Advanced Professional Roles and Values Task 1 (VAP1) (C128)

This post covers Advanced Professional Roles and Values (VAP1) (C128) in as less space as possible to help you through it while saving your time.

First, the task is made quite practicable by the university-provided template that you'd find enclosed to your resources for this paper. You want to closely follow the templates with all of the headings and subheadings provided.

So, my walkthrough is based on the template, and I discuss here pointers as given in the Rubric.

APR&V Task covers advanced concepts broken down into four competencies:

1. 740.2.4: Advanced Professional Accountability
2. 740.2.5: Self Advocacy of the Nurse
3. 740.2.6: The Professional Nurse, and
4. 740.2.9: Healthcare Work Environment 

Probably, you've already gone through the directions file for the task and know that the paper is divided into these four parts. So let's just begin.

The scenario revolves around the case of Mr. Miles, the 70-year-old patient, who is admitted to the hospital for bowl irritation. We don't know how, but Mr. Miles goes septic, and it causes renal failure putting his life at a risk. Since he wished to live an adventurous life, he refuses to choose dialysis as an option, and probably insists on choosing a DNR. The complication is that prior to signing the DNR document, Mr. Miles goes into coma.

So, in this paper, our job is to handle the complexities in Mr. Miles' case. From here we follow the Rubric to address the points.

A. Evidence-Based Practice

This section requires you to justify the use or non-use of the DNR document. It's tricky. Let's solve the puzzle by dissecting every piece from it. First, it's a legal matter. A Google search will return thousands of cases that revolve around the use/misuse of DNR. So, Mr. Miles wished to but couldn't sign the DNR directive.

Second, renal failure has not put his life and functionality to a halt though, yes, it may not be the same. The dilemma we face here (the doctor, the nurse, and the family), thus, is that dialysis is a practicable option that can save Mr. Miles' life, but he wished to use the DNR directive.

To solve the puzzle, review of literature informs us that Mr. Miles' case is that of partial DNR consent: i.e., he wished to opt for it but couldn't sign it. Let me remind you that we're only concerned here with your role, that of the nurse as a patient advocate, and we're aware that it's the nurse's professional responsibility to respect and follow his/her patient's wish.

But the dilemma does not leave us. It's still complicated. What if the family wants to save his life, and I think it's pretty logical for them to do so. Note the point here that we need to discuss the legal framework about the authority a family member has in giving his/her consent in such a scenario. The hierarchy has the spouse on top, then the children, and then anyone else (surrogate).

So, because it's complicated, I cannot say what to do. However, I have dissected all the pieces of the puzzle for you to decide whether you'll follow Mr. Miles' last wish for the DNR or the family's directive (if different).

Whichever you choose, remember, you must discuss the significance of discussing the situation at length with relevant stakeholders and witnesses. Here, we have the family, probably the doctor, and you as the witnesses. Make your decision, and this section is complete.

Remember to cite references for these points.

B1. Moral Responsibility

You need to discuss the nurse's moral responsibility in relation to the patient, the nurse (your legal role), the family, and the hospital. So, we must justify these in the light of available legal framework.

First, the patient. Morally, ethically, and per Ethics Code, I think you understand what your moral responsibility is. Since it is an open-ended area, you should decide what you are to the patient (Mr. Miles) in this situation. You have full legal right to advocate for your patient.

Now, the nurse. You must justify your role, responsibility in this scenario. As a nurse, what does the law of your state say about partial DNR? Google it. Consider the principle of patient autonomy. You should also find out your hospital's policy for partial DNR. Nurse Practice Act is equally applicable here.

So, whatever your decision is, whether to let Mr. Miles respectfully pass....or to follow the family and/or the hospital's policy, your role MUST be justified. This is the prime principle of nursing Ethics Code and the law. Justify your decision, and if you undergo a moral dilemma, be open, involve your team, discuss it thoroughly, etc. Your decision must be accountable. So, I think you can decide what to you.

Hint: You'd first look into the hospital's policy, Mr. Miles' wish, your role as an advocate, and discuss the possible decision with relevant people in the management, and take a position.

The family. There are no easy answers in real-life scenarios that match that of Mr. Miles. Say the same thing here. Highly the role of open and transparent communication with the family, and...REMEMBER...emphasize that you as a nurse must insist on documenting a decision whatever it be (recall the accountability principle).

Agency here clearly implies the scope of the nurse's individual action. But, it should be remember that while you want to highlight the individuality of the nurse (yourself), you should link your role to other processes that mediate this agency. You can't take a decision without considering the state law, the NPA, etc. So, agency is to be exercised within the available scope (say the same).

B2. Stakeholder Impact

Patient: So, up to this point, I think it's pretty clear that we're heading toward a big decision, and Mr. Miles as probably the most important stakeholder will be the center that decision. Hospice can be highlighted as a rational route to the decision if you want to go in that direction.

Family: Whatever the final decision is, family is an equally important stakeholder facing the trauma probably of the worst kind. So, here we want to highlight the role of education to the family about the process of the decision (any), and the steps of care planned for Mr. Miles.

C. Discussion of Code of Ethics

Which Provision from the Ethics Code is applicable here? Probably, more than one, but you just want to focus on the most relevant: Provision 2. Quote it with full reference.

Now your analysis of the provision should point to the direction of your primary responsibility as an advocate of your patient, and under this provision, what role you're going to play. Hint: No matter the intensity of the conflict, your job is to advocate for the patient's wish.

C2. Importance of Patient Autonomy

I think this pointer should become self-explanatory to you now. It requires a little expansion. So, with the help of literature highlight what autonomy means for a patient, and as a nurse what your obligation is to this principle. Also, write a few sentences for patient's independence and its relevance to this scenario.

D1. Legal Conflicts

Legal conflict is expected. Here, we need to highlight the principle of patient autonomy, his right to self-determination, and the nurse's professional obligation to stand for her patients. So, she must guard his interest, AND any decision MUST be documented properly through every step. This is the only way to avoid ramifications in the wake of the decision. Certainly, the family is the surrogate, so probably, once they are convinced of the viability of the decision, the spouse or children will sign it.

