Reflect on the physical and social factors of vulnerability

Reflect on the physical and social factors of vulnerability I have recently undertaken a student nurse placement in a community hospital in North Wales. I was mainly employed on the care of the older person ward. This ward dealt with older people awaiting or recovering from surgery or awaiting re-housing into care facilities or their own modified house. Many of the patients could be considered vulnerable. Normal aging, illness and life experiences had increased the vulnerability of many of the patients and the coping skills of many had been severely diminished. In this essay, I will examine one of the patients I came into contact with regularly. In accordance with the Nursing and Midwifery Code of Conduct (NMC 2008) all names and placement details will be concealed, and I will refer to the patient as Mr. A at all times. I will discuss Mr. As medical conditions and how and why these medical conditions have led Mr. A to be regarded as vulnerable, covering physical, social, psychological and environmental factors. Mr. A was a 67 year old gentleman who was morbidly obese. He had a BMI of over 40  kg/m2 and was bed bound. He also suffered with Aspergers Syndrome which is a type of autism mainly affecting social and communication skills. Both of these in addition with being an older person would have led to him to be vulnerable in various aspects. Vulnerability  is the susceptibility to physical or emotional injury or attack. Vulnerability refers to a persons state of being liable to succumb to  manipulation,  persuasion  or  temptation. (Bankoff, et al. 2004). A vulnerable adult is one who due to Age, Physical injury, Disability, Disease or Emotional or Developmental disorders is unlikely to be able to provide for their own basic necessities of life; they may also have an increased risk of harm or injury. This would include, but is not necessarily limited to adults who reside in long-term care facilities such as nursing homes, adult family homes, boarding homes, assisted living facilities or those who receive health care or other assistance in providing for the basic necessities of life while residing in their own home. Roper, Logan and Tierney(1980) published a nursing model outlining 12 activities of daily living that are crucial to a person basic needs, some of which are essential such as breathing, eating and drinking and others which enhance the quality of life such as work and play and expressing sexuality. When an individual becomes old, frail, ill and immobile they may be dependent on others to help them with the 12 ADLs. This can result in people feeling vulnerable. Fernandez LS et al (2002) states that impaired physical mobility, diminished sensory awareness, chronic health conditions, and social and economic limitations can result in vulnerability of the elderly to disasters such as falls or accidents. Frail elderly with serious physical, cognitive, economic, and psycho-social problems are at especially high risk. Mr. A was 67 and according to the Geriatric Pharmacology Research Group in Newcastle upon Tyne, The frail elderly are individuals, over 65 years of age, dependent on others for activities of daily living, and often in institutional care. As with Mr. A, he was 67 years old and was reliant on carers for many if not all of the Activities of Daily Living. He was also in institutional care for pressure sores. Due to all of these points Mr. A would be classed as frail elderly. Mr As problem with weight was the main cause of his hospitalisation, he stated he had weight consistently put on more and more weight over the years. He felt very responsible for his weight gain but was reluctant to do anything about it even though he was classed as morbidly obese. Obesity  is a  medical condition  in which excess  body fat  has accumulated to the extent that it may have an adverse effect on health, leading to reduced  life expectancy  and/or increased health problems.  Body mass index  (BMI), a measurement which compares  weight  and height, defines people as  overweight  when their BMI is between 25  kg/m2  and 30  kg/m2, and obese when it is greater than 30  kg/m2. Mr. As obesity led him to be largely bedbound and incapable of maintaining his health, his home or personal hygiene. When Mr A was living in his own home district nurses would regularly come in to tend to his pressure sores. Pressure sores are  lesions  to the skin caused by many factors such as unrelieved  pressure and friction. These pressure sores were the result of Mr A being unable to move so constantly having to stay in the same position and thus having unrelieved pressure on different parts of his body. As Mr. A was bedbound he could not tend to his own housekeeping and his house became so untidy the district nurses found it too hard care for him in the chaotic surroundings so referred him to a community hospital. While he was in a community hospital a council funded cleaning team organized his house in order for him to be discharged back to a manageable house. Another reason that district nurses were finding Mr. A hard to manage was that he suffered from Aspergers Syndrome and would often be aggressive with the district nurses. Aspergers syndrome  is a type of autism that is characterized by difficulties in social interaction, along with restricted and repetitive patterns of behaviour and interests. It differs from other autisms as sufferers linguistic  and  cognitive development are often fine and develop well. The exact  cause of Aspergers  is unknown.  There is no single treatment but interventions are used to improve sufferers symptoms and functions. The main treatment used is  behavioural therapy, focusing on the specific insufficiency of the patient. These tend to consist of poor communication skills, obsessive or repetitive routines, and physical clumsiness.  Most individuals improve over time, but difficulties with communication, social adjustment and  independent living  can exist and continue into adulthood.  