Friday, February 19, 2010
Friday, January 22, 2010
Nurs in the Eye of Patients
NURSES IN THE EYES OF PATIENTS
When people come to see a doctor they do not only meet doctor but also a nurse. In hospital, nurses work for an expert doctor or as part of a team to assess, plan implement and evaluate healthcare. In many cases, they work to help patients during the day and night. They help patients for a daily need. Generally, nurses perform a wide range of clinical and non-clinical functions necessary to the delivery of health care.
Nurses may work in occupational health settings such as free-standing clinics and physician offices, or nurse-run clinics. Many of them work as a team in hospital.
In hospital, one of the most important responsibilities of a nurse is to monitor a patient’s vital signs and record significant changes. Keeping an eye on a patient’s blood pressure, pulse, temperature, and respiration are important to realizing whether a patient is getting better or worse. As a result, nursing assistants are usually the first to know how well a patient is responding to a medicine or treatment method. They check the patient’s vital signs regularly and routinely, and report any new health issues or side effects, negative or positive improvements, and other significant changes.
Nursing assistants are also responsible for maintaining a patient’s personal hygiene while they are in the hospital, and/or medical facility. Some of these tasks include, but are not limited to helping the patients to shave, take their baths, and clipping their nails. They may also assist in dressing and undressing patients who are unable to perform these tasks for themselves. Another separate, but closely related duty is to facilitate a patient’s restroom needs – some hospitals have special staffs providing restroom needs . And the level of help required will depend on the patient’s situation, some will merely need to be walked to a restroom, others may require aid with emptying a catheter, and there may even be patients that are bed ridden and require more assistance. This type of task may be portrayed as the worst part of a nursing assistant’s job; but it is a very important aspect to fulfilling the nursing code of ethics, as such responsibilities are the ones that ensure that patients are able to maintain their dignity in spite of their particular ailment.
However hardwork they perform, nurses, rather than physicians, have been the subject of blame in recent cases. Patients complain that nurses failed to meet the standard of care. They fail to set up a patient’s food and nutritional supplements. Patients complain that nurses fail to monitor the patients at all time.
In some worst cases, nurses were blamed for causing malpractice, giving unsuitable medicine, giving injection based on false assumption – they even get sued for what they think the did not do.
On the contrary nurse believe that they have met the standard in taking care of their patients. Cost-cutting measures also have contributed in part to another problem: patient dissatisfaction with the health care system. Many patients complain that they are merely case numbers to be handled efficiently, without care and concern from staff members, including nurses. Cost-cutting combined with patient dissatisfaction has created a double bind for nurses. Although they need to spend more time with patients if they are to interact with them more fully, nurses actually have less time. In addition, many nurses are surprised that patients perceive they receive unsatisfactory care because the nurses believe they are providing care exactly the way they were taught in nursing programs that focused on caring for patients. (3) In fact, nursing care concentrates on objective, physical care concerned with assessment, diagnosis, planning, implementation, and evaluation. (4) Objective care also includes psychological support, which involves supporting behavior changes, teaching patients to live with their medical conditions, and connecting patients to support groups. (4) From a patient's perspective, however, caring entails an emotional, subjective interaction with nurses in which nurses display genuine care and concern for them, not just as patients, but also as human beings. (5-7) Taking care of patients is an objective process centered around patients' medical-surgical need s, including psychological support, whereas caring for patients is a subjective process centered on nurses' humanness. These two different care approaches often are blurred, and when they are misunderstood, problems arise.
From the patient's perspective, the following actions indicated an uncaring nurse:
- Uncaring nurses' interactions with patients always were hurried, and these nurses never took time to talk to or really listen to patients.
- Uncaring nurses demonstrated a lack of interest in patients as people.
- The actions and behaviors of uncaring nurses were rule-bound and super-efficient; these nurses appeared tense, and they avoided eye contact with patients.
- Uncaring nurses' interactions with patients were perceived as scolding.
- Uncaring nurses were physically absent for long periods of time, or they made only short, superficial appearances.
