Caring for patients with PEG feeding

Caring for patients with PEG feeding According to Boud et al. (1985),Reflection is a form of response of the learner to experience. Reflection helps to recall about an experience, makes us think about it and finally helps us to evaluate it. I feel reflecting back on our experience can broaden our knowledge and skills by making us conscious of our strengths and shortcomings and thus in the long run help us to excel in that particular task. Since nursing concepts and practices are changing day by day, reflection is of much importance to provide effective and competent care in nursing. Among the various models of reflection I have chosen Gibbs model of reflection (1988) to reflect my experience in achieving the learning outcome, care of patients with PEG feeding. This model of reflection consists of six stages as seen in diagram. http://www.qmu.ac.uk/futurefocus/images/writing_clip.gif PEG feeding is the most common form of enteral feeding in people requiring artificial nutritional support for longer than 4-6 weeks. According to a study among stroke patients conducted by Cummins C, Marshall T, Burls A (2002) to ascertain whether endoscopic feeding is more effective than nasogastric tube feeding (NGT), concluded that PEG feeding was more efficient than NGT feeding, and also when compared with NGT feeding, PEG feeding of dysphagic stroke patients was associated with small increases in patient well-being. Since I am working in an acute stroke ward, we get many clients with enteral feeding. Dysphagia secondary to acute stroke is an appropriate referral for PEG-feeding rather than nasogastric feeding (Norton et al, 1996 as cited by Chapman, W. and Ditchburn, L., 2005). Even though I have cared for patients with nasogastric tube during my previous working experiences, I have never got a chance to care for a patient with PEG feeding. So I selected this learning objective to get acquainted with it to provide effective care for those clients. I read books and journals to acquire knowledge and also browsed the internet to gather related information. I also observed meticulously senior colleagues caring for patients with PEG feeding and administering the feed. I also read the active hospital policy to comply with it. Then, I undertook care of patients under supervision, my mentor and other colleagues gave me feedback on my performance and I was able to make corrections based on it. Initially I was anxious and tense in undertaking care of a client with PEG feeding. Undertaking care under supervision helped me to clarify doubts regarding the procedure and build my confidence. As the patients are nil by mouth, oral care was provided which is an inevitable component while caring for a client with PEG as well as cleaning the site of tube insertion after healing with mild soap and water daily and drying thoroughly (Arrowsmith, 1996 as cited by Chapman, W. and Ditchburn, L., 2005). Also, I made a point to flush the tube with sterile water before and after feeds or administering medications (NICE, 2003) and to rotate gastrostomy tube to prevent blockage (Stroud, H., Duncan, H., and Nightingale, J., 2003) Refreshing my knowledge and working under supervision enabled me to build my confidence. Guidance and feedback given to me by my mentor and colleagues helped me to perform better each time. My mentor has assessed me competent in caring for a client with PEG. I feel by selecting this learning outcome I was able to achieve an important skill essential for my placement area. By reading journals and active hospital policy I was able to understand the rationale behind each of my action. This has helped me build my confidence immensely as well as to expand my knowledge on the same. I also ensured documentation in enteral checklist was completed regarding the time the feed started, volume, rate per hour recorded in a consistent, concise manner, which fulfils the principles of record-keeping as laid down by the NMC, 2008. I believe that by taking this learning objective I was able to gain knowledge and skills for safe and effective practice when working without direct supervision (NMC, 2008). Working along with my mentor and colleagues gave me opportunity to clarify doubts and achieve this skill which expanded my skills and knowledge and made me familiar with another method of maintaining nutritional status. Learning new skills and keeping knowledge up to date helps one to develop professionally. By accomplishing the learning objective I am able to care for patients with PEG feeding and this will benefit me to provide efficient care. In order to provide proficient care in forthcoming days, I should keep myself aware of the policies and procedures followed in the trust and must keep my knowledge and skills up to date (NMC, 2008) to function better. Also, I must consult and take advice from colleagues when appropriate (NMC, 2008).

