Reciprocal love in John Donnes Holy Sonnets - 1733 Words

Reciprocal love in John Donnes Holy Sonnets Holy Sonnet XV deals with the question of reciprocal love that runs throughout Donne’s religious poetry. The Sonnet is an address of the speaker’s mind to the speaker’s soul; it is a meditation on the Trinity and man’s relationship to God. The poem’s form and the multi-layered conflation throughout expound upon the nature of the Trinity. The theme of humility in reciprocal religious love or receiving and understanding God’s glory (as Donne understood it) runs throughout the poem. This allows the speaker’s soul to understand his own need for humility in order to love god fully. Donne uses the Sonnet form cunningly in this poem; the formal divisions of the Sonnet reflect the trinity, with†¦show more content†¦Line seven shows the speaker’s humility with â€Å"deign,† a humility that is necessary in order for a reciprocal love relationship, which is the aim of the meditation. However, in conjunction with showing hum ility through the use of â€Å"deign,† man is simultaneously elevated in status, because God chooses him as a partner for the expression of â€Å"glory,† which is perhaps God’s pure love. Donne uses â€Å"beget† twice, once in past tense, and once as a present participle with â€Å" still begetting†(6). This implies the past and present, as well as motion forward in time (â€Å"still†), and therefore the future. The notion of continual creation references the eternal. It is perhaps not coincidental that this reference to eternity occurs in line six, which is the exact middle of the three four line sections that represent the three aspects of the trinity. Thus, we see yet another level of conflation: conflating the trinity not only with the mind, body, and soul in man, but also with the past, present, and future, as embodied by the eternal. Here we can understand Donne’s concept of God as â€Å"The All,† which he describes in â€Å"Annunciation† from La Corona. God â€Å"the all† manifests himself to man through the trinity, and the tripartite nature of God manifests itself through all creation in man himself, in time, and even in the three-dimensional nature of visible space. In the third section, the role of conflation in the sonnet becomes very

Proposal of Divorce Free Essays

Proposal: Divorce The topic I will be discussing in my paper is on Divorce and the affects it has on the household. To me this topic is significant because my parents were separated. Although they were never married, it seems as though the affects of divorce are similar. We will write a custom essay sample on Proposal of Divorce or any similar topic only for you Order Now In society, this topic is significant because today, divorce happens all the time. It seems as though it is just as popular as getting married. When divorce is brought to society’s attention it is looked at many different ways. Some people analyze it as a good thing. â€Å"If they weren’t truly happy, then its best to go their separate ways†. Other viewers in society such as priests and ministers tend to take a different view. â€Å"They were brought together by God. They took a vow; ‘Until death do we part’, and although it’s not a sin, it is looked down upon†. Different views on the topic of divorce seem to have one idea in common: the affect it has on the household. Divorce is a very tough process and can be very strenuous on the kids in the family. While researching this topic I plan to go to a church group that may help deal with the issues involved in divorce. I also plan on investigating the different organizations that help the family and kids recover from the separation of their parents. Online, there are studies and research done on the affects that a divorce has on the family that I will be taking a look at. Throughout the duration of writing this paper I plan to research my topic as much as possible. Research can take up to a matter of days or weeks. However, this paper does have a deadline and I am sure I will not achieve 100% of the information that an actual research might use. I will research this topic as much as I need to for as long as I can to get an accurate reading on the topic of Divorce and the affect it has in the household. Because I am the only researcher for this topic, there will be a lot to do. This includes: gathering general information, going to different places that help kids of divorced parents, pull all the information together and write a paper that explains the effects that divorce has on the household. I feel that this paper will help those around me look at divorce in a different way. Some may change their view, while others may stay the same. I just have to get the facts on both sides and present it to them so that people can truly understand the effects that divorce has on a household. How to cite Proposal of Divorce, Papers