In some cases what the patients complain about is true. Some nurses do not follow the traditional role of working in a hospital setting in documenting what and how much they eat and their level of fluid intake is another responsibility of a nursing assistant. they failed keep track of what their patients can eat, and what they are allowed to have. For example, when a patient is receiving surgery the doctor will say that they are not allowed to have any food or fluids after a certain time. Unfortunately, the people who prepare meals may have sent a meal to the patient, because they were unaware of the doctor’s orders. Nursing assistants do not step in and verify this and other information such as the types of food a patient may be allergic to, or unable to eat due to digestive concerns.
Some of them even ineffectively give a patient their medicine and ensuring that he or she actually takes it correctly is also a duty of a nursing assistant which are expected that they may be looked upon to double check the accuracy of orders or to inform physicians and/or nurses of any medication or substances that a patient may have already taken that could affect their treatment.
Whatever happens in hospital, nurses actually have, long understood the responsibility required of them in their practice. During the process of formal education, students are continuously reminded of their professional responsibilities. Nurses are, however, not always as knowledgeable of the view of those outside of the nursing profession regarding their responsibilities.
But what cause them in the situation where they are. Some experts state that they can’t maintain good standards because they are overloaded , the profession of nursing as a whole is overloaded because there is a nursing shortage. They are overloaded by the number of patients they oversee. They are overloaded by the number of tasks they perform. They work under cognitive overload, engaging in multitasking and encountering frequent interruptions. They work under perceptual overload due to medical devices that do not meet perceptual requirements insufficient lighting, illegible handwriting, and poor labeling designs. They work under physical overload due to long work hours and patient handling demands which leads to a high incidence of MSDs. In short, the nursing work system often exceeds the limits and capabilities of human performance. These overloads can limit capabilities of performance.
The board set a precedent that it was each nurse's job to double check the physician's orders and evaluate the situation to make sure that nothing violated hospital policy and that nothing was outside the normal standard of care all of which to ensure quality care for all, to maintain their credentials, code of ethics, standards, and competencies.
As a conclusion, what patients view as a good caring of a nurse is a nurse's physical presence. They feel good if nurses are coming checking them up. They feel welcomed when nurses speak to them in good tone of voice. They feel safe when nurses try to give an answer to whatever questions they ask, even if they say they will ask the doctor. And it was considered caring if the nurse made direct patient eye contact and disclosed personal information.
Finally, patients are hoping for skillful and caring nurse with a kind face who has an empathetic nature to be available in many hospital.
When people come to see a doctor they do not only meet doctor but also a nurse. In hospital, nurses work for an expert doctor or as part of a team to assess, plan implement and evaluate healthcare. In many cases, they work to help patients during the day and night. They help patients for a daily need. Generally, nurses perform a wide range of clinical and non-clinical functions necessary to the delivery of health care.
Nurses may work in occupational health settings such as free-standing clinics and physician offices, or nurse-run clinics. Many of them work as a team in hospital.
In hospital, one of the most important responsibilities of a nurse is to monitor a patient’s vital signs and record significant changes. Keeping an eye on a patient’s blood pressure, pulse, temperature, and respiration are important to realizing whether a patient is getting better or worse. As a result, nursing assistants are usually the first to know how well a patient is responding to a medicine or treatment method. They check the patient’s vital signs regularly and routinely, and report any new health issues or side effects, negative or positive improvements, and other significant changes.
Nursing assistants are also responsible for maintaining a patient’s personal hygiene while they are in the hospital, and/or medical facility. Some of these tasks include, but are not limited to helping the patients to shave, take their baths, and clipping their nails. They may also assist in dressing and undressing patients who are unable to perform these tasks for themselves. Another separate, but closely related duty is to facilitate a patient’s restroom needs – some hospitals have special staffs providing restroom needs . And the level of help required will depend on the patient’s situation, some will merely need to be walked to a restroom, others may require aid with emptying a catheter, and there may even be patients that are bed ridden and require more assistance. This type of task may be portrayed as the worst part of a nursing assistant’s job; but it is a very important aspect to fulfilling the nursing code of ethics, as such responsibilities are the ones that ensure that patients are able to maintain their dignity in spite of their particular ailment.
However hardwork they perform, nurses, rather than physicians, have been the subject of blame in recent cases. Patients complain that nurses failed to meet the standard of care. They fail to set up a patient’s food and nutritional supplements. Patients complain that nurses fail to monitor the patients at all time.
In some worst cases, nurses were blamed for causing malpractice, giving unsuitable medicine, giving injection based on false assumption – they even get sued for what they think the did not do.
