The management of wound dressings whilst on placement

The management of wound dressings whilst on placement This reflective piece will look at the management of wound dressings whilst on placement in the community. I will use the Gibbs model of reflection this will allow me to describe the event, explore my thoughts and feelings, make an evaluation on the event and then analysis different components which can be explored separately including different dressings and why they are used, finally I will conclude and action plan looking at if this happened again what I would do differently. Whilst on placement in the community I visited a lady who had chronic leg ulcers on both legs and the district nursing team had been visiting this lady for a number of years. The lady had oedematous legs and poor mobility and sat in a recliner chair although the chair was never reclined. I had visited the lady previously on a number of occasions and had applied her dressings and documented what I had done and the dressings used in her district nursing records. On this occasion the lady requested that I didnt put the K-lite dressing on and allows the other nurse do this, as previously when I had dressed her legs she stated the dressing had become loose. I mapped the dressing so that the notes had an up to date record of the size of the wounds and washed and redressed the legs as per the plan of care. The plan of care stated to wash the legs apply aqualcel ag silver this is used for wounds that have a high level of exudates, then atruman was applied covered by mesorb, comfifast yellow then K-soft and then I passed over to the Registered Nurse (RN) to apply the final layer, whilst she applied the final layer I documented the notes that the leg had been mapped, washed and redressed as per the plan and noted that strikethrough was on the dressing prior to removal I also noted the patients level of pain at the time of the cleaning and mapping of the wounds and also after the legs had been redressed. I documented the patients records that the patient had been advised to elevate the legs when resting to aid healing. When the patient advised me that she would prefer the RN to do the top layer I felt like my confidence had been knocked. The patient had never said this before and always stated not to wrap the dressings too tight as she found it very uncomfortable. I told her that I didnt do them too tight as she always stated not to do so and apologised to her that they had fell down and in future would ensure that they werent too tight but would not fall down either. When I left the patients house with the RN she told me that this lady does this to all the new nurses that visit her and not to worry about it. Pressure sores and leg ulcers are classed as chronic wounds and are defined as slow healing wounds with the likely hood of reoccurrence and the pain that a patient feels may be severe and ongoing (Dealey 1999). The dressing plays a major part in the reduction of pain and by choosing the wrong dressing this can cause discomfort when removing the dressing and the nurse needs to avoid this by using careful assessment prior to administering the dressing (Dealey 1999). For a wound to heal the key is to have successful wound management, the nurse should use a wound assessment tool this will ensure that there is valid reliable and also consistent information documented. Wounds need to be regularly reassessed to ensure that evaluation is given on the treatment that the patient has received. When making a wound assessment this should include the location of the wound, the cause, etiology, tissue type the size and the exudates and finally the level of pain the patient is experiencing (Prescribing Nurse Bulletin). To achieve optimum healing the role of the nurse is to be able to select the most appropriate dressing for the wound, this is to be based on the most up to date evidence, and recent development of new dressings makes this a challenge for the nurse (Lansdown 2004). The wound should be assessed for slough and necrosis, signs and symptoms of infection and wound malodour. The patients records need to be documented to state if the wound is healing, e.g. granulisation and epithelisation (White 2005). The ideal wound dressing that will meet the treatment objective and promote the wound from further injury would be a moist wound healing dressing, that manages excess exudates and prevents the wound from maceration and further wound breakdown, ensure that it prevents the exit and entry of organisms, it will cause minimal trauma at the time of removal and is cost effective (Northern Health and Social Services Board NHSSB 2005). One important factor in wound dressings is to ensure that dressings get the maximum exposure to the wound bed. This can be achieved by a dressing that decreases the voids and spaces where bacteria can thrive (Jones etal 2005). Aquacel Ag dressings contain Hydro fibre Technology and it gels on contact with the exudates and micro-contours to the wound bed this helps to eliminate voids or spaces where bacteria and fluid can collect it maximising exposure of the wound to antimicrobials. It is presented as a soft sterile, non-woven pad and is impregnated with ionic silver (Aquacel Ag 2006). This dressing can absorb a large amount of fluid and helps to prevent exudates leakage onto the periwound skin. The dressing can be left in place for up to 7 days however should strikethrough be evident on the dressing then the dressing needs to be changed (NHSSB 2005). It has been recognised that silver is an effective antimicrobial agent (Thomas and McCubbin 2003). It has proved that it is effective against methicillin and vancomysin-resistant strains of bacteria (Lansdown 2002) Atrauman dressings are made of a fine mesh of hydrophobic, polyester fibres and have mesh pores with a smooth surface this effectively counteracts adhesion to the wound by preventing new tissue from penetrating the dressing and allowing the exudates to pass through, this means that the dressing is easy to remove and causes minimum discomfort to the patient and also to the wound. The dressing is highly permeable to air and water vapour and has been found to be very well suited to the management of infected wounds (Hartmann 2010). In recent years Honey has been found to benefit wound healing, clinically topical honey treatment has been found to possess antimicrobial properties, promote autolytic debridement, deodorise wounds and stimulate the growth of wound tissues to quicken healing, it also stimulates anti-inflammatory activity helping to reduce pain, oedema and exudates (White 2005). A fast rate of healing has been reported in wounds treated with honey (Ahmed 2003) it helps the developing of a clean granulating wound bed (Stephen-Hayes 2004) It is clear that wound management is a complex area and the it is the nurses responsibility to ensure that they give the correct care to the patient and they use the dressings that are selected on their knowledge and understanding of what the dressing will achieve they need to be constantly aware of new products available to treat the wounds. By regular assessment of the wound they will be able to see if the dressing selected is helping to promote wound healing. I am aware that if I wish to work in the community I would need a good knowledge of dressing that is used in wound management. I know that I am likely to meet patients who try to make me doubt my ability however this is something that I know I will over come as my confidence builds and I become more used to working in the community.

