Life :: essays research papers

THE STORY OF LIFE Sometimes people come into your life and you know right away that they Were meant to be there, to serve some sort of purpose, teach you a Lesson, or to help you figure out who you are or who you want to become. You never know who these people may be (possibly your roommate, neighbor, worker, long-lost friend, lover, or even a complete stranger), but when you lock eyes with them, you know at that very moment they will affect your life in some profound way. And sometimes things happen to you that may seem horrible, painful, and unfair at first, but in reflection you find that without overcoming those obstacles you would have never realized your potential, strength, willpower, or heart. Everything happens for a reason. Nothing happens by chance or by means of good luck. Illness, injury, love, lost moments of true greatness, and sheer stupidity all occur to test the limits of your soul. Without these small tests, whatever they may be, life would be like a smoothly paved, straight, flat road to nowhere. It would be safe and comfortable, but dull and utterly pointless. The people you meet who affect your life, and the success and downfalls you experience, help to create who you are and who you become. Even the bad experiences can be learned from. In fact, they are probably the most poignant and important ones. If someone hurts you, betrays you, or breaks your heart, forgive them, for they have helped you learn about trust and the importance of being cautious when you open your heart. If someone loves you, love them back unconditionally, not only because they love you, but because in a way, they are teaching you to love and how to open your heart and eyes to things. Make every day count. Appreciate every moment and take from those moments everything that you possibly can for you may never be able to experience it again. Talk to people that you have never talked to before, and actually listen. Let yourself fall in love, break free, and set your sights high. Hold your head up because you have every right to. Tell yourself you are a great individual and believe in yourself, for

Plato Thought on Education Essay

â€Å"The object of education is to turn the eye which the soul already possesses to the light. The whole function of education is not to put knowledge into the soul, but to bring out the best things that are latent in the soul, and to do so by directing it to the right objects. The problem of education, then, is to give it the right surrounding. † (Plato) In the fifth century B. C. E Plato was born into an aristocratic Greek family. As a youngster his intention was to be engaged in politics. However in his twenties his thoughts were change after coming into the circle of Socrates, who was to be the lasting influence on his thought. Hence, following the execution of Socrates on accusations of the corruption of youth Plato abandoned direct involvement in politics and turned to writing and education. Plato was well known for his works which were all written in the form of dialogues. In the Republic, written about 385 B. C. E and in the Laws, his last work, on which he was still at work at the end of his life Plato addresses childhood in the context of education. Plato saw education as â€Å"the one great thing†, no scheme of human life was so important to him, since he rejected birth as a criterion for distributing the function of education. He believes that the aim of education was the harmonious development of human personality with the central purpose was to produce the right type of individualities in the state. Therefore, Plato saw the state primarily as an educational entity. His scheme of education was greatly influenced by Spartan system of education. In the Spartan system the family had no control over the education of its members. The state was controlling all aspects of education. In the Republic, Plato devotes much attention to the education of the child as a future citizen. He believes that the child belongs to the state and its education is the responsibility of the state in addition education must be compulsory for all. Furthermore, Plato was not concerned with training children for a trade but rather with giving them an education in virtue, which is to produce â€Å"a keen desire to become a perfect citizen who knows how to rule and be ruled† in turn. Education was seen as the correct channelling of pains and pleasures, aiming at establishing â€Å"a nature in which goodness of character has been well and truly established† so as to breed a familiarity with reason, since Plato saw reason as man’s true nature, therefore it has to be nurtured from childhood by irrational means. In Plato views education was to begin before birth therefore he recommends that the care of the soul and body of the child begin with prescribed walks for the pregnant woman before birth. For the first two years of life children should be kept well wrapped up, even though they should be taken to the country or on visits. Also, they should be carried until they are old enough to stand on their own to prevent subjecting their limbs to too much pressure. This was necessary since the main importance of movement lies in its influence on the early development of a well-balanced soul and the cultivation of the body is mainly for the soul’s sake. Another aspect of education was the formation of character. Plato saw storytelling as the main tool in the development of character. Since stories should provide models for children to imitate, seeing that as ideas taken in at an early age become indelibly fixed. Moreover storytelling must begin at an earlier age than physical training. â€Å"Physical training may take two or three years, during which nothing else can be done; since weariness and sleep are unfavourable to study. Physical training was vital as the exercises were an important test of character. Additionally