Woman and Dinner Party Essay Example for Free

Woman and Dinner Party Essay Many men these think that women don’t know how to stay calm in a situation. They say men know how to control their emotions way more than women do. The short story the Dinner Party by Gardner carries out a message. The message is that women can have just as much control as men can. The story starts off at a fancy dinner party in India at a colonial official’s house. A young woman starts a discussion on how women have overcome the jumping-on-a-chair-at-the-sight-of-a-mouse era. A colonel disagrees with this and says that a woman’s first reaction in a crisis is to scream. He thinks men have more self control than women because even though they make feel like screaming they don’t. An American naturalist was present at the dinner party. He decides to look around the room and notices a strange look come across the hostess face and her muscles contracting. She then whispers to the native boy behind and his widen and brings in a bowl of milk. In India this means bait for a snake. He comes to the conclusion that there is a cobra in the room. He looks around the room but the room looks clear. He knew the snake was under the table and he his first impulse was to jump back and warn the others but he had stayed calm. He then tells the people in the room what they must do. He said he wanted to test the self control that the people had and told them about the snake. The snake does not strike and everything under control. The host speaks up and tells the colonel that he was right and that men have more control. The American asks the hostess how she knew about the snake and she then says â€Å"It was crawling across my foot.† He we can see that the colonel was wrong and that women can have just as much control as men. Mona Gardner carried out the message by showing us the self control of men but also showed us that woman can have the same control and that they have overcome that stereotype.

Handwashing Practices among Health Workers

Handwashing Practices among Health Workers BACKGROUND Hand washing or hand hygiene is the process of cleaning ones hands with or without the use of water or another liquid, or with the use of soap for the purpose of removing soil, dirt, and/or microorganisms. Handwashing involves five simple and effective steps; Wet, Lather, Scrub, Rinse and Dry. Regular handwashing, particularly before and after certain activities, is one of the best ways to remove germs, avoid getting sick, and prevent the spread of germs to others. Its simple, its quick, and it can keep us all from getting infected (CDC, 2016). The provision of healthcare worldwide is always associated with a potential range of safety problems. Yet, despite advances in healthcare systems, patients remain vulnerable to unintentional harm in hospitals (Devnani et al. 2011; Mani et al. 2010). One of the most significant, current discussions in healthcare delivery in hospitals is healthcare associated infection (HAI), sometimes called hospital acquired infection (Mani et al. 2010; Momen Fernie 2010) or nosocomial infection, which is any infection that a person develops as a result of treatment in hospital (Minnaar 2008, 2). Nosocomial infection is a global public health problem with an estimated 1.5 million suffering consequences at any given time [WHO,2009] noted that at least 25% of all hospital infections in the developing world are nosocomially acquired. The hands of health care providers are major agents of infection transmission in hospitals leading to the campaign to improve hand hygiene, Clean Care is Safer Care [WHO, 2005]. Two types of hand colonizing flora are predominant in hand skins. These are the Resident flora that are not easily removed by the simple friction associated hand washing and the Transient microorganisms which are not usually hand colonizers but they are most likely associated with infection [ Grayson, 2009]. Various types of such microbes are found on patients, instruments and other items and are important in infection transmission  [Hubner, 2006]. Improper hand washing practices serve as means of infection transmission in hospital wards (Duckro, 2005). Hand hygiene was thought to be a key factor in reducing hospital acquired infection during the initial development of healthcare systems (Akyol 2007; Ott French 2009). The battle with HAI started when the Hungarian obstetrician, Semmelweis (1847), observed that puerperal fever was more common on a maternity ward, where physicians and medical students provided care to women in labour, than it was on the ward where midwives assisted deliveries. He noted that physicians and medical students were contaminating their hands while performing autopsies and later attending the examination of women without hand washing. Arguably, he was the first to recognise the importance of hand washing in controlling the transmission of infection (Akyol 2007; Meers et al. 1992; Trampuz Widmer 2004). Equally important was the work of Florence Nightingale during the Crimean war, when she called for basic public health in a military hospital in Scutari in 1854. PROBLEM STATEMENT Hospital acquired infections has resulted in many negative impacts on health workers, patients and families over the world (WHO2012). The working environment, health workers and patients are the main reservoirs of hospital acquired related infection (weber, 2013). The transmission of infection from patient to patient mainly occurs at the hands of health workers (Ellingson K, 2014). The hands of health professionals are contaminated during patient care on a daily bases despite wearing gloves (Kendal A, 2012). Handwashing is critical in the prevention of hospital acquired infections. It is a very simple procedure and work well in the prevention of diseases as people are the carriers of pathogenic microbes. The practice is however unacceptably low among health workers (Takahashi Turale 2010; Trampuz Widmer 2004). Hand hygiene compliance rates in different developed countries rarely exceed 50% (Mani et al. 2010; Maxfield Dull 2011; Ott French 2009). For instance, figures show that in the USA it is 50%, in Switzerland 42% and in the UK 32% (Takahashi Turale 2010). Hence, poor compliance has resulted in high morbidity and mortality. In the USA, there are between 1.7 and 2 million people who contract HAI and 88 to 99 thousand deaths are attributed to HAI annually. Furthermore, HAI affects nearly 10% of hospitalised patients and presents major challenges in healthcare facilities. Consequently, annual medical expenses have increased in the USA to approximately $ 4.5 billion (Maxfield Dull 2011; Smith Lokhorst 2009; Trampuz Widmer 2004). Hand hygiene practice among HCWs is considered to be the single most clinical and cost effective measure to prevent HAI, a view recognised internationally (Momen Fernie 2010; Ott French 2009; Takahashi Turale 2010).The World Health Organisation (WHO) strongly emphasise the essential need for hand hygiene during healthcare delivery, to avoid possible infection and subsequent complications; hence, the Clean Care is Safe Care programme, launched by WHO in 2005 as part of the First Global Patient Safety