David And Hamlet :: essays research papers

Hamlet and David  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  In Hamlet and The Mountain and the Valley, both literary pieces present us with two melancholic characters who live in conflict due to the dichotomy of their natures . Both Hamlet and David are similar because they are conflicted by foils and similar in the nature of this tragedy. Each has deep inner problems of conflict.   Ã‚  Ã‚  Ã‚  Ã‚   Hamlet is first tormented by the death of his father, the king of Denmark. Then he is cast into utter agony when Gertrude, the mother he loves dearly is hastily married to his uncle, Claudius. Through a ghostly revelation, Hamlet learns that his suspicions that Claudius murdered his father are true. He becomes incensed and wants to enact revenge upon the guilty party. From this point on, Hamlet struggles with his plan for revenge that conflicts with his opposite contemplative nature.   Ã‚  Ã‚  Ã‚  Ã‚   Hamlet does not take the opportunity to slay Claudius as he prays because he believes it will save his soul. His contemplative nature takes over regarding the ghost’s revelation and he decides to devise a play to pique Claudius’ conscience and make sure he is really guilty.   Ã‚  Ã‚  Ã‚  Ã‚   Whenever Hamlet denies his true nature, his actions are very harsh. During a heated discussion with his mother Gertrude, he accidentally slays Laertes’ father, Polonius, thinking it to be Claudius. Hamlet quickly brushes it aside. He also sends his friends , Rosencrantz and Guildenstern, to their deaths when he learns of Claudius’ plot to have him put to death when he arrived in England as a so called diplomat.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Hamlet cannot decide between a life of action and revenge, or contemplation and fate and he is genuinely concerned with the deeper truths upon which his life is ordered- fate and freewill.   Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Ernest Buckler portrays the life of his main character, David Canaan, in conflict, through a slow moving metaphor from the valley to the mountain. David is a deeply intellectual character and like Hamlet has a conflicted dichotomous nature.   Ã‚  Ã‚  Ã‚  Ã‚  One of his difficulties arise from the death of his girlfriend Effie. He feels guilty and responsible for. Also, when his friend Toby comes to the valley for the first time, David is torn between making Toby feel comfortable, while at the same time trying to avoid hurting his family’s feelings.   Ã‚  Ã‚  Ã‚  Ã‚  David also feels separate from Joseph, his father, and Chris, his brother, who are much different from him. David is inflicted with an emotional and physical scar which is never healed because of an incident with Chris .

