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Psychology homework help

Psychology homework help. This is a paper that is focusing on the Critical Chain Project Management research paper. The paper also provides additional information to use in writing the assignment paper.,The Critical Chain Project Management research paper,Overview,You are required to submit a research paper on one of the project management topics listed below. The intent of this paper is for you to delve deeper into a particular topic, analyse and synthesize the material in a concise manner, and demonstrate critical thinking. It is about you ADDING VALUE to course content, not repeating it. Think of it as a mini literature review with an organizational example included to consider the usefulness of scholarly work. This is primarily about reporting back on what the literature says–it is not an opinion piece. You are encouraged and expected to critique the literature (what you think of it), but you must FIRST talk about the theories and the constructs, then you can offer your opinion on it and how it applies to you.,The following are a suggest of Project Management Topics area for the Individual Paper;,DMAIC Project Management, PRINCE2 Project Management, Waterfall Project Management, Critical Chain Project Management (CCPM), Capability Maturity Model, Organizational Project Management Maturity Model (OPM3), ,Systems Development Life-Cycle (SDLC), New Product Development,Instructions,Firstly, the paper is to follow APA rules and guidelines., Secondly, you must have at least 4 academic sources, maximum two of which can be the course textbooks; the remaining must be peer review articles., Thirdly, the paper is to be 2500 (+/- 10%) words in length., The paper must have a title page and a separate page for references at the end. It is expected that the introduction comprises no more than 10% of the paper, the research body is to be roughly 70% of the paper, and the remaining 20% to be conclusion with application/reflection. Structure the paper such as to have titles and also subtitles that reflect the content of the paper., Evaluation,Analysis Paper will be a mark in its entirety out of 100. The following rubric indicates the criteria students are to adhere to, and their relative weights to the assignment overall.,Attachments,Click Here To Download,Psychology homework help
University of Nairobi Current and Emerging Technologies Discussion.

Computerized Operating Systems (OS) are almost everywhere. We encounter them when we use out laptop or desktop computer. We use them when we use our phone or tablet. Find articles that describes the different types of operating systems (Linux, Unix, Android, ROS, z/OS, z/VM, z/VSE, etc). Do not select MS WINDOWS. Write a scholarly review of comparing any two or more OS; attach a copy of the article to your postings. Remember, this assignment is to be scholarly; it is not enough for you to simply post your article and add cursory reviews. Cited references are required. In addition you must read the postings of the other students and comment significantly on those areas. Please see Discussion Forum of the class syllabus for additional details on content.Reply 1 for IOS vs AndroidReply 2 Complexity between Android and LinuxReply 3 Linux and Unix operating systems150 words each strictly no plagiarism
University of Nairobi Current and Emerging Technologies Discussion