Challenge. This programme offers new guidelines on hand hygiene training, observation and performance reporting in healthcare settings. Out of every 100 hospitalized patients, at least 7 in high-income and 10 in low-/middle-income countries will acquire a healthcare-associated infection. Among critically ill and vulnerable patients in intensive care units, that figure rises to around 30 per 100 (who,2014). Factors that contribute to poor hand washing compliance include absence of hand washing sinks, time required to perform hand hygiene, patients condition, effect of hand-hygiene products on the skin and inadequate knowledge of the guidelines(Larson and Kretzer, 1995; Simmons et al., 1999;Meengs et al., 1994; Doebbeling et al., 1992; Voss and Widmer, 1997). PURPOSE OF THE STUDY The purpose of this study is to determine the knowledge, attitude, and practices of healthworkers and also compare between healthworkers regarding their knowledge, attitude, and practices on hand washing. MAIN OBJECTIVE To determine hand washing practices among health workers in the Tamale West Hospital. SPECIFIC OBJECTIVES Assess the knowledge, practices and attitudes of healthworkers on handwashing Assess the differences across age groups, gender and experience regarding KAP of handwashing Compare between healthworkers regarding KAP of handwashing Assess the availability of resources for handwashing RESEARCH QUESTIONS What is the knowledge, practices and attitudes of healthworkers concerning handwashing? Are there differences across age groups, gender and experience regarding KAP of handwashing? Can KAP between healthworkers regarding handwashing be compared? Are there available resources for handwashing? SIGNIFICANCE OF THE STUDY Hand washing is considered the most important single and simple practice for preventing hospital acquired infection. An intricate problem may be caused by a number of factors if there is failure to practice effective hand washing. Understanding the factors that influence this behavior is key to change the behavior of poor effective hand washing practices. More studies are needed to identify, which of the factors contribute significantly to the problem of poor compliance with hand washing recommendation. OPERATIONAL DEFINITION OF TERMS Hand washing Hand washing is the process of cleaning ones hands with or without the use of water or another liquid, or with the use of soap for the purpose of removing soil, dirt, and/or microorganisms. Health care workers Professional personnel working in clinical setting of a health facility Veronica buckets Buckets used to store water for washing of hands Nosocomial infection/hospital acquired infection are infections gotten from the hospital setting. LITERATURE REVIEW KNOWLEDGE, PRACTICES AND ATTITUDES OF HEALTHWORKERS ON HANDWASHING Hand hygiene practice among HCWs is considered to be the single most clinical and cost effective measure to prevent HAI, a view recognized globally. Despite the relative simplicity of this procedure, adherence to hand washing recommendations is unacceptably low, usually well below 50% (Ekwere Okafor, 2013). Most nosocomial infections are thought to be transmitted by the hands of health care workers. It has long been known that hand hygiene among health care workers plays a central role in preventing the transmission of infectious agents. Hand-washing (HW) is the most effectiveway of preventing the spread of infectious diseases But despite a Joint Commission requirementthat Centers for Disease Control and Prevention hand hygiene guidelines be implemented in hospitals, compliance among health care workers remains low The reasons for low compliance to hand hygiene have not been defined in developing countries probably due to limited studies on hand hygiene. Factors that contribute to n oncompliance to HW among health careworkers are: lack of awareness and knowledge among health care workers as regard the importance, techniques, methods and quality of hand hygiene (Abd El Aziz Bakr, 2009). Alex-Hart and Opara, (2011) study on hand washing revealed that, more than halve (55.4%) of the health workers lacked the knowledge of good hand washing technique as most believed it involved the use of soapy water in a basin. This may be due to the fact that running water is not readily available, so the use of soapy water in a basin may have been the available alternative. With its repeated use over time, most health workers may have come to perceive it as the ideal hand washing technique. The NMCS Code of Standards and Conduct requires nurses and midwifes to provide a highstandard of practical care all the time. Yet, the momentum for hand hygiene, some nurses are still presenting with low compliance because they perceive it as not their problem, that it is something to do with infection control staff and they have to deal with it . Furthermore, Nazarko (2009) indicates that nurses often fail to practise hand hygiene because they are busy and they feel hand hygiene takes up precious time. In addition, nurses often perceive that gloves can be used as an alternative to hand hygiene. They usually tend to remove the gloves without washing their hands or use the same gloves to deliver intended care to multiple patients. Even when they remove their gloves, only 20% of nurses actually clean their hands (Ott French 2009). According to Canham, (2011) nurses avoid hand hygiene because they are frightened that skin problems such as dermatitis could develop, especially with alcoh ol hand-rubs. DIFFERENCES ACROSS AGE GROUPS, GENDER AND EXPERIENCE REGARDING KAP OF HANDWASHING Nurses tend to wash their hands more often than doctors and among non-health care workers, females tend to wash their hands more often than males. This study examined the influence of gender on the hand washing rates of health care workers (HCWs). The null hypotheses were that, there would be no inter-gender difference in either hand washing rates in healthcare workers across professions, or within professional groups. Although increased compliance with hand washing protocols has been shown to decrease infection rates, hand washing compliance remains poor, particularly among some professional groups. Studies of hand washing frequency have recorded hand washing rates following patient contact ranging from 10.6% to 61%, and significant differences have long been noted in hand washing frequency between professional groups such as nurses and doctors. (Van de Mortel, 2001) Van de Mortel, (2001) studies again found out found that, registered nurses (RNs) washed their hands following patient contact significantly more often than doctors in the Intensive Care Unit (ICU). The RNs washed their hands 71% percent of the time, whilst junior and senior resident doctors (RMOs) washed their hands 50% of the time and specialists washed only 25% of the time. He postulated that, failure to wash hands may be a gender-related phenomenon. The proportion of female nurses is considerably higher than the proportion of female doctors. In the above study, 90% of the nurses were female; 45% of RMOs and 6% of specialists were female. (Van de Mortel, 2001). Several studies have examined, among other variables, the