Nursing practice for the assessment of pain - MyAssignmenthelp.com

Question: Discuss about the Nursing practice for the assessment of pain. Answer: Introduction Intubation refers to the medical procedure that in false insertion of a tube inside the body of a patient. Management of the airways is a commonly performed process in Intensive Care Unit (ICU), which results in emergency and planned intubation in critically ill patients (Griesdale et al., 2012). Moderate to severe pain is a common health disturbance experienced by most patients in the ICU. Inadequate assessment and management of pain among these patients increases the rates of mortality and morbidity (Alderson Mckechnie, 2013). Therefore, this topic has been selected for analysis in order to identify the best nursing practices that can reduce pain among intubated patients, thereby improving their health outcomes. Discussion Critical Evaluation The study conducted by Ayasrah et al., (2014) focused on identifying the pain indicators and their effectiveness. One major advantage is that it considered patients who were adults and were placed under mechanical ventilation for a minimum time period of 72 hours, to prevent misleading results. Owing to the fact that critically ill patients are often unable to decide for themselves and lose the power of speech, the researchers demonstrated a correct step in obtaining consent from their family members, who acted as the decision makers (Schenker et al., 2012). Furthermore, categorization of the collected medical records on the basis of non observable, and observable indicators and response to pain treatment was an accurate step. Using SPSS software package gave exact percentage and frequencies for all pain related indicators (Kanda, 2013). It suggested that use of recognised pain scale is the most essential nursing practice that needs to be implemented in ICU. However, major limitation s were associated with consideration of only three hospitals, which might have contributed to a selection bias (Elwert Winship, 2014). In addition, failure to include information on the methods that are implemented for obtaining self reports of pain was another drawback. On the other hand another systematic review conducted by Varndell, Fry Elliott (2017) examined suitability and psychometric properties of pain instruments for using non verbal critically ill patients. Use of key search terms and inclusion of 26 studies for the review was also adequate. Using the critical appraisal skills program (CASP) helped in systematically examining the reliability, trustworthiness and relevance of the articles (Zeng et al., 2015). Inclusion of studies conducted across various countries assisted in eliminating selection or population bias (Mangin et al., 2012). Furthermore, assessing the reliability and validity of all instruments mentioned in this study provided comprehensive results. 1 major advantage of the review can be related to identification of 5 observational pain assessment tools, namely, CPOT, BPS, PAINAD, FLACC and NVPS (Stites, 2013). Furthermore, it also emphasized on use of appropriate observational pain assessment tools to improve its management for intubated adult patients in ICU. Strongest evidence for the use of CPOT increases its importance in nursing practice (Herr et al., 2012). However, some drawbacks were associated with data extraction being carried out by one author, variation in detail and quality of description of the instruments, and exclusion of un-reported researches. Additionally, a cohort study conducted by Rijkenberg et al., (2015) compared the validity and reliability of the CPOT (Critical-Care Pain Observation Tool) and BPS (Behavioral Pain Scale) pain observation tools up on mechanically ventilated patients in ICU. Inclusion of adult patients who had been in ICU for more than 12 hours, under mechanical ventilation and inability to self report the pain status was a correct method owing to previous findings with suggested success of CPOT and BPS in assessing pain (Keane, 2013). Data extraction using patient clinical information helped in providing