Family must be taken into full confidence about the patient's wish, possible options, (e.g. CPR), and expectations from the family. This is a mandatory exercise in any situation. After that, whatever decision you choose, legal conflict can be avoided by transparently recording it.

As a nurse your role and obligation must be communicated to every stakeholder out there while the organization's policies and position in such cases must be integrated by consultation with the management.

D2. Legal Implications on Nursing Role

The implications may be serious. Thus, here you have to discuss your obligation to advocate for the patient's rights within the available legal framework (NPA, state, and hospital laws/policies). You action must be justified by these frameworks, and this is the only way for the nurse to avoid legal ramifications.

Potential disciplinary action against a nurse may be relevant to one or more of these areas: negligence, consent, accountability, confidentiality, and advocacy. As far as your course of action is justified, your position is safe.

Potential Litigation is highlighted in two cases in literature: (1) when there is a DNR directive, but CPR is initiated; (2) when there is no DNR directive, but caregivers don’t use the CPR approach. Thus, a clear route to either decision is needed to avoid litigation.

D3. Actions to Prevent Conflicts

Same as above: clear legal understanding, clarity of each stakeholder's role/responsibilities, and transparent consultation while keeping in view relevant legal framework at all the levels of the hierarchy are needed to prevent conflicts. Some detail from above can be represented here to make the case more solid.

That's it. We're done. Keep in mind that each section requires just a few sentences (4-5 maybe). It is this succinct approach that will still lead to a large overall piece.

I'd be happy to have your feedback.

Should you need any further assistance, please do not hesitate to reach me at: /meokhan2/at/gmail/./com. Thanks.

 

Common sexual violence in a culture: Objectification (Nussbaum) and derivation (Ann Parker): Philosophy essay.

Question: We have discussed objectification (Nussbaum) and derivation (Ann parker). can you think of other forms of sexual violence common to our culture that do not fit these two patterns? explain.

Introduction

            In this essay, I am going to critique the two prescribed readings (Nussbaum, 1995; Parker, 2016) briefly to first theorize the arguments made by these two writers about different forms of objectification and derivatization followed by my personal viewpoint regarding these two positions. I will argue that whereas objectification is a very broad and problematic concept, derivatization is also not any less complex. Instead, I am going to present a third view that coalesces these two positions by moderating them and making them less complex: I argue that rather than concerned with feminism, objectification and derivatization are issues that pose a challenge to humanity at large. A sojourn to sexual exploitation of women, men, and people with different identities through objectification or derivatization, is probably, possible when we, as one community, learn to realize that we need to respect differences in life in any way. This is happening through latest models of education. I would conclude the essay by restating the thesis and summarizing my claims.

           Nussbaum (1995) critiques the notion of objectification of women, central to feminist argument, in a more complex way by focusing on not just objectification of women in any way but sexually. She expands the view and identifies seven different features of sexual objectification of a woman in a man-dominated society: (1) Instrumentality – treating a person as a tool; (2) denial of autonomy – denying a person in a way that implies that the person lack self-determination and autonomy; (3) inertness – treating someone without acknowledging or admitting that they, as a human, have agency; (4) fungibility – making a person interchangeable with other things; (5) violability – denying someone the integrity of personal boundary and limit; (6) ownership – treating an individual as if she is owned by someone who can probably sell her or buy another; (7) denial of subjectivity – neglecting altogether a person’s feelings and experiences. She thus expands on then prevailing concept of instrumentality giving us a much broader view of objectification. However, Nussbaum adds another layer to her primary premise, the importance and role played by the context and postulates that it is context that needs to be taken into account to decide whether a personal sexual objectification has really occurred or not. If the context is such where two lovers, while keeping the profound sense of each other’s autonomy and self-determination, indulge in the benign objectification, then it is positive and wonderful as it kindles their intimate lives.

            I personally find this view quite enlightening yet very complex to apply to real life context. For instance, it is difficult for me to understand that, besides just women portrayed in media in certain ways, probably these seven forms of objectification take place on a regular basis while we interact with others in daily life. For example, a teacher may deny autonomy/self-determination to her students (does not let them go out the class) when an important test/lesson is going on. My employer, as per common employment norms, wants me to stay at work during the office hours and to do the jobs assigned to me (instrumentality?). Therefore, I think the concept raises as many problems as it solves. Probably, the right approach, here, to develop the idea of objectification, would be to just include its negative examples and try to create awareness among people not to a part of it. Similarly, I find such objectification (or rather exploitation) happening other than sexual exploitation of women.

            Parker’s (2016) critique of Nussbaum’s notion of objectification takes a refreshingly different direction. While she gives Nussbaum some credit for expanding on the idea of instrumentality, she adds a completely different layer to sexual exploitation of individuals (not just women) by introducing derivatization and genitalization. By sharing the sad episode of the murder of Gwen by Michael and Jose, because Gwen did not fit into their worldview of what a woman should be like: Michael and Jose ‘derivatized’ Gwen: “To derivatize is to treat someone as a someone whose life, whose body, reflects and reinforces my sense of my own life” (Parker, 2016, p. 113). She also notes the derivatization of Daisy by her aunt Tia Chuchi while Daisy expresses her desires for another woman (something not the norms in the Columbian culture). Thus, Parker argues that the major problem is when people want to see others (outliers or the different) according to their worldviews. Hence, since Gwen challenged or probably confounded Michael and Jose’s worldview of what a woman should be like (per her body), they killed her.

            Once again, although Parker (2016) problematizes the concept of derivatization quite philosophically, I personally believe it is not this easy to attribute Gwen’s murder to Michael and Jose’s worldviews of a woman alone.

First, this is a well-known fact that transgenders, lesbians, and gays have existed throughout history and in every part of the world (Friedman & Schustack, 2016). Hence, it is difficult to say that whether it was Michael and Jose’s shock to Gwen’s transgendered identity or it was some other factor. Probably, a thorough research of the case can lead us to more meaningful ways by which the real motifs of the murder can be revealed. It is possible that even though the two young men may have been shocked to find Gwen’s gender, alcohol, (probably drugs), and other factors led to a physical scuffle followed by that tragic event.