influence of gender on hand washing frequency in health care workers however; these studies arrived at conflicting conclusions. Van de Mortel, (2001) found that hand washing frequency in the emergency department was lower among female nurses, RMOs and specialists tha n among males within each of those groups, however, the sample size of the study was small (n = 13 nurses, 11 RMOs, and 11 specialists). In contrast, in an extensive study of hand washing practices in two countries, it revealed that female health care workers were washing their hands more frequently than males, regardless of occupational group. However, this study was based on self-reported practices collected by questionnaire, and a degree of bias may have been introduced due to the fact that non-responders may have exhibited different behavior than responders. There is also a tendency for people to overestimate socially desirable behavior when answering questionnaires. To illustrate the latter point, Van de Mortel, collected data on hand washing frequency among doctors, both by means of questionnaires and by covert observation. He found that doctors estimated that they washed their hands 73% of the time, but the data collected by covert observation showed the percentage of doctors washing their hands following patient contact was in fact only 10.8%. METHODOLOGY This chapter describes the study area, the study design, the study population and the sampling procedure as well as the recruitment of respondents and the data collection procedure. The data entry and analysis is also outlined in this chapter. RESEARCH DESIGN This study is a cross-sectional study method designed to assess the knowledge, attitude and practices of health workers in TTH towards handwashing. Including assessing the differences across age groups, gender and experience regarding knowledge, attitude and practices of handwashing, and also, compare between healthworkers regarding KAP of handwashing RESEARCH SETTING The study will be conducted at the Tamale Teaching Hospital (TTH). It is a foremost tertiary referral centre providing patient care to residents of Tamale and neighboring towns and cities. There are 30 wards in Tamale Teaching Hospital. There are 74 doctors and 655nurses at the hospital. Hand-washing facilities are located in all the wards and clinics in the hospitals. Each ward is provided with at least a Veronica bucket for hand washing, running tap water, soap (liquid or cake) and sometimes, a towel for hand drying. TARGET POPULATION This study targets the clinical staff of the Tamale Teaching Hospital with a total population of 729. There are 31 wards in Tamale Teaching Hospital SAMPLE, SAMPLE SIZE, AND SAMPLING TECHNIQUE The sample size is 360 respondents this was arrived at by the using Cochran formula. Sample Size = [z2 * p(1-p)] / e2 / 1 + [z2 * p(1-p)] / e2 * N] N = population size z = z-score e = margin of error p = standard of deviation N= 729 Z= 1.96 (using 95% confidence interval) E=0.05 P= 0.5 Sample size = [(1.96)2*0.5(1-0.5)]/0.052 / 1 + [1.962*0.5(1-0.5)]/0.052* N Sample size = 384.16/1.076 Sample size= 357 An extra 3 was added to make it a total of 360 respondents. There are 30 wards in the hospital. 12 respondents would be sampled from each ward if they are eligible for the study. INCLUSION CRITERIA Respondents must be registered healthcare workers in the Tamale Teaching Hospital. EXCLUSION CRITERIA Medical, nursing and other clinician students are excluded from this study. DATA COLLECTION TOOL A well-structured questionnaire will be used to collect socio-demographic data, knowledge on handwashing from the respondents. PROCEDURE FOR DATA COLLECTION Probability sampling technique will be used. This is to help get an equal proportion of participants from the various wards used. The data collection will employ the use of structured questionnaire which respondents will check and will also give short answers to some questions to solicit data from respondents. All the wards will be successfully visited on a daily basis to get eligible participants for the study. These wards will be visited on a daily bases recruiting respondents until the last questionnaire is administered. The wards in the Tamale Teaching Hospital include; Purposive sampling will be used to select clinicians from the hospital who will be available during the data collection from Tamale Teaching Hospital. The study data will be collected based on the socio-demographic characteristics of respondents, general knowledge about handwashing, assess the differences across age groups, gender and their experiences regarding handwashing through the use of a structured questionnaire administered by the research assistants with minimal clarification from the research assistants. Primary data will be collected and used in the analysis. DATA ANALYSIS The data will be coded in excel and then entered into SPSS V.16 for analysis. Responses will be assigned codes in the form of numbers, which will make it easy for keying in the responses into a computer format. Univariate analysis will be done for socio-demographic characteristics of respondents and also for areas that require only descriptive statistics. Bivariate analysis will be performed to find associations or relationships between socio-demographic characteristics and level of knowledge, attitudes and practices of clinicians on handwashing. Likert item was rated on a 1-5 response scale; where strongly agree=5, agree-4, neutral=3, disagree=2, strongly disagree=1. The scores were graded into positive, neutral or negative. ETHICAL CONSIDERATIONS Ethical approval to use the hospital was from the Ethics and Research Committee of the hospital. Formal consent will also be obtained from the respondents prior to administration of questionnaire. Individual participants will be told that the study is purely for academic purpose and names as well as addresses will not be and also needed assuring them of their privacy and confidentiality. Respondents were also told that they had the right not to participate in the study. LIMITATIONS OF THE STUDY The cost and inexperience of researchers in conducting this study will be a challenge. Also, bias in the sampling procedure can also occur. REFERENCES Abd Elaziz, K.M. Bakr, I.M (2009) . Assessment of knowledge, attitude and practice of hand washing among health care workers in Ain Shams University hospitals, Cairo, Egypt J PREV MED HYG 2009; 50: 19-25 Alex-Hart A. B. and Opara, P. I. (2011). Handwashing Practices amongst Health Workers in a Teaching Hospital. American Journal of Infectious Diseases 7 (1): 8-15, 2011 Ekwere, T. A Okafor P. I (2013) Hand hygiene knowledge and practices among healthcare providers in a tertiary hospital, South West Nigeria Nazarko, L. 2009. Potential pitfalls in adherence to hand washing in the community, British Journal of Community Nursing 14:2, 64-68. Ott, M. French, R. 2009. Hand hygiene compliance among healthcare staff and student nurses in a mental health setting, Mental Health Nursing 30, 702-704. Van de Mortel, T. F. (2001) Gender Influences Hand washing Rates In the CriticalCare Unit. American Journal of Infection Control, vol. 29, no. 6, pp. 395-399.