accurate medical records. Training the ICU nurses to use the 2 pain assessment tools helped them to gain a sound understanding of the procedure. Using SPSS software and Cronbachs coefficient was also an accurate step (Bonett Wright, 2015). The results suggested that CPOT is a more preferable tool. However some limitations are associated with failure to blind the nurses to the study, completion of BP S first that could affect data, small number of patients in final analysis and failure to translate and validate the two instruments in Dutch, which might have contributed to misleading results (Hrbjartsson et al., 2012) (Marshall et al., 2013). Critical observation Health assessment is usually regarded as the first phase in nursing practice where nurses are expected to use their clinical expertise and knowledge to express care for their clients (Shehabi et al., 2012). Pain is a common experience among intubated patients in the ICU, and gets aggravated by factors such as invasive procedure, stage of health disorder and surgical intervention (Herr et al., 2012). It acts as a source of suffering and creates a long-term imprint on such patients. During my clinical placement, I had been selected to work with post -operative patients on intubation, in the ICU. Most of the patients were under continuous infusion of analgesics and sedatives. There were 2 patients in ICU, following an operation for intestinal obstruction. Nasogastric intubation was administered to the patients for nutritional support and aspiration of the stomach contents. However, I found them to be extremely restless and demonstrated non-compliance with the intubation tube. This significantly increased their pressure. The patients were found to move to their extremities restlessly and also showed facial grimaces. Initially, with the help of a co-worker I tried to reassure the patients by talking to them. However, their gestures suggested that they were facing physical discomfort due to severe abdominal pain. I immediately notified it to the ICU doctor and raised my concern that absence of adequate pain management techniques could be the reason for their restlessness and agitation. The doctor agreed on the possibility and instructed the nurse-in-charge to assess their pain. Extensive study of literature, has worked towards establishing the reliability of CPOT on assessing pain in ICU patients (Buttes et al., 2014). The nurse was found to use the CPOT tool and she began observing their facial expressions and body movements. She also recorded their comp liance with the intubation and scored it as per the scale provided. I observed the nurse to move the patient's arms and recorded the level of resistance that was displayed, following the advice by the senior RN. Furthermore, the body and facial indicators of pain were also recorded, while turning the patients on their sites. This was followed by adding up all the scores which helped the nurse to determine the total score for both the patients. While in one patient had a score of 6, the other had a total score of 8. High scores in both the patients indicated that they were suffering from severe pain and needed immediate pharmacological or non pharmacological intervention. Thus, my critical observation suggests that the nurse demonstrated an accurate practice as CPOT tool has been recommended by research studies, for the assessment of pain severity among non-verbal and critically ill patients (Linde et al., 2013). Adherence of the concerned nurse to the best practice can be further illustrated by the fact that evaluation of muscle tension, body movement, facial expression and compliance has been identified as the best parameters that can determine severity of pain, according to international c linical guidelines (Buttes et al., 2014). Thus, the placement helped in establishing the fact that pain assessment and its measurement is major vital sign that needs to be recorded in nursing practice in order to improve health outcomes of patients. Conclusion To conclude, it can be stated that pain assessment is crucial to implementation of optimal pain management interventions. Critical evaluation of the three articles and the reflection during clinical placement emphasizes on the use of CPOT tool in assessing pain among critically ill patients, under incubation in Intensive Care units. This will help in measuring the severity of the ear pain and administer appropriate pharmacological or non pharmacological interventions. References