factors affecting saccharomyces cerevisiae. Chapter 1: Introduction Research Questions: What is the effect of differing temperatures on Saccharomyces cerevisiae population growth? What is the effect of differing pH levels on Saccharomyces cerevisiae population growth? What is the effect of differing glucose concentrations on Saccharomyces cerevisiae population growth? The yeast Saccharomyces cerevisiae is a single celled fungus that reproduces asexually by budding or division. It is one of the most well studied eukaryotic model organisms in both molecular and cell biology. S. cerevisiae is a very good type of yeast for biological studies owing to the rapid growth (doubling time 1.5-2 hours at 30 °C), the dispersed cells and the ease of replica planting. Moreover is a non-pathogenic organism, so can be handled fearlessly with only little precautions. Also large amounts of commercial baker’s yeast are available with result being an easy and cheap source for biochemical studies. S. cerevisiae has round to ovoid cells between 3-8μm in diameter. 1.2 Respiration In biology, respiration is defined as: “the process by which the energy in food molecules is made available for an organism to do biological work” (Kent, 2000; p.100). It is also called Cellular respiration. This process of cellular respiration happens in every living cell as it is the only way to obtain energy in a form that will be usable for the cell, so it can carry out the functions of movement, growth and reproduction (ibid). The food in yeasts must be obtained as they cannot produce it on their own. For yeasts, a very good source of energy is sugars. All strains of S. cerevisiae can metabolize glucose (a hexose sugar), maltose and trehalose. 1.3 Types of Respiration There are two main types of respiration that take place within a cell: Anaerobic respiration (without oxygen) and Aerobic respiration (with oxygen). S. cerevisiae can metabolize sugars in both ways, but in this research the cultures of yeast were exposed to air hence to oxygen, so aerobic respiration was mainly the way that yeast cells grew and reproduced. 1.4 Enzymes Thousands of chemical reactions are carried out within a cell. These reactions most of the times occur in a very slow rate. For that reason living organisms make biological catalysts which are called enzymes and speed up these reactions. “Enzymes are globular proteins which act as catalysts of chemical reactions” (Allot, 2007; p.18. Also cells can control which reaction occurs in their cytoplasm by making some enzymes and not others. Enzymes achieve to increase the rate of a reaction by decreasing the activation energy (the minimum amount of energy required for a reaction to occur) (Greenwood. Et al. 2007; p.167) of the substrate or the substrates, when binding to the activation site (Greenwood. et al. 2007; p.114). Enzymes are sensitive molecules with very specific structure which enables them to carry out specific reactions. This structure including the active site can be damaged by various conditions and substrates. This damage is called denaturation and is usually permanent for an enzyme and if denaturation is occurred the enzyme can no longer carry out its function. As a result when enzymes are required to catalyze a reaction, is necessary that they have appropriate conditions. Different enzymes have different ideal conditions called optimum. The factors that affect the enzyme activity are: the temperature, the pH, the substrate concentration. The effect of temperature, pH and substrate concentration upon the enzyme activity which affects the growth of S. cerevisiae yeast cells are studied in this research. 1.5 Effect of Temperature As the temperature is increased in an enzyme-catalysed reaction, the rate of reaction is increased up to maximum in a specific temperature. This is called optimum temperature. The optimum temperature of Saccharomyces cerevisiae is 30o- 32oC. Above this temperature the rate starts to drop rapidly. This is due to the high energy that causes vibration inside the enzyme with result the bonds which maintain the structure of enzyme to break. This causes denaturation and the active site can no longer fit the substrate. 1.6 Effect of pH (hydrogen ion concentration) Most of the enzymes operate effectively in a small range of pH values. Between these pH values there is an optimum pH value in which the enzyme activity is the highest. The optimum pH of Saccharomyces cerevisiae is 5.5. Acids and alkalis cause denaturation of the structure of the enzyme by breaking mainly hydrogen and ionic bonds with result the substrate can’t fit the active site. Furthermore the charges of the amino acids within the active site are affected by pH changes, so the enzyme is not able to form an enzyme-substrate complex. Above and below the optimum pH the enzymatic activity hence the rate is reduced considerably. 1.7 Effect of Substrate concentration In an enzyme-catalysed reaction the rate increases in direct proportion to the substrate concentration. The optimum glucose concentration of Saccharomyces cerevisiae is 2%. At low substrate concentrations, the rate of enzymatic activity increases sharply as the substrate increases. This occurs due to the more frequent collisions between the substrate molecules and the unoccupied active sites. On the other hand, at high substrate concentrations the biggest part of the active sites have been occupied with result when increasing the substrate concentration there is little effect on the rate of enzymatic activity. 1.8 Purpose of the research The purpose of this research that is carried out to examine the growth of S. cerevisiae yeast cells in different factors and various conditions is not so in order to discover which are the optimum conditions in each factor (as this species of S. cerevisiae is very well studied and examined professionally because of its usage in food industry) but to examine in real conditions and not theoretical ones how altering the environment of a cell affects the way its enzymes work and help the whole cell to live and divide in all of the previously ways that were mentioned in the introduction part. factors affecting saccharomyces cerevisiae
Grand Valley State University The tales of Elena Diakonova Maus genre Discussion.