Solar Energy What Will Save Our Earth Environmental Sciences Essay

Solar Energy What Will Save Our Earth Environmental Sciences Essay Around the world, everyone seems to have green on their minds. However, this isnt green as in money, this green deals with the green movement. The green movement was started by environmentalists, whose goal it was to make known we are damaging our earth and that we need to make changes to save it. The main focus of the green movement is to create alternative energy sources for the world to use instead of depleting our fossil fuel energy resources. With fossil fuels being non-renewable resources, we all must recognize the energy problem and work towards other options. Eric McLamb, in his online article on energys future today, states non-renewable fossil fuels were  formed from plants and animals that lived hundreds of millions of years ago and became buried way underneath the Earths surface where their remains collectively transformed into the combustible materials we use for fuel.  (McLamb, 1) Without our supply of fossil fuels, society would fail to exist as it does today. Our most common fossil fuels today are oil, coal and natural gas, giving us our heat and electricity. Eric McLamb continued on to state,  This means that fossil fuels, along with nuclear energy-a controversial, nonrenewable energy source- are supplying 93% of the worlds energy resources.  (McLamb, 1)   We obtain most of our fossil fuels through a mining process. During the various mining processes, the surrounding environment can be highly damaged. Numerous oil spills have occurring while mining, damaging large areas of our ocean ecosystems. In addition to damaging water, the mining of coal strips enormous pieces of land, destroying our land ecosystems. Our ecosystems are being destroyed, as well as our atmosphere. When burned, fossil fuels release large amount of carbon dioxide into the atmosphere. The carbon dioxide in turn contributes greatly towards our planets global warming epidemic, which then creates other issues. With global warming causing temperatures to rise, ice in places such as Antarctica, is melting causing ocean water to rise and negatively impact its surrounding ecosystems and other bodies of water.  Rising sea levels alone can impede processes ranging from settlement, agriculture and fishing both commercially and recreationally. Air pollution is also a direct r esult of the use of fossil fuels, resulting in smog and the degradation of human health and plant growth. (McLamb, 1)   By the year 2020, world energy consumption is projected to increase by 50% If the global consumption of renewable energy sources remains constant, the worlds available fossil fuel reserves will be consumed in 104 years or in the 22nd century.(McLamb, 1) With our non-renewable resources depleting and our population continually growing, the need for other energy sources will not be decreasing anywhere in the near future. The energy sources being considered today center around natural elements; wind, solar, and water energy sources. All of these sources are efficient, renewable, and healthy for our environment. For the purpose of this essay, I chose to focus strictly on solar energy. More specifically, I chose to focus on the benefits and detriments of solar energy on the U.S environmentally.  I strongly believe that the U.S. needs to make the switch to solar energy and would environmentally benefit from doing so. Solar energy is radiant energy from the sun, which is then harnessed and used to produce electricity. Solar energy began in the 7th century, using glass and the sun to make fire. Through the years the need for solar energy has increased and is used today to heat rooms, heat water, and generate electricity. In order to heat rooms and water, the radiant energy from the suns rays must be captured. It is difficult to capture rays because they are so spread out, the concentrations very dramatically. NEED, The National Energy Education Development Program, shares about how much solar energy that is available depends on  the time of day, the season of the year, and the clearness or cloudiness of the sky.  (Solar, 40) Once the energy is caught, it needs to be transformed into usable energy. The main processes to transform the rays into energy are photovoltaic, solar power towers or by burning biomass. Photovoltaic cells are the most common and efficient way to convert solar energy. An enthusiast, Marissa Schiff, states in her article Why the U.S. Should Rely More Heavily Upon Solar Energy, The photovoltaic effect occurs when sunlight is absorbed by the cells that are similar to computer chips. The solar energy in this instance gets the electrons moving by separating them from their atoms which allows the electrons to move through the material and thus creates electricity.(Schiff, 2) Silicon is the most common material used in photovoltaic cells and they are most efficiently used in rural settings. Another way to convert solar into energy is through solar power towers, also known as central receivers. Schiff continues on to address solar power towers that generate energy from sunlight because they concentrate solar energy onto a tower which has a receiver on the top that converts energy and creates steam.  (Schiff, 2) Solar power towers are ideally for more populated areas, such as large cities. Lastly, a common way to convert the harnessed energy is through the burning of biomass. Schiff states,  the biomass produces usable energy because it contains energy stored from the sun through the process of photosynthesis.  (Schiff, 2) The burning of the biomass releases heat, which in turn can heat up buildings and can be used to create steam to generate electricity. When speaking of solar power, people tend to think of the positive effects it has on our environment. However, there are many detriments when it comes to the existence of many solar power plants. For example, the Solar Energy Development Programmatic Environmental Impact Statement website states, All utility-scale solar energy facilities require relatively large areas for solar radiation collection when used to generate electricity at a commercial scale, and the large arrays of solar collectors may interfere with natural sunlight, rainfall, and drainage, which could have a variety of effects on plants and animals.  (Solar Energy, 1) The loss of land could damage many animals habitats, as well as stop current land use. For example, the land may currently be used for the grazing of sheep or even an archeological site. Also, most solar power plants would chose to use photovoltaic cell panels to capture the suns rays. These photovoltaic panels, although they have a coating on them, cou ld be damaged and release harmful chemicals into our environment. As the Solar Energy Development PEIS points out, concentrating solar power systems may employ liquids such as oils or molten salts that may be hazardous and present spill risks.  (Solar Energy, 1) In addition to damaging the land, the water sources surrounding the solar power plant may be damaged. Many solar power plants use turbines to generate the electricity after captured by the panels. These turbines use water for cooling purposes. As many solar power plants would be located in arid, hot climates, the water sources would already be limited. If a solar plant was to be built in such a place, there would be an increased strain on the water reserves. Another thought is if the water was contaminated accidently while cooling in the turbine, it could contaminate the entire water supply. Overall solar power plants could possibly cause a lot of damage to our environment. They are massive facilities that would have to be treated much like that of a construction site, with extreme caution. Although there are several possible detriments to our environment, if we choose to convert to solar our environment would be greatly saved. Solar energy, along with all renewable resources, does not pollute our air and is quiet efficient. Solar energy would reduce global warming due to carbon dioxide emissions because it doesnt emit any at all. Solar energy also does not release nitrogen oxide or sulfur dioxide into our atmosphere, which would reduce smog and acid rain. (Schiff, 1) Also, as previously addressed, we must make the switch to solar energy in order to conserve our remaining fossil fuels so that we dont run out within the next 104 years as proposed. Fossil fuels must be mined; solar on the other hand does not. Solar would reduce the waste that occurs through these mining processes that negatively effects our environment, such as dust, drainage and emissions. Finally, the efficiency of fossil fuels for electricity is relatively low. McLamb states,  When you burn these fossil fuels to create electricity, we only convert about 35% of the energy produced into electricity; the other 65% is lost mostly in heat.  (McLamb, 1) As our fossil fuels are steadily depleting we need a reliable energy source with a higher efficiency. Although single solar cells have relatively low efficiency, when millions are combined to create an entire solar power system, the efficiency increases. Since the sun is everlasting, the efficiency isnt as big of a deal as in the case of our fossil fuels. As our fossil fuels continue to deplete, everyone from environmentalists to national oil companies, are recognizing the fact that we must decide on an alternative energy source for our nation.  Ã‚  Through the evidence collected here, it is clear solar energy has its benefits and detriments, but it is understandably the best energy alternative.  Although solar energy does present some detriments to our environment, they are only possibilities, not proven facts.  Ã‚  The fact is that solar energy is dramatically better for our environment than todays fossil fuels.  Ã‚  Initially expensive, yet worthwhile in the long run, environmentally-friendly solar energy is the direction the U.S. should be heading.     Ã‚   MLA Works Cited McLamb, Eric. ecology.com | Fossil Fuels vs. Renewable Energy.  The Ecology Global Network | Ecology News and Information for Residents of Planet Earth. N.p., n.d. Web. 21 Nov. 2012. . Schiff, Marissa , and Jason Vaupen. Economic Benefits.  Why the U.S. Should Rely More Heavily Upon Solar Energy. N.p., n.d. Web. 22 Nov. 2012. . Solar.  Solar at a Glance 2008. The NEED Project, n.d. Web. 21 Nov. 2012. . Solar Energy Development Environmental Considerations.  Solar Energy Development PEIS Information Center. N.p., n.d. Web. 25 Nov. 2012. .

Cynicism in Dorothy Allisons Short Story, This Is Our World :: Our World

Cynicism in Dorothy Allison's Short Story, This Is Our World Is â€Å"The world is meaner than we admit† (Allison 159)? In the short story, â€Å"This Is Our World,† Dorothy Allison asks this question, and her response startled me. I disagree with her way of thinking. Allison says that the world is a cruel, mean place. I think that the cruelty is balanced out with the goodness in the world. I was surprised to read her negative examples of how bad of a place it is that we live in and call â€Å"home.† This story was written with reference to events and occurrences that I have never experienced and things I have never seen. I found it difficult to relate to these events. The minister, the narrator, and her mother walked around the building where the narrator’s mother was to be baptized. Then they looked at the baptismal font. Allison states, â€Å"Watching baptisms in that tank was like watching movies at a drive-in† (155). I was glad to read that the narrator was not the one being baptized, because I feel she did not understand the true significance of the baptism ritual. She spoke of the Jesus painting as being, â€Å"rouged and pale and pout as Elvis Presley† (155). She was also trying not to giggle at the other little boys that were being baptized that day, â€Å"He looked as if he hoped someone would rescue him. It was too much for me. I began to giggle helplessly† (156). The narrator was too young to understand fully what it meant to be baptized. I believe that it is one of the reasons that Allison has such a negative attitude towards life. Maybe she did not agree or understand the meaning of a baptism, or religion as a whole. This could stem from a broken home life and no strong father figure. Although I have been fortunate enough to have a father and mother who love me a great deal, I still think the world can be cruel and mean. But meaner than we think? Every day we hear of some new tragedy that she speaks of, â€Å"the woman who drowned her children, the man who shot first the babies in her arms and then his wife, the teenage boys who led the three-year-old away along the train track, the homeless family recovering from frostbite with their eyes glazed and indifferent while the doctor scowled over their shoulders† (159), but every day we also hear of the good things.

The Men of Their Eyes Were Watching God by Zora Neale Hurston Essays

The Men of Their Eyes Were Watching God by Zora Neale Hurston   Ã‚  Ã‚  Ã‚   In Their Eyes Were Watching God, by Zora Neale Hurston, the reader is given a particular glimpse into Janie's life with reference to the men she has known.   Janie's three men are all very different, yet they were all Janie's husband at one point in her life.   Although they all behaved differently, in lifestyle as well as their relationship with Janie, they all shared certain similarities.        Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Janie's first husband was a poor old soul named Logan Killicks.   He was an ugly, dirty farmer whose prime concern for Janie was that she do her share of the work in order to keep the farm up and running.   Janie was simply another pair of hands to do some work.   When compared with Janie's second husband, Logan seems uncaring and rude.      When Janie first met her second husband, Joe, he was very caring and reassuring - an ideal husband.   Joe was an ambitious young man with many goals set out for him.   And like Janie, he was raised around a white background.   Joe strived to be and have the best at everything.   However, once Joe got Janie as his wife, he became a jealous and demanding man, just as Logan had been.   Joe saw himself as a god, his sentences began with " I god..." ... ...use he used it to help himself become mayor.   Tea Cake loved Janie for who she was as a woman.   All three had completely different things to offer Janie economically, socially, and emotionally.  Ã‚  Ã‚   The two rich men loved a woman, the poor man loved Janie.    Works Cited and Consulted: Hurston, Zora Neale. Their Eyes Were Watching God. New York: Perennial Classics, 1990. Interpretations: Zora Neale Hurston's Their Eyes Were Watching God. Ed. Harold Bloom. New York: Chelsea House Publishers, 1987. Williams, Shirley Anne. Forward. Their Eyes Were Watching God. By Zora Neale Hurston. New York: Bantam-Dell, 1937. xv.