On the contrary nurse believe that they have met the standard in taking care of their patients. Cost-cutting measures also have contributed in part to another problem: patient dissatisfaction with the health care system. Many patients complain that they are merely case numbers to be handled efficiently, without care and concern from staff members, including nurses. Cost-cutting combined with patient dissatisfaction has created a double bind for nurses. Although they need to spend more time with patients if they are to interact with them more fully, nurses actually have less time. In addition, many nurses are surprised that patients perceive they receive unsatisfactory care because the nurses believe they are providing care exactly the way they were taught in nursing programs that focused on caring for patients. (3) In fact, nursing care concentrates on objective, physical care concerned with assessment, diagnosis, planning, implementation, and evaluation. (4) Objective care also includes psychological support, which involves supporting behavior changes, teaching patients to live with their medical conditions, and connecting patients to support groups. (4) From a patient's perspective, however, caring entails an emotional, subjective interaction with nurses in which nurses display genuine care and concern for them, not just as patients, but also as human beings. (5-7) Taking care of patients is an objective process centered around patients' medical-surgical need s, including psychological support, whereas caring for patients is a subjective process centered on nurses' humanness. These two different care approaches often are blurred, and when they are misunderstood, problems arise.
From the patient's perspective, the following actions indicated an uncaring nurse:
- Uncaring nurses' interactions with patients always were hurried, and these nurses never took time to talk to or really listen to patients.
- Uncaring nurses demonstrated a lack of interest in patients as people.
- The actions and behaviors of uncaring nurses were rule-bound and super-efficient; these nurses appeared tense, and they avoided eye contact with patients.
- Uncaring nurses' interactions with patients were perceived as scolding.
- Uncaring nurses were physically absent for long periods of time, or they made only short, superficial appearances.
In some cases what the patients complain about is true. Some nurses do not follow the traditional role of working in a hospital setting in documenting what and how much they eat and their level of fluid intake is another responsibility of a nursing assistant. they failed keep track of what their patients can eat, and what they are allowed to have. For example, when a patient is receiving surgery the doctor will say that they are not allowed to have any food or fluids after a certain time. Unfortunately, the people who prepare meals may have sent a meal to the patient, because they were unaware of the doctor’s orders. Nursing assistants do not step in and verify this and other information such as the types of food a patient may be allergic to, or unable to eat due to digestive concerns.
Some of them even ineffectively give a patient their medicine and ensuring that he or she actually takes it correctly is also a duty of a nursing assistant which are expected that they may be looked upon to double check the accuracy of orders or to inform physicians and/or nurses of any medication or substances that a patient may have already taken that could affect their treatment.
Whatever happens in hospital, nurses actually have, long understood the responsibility required of them in their practice. During the process of formal education, students are continuously reminded of their professional responsibilities. Nurses are, however, not always as knowledgeable of the view of those outside of the nursing profession regarding their responsibilities.
But what cause them in the situation where they are. Some experts state that they can’t maintain good standards because they are overloaded , the profession of nursing as a whole is overloaded because there is a nursing shortage. They are overloaded by the number of patients they oversee. They are overloaded by the number of tasks they perform. They work under cognitive overload, engaging in multitasking and encountering frequent interruptions. They work under perceptual overload due to medical devices that do not meet perceptual requirements insufficient lighting, illegible handwriting, and poor labeling designs. They work under physical overload due to long work hours and patient handling demands which leads to a high incidence of MSDs. In short, the nursing work system often exceeds the limits and capabilities of human performance. These overloads can limit capabilities of performance.
The board set a precedent that it was each nurse's job to double check the physician's orders and evaluate the situation to make sure that nothing violated hospital policy and that nothing was outside the normal standard of care all of which to ensure quality care for all, to maintain their credentials, code of ethics, standards, and competencies.
As a conclusion, what patients view as a good caring of a nurse is a nurse's physical presence. They feel good if nurses are coming checking them up. They feel welcomed when nurses speak to them in good tone of voice. They feel safe when nurses try to give an answer to whatever questions they ask, even if they say they will ask the doctor. And it was considered caring if the nurse made direct patient eye contact and disclosed personal information.
Finally, patients are hoping for skillful and caring nurse with a kind face who has an empathetic nature to be available in many hospital.
