Big Game and Greasy Lake: two stories depicting a similar theme Essay

T. Coraghessan Boyle’s "Greasy Lake" and "Big Game" are similarly structured but completely different short stories that explain the transitions of people from fake slaves of their image to genuine and realized individuals. If not portrayed in the stories, the development in the characters certainly escapes into the reader’s imagination and almost magically makes them the learned. The plot of the two stories is one of the strongest lines connecting them together by way of foundation, but at the same time it establishes completely different story lines that follow the same beat. Boyle’s evolution from "Greasy Lake" to "Big Game" has also provided for a progression in his style. Evident from the two stories is the contrasted amounts of detail and abstract detail. In some sense, Boyle has mellowed over the two stories by leaving out many of the twists and turns of "Greasy Lake" in "Big Game," but in the same sense has become more exciting with more violence and action. The plots in the two stories are similar in structure and pattern of action. They both include violence and regretful lessons learned the hard way, and seam to involve similar events and characters. A definite change in Boyle’s plot over the course of the two stories however, is the loss in significance and importance of the plot and the take over by setting and character instead. &...

Burnning Notebooks as Therapy Essay -- Personal Narrative Writing

Burnning Notebooks as Therapy For many people, the purpose of journaling is a sort of catharsis. With pen on paper, they are able to work through problems and issues. These problems are overcome simply by allowing time to process these tribulations enough to form sentences about them. I too use writing for this purpose. However, I often do not allow writing to be the last step in my emotional eradication. I was seventeen the first time I held a match to a completed page, but lighting the fire is the last step. Before a notebook can be burned, it must first be filled; this isn't an easy task. A Mead composition notebook contains one hundred sheets--or two hundred pages. The goal in essence is to write. As each word flows onto the paper through the pen, some event must set the precedent; be it long narrations of break-ups or pained descriptions of breakdowns, copious amounts of material must pave the way--the emotionally passive life cannot be translated onto paper. However, for those who can complete the task, the reward comes when the back cover is closed. It is then that the... Burnning Notebooks as Therapy Essay -- Personal Narrative Writing Burnning Notebooks as Therapy For many people, the purpose of journaling is a sort of catharsis. With pen on paper, they are able to work through problems and issues. These problems are overcome simply by allowing time to process these tribulations enough to form sentences about them. I too use writing for this purpose. However, I often do not allow writing to be the last step in my emotional eradication. I was seventeen the first time I held a match to a completed page, but lighting the fire is the last step. Before a notebook can be burned, it must first be filled; this isn't an easy task. A Mead composition notebook contains one hundred sheets--or two hundred pages. The goal in essence is to write. As each word flows onto the paper through the pen, some event must set the precedent; be it long narrations of break-ups or pained descriptions of breakdowns, copious amounts of material must pave the way--the emotionally passive life cannot be translated onto paper. However, for those who can complete the task, the reward comes when the back cover is closed. It is then that the...

Toni Morrisons Sula :: Toni Morrison Sula Essays

Toni Morrison's Sula In the book Sula by Toni Morrison, Morrison’s ambiguous link between good, evil, and guilt, she is able to show that these terms are relative to each other and often occur mutually. In her comparison of good and evil, Sula states that "Being good to somebody is just like being mean to somebody. Risky. You don't get nothing for it" (145). Good and evil are being compared as if they are equal and that is how the book is structured. For instance, Eva's burning of Plum is a complex conjunction of motherly love and practicality and cannot be described as simply being a good act or a bad one. The killing of Chicken Little is a similarly ambiguous situation from which Sula and Nel's feelings are unclear. Lastly Sula, upon her death bed, questions what it means to be good and suggests that it what may be considered bad could in reality be good. Both in the syncopated style of Morrison's writing and the morally ambiguous portrayal of characters, cause the reader to question morals and think about them on a larger scale. Although on the surface, Eva's burning of Plum appears as a ghastly and un-motherly act (not to say that it isn't ghastly), with more analysis becomes a more perplexing question. When Eva pours kerosene on Plum, it is described as a sort of baptism, "He opened his eyes and saw what he imagined was the great wing of an eagle pouring a wet lightness over him. Some kind of baptism, some kind of blessing he thought" (47). Eva believes that she is liberating Plum from his depressed, drugged life and saving his soul. The eagle that plum imagines seeing is a symbol of liberty and the wing is a symbol for maternal love as a bird may nestle its chicks with its wing. Even when Nel later visits Eva in the nursing home, Eva approves of her liberation of Plum. She disapproves of Nel and Sula's throwing Chicken Little in the water, yet justifies killing Plum by saying, "It's awful cold in the water. Fire is warm. How did you get him in?" (168). Sula and Nel are both guilty for Chicken Little’s death, one for throwing him into the river and the other for watching it. No one is going to defend their actions, however whether Nel is guilty or not is a far more difficult question.