Succubus Blues CHAPTER 26

â€Å"Why so blue, Kincaid?† I looked up from the information desk's computer screen to see Doug leaning lazily over the counter's edge. â€Å"Am I?† â€Å"Sure. You have the saddest look on your face I've ever seen. It's breaking my heart.† â€Å"Oh. Sorry. Just tired, I guess.† â€Å"Well, then, get out of here. Your shift's over.† Glancing down, I read the time on the computer. Five-oh-seven. â€Å"I guess it is.† He eyed me askance as I rose listlessly from the chair and made my way out from behind the desk. â€Å"You sure you're okay?† â€Å"Yeah. Like I said, just tired. I'll see you around.† I started to walk away. â€Å"Oh, hey, Kincaid?† â€Å"Yeah?† â€Å"You're friendly with Mortensen, aren't you?† â€Å"Sort of,† I conceded cautiously. â€Å"Do you know what happened to him? He used to be here, like, every day, and now he's been gone all week. It's freaking Paige out. She thinks we offended him or something. â€Å" â€Å"I don't know. We're not that friendly. Sorry.† I shrugged. â€Å"Maybe he's sick. Or out of town.† â€Å"Maybe.† I left the store, stepping out into the dark autumn evening. Friday in Queen Anne brought people in droves, drawn by the area's assortment of activities and nightlife. Ignoring them, lost in my own thoughts, I walked over to my car, parked a block away. Immediately, a vulture in a red Honda slowed down and put her signal on, realizing my spot was about to be vacated. â€Å"You ready for this?† Carter asked me, materializing in the passenger seat. I fastened my seatbelt. â€Å"Ready as I'll ever be.† We drove up to the University District in silence, a hundred questions on my mind. Since removing Seth from my apartment last week, the angel had told me not to worry, that he would see to the writer's recovery. I'd still worried anyway, of course, about both Seth and the deal I'd made with Jerome. I was about to become the single greatest source of chaos and temptation in Seattle; even Hugh's stellar track record wouldn't look so good†¦ er, bad, anymore. I would be more than the slave Helena had claimed I was. The very thought made me ill. â€Å"I'll be with you,† Carter told me soothingly as we approached Seth's door minutes later. The angel flickered briefly in my vision, and I realized he'd gone invisible to mortal eyes, though not to mine. â€Å"What does he know?† â€Å"Not much. He's been awake more and more these last couple of days, and I've told him a little, but really†¦ I think he's been waiting for you.† Sighing, I nodded and stared at the door. Suddenly I felt unable to move. â€Å"You can do this,† Carter said gently. Nodding again, I turned the door handle and stepped inside. Seth's condo looked much the same as when I'd last been here, the kitchen still bright and cheery, the living room lined with boxes of unpacked books. Faint music drifted from the bedroom. I thought it was U2, but I didn't recognize the song. Moving toward the sounds, I reached Seth's bedroom, pausing in the doorway, afraid to cross the threshold. He was in bed, half sitting up, propped up by pillows. In his hands he held The Green Fairy Book, looking to be about a third of the way through it. He looked up at my approach, and I nearly sagged in relief to see how much better he looked. His color was back, his eyes bright and alert. Only that facial hair looked ragged and unkempt, the result of no shaving for a week, I guessed. That answered my question about whether or not Seth had maintained the thin, neat beard on purpose. He reached for a remote on the bedside table and turned the music off. â€Å"Hey.† â€Å"Hey.† I took a few more steps into the room, afraid to get any closer. â€Å"Do you want to sit?† he asked. â€Å"Sure.† Cady and O'Neill's faces scrutinized me from the bulletin board as I brought a chair alongside Seth. I sat down, looked at him, and then looked away, unable to handle the depth of those amber-brown eyes after seeing into his mind. Our old silence fell between us, the progress we'd made in conversation banished to the winds. Seth would not take the lead this time. As Carter had observed, the writer was waiting for me. I looked back up, forcing myself to meet his eyes. I had to do this. I had to do the explaining here, but I balked at it. It was ironic, I thought. Me, who half the time didn't know when to shut up. Me, famed for always having some catchy quip at the ready. Knowing it would never get any easier, I took a deep breath and let it all out, conscious of the weight of heaven at my back and the hell I'd just consented to stretching out before me. â€Å"The truth is†¦ the truth is, I don't really work in a bookstore. I mean, I do, but that's not really why I'm here, what my purpose is. The truth is that I'm a succubus, and I know you've probably heard of us before – or think you've heard of us before, but I doubt what you've heard is correct†¦Ã¢â‚¬  On I went. I told him. I told him everything. The rules of the succubus lifestyle, my dissatisfaction with it, why I wouldn't date people I liked. I told him about other immortals, angels and demons walking among us. I even explained about nephilim, hinting that Roman's presence in my apartment had been part of a lure on my part, but mostly skimming over the embarrassing circumstances Seth had found us in. On and on, I talked, not even knowing what I said half the time. I only knew I had to keep talking, keep trying to explain to Seth that which defied explanation. I finally reached the end, my stream of discourse exhausted. â€Å"So. So, I guess that's it. You can believe it or not, but the forces of good and evil – as humans perceive them, at least – are alive and well in the world, and I'm one of them. This city is filled with supernatural agents and entities; humans just don't realize it. It's probably just as well, really. Otherwise, if they knew too much about us, they might find out how pathetic and fucked up our lives actually are.† I shut up, thinking if Seth hadn't seen what he had already seen, he probably would have thought I was crazy. Hell, even after it all, he still probably thought I was crazy. He would be justified. Those brown eyes weighed me and my words in silence, and an annoying wetness welled up in my own eyes. I looked away to hide it, blinking rapidly, because while succubi might be accused of doing all sorts of bizarre things around mortal men, I was pretty sure crying wasn't one of them. â€Å"You said†¦ you said you used to be human.