Thursday, January 21, 2010
SABANG
SABANG
We should be proud that we have a famous island here in Aceh. The Island that we call Sabang has been a very important island in Aceh. Sabang used to be a big port of Sumatra, besides Riau, under the Dutch colonialization.
Now, Sabang is planned to be built as a place of world free trade zone, where goods and commodities can be shipped around the world through Sabang. A new regulation was passed in 2000 saying that Sabang was to become one of the places used as free trade center zone (source: http://bappeda.sabangkota.go.id).
Sabang is also a naturally beautiful place for people to visit. It has huge mountains and long beaches. The beaches in Sabang are known as one of unexploited and unpolluted beaches in Indonesia. People do not have any trouble enjoying the beaches; snorkeling, diving, and viewing the coral reefs. Therefore it is no wonder that Sabang attracts people locally, nationally, and internationally as well.
Having good and unpolluted beaches, Sabang has helped people around Indonesia and some around the world see the natural beaches available. But the problem is that the people who come from another country, especially western country, do not comply with applicable regulations here in Sabang. They come in clothes which are not suitable to be wearing around Muslim community
Sabang is a naturally good and beautiful place to visit. It is wonderfully lies in the west of Indonesia, where it leads to Malacca Strait, India and the neighboring countries, and Thailand.
Sabang, besides its positive elements, has negative effect too. It is used by the irresponsible to smuggle drugs, used machineries and clothes.
But first, thinking of the positive elements, Sabang is potentially important for a port. It is located right at the door of Malacca Street where a lot of ships passing through every day. Sabang is gradually growing as a potential port in Indonesia, especially for Acehnese.
Because of its location, Sabang is designed as a port for major shipping activities in Aceh. So shipping of commodities does not depend on Belawan, a port in Medan, anymore. This also cuts costs of shipping commodities, where shipping from Belawan to Banda Aceh is more expensive.
Considering its location on the first point of Malacca Street, Indonesian government wishes that they do not depend on Singapore for importing and exporting commodities and other materials. They want that Sabang can sometime be as major a port in South East Asia as Singapore.
Sabang is also considered one of the best travelling destinations in Indonesia after Danau Toba in Medan. It is considered one of the best because Sabang has beautiful places within the island. It has a Rubiah island where people spend time viewing coral reefs and assorted fishes. It has hills and cliff which are good for hiking. It also has beautiful white beaches under thick shadow of tree. Sabang island is also known for its calm and comfy weather.
It also attracts people because it is the zero kilometer point (kilometer nol) of Indonesia, the starting outer point of Indonesia. This is especially famous to Indonesian residents. They come from Jakarta, Kalimantan, and Sumatera Utara. Going to ‘zero kilometer point’ has a special emotional effect on them. They are proud of having been to the first step of Indonesia land.
Aceh Government plan to design Sabang as an Islamic travel destination. They plan that whoever go to Sabang they have to pay attention to Islamic rules, traditions and customs in Sabang.
However, when many people come to visit Sabang they do not pay attention that they should keep Sabang as clean as it is. They do littering and cut things. This is especially true in the city and at beaches. They do not do it intentionally but they ignore the mutual responsibility to keep Sabang comfortable to visit.
Thus, the most often thing the local residents complain about is the costume code. When the west is also attracted by Sabang, many of them come to visit for the purpose of diving and others are for sightseeing. Indonesia is generally a country where customs and traditions are attached with religion. Not being informed about this situation, the west comes in to Sabang with their cultures in hand. Most of them are wearing clothes that do not fit in Moslem community. They do not give it a care that they have to obey the rules, to not wear indecent clothes or be in indecent manner.
The government has to work hard to make Sabang as a famous island as well as real Islamic travel destination.
We should be proud that we have a famous island here in Aceh. The Island that we call Sabang has been a very important island in Aceh. Sabang used to be a big port of Sumatra, besides Riau, under the Dutch colonialization.
Now, Sabang is planned to be built as a place of world free trade zone, where goods and commodities can be shipped around the world through Sabang. A new regulation was passed in 2000 saying that Sabang was to become one of the places used as free trade center zone (source: http://bappeda.sabangkota.go.id).