a child’s character will also be formed while he or she plays Plato attached much importance to children’s games. Even though the sexes are to be separated at the age of six, he believes that children are to be brought together for games. Teachers must provide children with miniature tools of the different trades, so that they can use the children’s games to channel their pleasures and desires toward the activities they will engage in when they are adults. However, children and adults should not imitate base characters when playing or acting, for fear of forming a habit that will become second nature. In addition to storytelling and play, reading, writing, music and arithmetic were an integral part of Plato’s educational system. Beginning at the age of ten a child is required to spend three years on reading, writing, and the poets, and another three learning the lyre. Then they would study elementary mathematics up to the age of seventeen or eighteen. He thought that all of this was to be done with as little compulsion as possible in, order to for them to learn â€Å"enough to fight a war and run a house and administer a state† (Republic, bk.7, 535-541). This period of education could not be extend or curtail neither by the child nor father either out of enthusiasm or distaste. Children were expected to work on their letters until they are able to read and write, but any whose natural abilities have not developed sufficiently by the end of the prescribed time to make them into quick or polished performers should not be pressed. Enforced exercise does no harm to the body, but enforced learning will not stay in the mind (Laws, bk. 7, 536). Plato also felt the necessity of moral education. The members of a society should learn that they are the members of one society and that they should live in the spirit of harmony and co-operation. Plato realizes that the better way of imparting moral instructions, is the sanction of supernatural authority. Plato also believes with conviction that a nation cannot be strong unless it believes in God. Certainly, Plato’s views on education have significantly influenced educational thought to this day and have become the basis of many educational policies His system of education includes instructions for the training of body, mind and soul. Plato also believed that an ideal state, embodying the highest and best capabilities of human social life, can really be achieved, if the right people are put in charge. Since the key to the success of the whole is the wisdom of the rulers who make decisions for the entire city, His view of philosophy as an educational activity and of education as the development of reason, the responsibility of which lies squarely with the state, is still a living educational challenge.

Managerial Leadership role for Nurses’ Use of Research Evidence Essay

The rapid noticeable change in healthcare delivery coupled with professional responsibilities of nurses to incorporate research evidence into their decision making underscores the need to understand the factors involved in implementing evidence-based practice. Linking current research findings with patients’ conditions, values, and circumstances is the defining feature of evidence-based practice. Significant and rational for using evidence in practice in nursing care Evidence-based practice (EBP) is an approach to health care where the best evidence possible is used in health professionals to make clinical decisions for individual. It involves complex and conscientious decision-making based on the available evidence, patient characteristics, situations, and preferences( McKibbon, 1998). Evidence-based practice in nursing is defined as â€Å"integration of the best evidence available, nursing expertise, and the values and preferences of the individuals, families and communities who are served† (â€Å"Sigma Theta Tau International position statement on evidence-based practice February 2007 summary,† 2008). The gist of evidence based health care is the integration of individual clinical expertise with the best available external clinical evidence and the values and expectations of the patient. There are different recourses of evidence which includes the following: †¢Research Evidence: which refers to methodologically sound, clinically relevant research about the effectiveness and safety of interventions, the accuracy of assessment measures, the strength of causal relationships and the cost-effectiveness of nursing interventions. †¢Patients Experiences and Preferences: identification and consideration of patient’s experiences and preferences are central to evidence-based decision making. Patients may have varying views about their health care options, depending on factors such as their condition personal values and experiences, degree of aversion to risk, resources, availability of information, cultural beliefs, and family influences. †¢ Clinical Expertise. AS the mixing of these different types of evidence may be influenced by factors in the practice context such as available resources, practice cultures and norms leadership styles, and data management, we must consider the level of evidence while using the research evidence to take the proper decision, look to appendix A which is represent the level of evidence. (Haynes, Devereaux, & Guyatt, 2002; Sigma Theta Tau International position statement on evidence-based practice February 2007 summary,† 2008). Evidence-based practice is a prominent issue in international health care which is intended to develop and promote an explicit and rational process for clinical decision making that emphasizing the importance of incorporating the best research findings into clinical care to ensure the best possible treatment and care derived from the best available evidence (E. Fineout-Overholt, Levin, & Melnyk, 2004) Once a new research is completed new evidence comes into play every