Marketing Image Culture :: Alan Liu Media Entertainment Essays

Marketing Image Culture As Alan Liu defines "cool", it is a non-political protest in society, "a gesture of ambivalent oppositionality." In Liu's terms, "cool" is a cultural component of the information age, and can only exist and have meaning within the environment it protests. This essay seeks to explore the relationship image culture, marketing, and Alan Liu's concept of "cool." In a recent presentation he gave at New York University, Liu previewed his forthcoming book The Laws of Cool : The Cultural Life of Information, which describes the importance of "cool" in the information age. To assist his explanation, he compares corporate culture to the Guayaki tribe of South America. Liu says that in both cultures there is a central problem, an unreasonable demand placed on some people that must be dealt with. As he opens his presentation, Liu makes an important point: being a part of a community is both empowering and stifling. The demand placed upon the information age worker is to retain productivity and remain valuable in the traditional sense, while in the postmodern sense being flexible and decentralized. Workers must keep order in their jobs to be productive, but also be able to excel at a wide variety of tasks that often require a breakdown and restructuring of corporate structures, departments, teams, and tasks. For the Guayaki, the job of hunting parallels the demand of flexibility required of Liu's information worker. Hunters are charged with the task of feeding their tribe, and sharing their wives, since Guayaki men outnumber women two to one. (I mention the latter condition because Liu made a point of it; whether or not this aspect of Guayaki life represents normality or hardship was not addressed in Liu's presentation.) Hunting in the forest with a bow and arrow requires a huge amount of skill, with dire consequences if unsuccessful, for the tribe will then not eat. In both "primitive" and technologically advanced cultures, there exists what Liu terms mandatory and individual disempowerment. Both hunters and information workers must defer to the will of their tribe. In response to stifling, both the tribesman and the information worker develop "cool." "The desire for flexibility and decentralization opens the gap between a culture and its people," says Liu. "Cool" is a technique for expressing that gap between a society and it's people. In the case of the Guayaki, this technique involves singing a highly personalized warrior song at nightfall, which essentially serves to fuel ego and one's sense of individuality. Marketing Image Culture :: Alan Liu Media Entertainment Essays Marketing Image Culture As Alan Liu defines "cool", it is a non-political protest in society, "a gesture of ambivalent oppositionality." In Liu's terms, "cool" is a cultural component of the information age, and can only exist and have meaning within the environment it protests. This essay seeks to explore the relationship image culture, marketing, and Alan Liu's concept of "cool." In a recent presentation he gave at New York University, Liu previewed his forthcoming book The Laws of Cool : The Cultural Life of Information, which describes the importance of "cool" in the information age. To assist his explanation, he compares corporate culture to the Guayaki tribe of South America. Liu says that in both cultures there is a central problem, an unreasonable demand placed on some people that must be dealt with. As he opens his presentation, Liu makes an important point: being a part of a community is both empowering and stifling. The demand placed upon the information age worker is to retain productivity and remain valuable in the traditional sense, while in the postmodern sense being flexible and decentralized. Workers must keep order in their jobs to be productive, but also be able to excel at a wide variety of tasks that often require a breakdown and restructuring of corporate structures, departments, teams, and tasks. For the Guayaki, the job of hunting parallels the demand of flexibility required of Liu's information worker. Hunters are charged with the task of feeding their tribe, and sharing their wives, since Guayaki men outnumber women two to one. (I mention the latter condition because Liu made a point of it; whether or not this aspect of Guayaki life represents normality or hardship was not addressed in Liu's presentation.) Hunting in the forest with a bow and arrow requires a huge amount of skill, with dire consequences if unsuccessful, for the tribe will then not eat. In both "primitive" and technologically advanced cultures, there exists what Liu terms mandatory and individual disempowerment. Both hunters and information workers must defer to the will of their tribe. In response to stifling, both the tribesman and the information worker develop "cool." "The desire for flexibility and decentralization opens the gap between a culture and its people," says Liu. "Cool" is a technique for expressing that gap between a society and it's people. In the case of the Guayaki, this technique involves singing a highly personalized warrior song at nightfall, which essentially serves to fuel ego and one's sense of individuality.