Some people with Aspergers syndrome may become angry and aggressive, either to themselves or to other people. Sometimes when a person with Aspergers feels angry, they cannot easily pause and think of alternative strategies to resolve the situation. The rapidity and intensity of anger, often in response to a relatively trivial event, can be extreme and can get so intense, they may go into a blind rage and unable to see the signals indicating that it would be appropriate to stop. (Attwood, 2006). At the community hospital Mr. A would often get aggressive or rude when more than one nurse would be in the room. If he felt he wasnt being listened to not being involved enough he would become very agitated and start shouting. The nurses took this into account and made sure Mr. A was involved at all times with anything going on in his room. I feel this condition may have led Mr. A to inadvertently isolate himself from people and people to him. When people do not understand something they can take a negative approach to it. Mr. As outbursts would have offended some people and cause them to detach themselves. This would quite possibly be due to the fact they did not understand or know about the condition and fear of the unknown leads to negativity in some cases. (Campbell, 2006) A person who is vulnerable to isolation or social pressure may be considered as suffering from social vulnerability. When people become isolated due to illness or reduced mobility they may find it difficult to access essential services. Mr. A had a job translating books from various foreign languages into English. He did this from his laptop every day and when he was transferred to hospital he left his laptop at home. This made his feel low all the time as he said he had no purpose to his day. The nursing staff through Multi Disciplinary Team meetings reviewed his situation and decided to let him have his laptop delivered to the hospital along with internet connection and had his mail transferred, this all to allow him to continue to work which elevated his mood greatly for the remainder of his stay. He reported he was much happier at the community hospital now that he could continue with his day to day life. Mr. A also said he felt isolated due to his obesity. As people age, they often become more vulnerable, their social circumstances particularly impact their health. As with Mr A, due to his obesity he was confined to his bed and this impacted on his social circumstances. It limited anything he wanted to do socially, for example, he could not venture out of the house, and could only find small ways of interacting with society. One of these ways was through his online job; this allowed him to interact through the internet without having to leave his bed. This had both a positive and negative side. Although it allowed Mr. A to interact with people, all be it virtually, which was important in developing his social skills it did however mean he did not have to move and so made little effort in changing his lifestyle. Mr. As lifestyle choices were undoubtedly the main cause of his hospitalization. He refused to try to diet at the hospital and stated he had always been this way, never wanting to diet. Family members would bring in unhealthy food for him; they were advised against doing this but made no attempt to stop. A dietician came to evaluate Mr. A and a plan was made but not stuck to by Mr. A. He was also offered physiotherapy in the form of help to start doing small movements with his arms and legs daily but he declined. This weight problem made him vulnerable to all sorts of illnesses; one in particular that was being managed at the hospital was his pressure sores. In hospital a special bed was required to accommodate his weight and relieve his pressure sores, along with bariatric chairs, wheelchairs and hoists. Mr. As weight and inability to move made him physically vulnerable. Many of the elderly are admitted to hospital due to something caused by a physical vulnerability. A physical vulnerability is when a person has an increased risk of injury. E.g. easily brakes bones, has reduced strength, reduced movement or dexterity. Many of the patients in the community hospital were there as a result of such vulnerability and had suffered injuries resulting from falls. Some had reduced mobility which meant they needed assistance in performing one or more daily tasks such as getting in and out of bed, preparing meals and eating them, doing housework, dressing, and performing personal hygiene. According to Holden and Smeeding sixteen percent of the elderly need help with at least one of these conditions. Elderly persons subject to two or more of the five they deemed insecure; those facing three or more were considered extremely insecure. Those people who are totally dependent on social services for survival are already economically and socially marginalized and require additional support at all times. Mr. A needed help with all physical activities, he was washed, dressed, fed, and cared for all by nurses and carers. He stated that because he could not do anything for himself he had no quality of life in the community hospital and although he was bedbound at home as well, he did have home comforts and had developed methods of reaching things he needed and wanted, such as a pik-stick. These new surroundings may have made Mr. A feel environmentally Vulnerable. Environmental vulnerability is when a person suffers reduced quality of life caused by external conditions and surroundings. The transfer to the community hospital was a major change of environment for Mr. A as he had to get used to new surroundings, new methods, and new people and as he has limited movement he stated he all the new goings on made him feel rather helpless as all he could do was press the bell and wait if he needed something. This was understandable and it was explained to Mr A in great detail the goings on, routines and layout of the hospital to try and overcome his worries. Brubaker (1987) tells of how having a major lifestyle change such as having to come to hospital for a long period of time can make the patient feel as though