Second, such derivatization (trying to fit others into my worldview), most probably, happens in every walk of life not merely in the domains of intimacy or identity. For instance, a fast-growing religion of the world is today known to impose their values on to others. Similarly, our workplaces, schools, legal justice system, and communities expect us to behave and act in certain ways. Probably, I find such expectation as also derivatization of another person’s values, identity, or self-determination. It is here that we are still struggling with concept like prejudice, racism, and cultural shock. For instance, a recent hashtag on Twitter (#RefugeesNotWelcome), which is still active, took to a frenzy a few months ago, because certain people were seen as different in many ways (and a threat) to the European and North American culture. I think this context also fits into Parker’s concept of derivatization because there is a clash or two worldviews. Those in host countries are trying to avoid these refugees simply because they do not reflect and reinforce ‘my sense of my own life’.

Third, I think in today’s growing immigration, mass mobility, and swifter communication on a global level, there is constant clash of worldviews. If Michael and Jose’s case presents an extreme example of this clash (shocked by Gwen’s transgendered identity – if it truly was the case that I doubt), we can find many such examples in daily newspapers and TV of probably both intense of milder scales. Thus, it would seem logical to argue that the problem is probably escalating and extremist views (imposing one’s sense of life over others) are shaping more rapidly and in more sublime ways.

Forth, Parker (2016) herself problematizes the notion of derivatization not solely as an issue of women’s rights, but, probably, as an issue of humanity. In other words, Parker argues that our broader society should acknowledge the rights of others the way they are, be it a transgendered individual, a lesbian, a gay, etc. Hence, she blames the prevalent social/cultural norms (in which children are taught in certain ways about their identities) as a major hurdle in avoiding deaths of persons like Gwen. I would agree with Parker here and would expand the argument that, as noted above, it is less with women or different looking individuals, probably, it is more about the current models of home, school, community, and state education and practice that is playing a role here rather than personal derivatization. For example, since Gwen’s inhuman murder in 2002, her mother, Sylvia Guerrero, has led an awareness campaign that focuses to educate the masses to respect transgenders and accept them the way they are. According to this news story (Fraley, 2016), Guerrero never heard the term transgender until media started referring her murdered daughter with it. Yet, it is quite visible to see that Guerrero was aware of Gwen’s identify differences but loved her daughter the way she was because she had affection, respect, and compassion for Gwen. Thus, I would argue that it is a matter of humanity in the broader sense and includes all those that threaten our worldviews, and to avoid such a shock, many among us might derivatize others be they transgenders, refugees, or a person belonging to another faith.

The central point then is that we should shape a narrative that focuses on global awareness of mutual respect and space to others’ differences, autonomy, and self-determination (including of course women). I think with advanced communication technologies, it is happening gradually though with a rather slower pace. However, it is also apt to enumerate that the crises are still going on as we see different such stories almost daily. The most horrible case is genocides that are going on in some parts of the world to this very day.

           

In conclusion, I would restate my main thesis that whereas objectification is a very broad and difficult concept to translate in daily life (as posited by Nussbaum), derivatization is also a complex construct. Both of these concepts focus on women’s treatment in particular but, in essence, extend beyond feminism to include ill treatment of humans as a race. Thus, I argued that rather than being concerned with feminism alone, Nussbaum and Parker project the concepts of objectification and derivatization as issues that pose a challenge to humanity at large. Society that understands the negative ramifications of sexual exploitation of women, men, and people with different identities through objectification or derivatization, is probably going to evolve gradually and is possible when we as one community learn to realize that we need to respect differences in life in any way. The most fundamental role is that of education that focuses on the world as a community because with mass mobility, today, cultural contact is swifter than ever before. As people encounter different worldviews more frequently, a more holistic form of education is inevitable that is all inclusive and primarily concerned with not just tolerance to but appreciation of diversity and interpersonal differences. I think it is the point where a number of global problems can be solved without having to derivatize anyone for any of their beliefs about life. Canada, globally admired for its mosaic-based social philosophy, is one of the prime role models for the world to inculcate in people the sense of mutual respect and harmony while getting along with differences with ease and joy rather than cultural shock and disdain.

References

Fraley, M. (2016). Gwen Araujo murder 14 years later: Transgender teen’s killers face parole. The Mercury News. Retrieved from http://www.mercurynews.com/2016/10/14/the-murder-of-gwen-araujo/

Friedman, H. S., & Schustack, M. W. (2016). Personality: Classic theories and modern research. New York: Pearson.

Nussbaum, M. C. (1995). Objectification. Philosophy & Public Affairs, 24(4), 249-291.

Parker, E. A. (2016). Sexual violence as derivatization.” In Desire, love, and identity: A Textbook for the Philosophy of Sex and Love. G. Foster, & D. Mills (Eds), (pp. 107-114). Toronto: Oxford University Press Canada.

Understanding Multicultural Competence (PSYR - 8421)

“Jia never shows emotion, not even in the wake of a terrible loss.” What does the previous sentence lead you to infer about Jia? As a psychologist, how would you judge what is reported to be Jia’s lack of emotion? The level of multicultural competence you achieve as a psychologist might likely influence how you assess this scenario. How might Jia’s cultural background as depicted in the Threaded Family media piece affect your assessment of her behavior? Your understanding of multicultural competence and why it is important has a profound impact on your client relationships.

For this Discussion, review this week’s Learning Resources. Consider your understanding of multicultural competence coming into this course. Think about populations in your community and how you might demonstrate multicultural competence working with those populations.

With these thoughts in mind:

Post by Day 4 an explanation of your understanding of multicultural competence coming into this course. Be specific in your explanation by describing a multicultural population in your community and what it would mean to work with clie

nts from that community and to demonstrate multicultural competence. Then explain what effect this week’s readings have had on your understanding of multicultural competence.