Chilean Mine Collasps

Chilean Mine Collapse BCOM/275 Chilean Mine Collapse In Chile, on August 5, 2010, a collapse inside a main access tunnel of a mine trapped 33 miners inside (Parry & Retther, 2010). The miners were trapped at a depth of at least 700 meters (Weik, 2010). There were 32 Chileans men and one Bolivian man trapped in the old gold and coppers mine (Parry & Retther, 2010). The miners estimated that they would not be rescued for four months. The miners had to receive emergency food and supplies through a bore hole. Around 2 p. m. , Raul Villegas had just finished filling the truck with rocks when he heard a loud crack (Yang 2013).Being at least 700 meters below the surface with dust filling the cavern did not affect Villegas because the sounds of collapsing rocks and the dissatisfaction of the earth was something that Villegas was used to hearing. Villegas proceeded to do his job as he passed a fellow miner Frank Lobos, in which he was walking down the mine to get some men for lunch (Yang, 201 3). As Villegas proceeded closer to the surface, cloudy grime overtook the truck enclosing him in dirt and gloom. As he began to see the surface there was a massive collapse (Yang, 2013). After the collapse, Villegas rushed from the mine onto the surface.After this incident occurred Villegas reported it to the supervisor, but it took hours later before he would notify authorities (Yang, 2013). Upon being trapped in a mine the 33 workers were anonymous because there were a bunch of the miners trying to make a living shaving away at the rocks. A century ago miners that were trapped were considered a lost cause. If the mine was caved in then the miners would hammer crosses into the ground. Because of this theory miners in the area started placing wooden crosses outside the entrance. For the saving team, leaving the 33 miners to decease in that pit-hole was not a possibility (Yang, 2013).Villegas and other miner workers was sent down the mine but after getting 400 meters, they realized that the ramp that was once there is now gone. Around 700,000 tons of rocks and more than six times that bulk of the solid concrete that distorted in the mine, which cut off slopes and destroyed the mines air circulation shaft. They later discovered that a stepladder was lost from that ventilation shaft that could have permitted the miners to freedom. Several hours after the collapse The Atacama region’s six-person special tasks crisis force was called to the mine which they entered around 9 p. . (Yang, 2013). On a Saturday, two months after a rock collapsed and sealed the Mina San Jose, a rescue hole was competed for the miners. Almost once every half hour, a man climbed into a cage nearly a half-mile underground and made a trip upward. They monitored the miners on video for any sign of panic and they were aided by oxygen masks, glasses to protect their eyes from light and sweaters for the climate from heat to chill air (Yang, 2013). Considerations to remember given the diff erent roles and people are very important, considering the people that were affected by this incident.Both the business and the family were affected by this accident because the company already established a bad reputation from the recent deaths that occurred. The family members were affected because they did not know if there love ones would make it out alive or not. In order for the company to stay in business there role was to recuse these men as quickly as possible, whereas the family role was to keep faith (Yang, 2013). The potential needs of the family member would consist of sympathy and assurance.When the family receives the message that their love ones are trapped in a mine they need assurance that they will do everything in their power to save them. The potential needs of the company’s employees when receiving the message is the assurance that there would be another job for them to support their families, also the assurance that they will save their fellow miners (Y ang, 2013). In conclusion, the action that the writer would take before and after the message is delivered is to intake the situation so there would be no surprises. The writer would also hope for the best and let the information soak in before reacting.The Chilean Miners are very strong men and they never lost their faith. They had to eat less, drink less and stress less in order to survive. Now these men has celebrated birthdays and enjoyed their life without looking back. References Parry, W. , & Retther, R. (2010, August). Facts about the Amazing Survival Story. Retrieved from http://www. livescience. com Weik, J. (2010, August 6). Over 30 workers trapped after Chilean copper mine collapse. Over 30 workers trapped after Chilean copper mine collapse, 4(224), 1-2. Yang, J. (2013, March). From collapse to rescue: Inside the Chile Mine disaster. Retrieved from http://www. thestrar. com

Eth 316 Individual Assignment Week 1 Essay

Utilitarianism is a theory that suggests that an action is morally right when that action produces more total utility for the group than any other alternative.aka The greatest good for the greatest number pg 153 Deontology is a moral theory that emphasizes one’s duty to do a particular action just because the action, itself, is inherently right and not through any other sorts of calculations—such as the consequences of the action. Because of this nonconsequentialist bent, deontology is often contrasted with utilitarianism that defines the right action in term of its ability to bring about the greatest aggregate utility. In contradistinction to utilitarianism, deontology will recommend an action based upon principle.â€Å"Principle† is justified through an understanding of the structure of action, the nature of reason, and the operation of the will.The result is a moral command to act that does not justify itself by calculating consequences. Virtue ethics is also sometimes called agent-based or character ethics. It takes the viewpoint that in living your life you should try to cultivate excellence in all that you do and all that others do.These excellences or virtues are both moral and nonmoral. Through conscious training, for example, an athlete can achieve excellence in a sport (nonmoral example). In the same way a person can achieve moral excellence, as well. The way these habits are developed and the sort of community that nurtures them are all under the umbrella of virtue ethics.