Martin Luther King Jr. Essay :: biographies bio biography

The Key to Being King Martin Luther King Jr. has changed today's society by giving women and men of color the inspiration they needed to succeed in life and he set the stage for more opportunities in America. He may be an example of what your fate is when you try your hardest to achieve your dreams, but there is no doubt that his legacy to obtain equal rights is not still carrying on today. He has also shown that hard-work and diligence is the key to achieving your dreams and his way of thinking during the Civil Rights Movement gives you an idea about being passive aggressive without using violence . Before it all, racism, discrimination, and segregation were overlooked and were norms throughout society. Mr. King decided to be a voice for all people that believed everyone should have equal opportunity, and by doing this Martin Luther King was not considered a hero in that era. While most people thought of the American Dream, Mr. King had a dream of his own, in his famous speech he quotes, ?one day right there in Alabama little black boys and black girls will be able to join hands with little white boys and white girls as sisters and brothers? (King). Mr. King gave a strong speech to support his cultural values, and to be a voice for all the people who believed in the Civil Rights Movement. Mr. King?s cultural values were for social change and for the way of life to be better for everyone. He addressed the fact that using violence is not the right way to resolve anything, but that the principle of love will win battles. Although Mr. King?s personal life seemed to have many rumors attached, he still had strong moral values about equality, and what was right and wrong in the world we live in. He used peace, integrity, diligence, and expected the best for society to change. During his demonstrations Mr. King received many threats, beatings, and arrests, this clearly showed me that he was not considered a hero to most people during his time period (The Seattle Times). He and the other Civil Rights activist put in time and effort to get their points across to the public and to change the nation. In the beginning of his speech he says, ? I am happy to join with you today in what will go down in history as the greatest demonstration for freedom in the history of our nation?

Marxist Feminism :: essays research papers fc

Marxist Feminism The objective of my paper is to examine the connection between Capitalism and women’s both social and economical inequality. Marxist feminism explores this question by laying out an economic theory that shows a correlation between the emergence of capitalism, production and private property and the continued oppression of women. Other theorists argue that this oppression is due to an already existing patriarchal society. Is the exploitation of women in the home through an unfair division of labor a result of the beginnings of capitalism? Is this exploitation in the home a cause of other inequalities, mainly those in the wage labor market? Is capitalism bolstered by already existing patriarchal social relations, or is capitalism continuing to reinforce patriarchal systems? Finally is it possible to liberate women and reach true equality in our current capitalist economy? These are the main questions I will examine throughout my paper. These questions and the objective of my paper are significant to explore because they will help me to better understand my current status as a women in our capitalist economy. Understanding the origin of women’s economic oppression, and other inequalities, is a part of reaching an idea of how to remedy our current situation as women. It is important to me to answer the questions I have laid forth in order to take small steps in personally and possibly publicly, changing the current position of women. BIBLIOGRAPHY Booth, Janine, Rosie Woods, â€Å"Women, Capitalism & Socialism† Worker Liberty Magazine, no. 58, Oct. 1999. Braunstein, Elissa, Nancy Folbre, â€Å"To Honor & Obey: Efficiency, Inequality & Patriarchal Property Rights, Feminist Economics, Vol. 7, no. 1, Nov 2001. Engels, Frederick. The Origin of the Family, Private Property and the State, 1972 (original date 1884). Hartmann, Heidi â€Å"Capitalism, Patriarchy, and Job Segregation by Sex† in Zillah Eisenstein (ed.) Capitalist Patriarchy & the Case for Socialist Feminism, New York: Monthly Review Press, 1979. Hartmann, Heidi â€Å" The Unhappy Marriage of Marxism & Feminism: Toward a More Progressive Union† in Lydia Sargent (ed.

12 Angry Men and To Kill A Mockingbird

Brain Storming†¦ Compare and contrast the two trials of Tom Robinson in To Kill a Mockingbird and Twelve Angry Men. * Similarities: * In To Kill a Mockingbird, Atticus defends Tom Robinson even though there was little chance he could win the trial. He did all he could to help Tom, and put 100% effort into the trial. In Twelve Angry Men, juror number 8 defends the boy, even though everyone else believes he’s guilty. They both did not give up and in it till the end. * They are dealing with prejudice in both.In To Kill a Mockingbird, the prejudice is seen because Tom is a black man going against a white man’s word, and the jury is all white and prejudice. In Twelve Angry Men, prejudice is seen because the boy in trial is from the slums; he is criticized because of where he lives. * Juror # 8 and Atticus both use evidence and facts to prove their point. They use logos. * In both the book and the play, a life is at stake. The defendant would be put in the chair if prove n guilty. * You never find out if the defendant is truly innocent or guilty. You only find out what the jury decides. The words of witnesses are doubtful. * Differences: * Atticus lost the trial, but juror # 8 convinced the rest of the jury to vote â€Å"not guilty†. * Atticus is a lawyer, so he was defending Tom in court. Juror # 8 was part of the jury and was defending the boy against the rest of the jury, trying to get them to vote â€Å"not guilty† * Tom is accused of rape; the boy is accused of murder. * In Twelve Angry Men, there is more physical evidence of the crime then in To Kill a Mockingbird. In To Kill a Mockingbird there is mostly just the word of witnesses for evidence.