day, technology advances, and patients present with unique challenges and personal experiences(Krainovich-Miller, Haber, Yost, & Jacobs, 2009). The nurse who bases practice on what was learned in basic nursing education soon becomes outdated, then becomes dangerous. Patients are not safe if they do not receive care that is based on the best evidence available to assist them at the time their needs arise, so all aspects of nursing, from education to management to direct patient care, should be based on the best evidence available at the time (Reavy & Tavernier, 2008). Through reviewing the literature there is a dramatically changing and advancing in the technology, available body information and quality of care provided, the rapid pace of change in healthcare delivery coupled with professional responsibilities of nurses to incorporate research evidence into their provided care and decision making underscores the need to understand the factors involved in implementing evidence-based practice (Bostrà ¶m, Ehrenberg, Gustavsson, & Wallin, 2009; Ellen Fineout-Overholt, Williamson, Kent, & Hutchinson, 2010; Gerrish, et al., 2011; Gifford, Davies, Edwards, Griffin, & Lybanon, 2007). Before that nurses must first believe that basing their practice on the best evidence will lead to the highest quality of care and outcomes for patients and their families(Ellen Fineout-Overholt, et al., 2010; Melnyk, et al., 2004). To let change occuring, â€Å"there must be a clear vision, written goals, and a well-developed strategic plan, including strategies for overcoming anticipated barriers along the course of the change†(Melnyk, et al., 2004). Emerging evidence indicates that the  leadership behaviors’ of nurse managers and administrators play an important role in successfully utlizing research evidence into clinical nursing(Amabile, Schatzel, Moneta, & Kramer, 2004; Antrobus & Kitson, 1999; Gifford, et al., 2007). There is a consistency between many researches that clamethe importance role of the leadership and leadership factors such as support and commitment of managers on the staff at the implication of EBP(Aitken, et al., 2011; Antrobus & Kitson, 1999; Melnyk, et al., 2004; Winch, Creedy, & Chaboyer, 2002). Nurse managers and administrators are responsible for the professional practice environments where nurses provide care, and are strategically positioned to enable nurses to use research. As being a role model, administrators must be committed to provide the necessary resources such as EBP mentors, computers, and EBP education. Some administrators have tried to encourage a change to EBP by integrating EBP competencies into clinical promotions. However, Miller (2010) argue that this extrinsic motivational strategy is unlikely to be as effective as when people are intrinsically motivated to change. Also there is a claimed that if people are involved in the strategic planning process, they are more likely to change to EBP. Intervention protocol for promoting nurses compliance to EBP As the Decision making in health care has changed dramatically, with nurses expected to make choices which based on the best available evidence and continually review them as new evidence comes to light (Pearson et al, 2007). Evidence-based practice involves the use of reliable, explicit and judicious evidence to make decisions about the care of individual patients. As an important role in providing safe and high quality care the nurses must take into account the quality of evidence, assessing the degree to which it meets the four principles of feasibility, appropriateness, meaningfulness and (Doody & Doody, 2011; Johnson, Gardner, Kelly, Maas, & McCloskey, 1991). What nurses need to operate in an evidence-based manner, is to be aware of how to introduce, develop and evaluate evidence-based practice. There more than one model for introducing the EBP in health care one of them that I chose is the Iowa model. The Iowa model focuses on organization and collaboration incorporating conduct use of research, along with other types of evidence(Doody & Doody, 2011; Johnson, et al., 1991). Since its origin in 1994, it has been continually referenced in nursing journal articles and extensively used in clinical research programmes. This model uses key triggers that can be either problem focused or knowledge focused, leading staff to question current nursing practices and whether care can be improved through the use of current research findings(Bauer, 2010; Doody & Doody, 2011; Johnson, et al., 1991; Titler, et al., 2001). By using Iowa Model; a question is generated either from a problem or as a result of becoming aware of new knowledge. Then a determination is made about the question relevance to organizational priorities. If the question posed is relevant, then the next step is to determine if there is any evidence to answer the question. Once the evidence has been examined, if there is sufficient evidence, then a pilot of the practice change is performed. If there is insufficient evidence, then the model supports that new evidence should be generated through research (Bauer, 2010). Step one of the Iowa model is to formulate a question. The question if asked in a PICO format is easier to use to search the literature. A PICO format uses the following method to frame the question: Frame question in PICO format †¢ P= Population of interest †¢ I= Intervention †¢ C= Comparison of what you will do †¢ O= Outcome(Hoogendam, de Vries Robbà ©, & Overbeke, 2012). The final step to the process is to share the outcomes of the practice change with other in the form of an article or poster. In using the Iowa model, there are seven steps to follow in detail as it is outlined in the figure shown in appendix B. Step 1: Selection of a topic In selecting a topic for evidence-based practice, several factors need to be considered. These include the priority and magnitude of the problem, its