500 Word Essay on a Kind Thing I Did for Someone - 630 Words

5150 Mr. Padilla English 101 5 December 2012 Argument Essay The topic of gay marriage has always been controversial. Anytime the idea of same sex couples being allowed to marry is brought up there’s almost always an argument started. It’s viewed by many as wrong and many think it should remain illegal, but why? If two people are happy, no matter the gender, why should anything stop them from marrying? Male and female, male and male, or female and female, it shouldn’t matter; if they’re happy and want to marry, let them. Most often the idea of gay marriage is viewed as wrong because of religion. In the bible it states that marriage should be between a man and a woman. Although the bible was written a very long time ago and I believe†¦show more content†¦Being truly happy is the only way to maintain a successful relationship. Another topic that raises a lot of conversation is the fact that same sex marriage affects the couple’s children. It’s argued that both a male and a female need to raise a child â€Å"normally.† A parent is a parent; if they are good at it then the child should not be affected by it at all. There are plenty of ways for a young boy to â€Å"bond† with a female and vice versa. A child goes to school which is the number one way to make friends and communicate with the opposite sex. With school comes extra curricula’s like sports, music, plays and a lot more, which are all ways to develop relations with the opposite sex. There is no difference between a straight family and a same sex family. The topic of same sex marriage will always be controversial and raise conversation. With the low divorce rate and the couples coming out, it’s only a matter of time. Although you may not agree with it, it could make a difference and change, which is what Am erica is all about. 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How Chris Kyle Was The Most Lethal Sniper During American...

It is one thing to initiate change and think of ethics within your unit using the principles and concepts from this course. It is a whole other experience to initiate any of these practices during combat operations out of necessity to save lives. Chris Kyle was a U.S. Navy Seal sniper during the battle of Rhamadi in 2006. Chris is known as the most lethal sniper in American history and for his autobiography American Sniper. The website visionary leader.org says that â€Å"visionary leaders require core values, clear vision, empowering relationships and innovative action†. Chris Kyle displayed these characteristics throughout his career. However, his most notable display of these individualities came while performing combat operations in†¦show more content†¦Sniper over-watch is a task where a sniper takes an elevated position to protect advancing troops with intelligence on their surroundings and lethal fire if necessary. During these over-watch missions, Chris discovered that the Marines were not proficient with the necessary skills for this type of battle. This became painfully evident to him by the number of Marines he witnessed through the lens of his sniper scope being carried away by their friends. At that moment, his new mission was whatever was necessary to save Marines. Chris had specialized training in this type of warfare being waged and knew that he could train these guys to endure. According to the Thomas N. Barnes Center, Change Management (pg 17) change is about survival and Chris wanted them to survive. He had built a rapport with these Marines over the course of a few months. That rapport set the stage for his plan. He spoke with the Marine platoon sergeant to gain permission to train his men. Promptly after that conversation Chris started a training regime that taught them everything they needed to know about asymmetric warfare, Navy Seal style of course. After he completed his training regime, his vision was soon to become a reality. He proceeded to build teams who now possessed necessary skills in asymmetric warfare and he motivated and inspired and gave them goals to attain. He then empowered them and

Study of a Diabetic with Type Two Diabetes and a Leg-Ulcer Free Essays

string(57) " and becomes tearful because of the state of her health\." Introduction This essay will focus on a type two diabetic patient with leg ulcer as the effect of the complications of diabetes. Limited mobility caused by leg ulcer will be discussed as the health deviation. My patient is Mrs B, 54 years old who was diagnosed with type two diabetes 13 years ago and lives with her husband and two daughters’ ages 18 and 16. We will write a custom essay sample on Study of a Diabetic with Type Two Diabetes and a Leg-Ulcer or any similar topic only for you Order Now She works as a senior staff for a beauty company. I chose this client because my sister died of complications of foot ulcer and my grand father died of diabetes. I came from a country where health services are not free and due to poverty, my sister was not diagnosed till she died and my grand father was only diagnosed in his old age when intervention was too late. Herbal medication was used for both my grandfather and my sister but failed due to lack of knowledge of the condition (Yodar 1989). All confidentiality will be maintained and informed consent form is included