Multicultural Psychology

Prescribed readings for this week open up a number of avenues by which my understanding of multicultural competence has simply increased manifold. It is quite surprising yet pleasing to note that multicultural competence is both complex and essential for a psychotherapist working in today’s society that is becoming more and more complex by the day (Constantine, et al., 2008). Multicultural competence is not only just about getting trained in this area, but is also about being explicitly aware of one’s own culture before they can attempt to understand others’. Moreover, culture is a set of a number of subjective constructs that an individual makes meaning with and cannot be understood with a straight forward approach such as through different models for multicultural competence. In addition, since evidence-based research is still limited, it is important to follow the paths of a highly-fluid professional such as described by Comas-Díaz (2010) in which the therapist is ready to play multiple roles with higher level of empathy. Moreover, multicultural competence is an on-going process that needs to be critiqued from time to time by the therapist in consultation with their colleagues, seniors, clients, and other relevant people so that the their focus remains on track, and keeping culture in the center of therapy is essential (Pedersen, et al., 2008).

With this understanding in view, I would like to describe the multicultural population I will be focusing on. It would be Hispanic population and specifically I would focus on the family structure, religiousness, and gender-roles in the population. My observation and readings on this population reveals that there are quite a few cultural differences I need to carefully analyze in order to effectively treat members of this community. For instance, it is generally believed in their community that male should not look for assistance and prefer self-dependence; however, this can yield serious health related issues because even if a male needs medical/psychological assistance, they would avoid it. Moreover, in general, Hispanic family structure is such that members would not share inside matters to people outside the family. Thus, trust, esteem, self-respect, dynamic interaction, and empathy become important tools for my cultural competence.

This community also has culturally-constructed beliefs that need immediate focus for change. For instance, substance and alcohol consumption by their young is seen as something common and is considered a part of their permissiveness culture. This aspect not only has adverse effect on their youth’s upbringing but also comes into direct conflict with the law. In addition, this community relies heavily on religiousness and spirituality when it comes to social, psychological, or any other issues. Moreover, it is often noted that the clergy and other religious official do not make referrals to professional therapists. The culture also attaches less value to female gender and comes directly under influence of socioeconomic status. Thus, these and some other very grave issues have continued seriously unattended, and I would focus on these attitudes of this population.

I would like to state in view of Cohen (2009) that multicultural competence is about understanding the many basic psychological processes that may differ from one culture to another. These processes can be subjective and objective and might turn out to contrast sharply with a process from another culture. It is here that the difference needs to be understood without stereotyping or bias. It is most probably the central tenet of multicultural competence that a therapist, while confronting their own cultural biases, should start from (Gallardo et al., 2009). This is what I believe has broadened my worldview on multicultural competence from the readings of this week.

           

References

Cohen, A. B. (2009). Many forms of culture. American Psychologist, 64(3), 194-204.

Comas-Díaz, L. (2010). On being a Latina healer: Voice, consciousness, and identity. Psychotherapy: Theory, Research, Practice, Training, 47(2), 162-168.

Constantine, M. G., Miville, M. L., & Kindaichi, M. M. (2008). Multicultural competence in counseling psychology practice and training. In S. D. Brown, & R. W. Lent (Eds.), Handbook of counseling psychology (4th ed., pp. 141–158). Hoboken, NJ: John Wiley & Sons, Inc.

Gallardo, M. E., Johnson, J., Parham, T. A., & Carter, J. A. (2009). Ethics and multiculturalism: Advancing cultural and clinical responsiveness. Professional Psychology: Research and Practice, 40(5), 425-435.

Pedersen, Paul B. Crethar, Hugh C. Carlson, Jon (2008). Conclusion: Developing multicultural awareness, knowledge, and skill. Inclusive cultural empathy: Making relationships central in counseling and psychotherapy (1st Ed.). , (pp. 223-241). Washington, DC, US: American Psychological Association.

Critical Essay: Plato’s Phaedo, Socrates' Dialogue on Life and Death, Body and Soul

Introduction

            In this essay, I would critique Plato’s Phaedo (360 BC). First, a critical summary of the great dialogue will be presented. Later, a critique of the dialogue would be provided. In the critique, I will specifically focus on one reason that Socrates claims is plausible enough for us not to fear death. Here I will also explain this reason through my personal perspective and relate it to life in general. The last section of the essay, Conclusion, would sum up the entire essay and would share with the reader my personal viewpoint on Socrates’ views about death as I see it.

            In this essay, the reason that I would like to identify is this: After death, the soul “passes into the realm of purity, and eternity, and immortality, unchangeableness”; and this “state of the soul is called wisdom” (p. 44). I will explain this reason critically and argue that this reason is strong enough for us to believe in what Socrates says: That we should not fear death. Thus, I will argue in favor of his view.

Phaedo: A Critical Summary

            Phaedo (Plato, 360 BC) is considered to be one of the great dialogues written by Plato in his middle period. This dialogue is regarded as one of Plato’s five major works including the Republic and the Symposium. Phaedo is Plato’s last dialogue (Bluck, 2014).

            The dialogue, Phaedo, takes place between Socrates and his friends. It is a discussion that revolves around the major premise, the desirability of death, and is led mainly by Socrates. Phaedo, one of Socrates friends, was one of the people present in the prison where Socrates was locked down to meet his death the very day. Phaedo is a narration of this dialogue by Phaedo to his friend Echerates.

            In the dialogue, besides the casual conversation, the major point Socrates makes is that death is actually a release for us from the many distractions that our body imposes upon our soul. In addition, Socrates argues that death gives an opportunity to a person to attain wisdom in its perfection because by leaving the body at death, the soul “passes into the realm of purity, and eternity, and immortality, unchangeableness”; and this “state of the soul is called wisdom” (p. 44). This premise by Socrates can be explained in simple words. He sees death as an opportunity for the soul to free itself from the changing, dissoluble, and mortal human body. Once free, the soul actually moves to a state which, unlike when in the human body, never alters, changes, and is pure, immortal, and it is this states of immortality of ‘the soul’ that Socrates regards as wisdom.

            Socrates centers his argument mainly on the premise mentioned in the foregoing paragraph. He also maintains that though a true philosopher desires death to reach to the state of perfect wisdom, he does not desire suicide because it is a wicked act, because we belong to the gods, and we do not have a right to finish our lives at our own will. Besides that, death is a blessing and should not be feared. He presents quite a few examples to substantiate this premise throughout the dialogue, and his friends take part as active interlocutors. At the end of the dialogue, Socrates drinks the poison and meets his death.