application to all areas of practice, its contribution to improving care, the availability of data and evidence in the problem area, the multidisciplinary nature of the problem, and the commitment of staff. Step 2: Forming a team The team is responsible for development, implementation, and evaluation. The composition of the team should be directed by the chosen topic and include all interested stakeholders. The process of changing a specific area of practice will be assisted by specialist staff team members, who can provide input and support, and discuss the practicality of guideline. A bottom-up approach to implementing evidence-based practice is essential as change is more successful when initiated by frontline practitioners, rather than imposed by management. Staff support is also important. Without the necessary resources and managerial involvement, the team will not feel they have the authority to change care or the support from their organization to implement the change in practice. To develop evidence-based practice at unit level, the team should draw up written policies, procedures and guidelines that are evidence based. Interaction should take place between the organization’s direct care providers and management such as nurse managers, to support these changes(Antrobus & Kitson, 1999; Cookson, 2005; Doody & Doody, 2011; Hughes, Duke, Bamford, & Moss, 2006). Step 3: Evidence retrieval Evidence should be retrieved through electronic databases such as Cinahl, Medline, Cochrane and up-to-date web site. Step 4: Grading the evidence To grade the evidence, the team will address quality areas of the individual research and the strength of the body of evidence overall (see appendix A for level of evidence). Step 5: Developing an Evidence-Based Practice (EBP) standard After a critique of the literature, team members come together to set recommendations for practice. The type and strength of evidence used in practice needs to be and based in the consistency of replicated studies. The design of the studies and recommendations made should be based on identifiable benefits and risks to the patient. This sets the standard of practice guidelines, assessments, actions, and treatment as required. These will be based on the group decision, considering the relevance for practice, its feasibility, appropriateness, meaningfulness, and effectiveness for practice. To support evidence-based practice, guidelines should be devised for the patient group, health screening issues addressed, and policy and procedural guidelines devised highlighting frequency and areas of screening. Evidence-based practice is ideally a patient centered approach, which when implemented is highly individualized. Step 6: Implementing EPB For implementation to occur, aspects such as written policy, procedures and guidelines that are evidence based need to be considered. There needs to be a direct interaction between the direct care providers, the organization, and its leadership roles (e.g. nurse managers) to support these changes. The evidence also needs to be diffused and should focus on its strengths and perceived benefits, including the manner in which it is communicated. This can be achieved through in-service education, audit and feedback provided by team members. Social and organizational factors can affect implementation and there needs to be support and value placed on the integration of evidence into practice and the application of research findings(Aitken, et al., 2011; Doody & Doody, 2011; Gerrish, et al., 2011; Reavy & Tavernier, 2008) Step 7: Evaluation Evaluation is essential to seeing the value and contribution of the evidence into practice. A baseline of the data before implementation would benefit, as it would show how the evidence has contributed to patient care. Audit and feedback through the process of implementation should be conducted and support from leaders and the organization is needed for success. Evaluation will highlight the programme’s impact. Barriers also need to be identified. Information and skill deficit are common barriers to evidence-based practice. A lack of knowledge regarding the indications and contraindications, current recommendations, and guidelines or results of research, has the potential to cause nurses to feel they do not have sufficient training, skill or expertise to implement the change. Awareness of evidence must be increased to promote the translation of evidence into practice . A useful method for identifying perceived barriers is the use of a force field analysis conducted by the team leader. Impact evaluation, which relates to the immediate effect of the intervention, should be carried out. However, some benefits may only become apparent after a considerable period of time. This is known as the sleep effect. On the contrary, the back-sliding effect could also occur where the intervention has a more or less immediate effect, which decreases over time. We must not to evaluate  too late, to avoid missing the measures of the immediate impact. Even if we do observe the early effect, we cannot assume it will last. Therefore, evaluation should be carried out at different periods during and following the intervention (Doody & Doody, 2011). Nursing leadership is an essential role for promoting evidence-based practice while the nurse managers and administrators are responsible for the professional practice environments where nurses provide care, are strategically positioned to enable nurses to use research. AS the leadership is essential for creating change for effective patient care the leadership behaviors are critical in successfully influencing the stimulation, acceptance, and utilization of innovations in organizations (Antrobus & Kitson, 1999; Gifford, et al., 2007). From my perspective I consider that the leaders and managers are the corner stone for utilizing researches and make practices based on evidence. By