Sabang is also a naturally beautiful place for people to visit. It has huge mountains and long beaches. The beaches in Sabang are known as one of unexploited and unpolluted beaches in Indonesia. People do not have any trouble enjoying the beaches; snorkeling, diving, and viewing the coral reefs. Therefore it is no wonder that Sabang attracts people locally, nationally, and internationally as well.
Having good and unpolluted beaches, Sabang has helped people around Indonesia and some around the world see the natural beaches available. But the problem is that the people who come from another country, especially western country, do not comply with applicable regulations here in Sabang. They come in clothes which are not suitable to be wearing around Muslim community
Sabang is a naturally good and beautiful place to visit. It is wonderfully lies in the west of Indonesia, where it leads to Malacca Strait, India and the neighboring countries, and Thailand.
Sabang, besides its positive elements, has negative effect too. It is used by the irresponsible to smuggle drugs, used machineries and clothes.
But first, thinking of the positive elements, Sabang is potentially important for a port. It is located right at the door of Malacca Street where a lot of ships passing through every day. Sabang is gradually growing as a potential port in Indonesia, especially for Acehnese.
Because of its location, Sabang is designed as a port for major shipping activities in Aceh. So shipping of commodities does not depend on Belawan, a port in Medan, anymore. This also cuts costs of shipping commodities, where shipping from Belawan to Banda Aceh is more expensive.
Considering its location on the first point of Malacca Street, Indonesian government wishes that they do not depend on Singapore for importing and exporting commodities and other materials. They want that Sabang can sometime be as major a port in South East Asia as Singapore.
Sabang is also considered one of the best travelling destinations in Indonesia after Danau Toba in Medan. It is considered one of the best because Sabang has beautiful places within the island. It has a Rubiah island where people spend time viewing coral reefs and assorted fishes. It has hills and cliff which are good for hiking. It also has beautiful white beaches under thick shadow of tree. Sabang island is also known for its calm and comfy weather.
It also attracts people because it is the zero kilometer point (kilometer nol) of Indonesia, the starting outer point of Indonesia. This is especially famous to Indonesian residents. They come from Jakarta, Kalimantan, and Sumatera Utara. Going to ‘zero kilometer point’ has a special emotional effect on them. They are proud of having been to the first step of Indonesia land.
Aceh Government plan to design Sabang as an Islamic travel destination. They plan that whoever go to Sabang they have to pay attention to Islamic rules, traditions and customs in Sabang.
However, when many people come to visit Sabang they do not pay attention that they should keep Sabang as clean as it is. They do littering and cut things. This is especially true in the city and at beaches. They do not do it intentionally but they ignore the mutual responsibility to keep Sabang comfortable to visit.
Thus, the most often thing the local residents complain about is the costume code. When the west is also attracted by Sabang, many of them come to visit for the purpose of diving and others are for sightseeing. Indonesia is generally a country where customs and traditions are attached with religion. Not being informed about this situation, the west comes in to Sabang with their cultures in hand. Most of them are wearing clothes that do not fit in Moslem community. They do not give it a care that they have to obey the rules, to not wear indecent clothes or be in indecent manner.
The government has to work hard to make Sabang as a famous island as well as real Islamic travel destination.
Saturday, January 9, 2010
Aceh, Warung Kopi dan Fasilitas Internet
Budaya warung kopi di Aceh memang tidak pernah pudar. Bahkan warung kopi semakin membludak seiring dengan perkembangan zaman.
Dulu, selain tempat beristirahat, warung kopi di desa-desa di Aceh dijadikan sebagai tempat musyawarah, formal dan tidak formal. Maka tidak heran jika Anda mereka menghabiskan 1/7 waktu mereka di warung kopi.
Dengan semakin banyaknya warung kopi di Aceh, maka pemilik berusaha menarik pelanggannya dengan beraneka cara. Salah satunya adalah memanjakan pelanggan mereka dengan fasilitas internetan koneksi cepat. Untuk memanfaatkan fasilitas ini, yang dipersiapkan pelanggan hanya sebuah laptop dan mereka bisa online 24 jam.
Dengan adanya fasilitas internetan, warung kopi di Aceh, khususnya di kota Banda Aceh, banyak dimanfaatkan mahasiswa untuk mengerjakan tugas kuliah. Mereka datang ke warung kopi dengan menjinjing sebuah laptop dan menghabiskan waktu tidak kurang dari 2 jam di depan monitor. Beristirahat sejenak, mereka bisa juga membuka jaringan komunikasi sosial seperti Facebook.