I need help please with two questions they each need to be 750 to 1000 words. Each need to have a title, also needs to be one inch margins and 11 point font Times new Romans. 1. Write your own free-verse monologue in Duffy’s style. Choose a character in history, myth, legend, popular culture, the Bible, etc., who has not been given a voice in their story. Try to use Duffy’s wit and playful language. You should fill a page or so—nothing as short as “Mrs. Darwin”! Character that you can have feeling and get into there voice. 2.
The genre of Maus is slippery—fiction/non-fiction/cartoon/story-board/graphic novel/ memoir/biography/autobiography. Make the case that it is non-fiction, and make the case that it is fiction. Where do you ultimately come down on the question?
Grand Valley State University The tales of Elena Diakonova Maus genre Discussion

University of Arizona Social Media Essay

University of Arizona Social Media Essay.

You have been assigned the task as Marketing Manager to scan social media web sites and try to mitigate the negative consumer postings from a recent crisis. Explain how organizations use social media to communicate with their consumers through a crisis and evaluate how the negative comments were handled by the organizations. Assess a recommendation for better communication and explain why.The Social Media paperMust be two to four double-spaced pages in length (not including title and references pages) and formatted according to APA style as outlined Must include a separate title page with the following:
Title of paperStudent’s nameCourse name and numberInstructor’s nameDate submittedMust use at least two scholarly sources in addition to the course text.Must document all sources in APA style as outlined in the Ashford Writing Center.Must include a separate reference page that is formatted according to APA style as outlined in the Ashford Writing Center.
University of Arizona Social Media Essay

BUS 110 North Carolina State University Functions of The Federal Reserve Discussion

research paper help BUS 110 North Carolina State University Functions of The Federal Reserve Discussion.

1. BUS 110 Discussion:
Please respond to the following questions. 250 word minimum
What are the major functions of the Federal Reserve? What other functions does it perform?
2. SOC 210 Discussion:

Discussion – due Thursday @ 9 p.m. (respond to others by Sunday @ 9 p.m.)
1. Choose one major social movement in the last 5 years.  Describe the purpose, how it started, and state whether you believe it was successful (how do you know this). 
2. Why are some social movements more successful than others?  
3. Describe one aspect of social change you would like to see. How would start your social movement to see this change hopefully come about. 
I will also send replies in a few days.

BUS 110 North Carolina State University Functions of The Federal Reserve Discussion

The UAE Economy Essay

Table of Contents Introduction Economy Problems in the UAE economy Political Unrest Prospects of the UAE Economy My Opinion of the UAE Economy My Recommendations References Introduction According to various economic indicators like the Gross Domestic Products (GDP), Human Development Index and steel and energy consumption; the economy of the United Arab Emirates (UAE) is considered a diversified and highly growing economy. The UAE economy is an open economy, has 10% of the world’s oil reserves and is the world’s fifth natural gas supplier. It has consistently enjoyed an increase in the GDP that averages 6.5% per annum. Economy The United Arab Emirates (UAE) economy is dominantly pearl production, agriculture, mining, fishing, real estate, and herding. It is argued that the increase in oil prices in 1973 is what led to the spiraling economy of the UAE; it has a large volume of oil and gas reserves, and since then henceforth petroleum has dominated the economy and accounts for most of the UAE exports and has also been largely associated with the growth in the UAE economy since oil contributes to thirty percent of the Gross Domestic Product (GDP). Majority of the UAE imports are mostly manufactured goods and machinery which account for 70% of the imports. To spur the economy, the UAE government has created free trade zones where goods for transshipment and re-exportation are granted 100% duty exemption. Government policies are also favorable to the citizens of the UAE; an example is a mandatory requirement that any company should have a minimum of 51% local ownership which is considered a strategy to place Emiratis in management positions in all companies. As a member of the Gulf Cooperation Council (GCC), the UAE is an active member of all functions that are economically oriented including investment policies and trade cooperation (UAE, 2011). Unlike the majority of the countries, the economy of the UAE is less dependent on the available natural resources as the main sources of revenue; despite relying on the exportation of gas and petroleum, the UAE economy is also driven by the flourishing construction industry and a booming services sector which has helped to diversify the economy. The prosperous infrastructure sector confirms that every sector of the economy enjoys quick expansion; the diversification and liberalization of the economy is one way of curbing heavy reliance on oil in the transformation of the economy and has led to investments in the production of aluminum, tourism and the telecommunication sectors. Land reclamation has also proved to be an economic force to the UAE economy; reclamation of land has enhanced food security and sufficiency. Land reclamation has facilitated the intensification of agricultural activities which accounts for 3% of the GDP and has employed the citizens. Tourism promotion has led to the growth of the tourism sector; the opening of the Burj al-Arab has been touted as one of the most luxurious hotels and the tallest in the world. Tourism has also been promoted through the selling of holiday homes which targets the wealthiest foreigners. Get your 100% original paper on any topic done in as little as 3 hours Learn More The trading in shares by the companies in the UAE is through Abu Dhabi Securities Market (ADSM) and the Dubai Financial Market (DFM). These two financial markets have demonstrated a justifiable growth and are considered among the established in the world according to the analysis of the volume of shares traded (UAE Central Bank, 2011). The real estate and construction sector has also been considered a booming sector in the UAE economy; this sector contributes to 15% of the GDP. The intensification of diversification as advocated by the government with the objective of reducing dependence on oil is what has led to the growth of the real estate sector. The evidence of booming construction and real estate sector is due to the heavy presence of cranes and also because Dubai is the hub for the world’s best construction companies (Kumar, Agarwal