there dignity is being taken away from them. This was noticeable with Mr. A. When he was first admitted to hospital, he resisted being washed on many occasion. This may have been due to there being many new nurses and carers that he was not used to. He may have felt shy and undignified having to be washed in his hospital bed my many different workers. This was overcome by making sure his door was always closed, windows and curtains shut, nurses and carers would also introduce themselves, ask for consent and talk Mr. A through the procedure, all in order to make him feel more comfortable. This seemed to cease his worries and he started to allow the staff to wash him on a daily basis. One major concern of Mr. As was the time it took from when he pressed the bell in the hospital or the emergency bell in his house to the time a nurse or carer got to him. He would panic during this period and this impacted greatly on his psychological well being leaving him psychologically vulnerable. Psychological Vulnerability is when someone is vulnerable to emotional or behavioural harm. While Mr. A was in the community hospital calming and relaxation techniques were taught to him to try and overcome his anxiety. He was taught deep breathing techniques and stated he found this particularly beneficial. Every time he started to feel anxious and worried he could now use these new techniques which take his mind of the worry and keep him calm. While I was working at the hospital I saw a huge change in Mr. As behaviour in terms of anxiety. He became much less aggressive when having to wait for a nurse.   There were many elderly residents at the community hospital that suffered many different types of psychological vulnerability. Many of the frail elderly who had suffered falls lost their confidence completely. One female patient told me that she did not want to go home as she did not feel she could cope. She did not feel safe in her home but would not want to move to a residential home. This must be a very distressing time and it is hard to reassure patients in this mind set. Through the MDT meetings it was decided that Mr. A would have to go to a residential home as it would not be safe for him to go home. Mr. A felt he would not enjoy being in residential and was completely opposed to the idea. However, three workers from the residential home came to speak to Mr. A, he was taken to view the residential home and his room, the Doctors and Nurses at the community hospital spoke to Mr. A at length and gave him time to voice his questions and concerns. With time Mr. A seemed to come around to the idea and realise it was the best option for him and by the end of my student placement Mr. A told me he was looking forward to moving out of the community hospital and into the residential home. I have outlined Mr. As conditions and how he was affected by physical, psychological, sociological and environmental vulnerability. Over the seven weeks I was in the community hospital alot was done to conquer Mr As vulnerability and re-merge him into society. Community hospitals are designed to reduce the risks to people who are vulnerable to social, physical, environmental and psychological injury. Hospitals have special floors, showers, seats and beds. They have controlled heating, lighting, diets, they encourage interaction between patients and with visitors (at certain times during the day) thus reducing social isolation. Highly trained staff monitor and review patients regularly to ensure they are receiving the best care and the support needed to leave hospital and to prevent their return. This all minimises the risk of patients feeling vulnerable and helps them to have a fast recovery and rehabilitation.

The Evolution of Lilith :: Lilith Essays

The Evolution of Lilith The first appearance of Lilith came in the form of a cameo in a story called the "Prologue of Gilgamesh". In it, a great tree is described, obviously the tree of life. On the top of a tree rests a bird, possibly an eagle, and in the center lives a "dragon[who] had build it's nest there...the demon Lilith..." This can be equated with the Midguard Serpent of Norse mythology and various other chaos creatures who lived and gnawed on the Tree of Life. The purpose these entities served was one of balancing the Yang with the Yin, tempering the force of Creation with the force of Destruction, order with chaos, as one cannot exist without the other. Thus Lilith, and other so-called "serpents" served an important purpose, that of keeping the Yang under control, and thus also serving a psychological purpose. When one rests too much in the light, one can develop a self-righteous attitude, and starts to think that they know everything. This was the true nature of the state Adam and Eve were in before the serpent in the garden, who was Lilith as we shall later see, were in....Adam and Eve had the false sense of security that they knew everything there was to know and carried within them the forces of creation (Yang). Lilith, on the other hand, who was the personification of Yin brought them down to earth when she got Eve to eat from the tree. Where Yang says "I know the right way, I know everything", Yin says "You don't know everything, you never will know everything, and there is no right way." Thus, Adam and Eve were brought down to earth, so to speak, when they partook of the fruit. The expulsion from paradise symbolized their acc eptance of reality, and Yahweh's displeasure symbolized humankind's need to control and escape reality. As one can see, each character in the story of the fall are archtypical symbols for forces within the human psyche... Going back to Lilith, after her appearence in the Prologue, she became described on tablets found in ancient Sumeria as "the hand of Inanna" who swept men into her temples for sacred sexual rights. Lilith became the symbolism of feminine allure, the dangerous seductive qualities of the dark moon.  Ã‚   Though she was never a Goddess in Sumerian lore, Lilith was nonetheless an important enough figure for later cultures to take note of her.