What are Robots and how are they being used now days?

IntroductionRobots ar change state the most reliable and used unreal tools in some(prenominal) aspects of human invigoration (Peter, H. 2013). Robots atomic number 18 mechanic everyy self operated tools that mess help us in manufacturing and in difficult surgeries much(prenominal) as obsession something really small that behindnot be held or seen by domain. This article pull up stakes excuse the importance of zombies and its role in qualification human sprightliness easier. However, we must image that Robots leave behind never replace humans in all aspect of live.Helpful Things that Robots doThe Robot is a tool that tail do different and difficult types of jobs such as in hospitals and manufacturing. Some people feel equal its more(prenominal) beneficial to let the zombie do a surgery because it is really finished. Robot do-nothing also build tiny things in manufacturing because they ar faster and more immaculate than humans. In some countries Robots are world used to replace house carnals like dogs, cats, rabbits, rats, guinea pigs and others. These Robot Pets are machines alternatively than living things and can give their owners push-down store of delight and they can also get a line us about real animal (Parker, S. 2010). Some robots are great fun and many people like to bunco with them because they are more challenging and fun to play with. For example, when you play Chess against a Robot it can defeat you very easily because it can think in advance of every move it can generate to win the game.Disadvantage of RobotsRobots have also many drawbacks such as it uses a pass on of power to function properly. Also, if the power is out, the robot will not function. Another drawback is that the robot cost a lot of cash to be built for a particularized job. However, in the coming years as technology is improving, Robots will become more and more part of our day-to-day life and cheaper to have. As Robots become more reliable, it will take over many tasks that are currently only being handled by humans. This is one of the main reasons for the increased of unemployment right off a days and more will be expected in the time to come as the technology continue to improve.Conclusion at present days Robots are very reformative and widely used in many aspects of our day-to-day life. They are considered smart tools that can be programmed to perform certain tasks that are normally handled by humans in a faster and more accurate way. However, we must understand that Robots will never replace humans in all aspects of life. At the end of the day they are only machines that are created by humans

Dutch Disease

(1. What is meant by the term? ) Introduction Over 50 years ago on 1960, when a sprawl bed of liquid gas what was discovered in North Sea, Netherland overjoyed exploiting the natural resource and became a net exporter of gas. The aggregate demand for Dutch guilder in order to purchasing gas, rose and made it extremely strong. It left a lot of currency to a level the manufacturing export was no longer competitive.To begin, low let us examine the indicators of the disease.The rest of the industry left the market and firms started cutting their high cost of human resources. Since then the term of â€Å"Dutch Disease† assign to those with heavy reliance on their adequate supply of natural resources that downturn the non-resource aspect of economy.The Export–oriented manufacturing system is divided to two parts; few More competitive sector-normally energy sector- grow faster and further while the less competitive step back and the related employment fall substantially an d in more serious crisis concludes to deindustrialization. Both mentioned event are correlated with exchange rate development.It might how have set up.

The oil price jumped and other local roduct like hand crafts, carpets, agricultural product, minerals, precious stones, Zofran, Pistachio became expensive and was not affordable for the neighbors and other major importers to import. Such small industries never sustained in the market and some of them wiped out. Iran became the largest importer of rice, wheat, carpets. That took many jobs and money out of economy.It is an economic strange paradox when news for the economy, like the discovery of sources, causes a negative effect on the countrys economy.In both situations, their intake of money from oil exportation is huge. It strengthens the Ruble wired and impact the export revenue as a whole. Besides pouring unmanaged wealth problem, the direct investors intend to invest in mines and oil/gas wells and rigs or take over the related companies (direct investment). Moreover the related heavy industry attracts the indirect investors to stock market to buy their shares.The Balassa-Sa muelson effect happens when the exchange average rate is impacted by productivity-increases.