in the appendix. This health deviation was also chosen because it is a costly problem in the UK with an increasing prevalence. National Health Service (NHS) spent approximately ?400 million a year on treatment on leg ulcers (www.journalofwoundcare.com). Andrew et al (2010) estimated that by 2025, people suffering from diabetes mellitus would have rapidly increased from 2.6 million at present to 4million. The understa nding of this condition and how it impacts on individual will prepare me for the future as I will be in a position to care for people with diabetes and also to educate them on the impact the illness can have on their well being. Type 2 diabetes is accompanied by peripheral resistance to insulin in muscle cells, increased production of glucose by the liver and altered pancreatic insulin secretion (Steven and Michael 2008). Increased tissue resistance to insulin generally occurs first and is eventually followed by impaired insulin secretion. Looking at the pathophysiology of Mrs B’s leg ulcer which resulted in limited mobility. Insulin is produced by the pancreas but could not be used due to inhibition of insulin resistance. This results in accumulation of glucose in her bloodstream not being used by target cells thereby leading to hyperglycaemia. Leg ulcer is caused by poor diabetic management and can either be venous or arterial (Tim and Sudhesh 2010). According to Mustoe (2004), accumulation of glucose in Mrs B’s bloodstream over a period of time causes increase in blood viscosity and leads to blockage and damage of the small vessels and peripheral nerves. This then lead to decrease in circul ation to her peripheral vessels and causing the pressure in her vein to increase (venous hypertension). Arteries loose their normal higher pressure due to venous hypertension and this allows inflammatory exudates to escape into the subcutaneous tissues of the crus subsequently breaks down the tissue. Walking barefoot at home is part of Mrs B’s upbringing. In addition to the pressure in her foot, she hit her foot against her daughter’s scooter and the skin break down. Venous hypertension stretches the veins and result into leakage of blood protein into the extra vascular space and leaving out the extracellular matrix molecules (venous insufficiency). Venous insufficiency causes build-ups of white blood cell (leukocytes) in smaller blood vessels which plug the vessel and contributes to ischemia in the limbs. Leukocytes can also release inflammatory factor, further contributing to chronic wound formation (Mustoe 2004). Diabetic mellitus is characterised by autonomic, sens ory and motor neuropathies. There are various complications for client with diabetes mellitus (type 2) due to inability of retaining control of their blood glucose (Palfreyman 2008). Mrs B developed a reduced mobility due to damaged peripheral vessels and nerves caused by decrease circulation as a result of increase glucose level in the blood. Reduced mobility can have a great impact on day to day activities as this also reduces the individuals independent and control of ones life. Mrs B as the bread-winner in her family now finds it extremely difficult to cope and to provide for her family since her husband also has a heart condition which prevents him from working. This is also distressing due to her children’s needs not being met and her inability to function effectively as a mother because of reduced mobility. Mrs B is on insulin, lansoprazole for prevention of gastric acid and fentanyl patch for pain killer (www.diabetes.co.uk/treatment and bnf) Leg ulcer cost NHS approximately ?400m a year of which community nursing services accounts for. Research has shown that 80-85% of client with leg ulcer are venous leg ulcers whilst 10-20% are arterial leg ulcers (www.journalofwoundcare.com). According to Simon et al (2004), leg ulcers are on rapid increase in the UK and have a huge impact on NHS budget. Immobility is also on increase because of inadequate bed in the hospital to admit such client for close monitoring. This results in district nurses spending more time on caring for client with ulcer in the community and yet most patients do not receive appropriate care. Chapman (2008) states that about 1.2%-3.2% in 1000 people suffers from chronic leg ulcer, which means 80,000-198,000 people in the UK suffers from venous leg ulcer. A UK study examined the prevalence of venous ulcer and it was 0.4/1,000 in men and 0.6/1,000 in women. The increase of leg ulcer is related to age. Same study shows that in men over 85 years old, the rates were 8.29/1,000 and 8.06/1,000 in women and 55% of patient had leg ulcer for more than one year (Moffatt et al, 2004). Research in Canada estimated that 2.0/1000 Canadian suffers from leg ulcer, of which 40% are homebound due to immobility caused by chronic leg ulcer and this has been a huge cost to the Ministry of Health (MOH). Approximately, $5,868 is spent on each client under standard community care thus, coming up to $511 million spent annually by the MOH on leg ulcers (Shannon 2007) Mrs B often becomes have low mood and becomes tearful because of the state of her health. You read "Study of a Diabetic with Type Two Diabetes and a Leg-Ulcer" in category "Essay examples" According to Rotter (1965) cited in Mamlin et al (2001), it is believed that the client has an