Symbol Essay on King Lear

Often in literature, symbolism is used to represent ideas or meanings in a metaphorical sense. However, in Shakespeare’s play, King Lear, the symbolism of blindness is used both in a metaphorical and literal way. This symbolism can first be seen in the metaphorical blindness of Lear, and then Gloucester, which then leads to the literal blindness of Gloucester later on in the play. These examples of blindness are an important part of King Lear because they help the reader to better understand the themes that Shakespeare wanted to convey through his work.The symbol of blindness can be found in the very first scene of the play, when Lear is demanding praise from his daughters to decide who will receive the better part of the land when he gives up his throne. He is metaphorically blinded by his pride and arrogance when his eldest daughter, Cordelia, replies by saying nothing. Lear is enraged, â€Å"Nothing will come of nothing†¦Here I disclaim all my paternal care†¦And as a stranger to my heart and me Hold thee from this forever† (I. i. 89-114), and he foolishly banishes the only daughter who truly loves him.He cannot see that through Cordelia’s silence, she is actually saying much more than her sisters, who were deceiving their father in order to receive power. Through the example of Lear’s actions, the theme that pride and arrogance can blind you is presented to the reader and continues on to evolve into a major theme of the play. Another theme that is introduced through the symbol of blindness is that people are easily deceived by others. This theme is apparent when Gloucester is deceived by his bastard son, Edmund. His plan is to deceive his father in order to â€Å"if not by birth, have lands by wit.† (I. ii. 164).He is so desperate for power that he goes to the extreme of putting his brother in danger due the fake letter he gave to Gloucester, making him believe Edgar had turned against him. Gloucester is blinded b y Edmund’s trickery and lies to the point where he orders for Edgar to be killed. Through his example of metaphorical blindness, Gloucester becomes an example of the theme that blindness leads to people being easily deceived by others. Gloucester is also an example of the literal symbolism of blindness that Shakespeare uses in King Lear.In the third act, comes the bloodiest part of the tragedy; Gloucester is literally blinded by Cornwall for helping Lear escape to Dover. After having both of his eyes plucked out, Gloucester asks to see his son Edmund, whom he believes is there to protect him. Regan reveals the truth to him, â€Å"Thou call’st on him that hates thee. It was he That made the overture of thy treason to us, Who is too good to pity thee,† (III. vii. 88-90), and Gloucester then realizes he has been deceived by Edmund and wronged his son Edgar. By not seeing Edmund’s treachery until he was blind, Gloucester presents another theme, blindness can lead to truth.By saying, â€Å"I stumbled when I saw,† (IV. i. 19) Gloucester helps the reader to understand that seeing can blind us from the truth. Through the symbol of blindness, whether metaphorical or literal, the meaning of the play is greatly enhanced by the themes the symbol presents. The reader can better understand the meanings and ideas that Shakespeare intended to portray through his characters. Lear and Gloucester, through their metaphorical and literal examples, allow the symbol to be used as an important part of the play. Symbol Essay on King Lear Often in literature, symbolism is used to represent ideas or meanings in a metaphorical sense. However, in Shakespeare’s play, King Lear, the symbolism of blindness is used both in a metaphorical and literal way. This symbolism can first be seen in the metaphorical blindness of Lear, and then Gloucester, which then leads to the literal blindness of Gloucester later on in the play. These examples of blindness are an important part of King Lear because they help the reader to better understand the themes that Shakespeare wanted to convey through his work.The symbol of blindness can be found in the very first scene of the play, when Lear is demanding praise from his daughters to decide who will receive the better part of the land when he gives up his throne. He is metaphorically blinded by his pride and arrogance when his eldest daughter, Cordelia, replies by saying nothing. Lear is enraged, â€Å"Nothing will come of nothing†¦Here I disclaim all my paternal care†¦And as a stranger to my heart and me Hold thee from this forever† (I. i. 89-114), and he foolishly banishes the only daughter who truly loves him. He cannot see that through Cordelia’s silence, she is actually saying much more than her sisters, who were deceiving their father in order to receive power. Through the example of Lear’s actions, the theme that pride and arrogance can blind you is presented to the reader and continues on to evolve into a major theme of the play.Another theme that is introduced through the symbol of blindness is that people are easily deceived by others. This theme is apparent when Gloucester is deceived by his bastard son, Edmund. His plan is to deceive his father in order to â€Å"if not by birth, have lands by wit.