           

Critique

            A critical analysis of the dialogue, Phaedo, offers quite a lot of points to discuss in this essay, e.g. the difference between the death of a philosopher and the death of a wicked person; whether it is only the philosopher that should be happy at their death or any other person (good or bad) can have the same joy. Because of limited space, however, I will focus on one reason by Socrates that death should not be feared since at death, the human soul, “passes into the realm of purity, and eternity, and immortality, unchangeableness”; and this “state of the soul is called wisdom” (p. 44).

            After thinking for a very long time and doing some research, I can substantiate that Socrates is right in this claim. He also substantiates this premise when he states that because the human body decomposes after death, the soul moves to a state which is eternal and pure. Following Socrates’ argument, I can explain this premise.

            It can be a clear observation that the body is mortal and decomposes after death. If we accept the religious beliefs of Christianity, and other religions such as Judaism and Islam, then we must admit that there is the soul that leaves the body after a person dies. Okay. So, the body decomposes, but the soul does not; rather it travels to another place. This is manifestly given in religious texts such as the Bible. However, I can explain this traveling of the soul on scientific bases. My research led me to an article which recollects the after-death-accounts by people who died for some time but came to life afterward. These people when surveyed about their experiences after death told the interviewer that they felt as if they were travelling to a distant place (Knapton, 2014).

            Leaving all the religious and scientific evidence apart, I can also prove that the soul, in view of Socrates, not only remains alive but also moves to an eternal (and most probably a pure or constant) state. I claim this point by my observation of the world. I can see that the entire world is in two parts, the day and the night, life and death, etc. The tree is a good example here. The trunk and the leaves need the sunshine and the air to stay alive. Whereas, its roots can remain alive in the opposite form and condition: The roots cannot survive in the sunlight and air. The green tree can also not survive when buried. So, my point is that the every object or state of the world is divided into two parts. These two parts of one object, though hand-in-hand with each other, are quite the opposite of each other. This condition remains constant, as far as my observation can relate, with every object of the world.

            This observation also convinces me that life is part of two halves: The body and the soul. Moreover, whereas the body decomposes, the soul must remain alive. The body, after death, continues to decompose (in natural conditions); this also convinces me that the soul would do the opposite of this process: It should continue to travel on. As the end result of the decomposition of the body is eternal expiration, the end result of the soul must be an eternal state of purity in a very similar way in which the day and the night function. The break of dawn creates the first gash in the heart of darkness, and the bright day is the opposite of the darkness of the night. The same, my observation convinces me, is true of the body versus the soul. One is to eternally decay and disappear, the other is to move toward a state or eternal purity (wisdom in Socrates’ words).

Conclusion

            After reading Phaedo and reflecting on life in general, I am very much convinced that death is not be feared because what happens to the human body is quite opposite of what happens to the human soul. Whereas the body decays into the labyrinth of morality, the soul travels to the purest state of immortality. The fear that an average human feels of dying is not because of their fear of death, it is because of the natural system in the human brain that has to put effort to save human life from any harm. We should not confuse the instinct of survival with the post-death condition.

            Thus, I can claim, in view of Socrates, that life is not to be feared but welcomed by us. However, it is well beyond the purview of this essay to argue whether, as Socrates states, it is only the philosopher who should not fear death or this kind of attitude is to be assumed by anyone dying. I would just make an observation that anyone dying should be happy of their death due to the fact that their body and their soul would go in two opposite directions. Whereas the former is to wither away, the latter must move to a state of eternity.

                       

References

Bluck, R. S. (2014). Plato's Phaedo: A translation of Plato's Phaedo. New York: Routledge.

Knapton, S. (2014). First hint of ‘life after death’ in biggest ever scientific study. The Telegraph. Retrieved http://www.telegraph.co.uk/news/science/science-news/11144442/First-hint-of-life-after-death-in-biggest-ever-scientific-study.html

Plato (360 BC). Phaedo. Abr. Ed. [Trans. Benjamin Jowett]. Public domain translation. [Classroom readings].

The Battle of Algiers: Critique and Analysis

Question: It is often easy to think of innocence and guilt as clear opposites, as different as day and night. However, many of the texts and films we have studied raise questions about this opposition, suggesting that their differences may not be quite so stark. In your paper, discuss how a particular work complicates conventional ideas of innocence. You might consider the role of women or children in combat, or the differences between civilians and soldiers. Or, you might consider the ways in which individuals are held responsible for the actions of their nations and governments, or for the actions of those they hold dear (family members, lovers, etc.). Remember to pay attention to elements beyond plot and character, such as textual structure, textual repetition and tension, camera angle, light, and sound.

Answer: The Battle of Algiers is a great film with deep social and psychological effects it bears on the audience. With its powerful direction and technical strengths, such as camera, light, and sound, the film mainly focuses on the ways by which guilt and innocence become blurred in the path of achieving a necessary purpose: Freedom. The world has long sung songs for innocence to be an ideal state for peace. Women and children have historically found a central place in this narrative. However, by critiquing The Battle of Algiers, it could be argued that when faced with a significant purpose like freedom, innocence of people (men, women, and children) becomes blurred with guilt. This argument would be supported by discussing many a technique Pontecorvo has used to problematize this conflict by focusing on technical areas of the film, light, sound, camera work, and by highlighting the deep psychological effects different scenes bear on the audience asking them to follow Pontecorvo’s lead.

The effective construction of the central thesis of this essay, whether the film complicates the conventional ideas of innocence and guilt can be achieved by focusing particularly on the roles of women and children in the film and the strategies Pontecorvo  has used to convey this conflicting mortality to us. In this connection, throughout, the film convinces me that the ideals of innocence and guilt are so much mixed up together that it is very difficult to say who is innocent and who is guilty. The film problematizes this aspect, in particular, given the fact that women played a vital role in Algiers’ struggle for independence. For example, in the very first scene in which La Casbah is panoramically framed, the FLN charter of demand runs in the background and a lot of children are shown sitting, moving, and running. One much younger child is shown running and the camera remains on him for quite a few seconds. At the same time, the charter of demand by FLN reads: “Algerians, it is your duty to save your country and restore its liberty” [07:43]. The director successfully portrays that these children are an integral part of the struggle, and we see that they are present in at least all the major scenes in the film either supporting the FLN gorillas or playing their aid.     