† He spoke the words awkwardly, no doubt trying to grasp the whole concept of mortal and immortal. â€Å"How then†¦ how did you become a succubus?† I looked back up at him. I could refuse him nothing in that moment, no matter how painful. â€Å"I made a bargain. I told you before that I was married†¦ that I had cheated on my husband. The consequences of that were†¦ not pleasant. I traded away my life – becoming a succubus – in order to repair the damage I had caused.† â€Å"You gave away eternity to fix one mistake?† Seth frowned. â€Å"That doesn't seem equitable.† I shrugged, highly uncomfortable with the topic. I had never spoken of it to anyone. â€Å"I don't know. It's done.† â€Å"Okay.† He shifted slightly in bed, the soft swishing of fabric the only sound between us. â€Å"Well. Thanks for telling me.† I recognized a dismissal when I heard one, and it dug into me like a blade. That was it. Done. Seth was through with me. We were finished. After everything I had told him, there was no way things could return to how they'd been, but really, wasn't that for the best? I hurriedly stood up, suddenly not wanting to be there any longer. â€Å"Yeah. Okay.† I moved toward the door, suddenly pausing to look back at him. â€Å"Seth?† â€Å"Yeah?† â€Å"Do you understand? Why I do what I do? Why we can't – why we have to – † I couldn't finish the thought. â€Å"It's impossible. I wish it were different†¦Ã¢â‚¬  â€Å"Yeah,† he said quietly. Turning, I fled his condo for my car. When I got into it, I buried my face into the steering wheel, sobbing uncontrollably. After a few minutes, gentle arms wrapped around me, and I turned toward Carter, crying into his chest. I'd heard reports of people who had angelic encounters, witnesses talking about the peace and beauty experienced by such moments. I'd never given any of it much thought, but as minutes passed, the terrible pain in my chest abated, and I grew calmer, finally lifting my head up to look at the angel. â€Å"He hates me,† I choked out. â€Å"Seth hates me now.† â€Å"Why do you say that?† â€Å"After everything I just told him†¦Ã¢â‚¬  â€Å"I suspect he's troubled and confused, yes, but I don't think he hates you. Love like that doesn't turn to hate quite so easily, though I'll admit the two intertwine sometimes.† I sniffled. â€Å"Did you feel it? His love?† â€Å"Not like you did. I sensed it, though.† â€Å"I've never felt anything like it. I can't match that. I like him†¦ like him so much. Maybe I even love him too, but not in the same way he loves me. I'm not worthy of that love.† Carter made a soft, chastising click. â€Å"No one is beyond being loved.† â€Å"Not even someone who just agreed to spend the next century hurting humans, corrupting souls, and leading them to temptation and despair? You must hate me for that. Even I hate me for that.† The angel watched me, expression steady and calm. â€Å"Why did you agree then?† I leaned my head back against the seat. â€Å"Because I couldn't stand the thought of me†¦ of that love being wiped out of his head†¦ of not being remembered.† â€Å"Ironic, huh?† I turned toward him, hardly surprised at anything anymore. â€Å"How much do you know about me?† â€Å"Enough. I know what you got for becoming a succubus.† â€Å"I thought it was the right thing then†¦Ã¢â‚¬  I murmured, my mind's eye turning to a faraway time and place, another man. â€Å"He was so sad and so angry at me†¦ he couldn't go on, knowing what I'd done. I just wanted to be blotted from his mind forever. I thought it would be better if he – if everyone – forgot about me. Forgot I'd ever existed.† â€Å"And now you don't agree?† I shook my head. â€Å"I saw him†¦ years later, when he was an old man. I shape-shifted to the form he'd known me in – that was the last time I've worn that face, actually – and approached him. He looked right past me, though. Didn't know me at all. The time we'd had together. The love he'd had for me. All gone. Gone forever. It killed me. I felt like one of the walking dead after that. â€Å"I couldn't let that happen. Not again. Not with Seth, after experiencing what he felt for me. Even if that love is ruined†¦ marred by what he thinks of me now. Even if he never speaks to me again. It's still better than that love never having existed at all.† â€Å"Love is rarely flawless,† Carter pointed out. â€Å"Humans delude themselves by thinking it has to be. It is the imperfection that makes love perfect.† â€Å"No riddles, please,† I told him, suddenly feeling tired. â€Å"I just lost the one person I might have loved again after all these years. Really, truly loved too. Not just pure excitement either, like with Roman. Seth†¦ Seth had it all. Passion. Commitment. Friendship. â€Å"Not only that, but I've agreed to go on ‘active duty' again as a succubus.† I closed my eyes, swallowing the bile in my throat. I thought of all the nice guys in the world, men like Doug and Bruce. I did not want to be their downfall. â€Å"I really do hate it, Carter. You have no idea how much I hate it, no idea how much I don't want to do this anymore. But it's worth it. Worth it if Seth can keep his memories.† I looked over at the angel uncertainly. â€Å"He can, can't he?† Carter nodded, and I exhaled with relief. â€Å"Good. At least there's one spot of hope in all of this.† â€Å"Of course there is. There's always hope.† â€Å"Not for me.† â€Å"There's always hope,† he repeated more firmly, a commanding note in his voice that startled me. â€Å"No one is beyond hope.† I could feel tears coming to my eyes again. Lord. I seemed to be crying all the time lately. â€Å"What about a succubus?† â€Å"Especially a succubus.† He put his arms around me again, and I gave way to my sobs once more, a damned soul taking momentary respite in the embrace of a heavenly creature. I wondered if what he said was true, if it was possible that there was still hope for me, but then I remembered something that made me half laugh and half choke all at once. Angels never lied.