Communication Is Important In Nursing And Nursing Process Nursing Essay

Share this: Facebook Twitter Reddit LinkedIn WhatsApp This essay will look at the importance of communication in nursing. To begin, the essay will consider the use of communication in nursing in the general context. The latter section will go on to reflect on the application of communication in practice in relation to conversation and basic psychotherapeutic support within the dementia care environment. Introduction Communicating is a fundamental skill in nursing. It governs every task a nurse undertakes from the point of admission to the point of discharge. There are a number of levels from simple phatic exchanges used to initiate conversation, extending to complex counselling techniques. Effective use of communication has been shown to benefit the nurse-patient relationship, contributing to overall well-being and accelerating the process of treatment. It is therefore an essential aspect of the nursing process. In some cases, it can even mean the difference between life and death. Good communication is often regarded as a delicate and complex art, requiring a good understanding of the interplay between numerous factors. This essay intends to provide a definition and to highlight a number of important professional, ethical, legal and moral responsibilities of the nurse in relation to communication (Sheldon, 2005). Discussion There are numerous definitions for communication. Potter and Perry (2001 p.445) offer a definition for communication as ‘…a process in which people affect one another through the exchange of information, ideas, and feelings.’ Thus, it is about sending and receiving a message, both verbally and non-verbally, with a shared goal of conveying a mutual understanding. In general regard to the verbal domain, the process is often reciprocal in nature as both informant and referent change role, seek clarification and offer an acknowledgement of understanding throughout the exchange. It is imperative to be aware of the effect that body language and paralinguistic features have on communication. Thinking about body posture and implementing the principles of SOLER (identified by Egan (1982) cited in Burnard and Gill (2009)) is useful in nursing. A relaxed posture can help in the process of active listening, helping to convey an empathic response to the patient. Argyle (1994) points out that people are often unaware of their own non-verbal communication, whilst it is clearly visible to the receiver. Incongruence between what is being said verbally and what otherwise is perceived does not help in facilitating a positive relationship from a patients’ perspective. However, for a nurse who is trained to be sensitive to such cues (particularly in mental health settings), it can sometimes present useful information about a patient’s mental state and is a possible indicator of deterioration. The Fundamentals of Care (2003) document published by the Welsh Assembly Government highlights that communication should take place using appropriate language and in a sensitive manner. Care should be taken to communicate effectively with people who are mentally impaired. In all patient communication the use of medical jargon should be limited wherever possible. As the Department of Health Valuing People Now (DH 2007) points out, as cited in Baillie (2009), people with learning disabilities have a right to healthcare just as much as other people and it should be just as accessible. In essence, nurses have to be open, flexible and versatile in their approach. Stuart and Laraia (2005) cited in Riley (2008) suggest that communication facilitates the development of a therapeutic relationship. Nurses should adopt a suitable style of questioning, using open and closed questions appropriately depending on the situation. It is always important to convey a warm and accepting attitude that is objective and value free, taking into account the different cultural variations that exist. Nursing is increasingly recognised as a holistic and person-centred process, with so many aspects of a patient’s life regarded as important to the process of recovery that communication in itself forms a significant aspect of treatment. Caris-Verhallen et al. (1999), cited in Crawford et al (2006), imply that communication promotes an increased level of self-esteem and reduces stress. These benefits also promote staff wellbeing. In addition, Watkins (2002) mentions the usage of self-disclosure as a factor that helps develop therapeutic relationships with patients, particularly within mental health settings. Teamwork is a factor too which relies heavily on good communication. Nurses are surrounded by different types of health care professionals and as Peate (2006) acknowledges, interdisciplinary communication can be difficult. The Nursing and Midwifery Council (2008) Code of Conduct states that, as a nurse ‘you must work cooperatively within teams and respect the skills, expertise and contributions of your colleagues.’ It is often the nurse that acts as an intermediary between the patient and another healthcare professional, disseminating information and explaining it in terms suitably appropriate to the understanding of the patient. Poor communication creates barriers which can often lead to patients feeling alienated and making complaints as well as often being a significant factor in cases of malpractice, neglect and negligence. Within many clinical settings, a lack of time presents difficulties in utilising effective communication. Nurses often have to take opportunities to build rapport using synchronous communication whilst carrying out other tasks and duties. As Crawford et al. (2006) point out, healthcare professionals are increasingly task driven and laden with administration which prevents them from spending time talking with patients using the ideal but time consuming ‘counselling type’ communication. Therefore, in modern healthcare settings, they suggest a newer model is used that encompasses Brief, Ordinary and Effective (BOE) communication Crawford et al. (2006). With regard to written communication, the NMC Code of Conduct (2008) highlights that nurses are expected to ensure that accurate and up to date records are maintained, with clear information about when the entry was made together with a signature of the person making the entry. Not only is this therapeutically useful, it is also an essential legal requirement and offers evidence that treatment has been carried out. Finally, Baillie (2009) explains that the telephone also forms an important, often overlooked mode of communication. As with all clinical work, it is essential for nurses to maintain professional etiquette and confidentiality, as well as acknowledge their level of competence to the caller and ensure that the call is documented where necessary (Baillie, 2009) Conclusion Communication has been demonstrated to have an important positive influence on treatment outcome. Nurses as a collective group represent a substantial aspect of all clinical health care professionals. They probably spend the most amount of time with a patient. As such, there is an enormous capacity for influence on treatment. It is therefore clear why there is a need for significant emphasis on this matter in nurse pre-registration programmes. Encouraging future and present generations of nurses to communicate more effectively could have a significant influence on increasing patient satisfaction and recovery time. It is therefore suggested that promoting effective communication has potential cost saving implications for local healthcare authorities too. This is important given the enormous strain that the NHS is under in the current economic climate. From a wider perspective, it could be speculated that effective communication indirectly has some bearing on aspects of future health and social policy. Reflection: Communication in The Dementia Care Context This next section looks reflects on communication within a dementia care setting and utilizes a Reflective Cycle model (appendix 1) adapted from Gibbs et al (1988) as cited in Bulman and Schutz (2008). The model begins by using a description about what has happened and then encourages the person whom is reflecting to acknowledge their feelings about the situation/event. From this, the evaluation phase encourages the reflector to make value judgements and to say what was good or bad about the experience. Next, an analysis can be made about the situation and this should hopefully generate ideas and themes about the situation. Through doing so, conclusions can be drawn both in the general sense and in terms of the reflectors specific personal experience. The final part of the reflection process with this model is the personal action plans stage whereby the reflector can suggest different, perhaps better ways of doing things in a similar future situation. Description The placement was a dementia care ward which was all-female bedded with people who were at various stages in terms of the development of their dementia condition. The majority of the patients were still relatively active in a physical sense and often quite talkative. I spent a significant amount of time sitting with various patients in the dayroom, often for observation reasons to help ensure their safety. This enabled frequent opportunity to talk to the patients and also to gain some insight into the nature of how dementia can affect people. There was one patient that particularly concerned me. In the interests of preserving confidentiality I will change her name and refer to her as Abigale. Although this reflection is predominantly