playing a role model for staff and handling the authority they have a magic force to urges the staff to use evidence based in there practice. Leaders can encourage the staff to use EBP in their practice in several ways such as increase the staff awareness, stimulating the intrinsic motivation of people, implying an effort to increase the will and internal desire to change through support encouragement, education, and appealing to a common purpose, monitoring performance, strengthen the body of knowledge that the staff have by forcing them to attend and participate in conferences, workshops & Journal clups, giving rewards to staff who collaborate in finding, utilizing and applying the EBP and make promotion and appraisal according to adherence to application of EBP. Implication of EBP For implementation to occur, aspects such as written policy, procedures and guidelines that are evidence based need to be considered. There needs to be a direct interaction between the direct care providers, the organization, and its leadership roles (e.g. nurse managers) to support these changes. The evidence also needs to be diffused and should focus on its strengths and perceived benefits, including the manner in which it is communicated. This can be achieved through in-service education, audit and feedback provided by team members. Social and organizational factors can affect implementation and there needs to be support and value placed on the integration of evidence into practice and the application of research findings. There are many ways that can be used to create an environment to implement and sustain an area of EBP such as : -Development of EBP champions; – Use of EBP mentors; – Provision of resources such as time and money; – Creation of a culture and expectation related to EBP; – Use of practical strategies including EBP workgroups, journal club and nursing rounds (Aitken, et al., 2011). EBP is being used in every aspect of the life, especially in the health care. The most common application of EBP is not only in intervention or treatment plane, but also the EBP process has been applied to making choices about diagnostic tests and protocols to insure thorough and accurate diagnosis, selecting preventive or harm-reduction interventions or programs, determining the etiology of a disorder or illness, determining the course or progression of a disorder or illness, determining the prevalence of symptoms as part of establishing or refining diagnostic criteria, completing economic decision-making about medical and social service programs. Nursing research proves pivotal to achieving Magnet recognition, yet the term research often evokes an hunch of mystery. Most of the policy, guidelines. And protocols that guide the work in the organization are based on evidance (Weeks & Satusky, 2005). Also, it is also useful to think of EBP as a much larger social movement. Drisko and Grady (2012) argue that at a macro-level, EBP is actively used by policy makers to shape service delivery and funding. EBP is impacting the kinds of interventions that agencies offer, and even shaping how supervision is done. EBP is establishing a hierarchy of research evidence that is privileging experimental research over other ways of knowing. There are other aspects of EBP beyond the core practice decision-making process that are re-shaping social work practice, social work education, and our clients’ lives. As such, it may be viewed as a public idea or a social movement at a macro level (â€Å"Evidence-Based Practice: Why Does It Matter?,† 2012). Cost effectiveness of using EBP in health care  Beneficial outcomes of the implementation and use of evidence-based practice by staff nurses include increased ability to offer safe, cost-effective,  and patient-specific interventions. Critical thinking skills and leadership abilities can also grow because of the use of evidence based practice; it is a way for staff nurses to become involved in change and regain ownership of their practice (Reavy & Tavernier, 2008). EBP used in clinical practice lead to make improvement in quality of provided care, which lead to improve the patients outcome, patient satisfaction and employee satisfaction. All these aspect are directly and indirectly lead to increase the cost effectiveness of the organization. When the patient satisfaction increased the patient acceptance to the organization increased, the employee satisfaction also increases and turnover will decrease all these things will increase the financial revenue to the organization. Also when using EBP in health care this will lead to decrease errors, complications and losses (e.g. compliance of evidence based infection control guidelines will lead to decrease incidence of infection, decrease length of stay an d decrease the cost of patient treatment), another example is using EBP to treat diabetic foot will result in decreasing the loses and increases the satisfaction so adherence to EBP will be costly effective when it result in better outcome, quality of care and satisfaction. Sometimes using EBP in certain area is costly; in such cases we must weighing the benefits ( immediately and after considered period of time) and mak e our decision based on the collected data and information. References: Aitken, L. M., Hackwood, B., Crouch, S., Clayton, S., West, N., Carney, D., et al. (2011). Creating an environment to implement and sustain evidence based practice: A developmental process. Australian Critical Care, 24(4), 244-254. Amabile, T. M., Schatzel, E. A., Moneta, G. B., & Kramer, S. J. (2004). Leader behaviors and the work environment for creativity: Perceived leader support. The Leadership Quarterly, 15(1), 5-32. Antrobus, S., & Kitson, A. (1999). Nursing leadership: influencing and shaping health policy and nursing practice. Journal of Advanced Nursing, 29(3), 746-753. Bauer, C. (2010). Evidence Based Practice:Demystifying the Iowa Model Providing optimal care through promotion of professional standard, networking and development, 25(2). Bostrà ¶m, A.