Further critical analysis suggests that this short but abrupt start depicts multifarious layers of feelings and relays subtle messages for the viewer to create their own meaning out of what they see. The camera movement is slow, avoids close-ups, and mixes this scene with that of a documentary like haphazardness to offer us a mixture of feeling that what we see is not a film but probably a depiction of some real life events and the little children shown in tattered clothes, though so innocent, would be affected by the horrible reality of life: The struggle of freedom would ask them to discard their innocence. Similarly, the long, documentary-like lenses to capture the Algiers physical setting (streets, alleys, stairs, houses, the French quarters, etc.) are combined with a very similar focus on a number of fighting, shooting, and raiding scenes to produce an effect of a documentary made by someone present there in all the mayhem. Quite a few scenes of this seemingly documentary-like film show women and children taking active part in the struggle for independence. They help the rebels by being informers, vocalists, spies, and practical fighters losing their innocence in the process.

For example, when Ali is approached by a teenage child to relay the first FLN message, there are many younger children (of different ages) focused and sharply contrasted with this boy. The message is quite clear: As soon as the children start to think and act sanely, they will become part of this resistance thus leaving aside the most important aspect of their life, innocence.

            More importantly, the light in the film uses high contrasts. Being a black and white film, this sharp contrasting between black and white is helpful for Pontecorvo to add the psychological dimensions of a situation (a gorilla attack or a reaction by the French paratroopers), and, oftentimes, complicated scenes take place in the dark to arouse the deeply striking psychological feel of the film. For example, the scene almost at the middle of the film, in which Ben M’Hidi explains the aims and phases of their struggles to Ali, is captured is stark darkness that takes the viewer to sway with the intensity of the struggles and the extreme sensitivity it holds for the two leaders and the people of Algiers in common. This is quite surprising to note that female freedom fighters are almost exclusively shown in the white light as opposed to their male counterparts mostly captured in dark shades, and children often in miserable conditions, torn clothes, but tied to the cause. Maybe, we are told that the two parts of life are put together to achieve a purpose.

            The most complicated scene in which Pontecorvo has undoubtedly asked the same question (whether women and children are innocent or guilty or whether they pay the price for something done by others related to them) is intensely visible when the three FLN member women disguise as French citizens and move into the French quarters with bombs in their baskets. Though the entry of Algerian laborers is barricaded and a search is diligently done by the guarding soldiers, these three women bypass the body and document search simply because they are disguised as French women. More lenience is shown toward the woman with a child.

Here the role of the sounds in the film must be commented as it seems to go parallel with the basic focus on highlighting the psychological effects of what is going on out there as innocence is shaded with guilt. To depict this, sounds are added from slow, fast, to hysterical beats in which different instruments from drums to human chanting add to a particular scene’s feeling on the viewer. Thus, in this scene, fast, feverish drumming sound remains throughout this scene as the three females prepare to play their part in the struggle up to the bombings that eventually occur. This certainly keeps the viewer jaw-struck thinking they might be captured: The viewer hypnotically follows the entire scene with complete submission to the director. Likewise, sounds explain the scenes to the audience. When there is no sound it has its own significance as it arouses deep suspense in the viewer.

One of the three women has a child to protect her identity. More importantly, Pontecorvo cleverly focuses on the innocent women and children on both sides. For example, the Algerian woman who plants the first bomb in the café shows us through her eyes the innocence of the common French citizens and particularly a little child on whom Pontecorvo places the camera for a while relays significant messages for us to compare the innocence and/or guilt on both sides. Since the scene moved me so much, I couldn’t help but present the screen captures of that child in the film here:

Now, we must revisit the first bombing in the film that was carried out by some French police officials to kill a suspected member of FLN. This explosion leaves a number of innocent civilians dead including men, women, and children of all ages. Their bodies in crippled forms are still in our memory as we compare this cute child being killed just in a matter of seconds. Certainly Pontecorvo is asking of all of us what we, as human beings, done to innocence. We also ask if the explosions by FLN activists would have taken place at all had it not been the first attempt from the French camp. The juxtaposition of civilians from both sides is artistically done to show us how complicated this relations between innocence and guilt is.

Similarly, when the last of the three explosion hits the race course, the French people running wild around capture the young Algerian boy selling candies in the race course. We are convinced that the crowd would beat him to death because their pain of losing their children and loved ones is so intense that the binaries of nationalism are forcing them to avenge their blood. Their instinct fails to see (as Pontecorvo again shows us) the other as innocent or guilty; it only wants revenge, blood for blood.

Overall, by drawing these strikingly painful comparisons of the acts of violence by both the sides, Pontecorvo invites us to debate the part violence has historically played in the struggle of oppression and freedom. Pontecorvo shows us that the side effects include innocent blood on both sides whether or not women and children take part in the struggle to kills each other. I personally believe that though we have moved into a time beyond postmodernism, I do not think such debates of sensitivity to innocent blood has done any good because a number of critics today ask the same questions of the deaths taking place at this moment in regions like Iraq and Afghanistan in the aftermath of the lives we lost on 9/11.

Pontecorvo tried to justify the element of violence through the words of Ben M’Hidi who says to Ali that terror attacks can serve for useful starting points but at the end the importance is of organizing the populations to order:

...wars cannot be won with terror attacks. Neither wars, nor revolutions. Terrorism is useful for starting a process, but afterwards the whole population has to act. [1:07:30-43].

This point may be of great importance, but personally my interpretation of the role of women and children in this film is that innocence remains at its place when other environmental forces go in balance. Once the balance is out, the boundaries between innocence and guilt can very easily blur on both sides. Since the same attitude has continued into our modern time, it is worth asking if we have done anything intangible to address the great loss innocence has suffered at the hands of humans around the world.

Sentinel City Simulation: Community Health & Population-Focused Nursing - KLP 1

Sentinel City Simulation is a very recent development. It is an immersive computer environment that enables students to practice various tasks on community health nursing – previously done on the ground causing to students a lot of stress and practical constraints.

The latest Sentinel City program (3.0), developed by American Sentinel University, has been well-received and has won APEX Grand Award, WCET Outstanding Work Award, and stood finalist for 2 SIIA CODiE Awards.

