phone or contacted him by email or  mail, use  je m’appelle,  as noted previously. Introducing by Name There are also distinctions between formal and informal introductions, as well as singular versus plural introductions, as noted in the tables in this and the subsequent section. French Introduction English Translation Mon prà ©nom est My (first) name is Je vous prà ©sente (formal and/or plural) I’d like to introduce Je te prà ©sente (informal) I'd like to introduce Voici This is, Here is Il s'appelle His name is Elle s'appelle Her name is Meeting People In French, when you are meeting people, you have to be careful about using the correct gender, as well as whether the introduction is formal or informal, as in these examples. French Introduction Enlish Translation Comment vous appelez-vous? (formal and/or plural) What is your name? Comment t'appelles-tu? (informal) What is your name? Enchantà ©. (masculine) It's nice to meet you. Enchantà ©e. (feminine) It's nice to meet you. French Names Nicknames - or  un surnom in French - are much less common in this Romance language than in American English, but they are not unheard of. Often, a longer first name will be shortened, such as  Caro  for Caroline or  Flo  for Florence.   French Name English Translation Le prà ©nom first name, given name Le nom last name, family name, surname Le surnom nickname Cheek Kissing and Other Greetings Cheek kissing  is certainly an accepted form of greeting in France, but there are strict  (unwritten) social rules to follow. Cheek kissing is generally OK, for example, but not hugging. So, its important to learn not only the words that go with cheek kissing - such as  bonjour  (hello) - but also the social norms that are expected when greeting someone in this manner. There are also other ways to say  hello  and ask  How are you?  in French.

Business Ethics Essay Example | Topics and Well Written Essays - 750 words - 15

Business Ethics - Essay Example The leadership style of Robert Nardelli is described as autocratic and directive. He was a task oriented and directive leader who employed severe strictness and inflexibility in Home Depot during his tenure as the CEO in the organization. The leadership style of Nardelli was characterized by centralized control without considering the behavior and acceptance of the employees and the customers. The incorporation of extensive technologies and new organizational procedures harmed Home Depot bringing down its stock prices in the long term and negatively affecting the shareholders. Though the immediate effects of his leadership were not erosive but after few years the growth of the company slowed down to a great extent due to the increased dissatisfaction of the employees as well as the customers of Home Depot (Baack, 2012). The management style of Nardelli was criticized to be inflexible and callous. But the leadership style of Nardelli was much influenced by his tenure at GE as a result of which he focused more on technology and goal driven business plans. But this kind of leadership was not suitable in the retail industry as the leadership style required in Home Depot needed to be more people oriented creating better employee and customer satisfaction. The reputation of home Depot suffered and the share prices feel whereas the competitor companies succeeded through the creation of better customer experience and satisfaction levels. Home Depot needed a constructive and participative leadership style as opposed to the autocratic leadership style of Nardelli. Due to the directive leadership style of Nardelli, the financial metrics of the company improved initially but the metrics of customer service and employee satisfaction declined. Home Depot need a situational leadership from the CEO but Nardelli was not able to respond to the requirements of the changing situation related to the

Concept Essay Example | Topics and Well Written Essays - 750 words

Concept - Essay Example Reference will be taken from various books that speak of Stoic ethical principles, while also exploring the modern application of such teachings. Unbridled and uncontrollable emotions, especially negative ones, left unchecked are never a good and pleasant thing to deal with. However, that seems to be how many people are these days; and one can see, hear and even experience it in many ways. A person would listen to an unfortunate girl’s story on how her boyfriend tempestuously broke-up their relationship just because she would not accept his advances for sex, or how a man beats up his kids for getting low grades, and sometimes for no apparent reason. It sounds close enough to be said as dystopian, but the world we live in is not even close to utopian either. This is a world where people have a stronger tendency to commit actions based on what they feel, being driven emotionally. When passion races uncontrollably, it can bring both the best in people, and also the worst. The tendency though is that there is nothing consistent, and that the negative results of taking things too emotionally or passionately leave a more las ting effect. In the view of Stoic ethics, it is an unwise tragedy to live according to one’s passions, while making life decisions that are purely based on feelings. Stoicism warns us about the dangers and consequences of living a life without the virtues of self-control or restraint. For Stoicism, getting easily upset and distressed would do no good to one’s life. It is a waste of time and energy to sulk or fume over the predicaments or setbacks in life. It would be better, according to Stoic philosophy, that we face problems with a dignified and calm acceptance. Stumpf (1999) posited that â€Å"moral philosophy in Stoic thought rested upon a simple insight, wherein each person was viewed as an actor in a drama† (p.109). It is the director of the drama who selects people to play various roles. In the drama of the world, it is

Journal Writing and Adult Learning Essay -- Teaching Writers Authors E

Journal Writing and Adult Learning The value of journal writing to a course with adult students cannot be overemphasized. (Sommer 1989, p. 115) Journals and diaries have a long history as a means of self-expression. Several themes prevalent in adult learning--coming to voice, developing the capacity for critical reflection, and making meaning--are reflected in the way journals can be used in adult education. Journals are useful learning tools in a variety of adult education settings. Dialog journals, for example, have become popular in adult literacy and English as a second language classrooms. This digest focuses on several types of journals, exploring their value in assisting adults through their learning journey and summarizing advice from the literature on effective ways to use journals. Types of Journals One type is the reader response journal or literature log, in which learners record their responses to readings. Used on all levels from adult basic education through graduate study, such logs enable readers to enter the literature in their own voice (Perham 1992), placing themselves in relation to the text and discovering what they think about it. Over time, the log itself becomes another primary text to which they can respond (Perl 1994). Usually, entries are shared with the class, stimulating discussion. In one variation described by Perham, a looseleaf notebook accessible to the whole class becomes a collaborative journal in which learners and teacher make ongoing comments. Both Perham and Perl feel that these response journals have the power to build a community of learners though the process of critical co-reading and co-writing. The learning journal is a systematic way of documenting learning and col... ...462) Roe, M. F., and Stallman, A. C. "A Comparative Study of Dialogue and Response Journals." Presented at the American Educational Research Association conference, 1993. (ED 359 242) Schatzberg-Smith, K. "Dialogue Journal Writing and the Initial College Experience of Academically Underprepared Students." Presented at the American Educational Research Association conference, 1989. (ED 308 737) Schneider, P. The Writer as an Artist. Los Angeles: Lowell House, 1994. Sommer, R. F. Teaching Writing to Adults. San Francisco: Jossey-Bass, 1989. Surbeck, E.; Han, E. P.; and Moyer, J. "Assessing Reflective Responses in Journals." Educational Leadership 48 (March 1991): 25-27. (EJ 422 850) \ Walden, P. "Journal Writing: A Tool for Women Developing as Knowers." New Directions for Adult and Continuing Education no. 65 (Spring 1995): 13-20. (EJ 502 496)