-M., Ehrenberg, A., Gustavsson, J. P., & Wallin, L. (2009). Registered nurses’ application of evidence-based practice: a national survey. Journal Of Evaluation In Clinical Practice, 15(6), 1159-1163. Cookson, R. (2005). Evidence-based policy making in health care: what it is and what it isn’t. Journal Of Health Services Research & Policy, 10(2), 118-121. Doody, C. M., & Doody, O. (2011). Introducing evidence into nursing practice: using the IOWA model. British Journal of Nursing, 20(11), 661-664. Evidence-Based Practice: Why Does It Matter? (2012). ISNA Bulletin, 39(1), 6-10. Fineout-Overholt, E., Levin, R. F., & Melnyk, B. M. (2004). Strategies for advancing evidence-based practice in clinical settings. Journal of the New York State Nurses Association, 35(2), 28-32. Fineout-Overholt, E., Williamson, K. M., Kent, B., & Hutchinson, A. M. (2010). Teaching EBP: strategies for achieving sustainable organizational change toward evidence-based practice. Worldviews On Evidence-Based Nursing / Sigma Theta Tau International, Honor Society Of Nursing, 7(1), 51-53. Gerrish, K., Guillaume, L., Kirshbaum, M., McDonnell, A., Tod, A., & Nolan, M. (2011). Factors influencing the contribution of advanced practice nurses to promoting evidence-based practice among front-line nurses: findings from a cross-sectional survey. Journal of Advanced Nursing, 67(5), 1079-1090. Gifford, W., Davies, B., Edwards, N., Griffin, P., & Lybanon, V. (2007). Managerial leadership for nurses’ use of research evidence: an integrative review of the literature. Worldviews on Evidence-Based Nursing, 4(3), 126-145. Haynes, R. B., Devereaux, P. J., & Guyatt, G. H. (2002). Clinical expertise in the era of evidence-based medicine and patient choice. ACP Journal Club, 136(2), A11-A14. Hoogendam, A., de Vries Robbà ©, P. F., & Overbeke, A. J. P. M. (2012). Comparing patient characteristics, type of intervention, control, and outcome (PICO) queries with unguided searching: a randomized controlled crossover trial. Journal Of The Medical Library Association: JMLA, 100(2), 121-126. Hughes, F., Duke, J., Bamford, A., & Moss, C. (2006). Enhancing nursing leadership: Through policy, politics, and strategic alliances. Nurse Leader, 4(2), 24-27. Johnson, M., Gardner, D., Kelly, K., Maas, M., & McCloskey, J. C. (1991). The Iowa Model: a proposed model for nursing administration. Nursing Economic$, 9(4), 255-262. Krainovich-Miller, B., Haber, J., Yost, J., & Jacobs, S. K. (2009). Evidence-based practice challenge: teaching critical appraisal of systematic reviews and clinical practice guidelines to graduate students. Journa l of Nursing Education, 48(4), 186-195. Melnyk, B. M., Fineout-Overholt, E., Feinstein, N. F., Li, H., Small, L., Wilcox, L., et al. (2004). Nurses’ perceived knowledge, beliefs, skills, and needs regarding evidence-based practice: implications for accelerating the paradigm shift. Worldviews on Evidence-Based Nursing, 1(3), 185-193. Reavy, K., & Tavernier, S. (2008). Nurses reclaiming ownership of their practice: implementation of an evidence-based practice model and process. Journal of Continuing Education in Nursing, 39(4), 166-172. Sigma Theta Tau International position statement on evidence-based practice February 2007 summary. (2008). Worldviews on Evidence-Based Nursing, 5(2), 57-59. Titler, M. G., Kleiber, C., Steelman, V. J., Rakel, B. A., Budreau, G., Everett, C. L. Q., et al. (2001). The Iowa Model of Evidence-Based Practice to Promote Quality Care. Critical Care Nursing Clinics of North America, 13(4), 497-509. Weeks, S. K., & Satusky, M. J. (2005). Demystifying nursing research: to encourage compliance with Magnet accreditation standards, f urther your facility’s research initiatives. Nursing Management, 36(2), 42. Winch, S., Creedy, D., & Chaboyer, W. (2002). Governing nursing conduct: the rise of evidence-based practice. Nursing Inquiry, 9(3), 156-161.

Face Down On The Ground essays

Face Down On The Ground essays Throw me into the hands of angry sinners. Has not every man felt thrown into reprobate hands? Father I beg of you...take the cup of suffering away from me. Ive been wallowing in my own olive garden, counting the tears that stream down my face. Ive been weeping over my losses and the tribulations I must face. What a glorious depiction of such agony. This is truly a beautiful painting of horror and distress, an inaccurate illustration of a man conjured to be a new man over time. This man crushed with such an amount of grief that he would rather die, but yet a man claiming honors that belong properly only to God himself. Is this the only solution for sin? Is this the messiah inaccurately portrayed on his knees peacefully praying? It is too easy to relate to such a Godly figure. Give me back the worldly possessions I have lost. Give me back my bride. Here I lay face down on my olive garden trying to rise to my knees. Stay awake and watch with me even one hour, Christ begs. Dont leave me here alone to decay, I plead. Miracles climaxed in His own bodily resurrection just after the agony suffered in the garden. I count my tears one by one. I count five hundred and thirty one tears. Ive been thrown into emptiness and solitude just as Christ was. Ive been on my face demanding a way out. My soul has been crushed with grief to the point of death. If the definition of being Christian is being Christ-like than I have never been more Christian. Such a photo as this is a mockery of the elementary descriptions outlined in the New Testament of the Bible: Jesus began to be filled with horror and deep distress. He told them, "My soul is crushed with grief to the point of death. Stay here and watch with me." He went on a little farther and fell face down on the ground. "Everything is possible for you, Lord. Please take this...