external locust of control. This is related with depression, fear and inability to cope with stress. Mrs B’s diabetes was diagnosed 13 years ago following her admission in St George’s hospital for a removal of gall stone. During her observation, the health care assistant informed the nurse that her blood glucose reads 19.4mmol/L. The nurse did a fasting glucose level test on her and it reads 10.9mmol/L. Her urine was tested and glucose was present in it. It was also noticed during her stay in the hospital, her increase in thirst was alarming. Random blood glucose tests, fasting blood glucose tests, urinary analysis for glucose and ketones, Hba1c level and formal glucose tolerance tests such as plasma glucose are procedures carried out to confirm the diabetes state of client. Eye test is also checked to confirm diabetic retinopathy whilst other cardiac investigations to rule out or recognise the presence of cardiac diseases (www.doh.gov.uk). Mrs B does not require surgery and does not fall in the categories of people who go through referral because her diagnosis was con firmed in the hospital. Her General Practitioner (GP) will also be informed so that h/she can refer her for follow up. Patient with diabetic type 11 will normally be referred by their to their local GP within 8 weeks to external bodies like out-patient where they will be able to see a diabetes specialist nurse for follow up (www.doh.gov.uk). Diabetes research in the UK is funded by the Juvenile Diabetes Research Foundation, the charity Diabetes UK and other private companies sectors. Diabetes specialist nurse specialised primarily with clients with diabetes and their aim is to educate, help client understand, control and manage their diabetes; and also provides physicians care for them (David 2010). The client was met on her admission to the ward for advance medical treatment for her leg ulcer which is also limiting her mobility. Mrs B is now finding her activities of daily living very hard to keep up with and has to depend on her husband who also suffers from heart condition and panic attack for her care. Her reduced mobility has become a challenge and concern for her as she is unable to meet the needs of her children and this stress is worsening the husband’s condition. According to National Institute for Health and Clinical Excellence (NICE), a consultant’s visit from GP’s referral should be within 9 week at best and at least, 18months (www.nice.org.uk/Gps). Health care professionals are undergoing stress, whilst NHS are target driven rather than effective treatment and consultants are trying to meet these target (www.doh.gov.uk). Palfreyman (2008) interviewed 266 people with the history of leg ulcer and identify the huge impact it has on ones quality of life even the ones with healed leg ulcer has a lower quality of life in comparison with people who has no history of leg ulcer. According Briggs and Fleming (2007) 8O% of patient with leg ulcer caused by complications of diabetes type 11 have excruciating pain, 75% of them have exudates, 65% of them suffer from depression, 56% of them have an offensive smell and 65% insomnia. Mrs B is experiencing reduced quality of life. The weight of bandage on her leg and exudates is burdensome. The smell is intimidating and embarrasing and leads to the client being withdrawn and hiding themselves. The pain is also mentally and emotionally disturbing which is also putting strain on her physical moveme nt (reduced mobility); also her being overweight is worsening her reduced mobility. Limited mobility has been the focus of concern for Mrs B. As the breadwinner of her family, anxiety, fear of the unknown and depression has increase rapidly in her life as she is experiencing extreme difficulties in mobilizing and in carrying our her day to day activities. According to Gavard et al (1993), â€Å"Depression occurs frequently in people with diabetes, especially in those with complications†. The Quality and Outcome Framework (2010) has introduced depression screening into regular diabetes surveillance (www.nhsemployers.org). Mrs. Book’s relationship with her husband and two daughters is affected as she gradually deteriorated and lost her independent. Her dependence is now on her husband who cannot engage in stressful work due to his heart condition and also the children are having problems with socializing because they have to rush home after school to help their mother. Mrs. Book condition has had great impact on her children as they struggle to maintain previous level of performance in their education. Limited mobility has leaded a strained relationship between Mrs. Book’s and her children. She cannot spend much time with them as she use to; taking them to the park, cinemas, shopping and holiday has also reduced. The weight of the bandage on her leg is burdensome at she often have to change the bandage when it is wet. She conceives her despair and was afraid to engage her husband because stressful situation can trigger his panic attack. This often led to conflict between her and her husband as the husband struggles to understand her. Research shows that supportive families can help client with chronic illness cope with behavioral or psychological disorder that may occur as a result of the illness. Same research shows that open expression of emotion such as crying