That said, a lot of nursing schools are now adopting this program since it makes learning much easier for students (desktop-based) and carries handy tools for assessment.

What about the first Community Health Nursing Paper, KLP 1?

Well, it is tricky because not much help is available online and the new interface poses considerable challenge to students who have already completed a few credit hours based on the traditional method. Second, as the program is well-designed, it ensures the students are really taking something out of it.

Keeping this scenario in view, I have written this post hoping that, like my other posts, it will help you lessen some of the study stress.

So, first, what do the Instructions for this paper require of you to do: The Instructions are divided into three broad areas:

1. The three umbrella competencies: 7019.1.1 (Epidemiology); 7019.1.5 (Env. Health); and 7019.1.8 (Cultural Com).
2. Surveying 12 specific city locations and to send a completed PDF action report (ensuring that you’ve spent time on the program).
3. Using different data tools: 

• Demographic assessment (reading the data for age, median income, percentage of the people with/without insurance, etc.)
• Neighborhood/community safety inventory (what safety mechanisms are in place? Are there any environmental issues, such as air pollution?)
• Windshield survey (WS) (Moving around seeing the infrastructure, homeless people, population density, etc.)
• Population health scavenger hunt (Consulting with data from school, university, the ABC clinic, the grocery store, etc.)

With this homework done, most of the work is similar to the traditional Community health Task previously covered in this blog.

However, what is troubling in this paper is that nothing is written or given in an analytic fashion. The student must plough through the four districts of the Sentinel City and connect other community resources (the 12 locations) by making sense and synthesizing relevant data to find out:

1. What 3 major community health problems the Sentinel City faces
2. What community resources are available to address ONE of the three problems
3.  The primary health topic you’d like to work on in the future paper (of the 3)

I am going to try to help you in this domain and hope that you’d find interpreting the City data convenient for your paper.


Analyzing the four districts of the Sentinel City
Please keep in mind that this section is written in a way that covers all the four tools required to be used. It is because it accumulates findings from these tools: Windshield survey is done by every student already and by surveying the city locations, you're making use of other tools (the demographics, environment, and scavenger hunt, etc.).

So, let’s start our data analysis. Demographics about the four districts (Acer Tech Center, Casper Park, Industrial Heights, and Nightingale Square) tell quite a few (and obvious) things about the populations in these districts.

Acer Tech Center has a total of 168390, white-dominant (70.2%) population, moderately higher income, $166,300, with much larger population above 18 and below 65 years of age, and with just a marginal proportion of the population (1.5%) without insurance.

Casper Park presents a very different picture: population, 352643, 24% Hispanics or Latinos, 10.9% citizens are children, 33.8% under 18. What about the uninsured under 65: a huge 22.7%.

Synthesis of the data

Now, let’s synthesize data for these two districts. Let’s take help from literature. So, literature has well-documented that income level, ethnicity, (among many other variables) and community health are related. Higher income levels are associated with cleaner neighborhoods, betterinsurance coverage, fewer children per family, etc.

Along these line, we can see that most of the uninsured (if not all) are most probably also the ones without jobs, and so maybe do not have a home to live in. So, the neighborhood they live in has low quality of life, junk food (cheap), lack of health care access.

Literature also informs us that lack of access to health care, combined with these factors, in the US, is associated with oral health problems, cardiovascular diseases, mental health issues, diabetes, obesity, and so on.

This way you get a very good individual picture of each of the four districts, and your WS survey would speak about the cleanliness of the neighborhood, number of people/children outside, etc. This way, describe each districts individually.

With this exhaustive account, you can move on to analyze other locations. For example, let’s take the data from the Better Health Clinic. Rates for STDs, pregnancies, and abortions are much higher (compared to global data matrices), and the Clinic provides services in these areas. Then why is there little progress?

Because in the community people are not being educated about lifestyle, safety, etc.

Adding from other locations
Similarly, Joe’s Grocery is to be hailed (hail Caesar) for being reported for so many infections caused. Here we are so sure that the authorities are not working as they should (another aspect missing for our community nursing).

Lily’s Restaurant serves unhealthy food. It must be cheap, right? Who consumes cheap food in US? You’re right? Then there is a very high calorie consumption percentage that people are using at home. What about the parks? Crime rates are higher, and the public space is occupied by the homeless population.

So, let’s sum it up. Jobless people, uninsured, children, and adolescents consume cheap food, lack access to health care. They don’t have much

to recreate to cope with their everyday stressors. Poorer neighborhoods are also congested with pollution and noise.

This tells us that at least 2 Districts present a very alarming condition; taking help from literature, we’re sure that many health issues (here you can add references from Healthy People 2020) such as obesity, diabetes, mental health problems, STDs, oral health, women-child health, (Day Care Center data) must be haunting our Sentinel City.

I hope I have tried to help you in the right direction. Once you pick up in this way, I am sure you can get over the entire paper very well.

Should you need any further assistance, please do not hesitate to reach me. I won’t bite! Yikes! Email me at: meokhan2/at/gmail/dot/com

Organizational Systems and Quality Leadership - WGU RTT1 Task 2 (FMEA-Focused)

Image Courtesy: Designed by Pressfoto (freepik.com)

Introduction
In this post, I will discuss in detail how to get over to the part involving FMEA in RTT1 Task 2. The task, overall, is quite complex, but this FMEA part, and what follows it, is far more challenging. Personally, I have had to write more revisions for this part alone than any other paper for WGU.

Given that not much help is available online (my personal experience), and your mentor will share with you the FMEA application material that does not focus on nursing, it can be really frustrating (I know!); hence, I am trying to make your life easier and hope that you will save countless hours of your precious time by going through my post.

FMEA (Failure Modes and Effects Analysis) is a useful tool, and WGU urges that its students know how to apply it to their workplace, and, trust me, they are not fooling us here. It really is useful.

Root Cause Analysis
The task starts with (A) the Root Cause Analysis (RCA) that focuses on understanding the basic causes of Mr. B's sad demise: Lack of staff, crowded ER, lack of coordination, and monitoring plus more doses than needed.