focused on my interaction with Abigale, much of what I mention is relevant to the patient population at large in respect of dementia care. Abigale was an elderly lady, perhaps in her early 70’s, who used to be a school teacher during her working years. Her condition was such that she was often quite talkative although the conversation was very much disjointed. She conveyed a range of emotions and often talked to me as if I resembled a particular character in her former life. Sometimes she spoke in a manner that suggested that she was seemingly happy about something and then for no apparent reason, she would become very upset and tearful. This happened on a frequent basis, with her emotions appearing to cycle between positive and negative affect in relatively short periods of time. Feelings Throughout the time I spent talking with Abigale, I always tried to talk warmly to her and convey an accepting attitude along with empathy, interest and compassion, reflecting the core principles of Roger’s client centred therapy. I was aware that my non-verbal communication was very important both to her and other patients. Within the dementia care setting, non-verbal communication is often even more important because it is often relied to a great extent. I always tried to portray openness in my body language, using the SOLER principles acronym outlined by Egan (1994), (see appendix 2). I found that she often used the mode of touch to communicate when sitting and/or talking with people and I attempted to replicate this in a similar, acceptable manner. I found this to be very effective which did surprise me. With a younger generation, touch tends to be a form of communication that I tend to perceive as not working very well for me. This maybe because I just haven’t utilised this method very much outside of friendship and family settings. I enjoyed spending time talking with Abigale. I particularly liked the way she continued to speak with a degree of authority that would perhaps be commensurate with her former role as a teacher. Even though her conversation was markedly unfocused and incongruent, she spoke in a very articulate manner. When I was able to answer her with a response she appeared to find satisfactory, it felt quite rewarding and it was good to see when she appeared to be happy. Sometimes she acted as if I resembled various people from her life. It was difficult to know whether to simply accept these non-sequiturs and go along with them, or correct her and risk upsetting her. Unfortunately, there were also times when I could not give her a response that she needed. I occasionally found it difficult to determine what she was actually talking about and I didn’t want to respond with something that wasn’t relevant. Despite my best efforts, it was difficult to seek clarification from her as she would often move on to some other topic. I also found it emotionally challenging at the times where she was upset for no apparent reason and I would have liked to have been able to offer more support. Sometimes, I have observed staff using diversion techniques to help distract patients from distressing situations. I have tried to use these occasionally. However, I tend to be a little uncomfortable doing this and I would rather be able to help somehow by having a greater understanding of the person and addressing their questions and concerns more directly. Finally, not having access to the computerised notes system (PARIS) was very frustrating as it meant that I only had information passed verbally from staff. Evaluation Whilst communicating with Abigale and indeed, other patients within the setting, I tried to maximise my listening capacity by blocking out noises that were external to interactions. However, because I felt I had a duty to the other patients, blocking all noises was impracticable. The dayroom tended to be a difficult place to have a conversation. The television appeared to be more or less continually switched on, and there were often domestic staff performing various cleaning duties. The ambient noise levels tended to be quite high and somewhat distracting both for myself and no doubt, the patients. Access to PARIS would have allowed me to gain a greater awareness about the patient as I would have been able to read comments and assessments made by the whole multidisciplinary team. Analysis Good communication forms an intrinsic part of the nursing process and is part of many nursing models. Roper et al. (1996) as cited in Peate (2006) list it as an aspect of daily living. Unfortunately, people who suffer with dementia experience a number of cognitive difficulties according to Mace (2005) as cited in Adams (2008) (see appendix 3) which make communication very difficult. The associated pathological diseases and consequences of aging also exacerbate these difficulties