Trap Ease Answer

Q1: They face once in a lifetime opportunity means that they are talking about the potential for profit and growth required following Information to Evaluate the Opportunity:-Determine the product selling point that will put it as a competitive advantage over other products. -make a survey about customers if they are willing to pay a higher price for the innovative product offered by the company.– make Competitive Frame of Reference (customer awareness-product quality-product availability-technical assistance-selling staff) -Identify the market segments (com/mkt3013-practice-2/">market segmentation), and select the target segment (market targeting). – Advantages of using the Ease-Trap over other competitors product (User Friendly-Child Friendly-Pet Friendly-No Poison-reuse-no clean up)I think the group is going to write the following â€Å"mission statement†: We produce a trap that you could use safer and easier than the traditional one, with no risk of catching your fingers while loading itI suggest writing the following â€Å"mission statement†: â€Å"we are making innovative mousetrap that traps mice easily, friend of the environment, and good value of money with no danger for your child†.Q2/ She identified the best target market (women) because they don’t like the mess or the risks created by traditional mouse traps. This is a good marketing segment to begin with They could try to focus on– Environmentalists as trap-ease is reusable so creates less of a strain on the environment which would make it a very attractive thing for them, -Animal lovers would love the Trap-Ease mouse trap because it doesn’t require poison or pose the risk of snapping closed on a paw or tongue of a pet. -Corporate Businesses as Food Company would probably like the Trap-Ease mouse trap because of its high quality more futuristic image and the fact that it would create as much of a mess, -families which have a kids as trap-ease with no danger for kids -hospitals-people who live in new cities as mice were spreadQ3/ They had positioned the product by mentioning that it is safer and easier to use than the competitors' products (Traps Mice Easily), and that there is no risk of catching one's finger while loading it.I think they can position the trap-ease as no dangerous for small children at home, Never seeing or touching a dead mouse again, fewer waists because it is re-useable, by having an incredibly good customer service team that could deliver services to their customers that were having problems using the productQ4/ The marketing mix of a company consist of the four P’s: Product: trap-ease.Price: about five times more expensive than standard trap.Place: trap-ease distributed directly through national grocery, hardware and drug chains (retailers) such as Safeway, sellers, Canadian tire, and shoppers drug mart avoiding any wholesaler or other intermediaries. Promotion: Trap-Ease had an promotion bud get about $60.000 They are spent $10,000 on advertising, the other $50.000 are spent on travel costs to visit trade shows and to make sales calls on retailersProblems:– Price is very high; she could offer a wider range of prices on the different models of their trap in order to offer more variety – Place: she was trying to distribute their product through large stores. They can use internet shop (E-shop) as People on the internet are often caring with quality, ease of use, and innovativeness and don’t mind spending a little more money to get what they want.It is also a high profit market because it reduces transportation costs and there are no middle man costs – promotion: she concentrated whole marketing budget on visiting trade shows and advertising on chatelaine and other home magazines ,she should promote over the internet for certain on sites and also think about putting out ads on TV. Q5/ Trap-Ease America’s competitor is any company that cre ates mouse traps competitors include Victor, JT Eaton, Riddex and D-CON who offers both baits and traps.They actually also offer a version of a no touch mouse trap in which you don’t have to touch the mouse after you have trapped it. They are selling this for $4.29 which is higher than the suggested retail price for the Trap-Ease mouse trap which is $2.99, which will give trap-ease a pricing advantage. Havahart offer traps which humanely catch everything from mice to voles and shrews and are competition for the humane factors of the Trap-Ease. There are also in direct competitor as poisons that are sold which are a danger to pets and animals as well as the mice they are supposed to kill.Q6/ Swot analysisInternal Strengths Weakness 1/very innovative product and engneered well 2/long life product as it is re-useable 3/with low risk specially for kids 4/highly environmemntal 1/high price 2/low promotion 3/do not detemine good target of market segmentation 4/product oriented stra tegyExternal Opportunities Threats 1/unique product,so it is a high potential market 2/less competitors 1/traditional marketers 2/chemicals and pesticidesNew marketing strategy:- 1/targeting:The targeting should have been done within a broader demographic area. Slums, warehouses, go downs, docks, kirana shops, retail stores, restaurant, canteens and cold storages must be targeted for potential customers. The segmenting must avail wholesalers and the intermediaries too apart from the retailers. Marketing channels like Toll-free numbers, newspapers, television, radio and mobile marketing must be used effectively to target MEN. Pest control companies must be primarily targeted and a joint venture can be planned if necessary. We should target to environmentalists, animal lovers and corporate business. 