Cultural safety in nursing Essay

The meaning of the term culture in nursing has changed significantly in recent decades. Culture may be seen as the learned, shared value and beliefs of a particular group (Spence, 2001). Cultural expression assumes many forms, including language, traditions, stress, pain, anger, sorrow, spirituality, decision making and even world philosophy (Catalano, 2006).Cultural safety is a process that involves the individual knowing of their self and their own culture, becoming aware of, respectful of, and sensitive to different cultures, asking who is at risk, preventing unsafe situations, and creating a culturally safe environment (Wood and Schwass, 1993). During my first night shift at clinical placement, I provided care for Anna (pseudonym), an 85- year old Maori lady, who was admitted to the ward following suicide attempt, which was related to the second anniversary of her husband’s death. She had a 20 year history of depression. On admission Anna was agitated and fearful, stating that she could not do almost anything that was requested of her. She had some disorganized ideas. For example, she thought she would be scalded by meals, or accidentally fall out of a window. We had just finished our handover when Anna rang the bell. I went to her room and found her sitting on the chair.†Good evening Anna,† I said.† My name is Parisa. I am your nurse tonight†. Anna looked worried and replied: â€Å"I am not sure if I have enough clothes!!!. † From the handover briefing I had understood that she was worrying about not having enough clothes. So I opened the door of the wardrobe and reassured her that she had plenty of clothes. Then I told her she needed to come back to her bed and have a rest. I helped her get back into the bed. Twenty minutes later, while I was doing the ward check, I heard someone crying. The sound of crying came from Anna’s room. I went to her room. It was midnight. Anna was lying alone; fearful, sad, and depressed. Left isolated, she wanted to call a nurse for help but she didn’t know how to explain what she needed. † Anna, what happened?† I asked. â€Å"Are you crying?† She didn’t reply. In this situation, it came into my mind that good therapeutic communication through the use of touch was very appropriate to  calm her. I held her hand, looked into her eyes, and asked her if she wanted to tell me what she was thinking at the time. She replied:† I feel I am a horrible person, can’t you see that? â€Å"I said, â€Å"A horrible person!!, what I see is a frightened person. You are scared, aren’t you?† She replied, â€Å"I am so scared of losing everything and everyone I love. Nurse, I am not a good person, I tried to commit suicide. I took an overdose of my pills, and I made my family worry about me†. She started to cry again. I listened to Anna and let her speak out all her feelings. I said,† I understand you feel it was the wrong thing to do† She replied: â€Å"Do you think God will forgive me? I need to cry, I need to pray†. With my eyes full of tears I asked her,† Would you like it if we prayed together?† She looked at me kindly and said â€Å"Yes, I would like to pray†. We held hands, and both of us started to pray in our own languages†¦ Learning and then not acting on what you learn is like ploughing and then never planting (Unknown). When I was in unit 4, we had a Maori Health paper where I gained lot of knowledge about the Maori view of health. This incident with Anna was an occasion in which I put the knowledge I had learned at university into practice. According to Durie (1998) the traditional Maori attitude toward health is one of holism. Health from a Maori perspective has always acknowledged the unity of: spiritual, emotional, physical, and family aspects. The spiritual perspective is the most necessary perspective for Maori wellbeing. It is defined as â€Å"attachment to religious values,† but does not have the same meaning as â€Å"religious beliefs†. When spiritual needs are met, an individual can function with a meaningful identity and purpose and can relate to reality with hope (Durie, 1998). Nursing is a discipline that professes to address the human person in a holistic manner, focusing on all dimensions of the person: body, mind and spirit (Lemmer, 2005). Care of the spirit is a professional nursing responsibility and an intrinsic part of holistic nursing. The holistic nursing perspective requires nurses to view each person as a biopsychosocial being with a spiritual core. Thus, nurses must be sure to address the spirit  along with the other dimensions to provide holistic care (Calatona, 2006, p.403). In my situation, I had to support Anna’s desire to pray and practise meaningful rituals. To confirm my assumptions about an underlying cultural issue, I asked Anna in a very respectful way about her cultural beliefs. I realized that Anna’s religious beliefs could be a vital way in which she expresses her spirituality. I asked her if she would like the service of a Maori Chaplain, and she accepted. Therefore, during the morning handover I informed Anna’s primary nurse that Anna wish to be referred to the Maori Chaplain Service. Fourie, Mcdonald, Connor and Bartlett (2005) clearly state that handover is a critical time where staff share information from which to base important decisions about patient care and management, particularly clients who appear unsettled and /or those who require extra intervention. Spiritual interventions have been demonstrated to be significant in the client’s recovery from disorder. The dimensions of religious ceremony, prayer and the client, relationship with God have been shown to have positive associations with mental health (Catalano, 2006). Reflecting on this experience I found that my therapeutic communication techniques of presence, and active listening, were very useful. â€Å"The affective aspects of nursing are related to emotional interchange between nurse and patient which includes presentation, active listening, therapeutic communication and discussion of spiritual issues† (Wichowski, Kubsch, Ladwig & Torres, 2003, p.1122). I used touch to help comfort her distress. Touch is a therapeutic tool which can provide sensory stimulation, induce relaxation, physical and emotional comfort, orient people to reality, improve level of awareness, convey warmth, respect, sensitivity and a powerful expression of a trusting relationship (Crisp & Taylor, 2003). I listened attentively to every single word that Anna said to show that I have a genuine interest in knowing more about her beliefs. Listening attentively and reflectively can help the client feel valued, understood and supported (Mohr, 2003). I have found out that through my active listening to her story, I displayed a caring attitude, and she is already participating in a culturally competent care. A nurse who is ready to listen to his/her patients, respects their  cultural and social backgrounds and does not make any stereotypical assumptions delivers a culturally safe practice (Bunker, 2001). My experience of nursing Anna, and learning how her cultural beliefs affected her mood helped me achieve and develop the skills to be culturally competent in my nursing practice. Culturally competent care involves the integration of knowledge, attitude and skills to provide culturally appropriate health care (Mohr, 2003). As I want to be a mental health nurse, my practice should be culturally appropriate through the sensitive and supportive identification of cultural issues (Australia & New Zealand College of Mental health nursing, 1995). I also learned that one of the skills that a mental health nurse should possess is the ability to integrate cultural perspectives within the delivery of appropriate interventions. This experience also gave me the opportunity to demonstrate my skill in communicating Anna’s problem to the primary nurse effectively. It also enhanced my critical thinking skills for I was able to find the link between her beliefs and her illness, and that led to p rovision of a culturally competent care.