making effective communication even more problematic (Adams, 2008). The role of communication is therefore especially important for dementia patients as they are likely to have difficulties with interpretation of messages (Kitwood, 1997 as cited in Adams (2008)). Indeed, I often found that what Abigale said and how she acted on the responses that I gave was often incongruent suggesting there was a problem with interpretation. However, when I attempted to seek clarification, it was very difficult or indeed impossible. According to Cheston and Bender (2003), dementia care can be improved by beingpsychotherapeutic and using every interaction as an potential opportunity to help and support them. The humanistic and Rogerian aspect of empathic listening is particularly important and provides clues about embedded emotional messages according to Cheston and Bender (2003). However, they go on to suggest that in order to be psychotherapeutic in an approach requires a good understanding of a person’s life history. Unfortunately, the short term nature of the placement meant that I was likely to remain relatively naive in terms of understanding her history and condition to any useful extent, so being truly psychotherapeutic in my actions was difficult. Nevertheless, I attempted to provide a contribution to the nursing process. I found that some of the communication strategies that nurses are encouraged to use in many settings need to be changed when consideration is given to the dementia care environment. Watkins (2001) suggests that clients respond better when nurses ask open questions. However, for dementia patients, asking open questions would appear to have a tendency to induce cognitive overload. As such, the Alzeimer’s Society Advice Sheet (2000) recommends that carers should ask short questions, one at a time which require only short answers. The Alzheimer’s Society (2000) also highlight the need to try and see the person behind the illness: Interests, likes and dislikes, hopes and fears, early life, places they have lived and visited, working life, people they love/have loved, friendships and personality. I did try to find out from Abigale aspects of her former life but in truth, I had very little understanding about these factors. Abigale tended not to respond directly to questions but rather hinted certain aspects on an adhoc basis. Therefore, hypothetically, if I was a named nurse for Abigale in the future, it would perhaps be useful to speak to her close family to gain some insight and as well as potential stimulus for conversations. Perhaps a reminiscence box containing various items such as photographs and objects would be useful in terms of triggering memories and developing conversations. I think it is important to acknowledge that it would have been better to take Abigale to somewhere quieter when she was upset. This would have been more conducive to conversation as well as offering some level privacy for Abigale. However, in the reality of the situation, there were limited places that were actually available on the ward. In addition, it was likely there were other patients that were also episodically distressed that made it difficult to devote full time to Abigale. The other patients tended to demonstrate similar emotions which coincided with the majority; hence there were ‘good’ and ‘bad’ days in terms of patient behaviours. Overall, I feel that on balance I offered a good level of support for Abigale. At times, I believe that I could have offered her more in terms of conversation if I had a better level of knowledge about her background. Indeed, sometimes I felt that I lacked the relevant stimulus to have a lengthy conversation. Despite it being my first placement, there were times where I would have liked to have had the knowledge to use certain basic level therapeutic approaches that are applicable to patients whom suffer from dementia. My mentor also mentioned an interest in validation therapy and I am aware too of the existence of other forms of therapy such as pre-therapy, reminenscence therapy, resolution therapy and the person-focused approach. However, I can clearly appreciate that as a 1st year nursing student, to gain such knowledge is totally impracticable, as well as potentially unethical and unprofessional if actually used without proper registered status. Indeed, under the NMC Code of Conduct (2008) I must recognise and practice within the limits of competency. As such, in order to be in a position to use many therapeutic techniques effectively, I would need significant further training and/or further professional accreditation. Conclusion (General) Communication with patients who have dementia is an extremely difficult and complex process. It is absolutely essential that nurses practice effective communication to help maintain the quality of