Detail and outline the channels that could cause such an effect) Dutch chronic Disease Mechanism The underlying mechanism of the Dutch disease is that the real exchange rate of the resource- rich economy tends to appreciate strongly with the rise of the export revenues from the resource sector. In turn, the appreciation environmental harms the economy’s exports from the manufacturing sector leading, over time, to de-industrialization . Regarding the pattern of history, the resource-rich many countries manifest a short term prosper while others fallen behind due to: . Natural Resource scientific discovery and exploitation 2.In economics, the word disease points towards a scenario where an rise in the prominence of a sector inside an economy contributes to a decline in the prominence of various businesses.Resource price artificially inflate the hard currency 2. Run up in commodity price 3. Losing price competition in market 4. Become weak in scale manufacturing sector 5.Th e spike in petroleum industry resulted in the decrease of exports.

Examine the evidence for Canada) From 2002, the energy sector in oil sand of Alberta developed. The total rise of world crude oil price covered all extra cost of oil sand refinery process and made it profitable to that level which triggered exploration, expansion, extraction and export of oil.Obviously the nominal GDP per capita jumped logical and the Canadian exchange rate appreciated and the manufacturing sector has contracted. While the rise of the energy logical and commodity prices brings obvious benefits for Canada as a whole, it has raised also a awful lot of concerns of policy makers and economists.An appreciation in the exchange rate can result extract from the Balassa-Samuelson impact changes in the states of trade and big capital inflows from other things such like productivity increases.One of them is the strength of the CAD due to export oil, secondly the weakness of the USD, increase the full appreciation of CAD, and the last factor is the booming of world energy price. Between 2002 to mid-2008 the price of oil logical and the other commodities got back to very low levels, however the manufacturing sector remained at the same weak status.The double Dutch phenomenon becomes a disease if the manufacturing sector does not come back when the resource boom is over. (4.Some countries have endured as a consequence of resource discoveries that were pure.

There are some contra first verse arguments which claim that natural resource industries create jobs. Strong currency brings significant growth. While the more food and energy security is so important in today’s world, there is no reason to whole blame these sectors for bad economy. Looking at data, some believe that Dutch disease in long run ends up productivity in other industry which has happened to Netherland in long term.Many nations have got into problems.Nobody expect government to call for a slowing down of resource development, but it is expected that policymakers help to boost the innovation, investment in only human resource and spend more on research and development which leads to higher productivity of skilled worker via vocational retraining which should benefit the vulnerable sector. Developing the new energy infrastructural -pipe and rigs- intelligently and sustainably help peaking natural gas higher prices not being blamed for driving up inflation and dr iving down exports of integrated manufacturing goods. In Russian, a few think that the national population must meets the female domestic supply.They claim that they are not that much depends on export revenue.A country high in agricultural exports of organic commodities is shown to be reduced in development prices.

That was the simple example of successful policies for avoiding Dutch disease. Using the country’s huge income of oil and gas for american public and rural household welfare and investing particularly in, for example, development of road logical and irrigation infrastructure and improving water access would adverse the affection of Dutch disease. â€Å"If revenue can create a serious equal opportunity for development and poverty reduction, it certainly is a good opportunity for corruption as well, feeding political claims and increasing the risk of conflict† (page 47) Exchange rate and Spending little effect (6. ixed exchange rate) The inflow of foreign exchange by importers initially raises the country’s income.America has come a long way.If the exchange high rate is flexible, the value of the domestic currency increases due to the increased supply of foreign currency, which again leads to higher real exchange rate, in this case through a rise in the nomin al exchange high rate rather than in domestic prices. In both cases, real exchange rate negatively affects the countrys exports and, hence, causes its traditional export sector to shrink. This entire making process is called the â€Å"spending effect. † †¢Corden, W.The supply of wealth might be uneven.

1982. Booming Sector and De-Industrialisation in a Small more Open Economy.The Economic Journal, 92 (368) pp. 825-848.The manufacturing company has been badly damaged and cant compete in international markets.Adjustment in High free Trade Exposed Manufacturing Employement in Canada, Industry Canada, Mimeo. †¢http://www. imf. org/external/pubs/ft/fandd/2003/03/ebra.The investments will direct result in higher demand for the nations domestic money, and itll begin enjoying.