Improvement Plan
In the next section, Improvement Plan (B), you have to discuss an improvement plan (employing tools such as PDSA, checklists, audits, feedback, etc.) that will ensure such sentinel events as those with Mr. B won't repeat. So, you would say that flex staff will be added, coordination will be improved, etc.

Change Theory
Ahead is the section that asks you to discuss in detail the role of a Change Theory (B1) in your plan. This part is to show the grader that you know how to theorize change in your organization and situate your Improvement plan - as proposed above (B). Quite a few change theories are available, and you can use just one theory here.

FMEA
And, NOW, the FMEA section (C). First things first. The FMEA tool is very complex and is used by major organizations. For you, as the instructions clearly lay, the task is to apply it to just one process addressing each step. This is the key.

It is connected to all the sections that precede, i.e. your RCA and the Improvement Plan.

So, let's say that we have devised an improvement plan that (with other areas as highlighted above) focuses on patients like Mr. B. Probably, we are convinced that Mr. B (and similar patients) have an ASA Score III or higher. There are quite a few issues that caused his unwanted demise, but it was the sedation policy that can be our focus here: Remember just on process.

To cut short, FMEA helps us to identify risks and manage any failures before they can occur. So now, we want to apply FMEA here so that things won't get again to the same point as they did for Mr. B. In other words, we want to make sure our new ASA-related sedation policy won't fail and our patients will be treated well. As we noted above, there are quite a few other things than just the sedation administration. It involves addition of the flex staff, training of all the staff (RN, flex, physician, and the anesthesiologist), and coordination among them in such a way that a patient with ASA III or greater is administered the dosage within the limit of safety.

EDIT: Syllabus REVISION hath arriveth!!! There are now more than 1 versions of this paper as per the profile of  a student. Remember, WGU's syllabus is proprietary?

So, in another version, that you might have, there are no Pre-steps and Three-Steps (by the way it's way too confusing, isn't it?). Instead. all of these steps are combined as Necessary steps for FMEA that you are required to take. BUT...these are the same as given below. Just combine them and number them from 1 to 6/7. 

Pre-steps 
This section might sound quite complicated to you, but it is NOT. We just need to apply our common sense here. For instance, we're saying that a patient with ASA score III or greater would be handled under this plan. We have already highlighted many changes from staff, training, to coordination.

So, simply put, the pre-steps are to focus on the mechanism of FMEA before it is employed. It is like preparing your horses before the actual journey.

Thus, in your pre-steps, highlight the addition of the flex staff so that such a patient is not left unattended. Training of all the staff would alert them all for such a patient. Next, let's introduce a checklist here. This checklist, noting the ASA score, will be filled, signed, and pooled together by all the relevant staff: the RN (or flex), the physician, and the anesthesiologist: The Multidisciplinary Team. Unless signed by all of these stakeholders, NO further treatment can be offered to such a patient, etc.

In addition, let's also introduce here the Risk Priority Number scale to assign numeric value to the likelihood of occurrence or frequency, detection, and the severity or seriousness pointers. The RPN is to be discussed in the Three-Steps section below; here we're just introducing it, so say that, the MD team would be trained to use RPN beforehand.

Hence, the summary of our pre-steps can read: Patients with ASA score III or higher are monitored with great care; all the staff collaborates closely to treat the patient, and the conscious sedation policy (including any other treatment) is administered with strict monitoring involving the use of a checklist when the team is trained for using this tool. A decision is made collaboratively only.

Three Steps
Here the application of RPN is discussed in detail. First discuss the tool in some detail (using credible references). Next, we would say that because a patient like Mr. B has ASA score III or greater, the score would be much higher for severity (or seriousness), moderately high for frequency (it's relative here - it depends on the age group a town has; however, for the town like we have in the scenario, we can go for moderate score for frequency), much lowly scored for detection because we've already experienced a case that resulted in Mr. B's sad demise.

Hence, the pooled ratings would certainly alert the MD team to be extra cautious, etc., etc.

You do NOT want to forget that this entire process of applying FMEA would be cyclic and will be improved by time. You can say that a flowchart will be introduced to improve our FMEA process, etc. We need more detail here than I have written - or you're going to disappoint the WGU guys grading your paper! :-D

The sad news is, we're NOT done here :-(. The complication continues as WGU wants to make sure you understand how you can test the plan in an actual intervention!

EDIT: Whereas in this version you need to focus on just ONE process, in another version, that you might be receiving, you have list 4 such processes in the FMEA table. Be mindful of that. However, it's easy. Pick any four: (1) Staff training, (2) Staff's concept development, (3) building a team for random assessment, (4) Collaboration...., etc.

This brings us to C4. Interventions.

Here discussing a tool like PDSA (Plan, Do, Study, and Act) is mandatory, or the WGU guys will be very upset with you!

First, you are to state a plan question: How can a patient with ASA score III or greater can be treated carefully with our new conscious sedation policy?

Now The Plan: The checklist will be our major source for data to find out if our plan is working. It is because we've planned that no treatment is possible UNLESS the checklist has signed feedback/remarks by at least the RN/Flex staff, the physician, and the anesthesiologist. Thus, our plan is to use this data to test the vigor of our Improvement Plan.

DO: We can't just start testing this plan to all the patients meeting this criterion (ASA). So, here we will say that we will handpick just ONE patient first and carry out this intervention i.e., see how our checklist is working for him/her.

Study: As our intervention is put to reality check, we will see how it is going: Whether we are improving or not, etc. Here, we need all other data as well: pre-admission record and history, ongoing treatment and handling, and the success of the intervention. Do you see that every bit of our plan is coming along so very clear and is laid down step-by-step? This is what those guys at WGU want to see (my experience).

The Act prompt can highlight that we will ensure further improvement is made to any weaknesses in the plan found through our PDSA, for example, we might consider introducing a smartphone application for the checklist, etc.

For D. Key Role of Nurses, you can write a detailed portion highlighting the immense importance attached to this role in health care not just in US but all over the world.

GOOD NEWS! We're done.

I hope with this carefully crafted post, I have helped you save some of your precious time. Happy Nursing!

Last, if you like the tutorial/walk-through, do not forget to drop a line or so. Should you need any further assistance, I would be happy to response.

Email me at: meokhan2/at/gmail/dot/com