life of the patients in their care. In practice, it is very difficult to ensure that psychotherapeutic support is well provided, particularly as psychological needs are more subtle and discrete. It could be argued that relatively low levels of staff and the often high levels of physical interventions often found within dementia settings means that the provision for effective communication regarding psychological care presents a significant challenge. I think the psychotherapeutic aspect of care is a important issue, particularly with the number of cases of dementia predicted to rise to almost 1 million in the UK by 2020 (according to Alzeimers Disease International, 1999, cited by Burgess, 2003). Conclusion (Specific) Overall, I feel quite positive about my experience on placement and about the use of communication. I believe that I worked to the best of my ability. Abigale and many other patients appeared to be quite advanced in terms of their dementia condition. This proved to be quite a challenge. I would like to have had more awareness about Abigale’s history. I can now more readily appreciate the importance of family and friends, not only in terms of direct contribution to care but also the indirect contributions that they make through providing information about the patient. Early recognition of emotional distress helps with the nursing process. It could have made it more feasible for me to talk to Abigale to provide reassurance and limit the likelyhood of her becoming upset, therefore preserving her dignity. I have gained a great deal of insight into dementia care both through the placement experience and through the process of reflection. In retrospect, I would like to have been able to offer more in terms of psychological support and this provides some insight into the psychotherapeutic aspect of care for future placements. Action Plan In future, I would like to have acquired a higher level of therapeutic skills to enhance my ability to communicate with people who have dementia. The predicted rise in dementia cases as previously mentioned means there is a greater likely hood of coming into contact and providing nursing care for a patient who has dementia. I think it would therefore be useful to develop a greater awareness into the condition, especially from a psychological perspective. I also hope to have training and therefore approved access to PARIS computerised notes system. References Adams T (2008) Dementia Care Nursing: Promoting Well-Being in People with Dementia and Their Families. Hampshire: Palgrave Macmillan Alzeimer’s Society (2010) Factsheet 500: Communicating. Alzeimer’s Society: London. Accessed: 30.06.10 Argyle M (1994) The Psychology of Interpersonal Behaviour (5th Edn). London: Penguin Books Baillie L (2009) Developing Practical Adult Nursing Skills (3rd Edn). London: Hodder Arnold. Bullman C Schutz S (2008) Reflective Practice in Nursing (4th Edition). Oxford: Blackwell Publishing. Burgess L (2003) Changing attitudes in dementia care and the role of nurses. Nursing Times, 99 (38) 18. Accessed: 30.06.10 Burnard P Gill P (2009) Culture, Communication and Nursing. Essex: Pearson Education Limited. Cheston R Bender M (2003) Understanding Dementia: The Man with the Worried Eyes. London: Jessica Kingsley Publishers. Crawford P Brown B Bonham P (2006) Foundations in Nursing and Health Care: Communication in Clinical Settings. Cheltenham: Nelson Thorns Ltd. Nursing and Midwifery Council (NMC) (2008) The Code: Standards of Conduct, Performance and Ethics for Nurses and Midwifes. NMC, London Accessed: 12.04.2010 Peate I (2006) Becoming a Nurse in the 21st Century. West Sussex: Wiley. Potters P A Perry A G (2001) Fundamentals of Nursing (5th Edn). St Louis: Mosby. Riley J B (2008) Communication in Nursing (6th Edn). United States of America: Mosby. Sheldon L K (2005) Communication for Nurses: Talking With Patients. Massachusetts: Jones and Bartlett Publishers Watkins P (2002) Mental Health Nursing: The Art of Compassionate Care. Edinburgh: Butterworth-Heinemann. Welsh Assembly Government (2003) Fundamentals of Care: Guidance for Health and Social Care Staff. Welsh Assembly Government: Cardiff. Accessed: 12.04.2010 Bibliography Ellis R B Gates B Kenworthy N (2003) Interpersonal Communication in Nursing: Theory and Practice (2nd Edn). Churchill Livingstone: London. Hamilton S J Martin D J (2007) Clinical Development: A framework for effective communication skill. Nursing Times, 103: 48, 30-31. Appendix 1 The Reflective Cycle (adapted from Gibbs et al.1988) cited in Bulman and Schutz, (2008). Appendix 2 Egan’s SOLAR Principles (Egan, 1994) as cited in Crawford et al. (2006) S Face people Squarely O Maintain an Open shape to the body L Lean forward slightly E Use appropriate Eye contact R Relax Share this: Facebook Twitter Reddit LinkedIn WhatsApp