might make the family member to empathize (Hanson et al 1992). On the contrary, this can be argued depending on the level of maturity of the family member. In Mrs. B’s case, open expression of emotions might not be appropriate in the presence of her children. Her children ages 18 and 16 years old fall in the 5th stage of Eric Erickson’s psychosocial theory of Human development (identity v Role confusion). This adolescent’s stage is when they start resolving identity and direction and also becoming a grown-up (http://www.businessballs.com/erik_erikson_psychosocial_theory.htm). Open expression of emotion of can be stressful to Mrs. B’s children in addition to the stress adolescent experience due to hormonal changes in their body (Seiffge-Krenke 2001). Mrs B’s finance is also affected. As a senior staff of a growing beauty company, she finds it hard to return to work as she is unable to move around to assist customers as her job demand. Abiding with her company’s uniform conduct is also a problem for her, although the manager has agreed for her to wear a trouser instead of a skirt, yet she has to take breaks often to change the bandage when it’s wet. She also has to wear a special shoe because she wasn’t fitting in her normal shoes because of the extent of the bandage on her ankle. Her condition contradicts her working environment. This might cause stereotyping and make her feel odd. Mrs B felt she is loosing control of her life as she is also not free to wear any clothing she want and has to wear clothing’s that covers her leg. As a result of her limited mobility, she feels guilty and sees herself as a failure for letting herself and family down. A study/ statistics was carried out by (Murray an d Fortinberry 2005) in Australian and it shows that problems encountered by the patient are comparable to those of the US and UK. This essay has improved my knowledge on complications of type 2 diabetes on individuals life and how it can ruin once career. I have lived with people with diabetes and got few friends with diabetes type 2, yet my understanding of their condition was shallow which I believe it has limited me in a way i should have help them. I have also come to the realisation of the strain leg ulcer can place on individual. Although I have nursed few patients with leg ulcer caused by their diabetes, I have not provided them with appropriate emotional and psychological support they might have needed due to my limited depth of the condition. Finally, I have deepened my understanding on how culture, upbringing and religion can affect a client’s view of their conditions. In future, when dealing with a patient with leg ulcer, I will put into consideration their culture, religion, job and environment where they live. This will help me to make an appropriate referral to a local group available in th eir area where they can meet other people with the same condition and moreover, people of the same culture. This will give them the opportunity to interact with others and see how they deal with it since they have the same culture. This essay was based on limited mobility caused by leg ulcer in type 2 diabetes patient. Pathophysiology of the health deviation and its effect on the client was discussed, the impact of the health deviation on client’s journey through health care and potential influences of the health deviation on the long term well being of client and family/ significant was also discussed in details. REFERENCES Andrew, S. P. and Anthony P. C (2010) The treatment of diabetic foot infections: Pathogenesis of diabetic foot disease 26, (7). Briggs, M. and Fleming, K. (2007) Living with leg ulceration: a synthesis of qualitative research. Journal of Advanced Nursing; 59: 4, 319-328. [online] Available at http://www.nursingtimes.net/assessing-the-impact-of-venous-ulceration-on-quality-of-life/1896181.article. (Accessed 16 Nov, 2010) C.J Currie., C.L Morgan., and J.R Peters (2008). The epidemiology and cost of inpatient care for peripheral vascular disease, infection, neuropathy, and ulceration in diabetes. Nursing Times 6(110) 42-44.7 Chapman. R (2008) Chronic Wound Pain. [online] Available at: http://www.painconcern.org.uk/pages/page78.php ( Accessed: 19 Feb 2010) David Uregbula (2010), The Role of a Diabetes Specialist Nurse. [online] Available at: http://www.ehow.com/about_5201899_role-diabetes-specialist-nurse.html#ixzz1DIN4J4hF. (Accesssed:26 Jan 2010) Deborah, A .S., Francis P.D. and Charles N.M (2004). Management of Venous Leg Ulcers. [Online] Available at: http://www.bmj.com/content/328/7452/1358.full (Accessed: 10 January 2011) Gavard J., Lustman P. and Clouse R (1993) Prevalence of depression in adults with diabetes: An epidemiological evaluation. [online] Available at: http://care.diabetesjournals.org/content/16/8/1167 16:1167– 1178. INGE SEIFFGE-KRENKE (2001) Diabetic Adolescents and Their Families: Stress, Coping and Adaptation. USA: CambridgeUniversity press Journal of Wound Care (2006): Venous Leg Ulcer. [online] Available at: http://www.journalofwoundcare.com/JWC/Supplements/206 ( (Accessed 15 Jan 2011) Mamlin N., Harris, K.R. and Case, L.P. (2001). A methological Analysis in Research of Locust of Control and Learning Disabilities: Rethinking a Common Assumption [online] Available at: www.findarticles.com/cf_o/moHDF/4_3476157546/p1/article.jhtm1. (Assesed: 