Johnnie Johnson - World War 2 Johnnie Johnson

Johnnie Johnson - World War 2 Johnnie Johnson Johnnie Johnson - Early Life Career: Born on March 9, 1915, James Edgar Johnnie Johnson was the son of Alfred Johnson, a Leicestershire policeman. An avid outdoorsman, Johnson was raised locally and attended Loughborough Grammar School. His career at Loughborough came to an abrupt end when he was expelled for swimming in the school pool with a girl. Attending the University of Nottingham, Johnson studied civil engineering and graduated in 1937. The following year he broke his collar bone while playing for Chingford Rugby Club. In the wake of the injury, the bone was improperly set and healed incorrectly. Entering the Military: Possessing an interest in aviation, Johnson applied for entry into the Royal Auxiliary Air Force but was rejected based on his injury. Still eager to serve, he joined the Leicestershire Yeomanry. With tensions with Germany increasing in late 1938 as a result of the Munich Crisis, the Royal Air Force reduced its entry standards and Johnson was able to gain admission into the Royal Air Force Volunteer Reserve. After undergoing basic training on weekends, he was called up in August 1939 and sent to Cambridge for flight training. His flying education was completed at 7 Operational Training Unit, RAF Hawarden in Wales. The Nagging Injury: During the course of training, Johnson found that his shoulder caused him great pain while flying. This proved particularly true when flying high-performance aircraft such as the Supermarine Spitfire. The injury was further exacerbated following a crash during training in which Johnsons Spitfire did a ground loop. Though he tried various types of padding on his shoulder, he continued to find that he would lose feeling in his right arm while flying. Briefly posted to No. 19 Squadron, he soon received a transfer to No. 616 Squadron at Coltishall. Reporting his shoulder problems to the medic he was soon given a choice between reassignment as a training pilot or undergoing surgery to reset his collar bone. Immediately opting for the latter, he was removed from flight status and sent to the RAF Hospital at Rauceby. As a result of this operation, Johnson missed the Battle of Britain. Returning to No. 616 Squadron in December 1940, he began regular flight operations and aided in downing a German aircraft the following month. Moving with the squadron to Tangmere in early 1941, he began to see more action. A Rising Star: Quickly proving himself a skilled pilot, he was invited to fly in Wing Commander Douglas Baders section. Gaining experience, he scored his first kill, a Messerschmitt Bf 109 on June 26. Taking part in the fighter sweeps over Western Europe that summer, he was present when Bader was shot down on August 9. Scoring his fifth kill and becoming an ace in September, Johnson received the Distinguished Flying Cross (DFC) and made flight commander. Over the next several months he continued to perform admirably and earned a bar for his DFC in July 1942. An Established Ace: In August 1942, Johnson received command of No. 610 Squadron and led it over Dieppe during Operation Jubilee. In the course of the fighting, he downed a Focke-Wulf Fw 190. Continuing to add to his total, Johnson was promoted to acting Wing Commander in March 1943 and given command of the Canadian Wing at Kenley. Despite being English-born, Johnson quickly gained the Canadians trust through his leadership in the air. The unit proved exceptionally effective under his guidance and he personally downed fourteen German fighters between April and September. For his achievements in early 1943, Johnson received the Distinguish Service Order (DSO) in June. A slew of additional kills earned him a bar for the DSO that September. Removed from flight operations for six months at the end of September, Johnsons total numbered 25 kills and he held the official rank of Squadron Leader. Assigned to No. 11 Group Headquarters, he performed administrative duties until March 1944 when he was placed in command of No. 144 (RCAF) Wing. Scoring his 28th kill on May 5, he became the highest-scoring British ace still actively flying. Top Scorer: Continuing to fly through 1944, Johnson kept adding to his tally. Scoring his 33rd kill on June 30, he passed Group Captain Adolph Sailor Malan as the top-scoring British pilot against the Luftwaffe. Given command of No. 127 Wing in August, he downed two Fw 190s on the 21st. Johnsons final victory of World War II came on September 27 over Nijmegen when he destroyed a Bf 109. During the course of the war, Johnson flew 515 sorties and shot down 34 German aircraft. He shared in seven additional kills which added 3.5 to his total. In addition, he had three probables, ten damaged, and one destroyed on the ground. Postwar: In the final weeks of the war, his men patrolled the skies over Kiel and Berlin. With the end of the conflict, Johnson was the RAFs second highest-scoring pilot of the war behind Squadron Leader Marmaduke Pattle who had been killed in 1941. With the end of the war, Johnson was given a permanent commission in the RAF first as a squadron leader and then as a wing commander. After service at the Central Fighter Establishment, he was sent to the United States to gain experience in jet fighter operations. Flying the F-86 Sabre and F-80 Shooting Star, he saw service in the Korean War with the US Air Force. Returning to the RAF in 1952, he served as Air Officer Commanding at RAF Wildenrath in Germany. Two years later he began a three-year tour as Deputy Director, Operations at the Air Ministry. After a term as Air Officer Commanding, RAF Cottesmore (1957-1960), he was promoted to air commodore. Promoted to air vice marshal in 1963, Johnsons final active duty command was as Air Officer Commanding, Air Forces Middle East. Retiring in 1966, Johnson worked in business for the remainder of his professional life as well as served as Deputy Lieutenant for the County of Leicestershire in 1967. Writing several books about his career and flying, Johnson died of cancer on January 30, 2001. Selected Sources James Edgar Johnnie JohnsonAir Vice Marshal James Johnnie JohnsonCentury of Flight: Johnnie Johnson