† (I. ii. 164). He is so desperate for power that he goes to the extreme of putting his brother in danger due the fake letter he gave to Gloucester, making him believe Edgar had turned against him. Gloucester is blinded by Edmund’s trickery and lies to the point where he orders for Edgar to be killed. Through his example of metaphorical blindness, Gloucester becomes an example of the theme that blindness leads to people being easily deceived by others.Gloucester is also an example of the literal symbolism of blindness that Shakespeare uses in King Lear. In the third act, comes the bloodiest part of the tragedy; Gloucester is literally blinded by Cornwall for helping Lear escape to Dover. After having both of his eyes plucked out, Gloucester asks to see his son Edmund, whom he believes is there to protect him.Regan reveals the truth to him, â€Å"Thou call’st on him that hates thee. It was he That made the overture of thy treason to us, Who is too good to pity thee,† (III. vii. 88-90), and Gloucester then realizes he has been deceived by Edmund and wronged his son Edgar. By not seeing Edmund’s treachery until he was blind, Gloucester presents another theme, blindness can lead to truth. By saying, â€Å"I stumbled when I saw,† (IV. i. 19) Gloucester helps the reader to understand that seeing can blind us from the truth.Through the symbol of blindness, whether metaphorical or literal, the meaning of the play is greatly enhanced by the themes the symbol presents. The reader can better understand the meanings and ideas that Shakespeare intended to portray through his characters. Lear and Gloucester, through their metaphorical and literal examples, allow the symbol to be used as an important part of the play.

Evaluation of Voluntourism Essay

A trend has started in the recent years, where people participate in organizations that commonly claim to be helping developing countries. This trend is fuelled by the gap year phenomenon, which is defined as â€Å"a period of time between 3 and 24 months taken out of education or a work career.† (Jones, 2004) With enthusiasm of â€Å"making a difference†, more and more people choose voluntourism, combination of tourism and volunteer projects, as their gap year holiday option. Despite the well-intended enthusiasm, opinions regarding the contribution of voluntourism on local community are divided. The primary issue of debate is whether voluntourism provide help to the local communities. While some researchers using surveys find local people satisfied with volunteer tourists, other research investigating quality, tasks, motivation and local need of voluntourism have found it doing more harm than good. Such a harmful trend has made the UK director of VSO, one of the baggie st and earliest international development charity, warn â€Å"Young people want to make difference through volunteering, but they would better off travelling†¦rather than wasting time on projects that have no impact†¦Ã¢â‚¬  (Ward, 2007) In this paper, we will evaluate both side of the debate and carefully assess the value of voluntourism for local community. In order to assess the benefit given by volunteer tourists, it is essential to look at the quality of the helpers. Unskilled volunteers may be a burden to local communities that have to take care of them. As Stephan peck, operations director at the Scout Association, puts it â€Å"[bad volunteers] are like a cancer† (Ainsworth, 2012). Therefore, the volunteer selection process is critical in recruiting needed and appropriate volunteers that benefit local communities. While supporters of voluntourism claims those volunteers as satisfying, looking into their selection experience shall make it clear that these tourists are hardly qualified as helpful volunteers. Research done by Richard Forsythe in Ghana vlountourism showed that only 36% of all studied volunteer applicants in various fields went through application process more complicated than filling appli cation forms, and â€Å"no individuals remarked upon the selection process as a particularly challenging experience, and indeed several of the organizations interviewed admitted to accepting ‘almost