23 January 2011) Moffatt, C.J. et al (2004) Prevalence of leg ulceration in a London population. [online] Available at: http://www.nursingtimes.net/the-burden-of-chronic-wounds-in-the-uk/527138.article QJM; 97: 7, 431–437: (Accessed on 18th Feb 2010) Murray B. and Fortinberry A (2005). Depression Facts and Stats. [online] Available at http://www.upliftprogram.com/depression_stats.html#statistics, (Accessed: 23 Feb, 2010) Mustoe T (2004). â€Å"Understanding chronic wounds: a unifying hypothesis on their pathogenesis and implications for therapy†. Am. J. Surg. 187 (5A): 65–70 National Institute for Health and Clinical Excellence (2008). [online] Available at:www.nice.org.uk/Gps. (Accessed 15 Jan 2011) Palfreyman, S.J. et al (2007b) Impact of intravenous drug use on quality of life for patients with venous ulcers. Journal of Advanced Nursing; 58: 5, 458-467. Palfreyman, S. (2008) Assessing the impact of venous ulceration on quality of life. Journal of Advanced Nursing; 104:41, 34-37. Ronald J. Shannon (2007) A Cost-utility Evaluation of Best Practice Implementation of Leg and Foot Ulcer Care in the Ontario Community.[online] Available at: http://www.cawc.net/images/uploads/wcc/5-1-Cost-utility_Evaluation.pdf (Accessed on 23 Feb 2011) Stephen R. Baker, and Michael C. Stacey. Article first published online: 21 JAN 2008 The Quality and Outcome Framework (2010) Depression screening into regular diabetes surveillance. [online] Available at: www.nhsemployers.org ( Accessed: 12 Feb 2011) Tim Holt and Sudhesh Kumar (2010). ABC of Diabetes (6th ed). UK. Wiley-Blackwell Yoder RA. Are people willing and able to pay for health servicesSoc Sci Med 1989; 29(1):35-42. [online] Available at: http://www.ispub.com/journal/the_internet_journal_of_health/volume_8_number_2_12/article/user_fees_in_health_services_in_nigeria_the_health_policy_implications.html. (Accessed on 21 Feb. 2010) How to cite Study of a Diabetic with Type Two Diabetes and a Leg-Ulcer, Essay examples

Sigmund Freuds Ego Defense Mechanisms Essay Example For Students

Sigmund Freuds Ego Defense Mechanisms Essay Sigmund Freud is perhaps one of the most well-known theorists in regards to the study of the human psyche. Freuds model of the human psyche is comprised of three core elements: the Id, or the unconscious mind; things out of our awareness. The Superego, or the subconscious mind, and finally the Ego, which lies between the unconscious and subconscious. In psychoanalysis, an ego defense mechanism is an unconscious personality reaction that the ego uses to protect our conscious mind from threatening feelings or perceptions. Freud proposes that there are nine ego defense mechanisms that act the ego uses in its job as the mediator between the id and the superego. Freuds ego defense mechanisms are as follows: denial, displacement, projection, rationalization, reaction formation, regression, repression, sublimation, and suppression. Ego defense seems to occur subconsciously we are often not aware that we are becoming defensive. I believe that we use a complex of many, if not all of Freuds ego defense mechanisms. Personally, I believe regression and rationalization may be the two defense mechanisms I use most. Regression is defined as returning to a previous stage of development. For example, if things do not go my way and continue to do so, it might be followed by bouts of temper tantrums and mood swings. Rationalization is supplying a rational or logical reason as opposed to the real reason. I have found that I use this tactic a lot, and was not aware of it before I had encountered psychology. For instance, I would often try and find explanations for things that bother me or defend myself in situations when things did not pan out as I had planned. If Im planning to do something but something else comes up, I may try and rationalize the decision by putting down the other option weather is going to be bad, I didnt really want to do that anyway, or I can always go later. Another example is entertainment movies, music, or activities; I may not like a certain type of film or genre of music, but when American pop-culture is rife with that type of music or movie, Ill try and rationalize my association with such things as everything in moderation or its fine, as long as I dont indulge. Displacement is another defense mechanism Ive noticed. If Im having a bad day or if Im mad for one reason or another, I notice that Id often take it out on undeserving people. Often I would use an angry tone or become very hostile with someone if Id just been in an argument, as my anger has not yet subsided. I think displacement is an unconstructive defense mechanism; there are negative consequences to both parties and no edification, or bettering or understanding of self takes place. As with everything, everything in moderation. I believe ego defense mechanisms are not completely unhealthy, and that using them to deal with some situations can prove to be beneficial in the development of our personality. However, if one relies primarily on ego defense mechanisms and refuses to deal with circumstances head on, they will develop problems later in life. In situations when one is undoubtedly guilty, it is impossible to rationalize or justify their actions or attitudes and hide behind unfounded explanations in an attempt to get off easy.