Hombres Necios by Sor Juana Essay Example | Topics and Well Written Essays - 500 words - 1

Hombres Necios by Sor Juana - Essay Example However, Sor Juana argues that these faults are caused by men themselves. This is seen in the first stanza of the poem where she argues that men wrongly accuse women forgetting that they are the ones to blame for the emergent faults. During the writing of the poem in the seventeenth century, gender equality was a main issue though it was hardly spoken about. Nonetheless, the poem gives a reflection of the scenario during this period while simultaneously condemning men’s actions against women. For example, the poem uses a relationship approach to show the inequality and atrocities committed to women. In every step of the relationship from courtship to the course of the relationship, men always strive to win and do not take responsibility for any fault at all but rather blame women. Generally, although Sor Juana argues for women, she does use the term ‘we’ in the entire poem. Additionally, the poem is arguably easy to understand owing to the short stanzas, four lines each, and the recurrence of the message. Although Sor Juana was from Mexico, the poem gives a reflection of the general societal setting in Latin America. During this period women’s voice and contributions to the society were limited with only two opportunities as either housewives or nuns. Although nuns enjoyed some privileges such as learning, they were still held back by the limitations imposed on women. As such, Sor Juana’s poem critiquing men was a bold move from a woman making her one of the first pioneers of feminism. Considering the odds against women, it is only logical to ask what motivated her. Did other women approve of her ways? More importantly, did her efforts bear any fruits? Additionally, the poem is relatable to the modern society where issues revolving around gender equality are still imminent. Gender inequality is not only an issue in Latin America but rather a global

Roots of conflic, viol and peace Essay Example | Topics and Well Written Essays - 1000 words

Roots of conflic, viol and peace - Essay Example In the effort to bridge this gap, peace paradigms such as power politics and world order were developed. The power politics paradigm, which is dominant in matters of international relations, stipulates that there is an absence of universally acceptable values that would serve all international actors. Power politics in characterized the use of threats by one nation to the other, be it military, political and/or economic (Wight, Bull and Holbraad, 2002). It is as a result of the absence of prevailing international government that renders international politics unpredictable and volatile, with nations perpetually changing alliances. The end result is an exposure to violence, insecurity and power imbalance. According to the power politics peace paradigm, it is imperative for states to engage in the implementation of policies that would effectively serve their national objectives construed as the acquisition of military strength and material power with the aim of deterring and compelling other nations. A nation that is known to possess material and military power is less likely to be expos ed though the acquisition of such rises serious moral and ethical issues. This means that states have no alternative but to attempt to steer away from international humanistic values that are pegged on the trust and good will of nations. The lack of a common and unified moral standard that can be used as the guiding point for international cooperation means that states are left with no alternative but to strive and compete against each other in the quest to attain the perceived security providers (Gandhi Marg Magazine, 2002). The basic idea, therefore behind power politics is that for peace to prevail, people must be prepared for war. The implicit being that the human competitive aspect predisposes the world to violence and it is through the forceful implementation of order, peace is attained. While power politics is not entirely indifferent to issues such as environmental degradation and poverty, it has been criticized for advocating for a moral minimalism approach, meaning that the world has been condemned to a self help attitude, with the stronger nations overpowering less empowered nations (Wight, Bull and Holbraad, 2002). On the hand, the world order paradigm stipulates that peace can be attained through the power of law. It calls for the development of sustainable cooperation among states, inter governmental organization and non governmental organizations. The proponents of world order consider the power politics approach as a recipe of inevitable disorder. They future insist that human have both the potential to be selfish and otherwise and if they so choose, human can cooperate for the sake of the greater good. According to the proponents of the world order, international cooperation is critical in the decentralization state centered international relations models that have completely failed to secure the general interests of human beings. The fact is the world is basically a global village due to immense technological advancements. Issues such as peace, poverty, disease, human rights violations, environmental degradation, disease and weapons of mass destruction, are a major concern to people across the divide. It is for this reason that the world order stresses the on the possibility of humans to choose to cooperate. It also