Alderson, S. M., Mckechnie, S. R. (2013). Unrecognised, undertreated, pain in ICUcauses, effects, and how to do better. Open Journal of Nursing, 3(01), 108. Ayasrah, S. M., ONeill, T. M., Abdalrahim, M. S., Sutary, M. M., Kharabsheh, M. S. (2014). Pain assessment and management in critically ill intubated patients in Jordan: a prospective study. International journal of health sciences, 8(3), 287 Bonett, D. G., Wright, T. A. (2015). Cronbach's alpha reliability: Interval estimation, hypothesis testing, and sample size planning. Journal of Organizational Behavior, 36(1), 3-15. Buttes, P., Keal, G., Cronin, S. N., Stocks, L., Stout, C. (2014). Validation of the Critical-Care Pain Observation Tool in adult critically ill patients. Dimensions of Critical Care Nursing, 33(2), 78-81. Elwert, F., Winship, C. (2014). Endogenous selection bias: The problem of conditioning on a collider variable. Annual Review of Sociology, 40, 31-53. Griesdale, D. E., Liu, D., McKinney, J., Choi, P. T. (2012). Glidescope video-laryngoscopy versus direct laryngoscopy for endotracheal intubation: a systematic review and meta-analysis. Canadian Journal of Anesthesia/Journal canadien d'anesthsie, 59(1), 41-52. Herr, K., Bursch, H., Ersek, M., Miller, L. L., Swafford, K. (2012). Use of pain-behavioral assessment tools in the nursing home: expert consensus recommendations for practice. Journal of gerontological nursing, 36(3), 18-29. Hrbjartsson, A., Thomsen, A. S. S., Emanuelsson, F., Tendal, B., Hilden, J., Boutron, I., ... Brorson, S. (2012). Observer bias in randomised clinical trials with binary outcomes: systematic review of trials with both blinded and non-blinded outcome assessors. Bmj, 344, e1119. Kanda, Y. (2013). Investigation of the freely available easy-to-use software EZRfor medical statistics. Bone marrow transplantation, 48(3), 452. Keane, K. M. (2013). Validity and reliability of the critical care pain observation tool: a replication study. Pain Management Nursing, 14(4), e216-e225. Linde, S. M., Badger, J. M., Machan, J. T., Beaudry, J., Brucker, A., Martin, K., ... Roy, R. D. N. (2013). Reevaluation of the critical-care pain observation tool in intubated adults after cardiac surgery.American Journal of Critical Care,22(6), 491-497. Mangin, B., Siberchicot, A., Nicolas, S., Doligez, A., This, P., Cierco-Ayrolles, C. (2012). Novel measures of linkage disequilibrium that correct the bias due to population structure and relatedness. Heredity, 108(3), 285-291. Marshall, B., Cardon, P., Poddar, A., Fontenot, R. (2013). Does sample size matter in qualitative research?: A review of qualitative interviews in IS research. Journal of Computer Information Systems, 54(1), 11-22. Rijkenberg, S., Stilma, W., Endeman, H., Bosman, R. J., Oudemans-van Straaten, H. M. (2015). Pain measurement in mechanically ventilated critically ill patients: behavioral pain scale versus critical-care pain observation tool. Journal of critical care, 30(1), 167-172. Rose, L., Haslam, L., Dale, C., Knechtel, L., McGillion, M. (2013). Behavioral pain assessment tool for critically ill adults unable to self-report pain. American Journal of Critical Care, 22(3), 246-255. Schenker, Y., Crowley-Matoka, M., Dohan, D., Tiver, G. A., Arnold, R. M., White, D. B. (2012). I dont want to be the one saying we should just let him die: intrapersonal tensions experienced by surrogate decision makers in the ICU. Journal of general internal medicine, 27(12), 1657-1665. Shehabi, Y., Bellomo, R., Reade, M. C., Bailey, M., Bass, F., Howe, B., ... Sedation Practice in Intensive Care Evaluation (SPICE) Study Investigators and the ANZICS Clinical Trials Group. (2012). Early intensive care sedation predicts long-term mortality in ventilated critically ill patients. American journal of respiratory and critical care medicine, 186(8), 724-731. Stites, M. (2013). Observational pain scales in critically ill adults. Critical care nurse, 33(3), 68-78. Varndell, W., Fry, M., Elliott, D. (2017). A systematic review of observational pain assessment instruments for use with nonverbal intubated critically ill adult patients in the emergency department: an assessment of their suitability and psychometric properties. Journal of clinical nursing, 26(1-2), 7-32. Zeng, X., Zhang, Y., Kwong, J. S., Zhang, C., Li, S., Sun, F., ... Du, L. (2015). The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta?analysis, and clinical practice guideline: a systematic review. Journal of evidence-based medicine, 8(1), 2-10.