Dulu, selain tempat beristirahat, warung kopi di desa-desa di Aceh dijadikan sebagai tempat musyawarah, formal dan tidak formal. Maka tidak heran jika Anda mereka menghabiskan 1/7 waktu mereka di warung kopi.
Dengan semakin banyaknya warung kopi di Aceh, maka pemilik berusaha menarik pelanggannya dengan beraneka cara. Salah satunya adalah memanjakan pelanggan mereka dengan fasilitas internetan koneksi cepat. Untuk memanfaatkan fasilitas ini, yang dipersiapkan pelanggan hanya sebuah laptop dan mereka bisa online 24 jam.
Dengan adanya fasilitas internetan, warung kopi di Aceh, khususnya di kota Banda Aceh, banyak dimanfaatkan mahasiswa untuk mengerjakan tugas kuliah. Mereka datang ke warung kopi dengan menjinjing sebuah laptop dan menghabiskan waktu tidak kurang dari 2 jam di depan monitor. Beristirahat sejenak, mereka bisa juga membuka jaringan komunikasi sosial seperti Facebook.
Tuesday, September 16, 2008
Class Reflection
Varying Activity Prevents Boredom
Implementing varying activity in class prevents me from getting bored. Playing game, group discussion and small joke really make this class easy to follow, even though I have to read reading many assingments outside class.
Moving from one classroom in Amstrong hall to the Library is another important aspect of varying activity. When I first saw this class schedule, I was wondering if I could stay in class for almost 4 hours.
note: sometimes I do not understand what is the purpose of some activity in class. I think Professor can tell me the purpose of an activity as she did when she told me 'narrowing down system when playing a card game'.
Monday, September 15, 2008
English Language Learner in School
Chapter 1 English Language Learner gives a description on who is considered as English Learner, how to welcome them to English Classroom and how to teach them using English language. And here I found that cultural understanding plays important role.
On other part, the book also suggest that teacher can allow student of non-native english to use their own language at the first few meeting. But the question is ‘can teacher understand the student’s language?’. It could be very difficult if there were many children with many different languages.
On the last part, the author gives description on the policy on using billingual language to accommodate student need as well as to make their learning abilities on content knowledge a little bit easier. I think this billingual program is good to those who have little ability of English, or new comer to the United States. However, this program is not for those who can understand and speak english well, even though their native language is not English.
In reflection to my own experience, native-english teacher who can speak my language--Indonesia—is a lot easier to understand and to follow instruction than those who can not speak my language. I have two teachers. Both come from the U.S. One teacher can speak my language while the other can not. I found out that I can easily follow and understand the first teacher. When I do not understand I can ask him to say in my language. This help me very much.
The other teacher can not speak or understand my language. I found that it is difficult to follow him. I think this is not only affected by his lack of understanding of my language but also by his lack of understanding the way we speak, the way we express my mind into word. So cultural and sosiolinguistic understanding does play important role.
Note: this chapter is not too usefull for me, because I am not the native English speaker but I will teach English in Indonesia, whose English is foreign Language.
On other part, the book also suggest that teacher can allow student of non-native english to use their own language at the first few meeting. But the question is ‘can teacher understand the student’s language?’. It could be very difficult if there were many children with many different languages.
On the last part, the author gives description on the policy on using billingual language to accommodate student need as well as to make their learning abilities on content knowledge a little bit easier. I think this billingual program is good to those who have little ability of English, or new comer to the United States. However, this program is not for those who can understand and speak english well, even though their native language is not English.
In reflection to my own experience, native-english teacher who can speak my language--Indonesia—is a lot easier to understand and to follow instruction than those who can not speak my language. I have two teachers. Both come from the U.S. One teacher can speak my language while the other can not. I found out that I can easily follow and understand the first teacher. When I do not understand I can ask him to say in my language. This help me very much.
The other teacher can not speak or understand my language. I found that it is difficult to follow him. I think this is not only affected by his lack of understanding of my language but also by his lack of understanding the way we speak, the way we express my mind into word. So cultural and sosiolinguistic understanding does play important role.
Note: this chapter is not too usefull for me, because I am not the native English speaker but I will teach English in Indonesia, whose English is foreign Language.
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