all volunteers’ having ‘very few requirements, and taking ‘anyone who is interested’†(Forsythe, 2011). Recruitment through application forms or basic information can only depend on the self-evaluation of applicants, who probably had no volunteering experience, as to whether they will be helpful to the local community. With such a lenient selection, the volunteers selected are much more likely to be burden than help to local volunteers and community who cry out: â€Å"A lot of people have very unrealistic expectations about overseas volunteering, and they want to be there for only a month or less and have no skills that are critically needed in the developing world† (Huang, 2012). People may expect those unqualified volunteers to receive some training before starting work, but research has also showed that volunteer tourists receive almost no training. When they do receive information, much of it is about the culture and language, safety and packing with little attention toward the skills and duties involved within the volunteer placements (Forsythe, 2011). Furthermore, no more than half the volunteers received supervision or guidance during the placement (Forsythe, 2011). The organization’s local presence is indispensible for placements’ appropriate, long-term effectiveness and safety of volunteers. With the growing number of teenagers participating in volunteer tours, supervision and protection by organization are vital. However, some volunteers set out with enthusiastic motivation ends up in a awkward situation as Hannah Saunders, a gap year volunteer: â€Å"When I arrived†¦they didn’t know I was coming or what to do with me.† (Ward, 2007) Although the volunteers’ intention maybe beneficial, they are unqualified, untrained and unguided. Such groups of volunteers can hardly provide any high-quality help that is needed by local communities. Supporters of voluntourism may cling onto the motivation behind voluntourism to justify the trend. Indeed, motivation is also a factor often discussed when talking about the benefits of voluntourism. Supporters of voluntourism argue actions that come from altruistic intension to help, although may not provide substantial help, are at least better than nothing. The supporters say that by just participating and showing concern, it is already helping the people in dispair. It is literally, â€Å"you are the difference!† With the belief in altruism, people advertise voluntourism, â€Å"in which enthusiasm and good intentions are allowed to prevail† (Simpson, 2004). However, it seems the good intension behind voluntourism is not enough to be allowed to â€Å"prevail†. While many people wish to believe that motivation behind volunteering abroad is purely altruistic, research using evolutionally, social psychological, organizational and game theoretic literature as fram ework, has found that, in general, people volunteered most often when personal benefits are high (Murnighan, Kim, & Metzger, 1993). Consistent with this result, almost all authors of articles about voluntourism, even the supporters, agree that voluntourism does not come from purely altruistic motivation. Despite the difference in motivational factors concluded by different authors, all of them agree that these motivations outweigh altruism (Forsythe, 2011;Corti, Marola, & Castro, 2010;Wearing 2001; Brown, 2005; Cohen, Reichel, Shwartz, & Uriely, 2002; Tosun, 2000; Unstead-Jones, 2008). It is commonly agreed that volunteer tourists plan to satisfy the needs of communities through meeting their own needs such as â€Å"experiencing cultures†. If actions from altruism intention are the ones that give hope and â€Å"prevail†, voluntourism with self-centered motivation is not one. Furthermore, less concern in local community than in self-gain may result in idealized, incorrect assumption about local needs. Reflecting this worry about incorrect assumption, Sacha Brown, Program Manager of World Youth Intern ational, a NGO taking volunteers overseas for their development projects says, â€Å" there is a lot of development that is useless and is based on erroneous assumptions around what is ‘best’ for the community or country† (Huang, 2012). Inexperienced volunteers’ erroneous expectations on local needs, together with their self-centered concerns, make them concentrate on their own enjoyment without examining what help is needed. Organizations that seek to profit from voluntourism may increase rather than reduce neglect of local need. The director of VSO is worried that competition between organizations may lead to more emphasis on volunteer enjoyment and â€Å"may not deliver the maximum benefits to the communities these people are working in†. (Huang, 2012) Indeed, one of the organizations interviewed by Forsythe implied that its placements were driven by preferences of volunteers rather than local needs. It is not only researchers who are concerned about whether volunteering tourists’ helps are actually needed. Some volunteers interviewed by Justine Tillon express their feeling of lack of acceptance by local government and citizens. Some of them felt that â€Å"the government and local citizens are forced to be helped by the participants†. When there is evidence that help is â€Å"forced† on local people, maybe we should really ask ourselves: â€Å"Does this kind of help make a peaceful word?