Prostitution Should Be Legal Essays - Sex Industry, Prostitution

Prostitution Should be Legal Referred to as the "oldest profession", prostitution ". . . has long been a problem which has provoked and disturbed Americans" (Kinsie 3). "Prostitution [is] the performance of sexual acts, solely for the purpose of material gain" (James [NA]). Prostitution remains, excepted and considered normal in some cultures. No gender specifics exist for prostitutes , but female prostitutes comprise the majority of prostitutes. A person male and married characterizing the majority of prostitutes clients, commonly referred to as a "John". Surprisingly, but true, US prostitutes work legally in some areas. "Prostitution is currently illegal in all 50 states" (Flowers 8), with the exception of 12 rural counties in Nevada. A variety of different types of prostitutes exist: streetwalkers, call girls, massage parlor/brothel/in house prostitutes, madams, indentured sex slaves, escort service prostitutes, professional dominatrics, homeless, drug addicted and part time prostitutes (Flowers 18, 19). In 1995, approximately 95,000 arrests were made (70% female prostitutes, 20% male prostitutes and 10% customers), mostly streetwalkers; a misdemeanor typically resulting in a fine, occasionally a 30-day jail term. More importantly than numbers, what motivates one to choose a career of prostitution? Perhaps persuasion, coercion, abuse, addiction or poor conditions/lifestyle and the financial lure. Legalizing prostitution ensures regulation and taxation, allowing the police to deal with more violent crimes and reduce the abuse of prostitutes by "Pimps". There remain many reasons why one may favor the illegal status of prostitution. Some see the "profession" as exploitive to women, a ". . . form of sexual slavery" (Abraham 1). Feminists claim that prostitution reinforces the status that women represent objects, undoing the prevails of women in the past. Yet still, many believe in neo-Victorism, a condescending belief that prostitutes are unaware of their action and need someone with more education to protect them (Abraham 1). Much of the public describes the profession of prostitution as dirty, immoral and degrading. For many, prostitution results in a destructive, abusive "career" in which Pimps, those who "own" and distribute prostitutes for the benefit of financial gain, and Johns abuse and violate women. Prostitution also greatly affects the community and the public. Those who use prostitutes for their pleasure risk the contraction of diseases, thus spreading with each new sexual partner, endangering the lives of many. Although valid reasons justify why one would want to keep prostitution with an illegal status, the benefits far out way the negative aspects of prostitution. Legalizing the profession increases the quality of lives for those who partake in prostitution as a career and those who "use" the business they offer. Legalization of prostitution allows regulation, requiring medical examination of prostitutes on a regular basis, helping to reduce the transfer of STDs and communicable diseases. According to the US Department of Health, 3% to 5% of STDs in the United States are linked to prostitutes (Prostitution in the US . . . [NA]). These relatively small numbers results in a "domino effect". If someone contracts a disease during an interlude with a prostitute, each sexual partner thereafter carries the potential risk of "contamination". In addition, the health of prostitutes most likely increases. Early detection and treatment of STDs, diseases or illnesses, and drug addiction constitute likely results of prostitution legalization. These actions increase the likelihood of prostitutes' good health, resulting in a safer environment for their clients as well. Exploitation from pimps eliminates with the legalization of prostitution. Pimps usually take a large portion of the prostitutes profit, up to 50% and sometimes more. This exploitation includes abuse, both physical and mental, often leading to murder. A legal status of prostitution allows prostitutes to work for themselves, or in a safe, controlled environment, such as a licensed brothel. Legalization allows for taxation of prostitution wages, like any other employment. Taxation of prostitution results in increased taxes collected by cities, counties and states. By taxation, prostitutes enjoy the benefits of unemployment insurance, disability insurance and social security, thus ensuring prostitutes the choice of continuing or discontinuing their career in prostitution. Cities, counties and states profit by taxation and legalizing prostitution results in a reduction of criminal prosecution costs. "Average arrest, court [and] incarceration costs amount to nearly $2000 per arrest. Cities spend an average of $7.5 million on prostitution control every year. Ranging from $1 million (Memphis) to $23 million (New York)" (Prostitution in the US. . . [NA]). This extra money and time provides police more time to deal with and prosecute violent crimes. The elimination of the prosecution of prostitutes saves time and money for the justice system