2/ PromotionsWhen two traps are sold in a single package it might not be appealing to the customers who are ready to experiment. So it should be one at a time. The cost must be cut down as low as possible at least for initial days because the customers are driven to products that are freely available for fewer prices. Here the packaging plays a prominent role. Free samples to the agencies must be initially given so that they get the customers acquainted to the product in order to gain a good name in the market. There should be mass distribution of the product and free demo services must be provided.The marketing network within the organization must be increased, instead of Martha being the single salesperson. There must be door-to-door salesperson to make the sales effective. The administrative costs must be cut down and more money should be spent in promotional activities like advertising in movie theatres. Showing a demo in the retail shops, approaching government to promote in railways and bus-stands as a social cause and environment savior. A brand ambassador must be endorsed to promote the product in order to attract the customers. Money back promise should be m ade to the customers if the products are found defective. This way they will gain the trust of the customers. 3/ Using Customers Value Triad:Though there’s value in terms of quality, satisfaction of the customers from the product is less because of its high price. And proper feedbacks must be taken from the customers as well as the retailers in order to assess the true position of the product. Online booking facilities must be provided so  that more customers can know the details about the product and buy it easily.The cost and communication of the four 4c’s concept must be kept in mind. The safety and re-usability aspects of the product must be communicated well to the customers. Retaining customers is very important and that can be done only through quality service. Customers are gods and promises made to them should be kept. They lost an order because of time the management and Matha doesn’t seem to learn from the mistake. The goodwill of the organization i s necessary for any product to remain for a long time. 4/ Planning:A proper market research is necessary to understand the wants of customers. Timely adjustments must be done based on the marketing environment. There must be a backup plan always when the target sales and profits are not achieved. When the sales have gone down in April, the marketing strategy must be immediately changed.The administrative costs must be cut down heavily. Also the reasons for why the product is not bought the second time must be found out and necessary changes made to the product as per customer benefits. Repeat buying will happen only when the services provided are beneficial to the customers. When the trade shows haven’t bought enough sales, the costs should be cut down there and allocate more money for advertising.Target Group Product Strategy Distribution Strategy Promoting Strategy ControlThe first thing I would do to change Trap-Ease’s marketing strategy would be to increase the amo unt of people in their marketing team. Although Martha was probably trying to keep down costs by not hiring anyone for her marketing team she made one important mistake. One of the most important things when coming out with a new product is the Marketing because until you’ve communicated the benefits of your product to the Consumer there will not be sufficient demand for it. Her entry into the market was too small scale and chances are that with such an innovative

Atticus Finch Is an Exemplary Father - 2244 Words

Atticus Finch, a lawyer and devoted father, is an intelligent man whose wisdom, consistency, and ability to see past the ill in people prove him to be a respectable and exemplary father. He teaches his children and the people of Maycomb how to stand up for one’s belief in the face of prejudice and ignorance even when faced with the possibility of being looked down upon and scorned. His personality and character is retained throughout the entire book, making him an ideal moral guide and voice of conscience. In her novel To Kill A Mockingbird, Harper Lee presents the character of Atticus Finch to convey her feelings and thoughts about race, morals, and society as a mass. In the difficult times of 1930’s Alabama, the county of Maycomb is a†¦show more content†¦One of the ways in which he does this is in the means that he rejects insincerity, but instead practices what he preaches: â€Å"Atticus is the same in his house as he is on the public streets (51). In a t ime period and a town that endorses hypocrisy, Atticus stands for truth, and teaches others by his example that it is possible for them to do the same. With typical Maycomb influences - such as Aunt Alexandra - surrounding Jem and Scout, Atticus’s constant genuineness in public and private presents an essential example if honesty for his children to follow. Once again, Atticus provides an exemplary example of humbleness in the modest manner of which he shot the stray dog. Despite having a commendable shooting talent, Atticus chose to keep this hidden, and was not eager to call attention to it. While Scout does not understand why, Atticus’s line of reasoning is clear to Jem, who now aspires to be a humble and modest â€Å"gentleman† such as his father. Atticus educates his children in standing up for what they believe in, and influences Jem and Scout to mature with a strong sense of justice and equality. 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