† All has been said, some supporters may provide research that show local satisfaction toward volunteer tourists. One of such research about Moroccan students’ satisfaction toward foreign volunteer teachers of French and English showed 79% of appreciation (Corti et al., 2010). The rate is indeed high, but we should look closer into this study. The job of the volunteers studied is to give English and French classes during vacation of school year. Out of 253 students who enrolled, 32.41% left to travel with their parents in the middle of classes (Corti et al., 2010). Although the desistance rate already implies that local community regards the classes as unserious holiday childcare rather than structured learning experience, several other questions can be raised against results of this and similar other studies. First, does the rate actually reflect the work done by volunteer teachers? The improvement in student’s language skills is not measured in the study. Since it was students who answered those surveys, it is questionable whether they looked at bigger picture and thought the experience educating or they were just excited to see foreigners. Inferring from previous evaluation of quality, training and supervision of volunteers, these teachers are likely to be unqualified as teachers. Of course supporters may say that the satisfaction rate is indeed the proof that the volunteers are qualified. That raises a second question. Is it voluntourism per se that is benefiting? Do they have to be volunteer tourists or they can be anyone? Considering that English and French are both official language of Morocco, classes given by mixture of nonnative and native speakers of the languages may hardly made any difference from that by local Moroccans who speak both languages. It is not clear whether the 79% satisfaction was toward â€Å"volunteers from abroad† or â€Å"people who helped†. Questions about the tourists’ help per se have been studied in different contexts. Study in Gahanna showed that many volunteers are placed in daily tasks and traditional chores such as bathing, dressing, feeding and supervising of children, that can be done by anyone else (Fosythe, 2011). To justify voluntourism itself, studies about unique benefit of voluntourism need be carried out. Through this paper, we have evaluated the quality, motivation and local need of voluntourism. While there are some studies showing satisfactions toward voluntourism presented, several essential questions are raised. Through evaluation, it became clear that volunteer tourists are unskilled, authentically motivated, and to certain extent, unwelcomed. Although it may be a valuable experience for tourists, it seems that voluntourism carry few value, if not harm, to local community. Whether or not it is primary desire, the desire to volunteer is laudable. However, we need to tread more carefully, especially when dealing with people who are already suffering. Unless we have enough knowledge and transferrable skills, we might do better to travel and bring money into developing countries. Works Cited Ainsworth, D. (2012). Bad volunteers are like a cancer, says Scout Association director. Third Sector Online . Brown, S. (2005). Understanding the motives and benefits of voluntourists: What makes them tick? Retrieved from http://www.voluntourism.org/newsstudyandresearc h1005.htm Cohen, E., Reichel, A., Schwartz, Z., & Uriely, N. (2002). ). Rescuing hikers in Israel’s deserts: Community altruism or an extension of adventure tourism? . Journal of Leisure Research . Corti, I. N., Marola, P. N., & Castro, M. B. (2010). Social Inclusion and Local Development through European Voluntourism: A Case Study of the Project Realized in a Neighborhood of Morocco. merican Journal of Economics and Business Administration 2 . Forsythe, R. (2011). Helping or hindering? Volunteer tourism in Ghana and its critical role in development . Huang, A. (2008, 8 1). Voluntourism: Benifit or Harm? Retrieved from Yahoo! voices: http://voices.yahoo.com/voluntourism-benefit-harm-775403.html?cat=9 Jones, A. (2004). Review of Gap Year Provision. Murnighan, J. K., Kim, J. W., & Metzger, A. R. (1993). the Volunteer Dilemma. Administrative Science Quarterly . Simpson, K. (2004). ‘Doing Development’: The Gap Year, Volunteer Tourists and a Popular Practice of Development. Journal of International Development . Taillon, J. (2007). The Identification of Motivation in Voluntourists: Particularly Extrinsic Motivators in Vacation-Minded Volunteer Tourism Participants. Retrieved from http://justintaillon.com/FINAL% 20PAPER.doc Tosun, C. (2000). Limits to community participation in the tourism development process in developing countries. . Tourism Management . Unstead-Jones, R. (2008). An Analysis of Volunteer Motivation: Implications for International Development. The Journal of the Institute for Volunteering Research . Ward, L. (2007). You’re better off backpacking-VSO warns about perils of ‘voluntourism’. The Guardian . Wearing, S. (2001). Volunteer tourism: Experiences that Make a Difference. CABI Publishing.

Film Analysis: “Braveheart”

Over the past decade, Hollywood has begun to turn to history as the source of inspiration for some of its award-winning movies. Most, if not all, of these films would be promoted by the producers, directors and even actors of the film as those that are as close to historical accounts and documentations about these events and individuals. Although this may be the case, a portion of the scenes shown in movies based on events and prominent individuals in history have been included in order to add to the drama and action to the film even if the scene does not have any historical documentation to support the scene to be included.In some cases, certain parts of an otherwise historical event may also be changed in order to make it more striking and memorable to the audience. The paper will provide an analysis on the accuracy of the events presented in the Academy Award-winning movie â€Å"Braveheart† starring Mel Gibson. The paper would provide a summary of important key points prese nted in the movie. Specifically, the paper would look into the accuracy of the battles portrayed in the movie to research conducted by historians with regards to Sir William Wallace, the hero depicted in this epic movie.The paper would also look into the viability of the romantic affair between Sir William Wallace and the Princess of France and the surrounding circumstances as depicted in the movie. Summary of â€Å"Braveheart† In order to analyze the accuracy of the situations and events of the movie â€Å"Braveheart†, a summary of the movie must first be provided. The film begins in Scotland in the year 1280 AD. The death of the king of Scotland left the country without a ruler of its own as the king did not have a son to leave the kingdom to.As a result, the rulers from neighboring countries began to compete with each other for the crown and ownership of the kingdom of Scotland. The most formidable of these competitors was Edward the Longshanks, king of England. His claim over Scotland was met with hostility from the commoners of the land. In order to extinguish any retaliation on the part of the common people of Scotland, Edward the Longshanks arranged a meeting whereby each leader of the different shires of Scotland were invited to attend, allowing them to bring along only one page as their companion.Among those who have been invited was a commoner named Malcolm Wallace who decided to take his eldest son, John, with him to the meeting. They were delayed to arrive to the meeting as Malcolm had to convince his youngest son, William, that he was still too young to go to the journey with them. Upon their arrival, Malcolm Wallace had realized that his son’s persistence had saved him from walking into a trap that had been orchestrated by Edward the Longshanks. All the attendees in the supposed meetings were hung inside the cottage where the meeting was supposed to have taken place, including the women and children.William, who had tried to follow his father and brother to the meeting, saw the brutality of the scenario – a vision that had left a lasting mark to the young boy (â€Å"Braveheart†). The brutality of the scene prompted Malcolm Wallace to stir some of the leaders in the shire to attempt a violent response for what Edward the Longshanks had committed to their fellow men. Unfortunately, the effort was a failed attempt, and Malcolm and his son were killed in the battle. On the day that his father and brother were buried, his uncle, Argyle, took him into his care (â€Å"Braveheart†).The film then fast forwards to a few years later. Edward the Longshanks, in his quest to rule over all of Europe, formed an allegiance with his rival, the King of France, through the marriage of the latter’s daughter to Edward the Longshank’s son and heir to the throne. Meanwhile, in Edinburgh, the Scottish nobles had formed a council. Included in the council was the 17th Earl of Bruce named Robert, who has been considered to be the leading contender to the crown of Scotland. Among the topics that begun to concern the council was the issuance of the decree of prima nocte by Edward the Longshanks.This gave nobles who have sworn their allegiance to the King of England the privilege to sleep with any newly married common woman on the first night as a married woman. This was done in an effort to encourage more Scottish nobles to swear allegiance to the King of England which then would lead to the surety of Edward the Longshank’s hold over Scotland (â€Å"Braveheart†). It was around this time that William Wallace, now an adult, returns to the shire that he had left when he was a young orphan.He reunites himself with Hamish, his childhood friend and the young woman named Murron who, during his father and brother’s burial, offered him a flower as a sign of sympathy. Because of the prima nocte decree, William and Murron married in secret and thus allowing William the privilege that most other men in the shire had been deprived of (â€Å"Braveheart†). The turning point for the pace of the movie and the life of William Wallace occurred just a few days after his secret marriage.A soldier of the English crown attempted to force himself on the young woman, but she had fought and, through the help of William, freed herself but only for a while. She was eventually caught by the soldiers and was executed in front of the entire town as an example on what would happen to them should they try to oppose any representative of the king of England, be it a soldier or a noble since according to the nobleman, an opposition to any individual representing the king of England is an opposition to the King himself (â€Å"Braveheart†).The death of Murron and the reasoning of the noble had caused William Wallace to begin a revolution beginning in his own town. His passion and determination to rid the country of the English had made a lot of Scottish c ommoners take up arms and join him in his cause. Town after town, he and his band of men which eventually led to the joining of the forces of the Scots and the Irish, had made the townspeople consider him as a legend and tales began to spread about him (â€Å"Braveheart†).News had reached the King of England and sent his daughter-in-law, the Princess of France, as an ambassador to negotiate some form of truce and ceasefire with William Wallace, who by now had been knighted by the Council of Scots, headed by Robert the Bruce. Wallace declined the offer of Edward the Longshanks by relaying to the future queen the haunting scene that he had stumbled on when he was a boy and when the King of England first offered a truce to the people of Scotland.Not only did the Princess of France become amazed by the intelligence that Wallace had exhibited, but she also began to grow fond of him in a romantic way (â€Å"Braveheart†). When she returned to London and delivered the message of William Wallace to the king, he decided to go into war with Wallace again. This time, he was to have a larger army by tapping into the allegiances that he had formed through the years. When news of this reached William Wallace through the help of the Princess of France, Wallace went to the Council of Scots to ask them to join their cause.Initially, Robert the Bruce gave Wallace his word and so did the other members of the council. However, on the day of the battle, Wallace first experienced betrayal when he saw two of the council men that showed up with their respective armies had turned around after being bribed by the King of England, and then later when he discovered that Robert the Bruce himself was fighting alongside the King of England as well (â€Å"Braveheart†). Upon seeing the effects of his betrayal to Wallace, Robert the Bruce was overcome with guilt and as a means to try to amend for his betrayal, helped Wallace escape the battlefield.This allowed Wallace to ta ke revenge on the two noblemen who have betrayed him in the battlefield (â€Å"Braveheart†). With news of Wallace’s escape reaching the King of England, another attempt was made on his life. This plot was overheard by the Princess of France, who again warned Wallace of the assassination attempt. Unfortunately, the third time, Wallace was finally apprehended. Robert the Bruce sent word to William Wallace that he would like to talk and make amends for his previous betrayal.Still trusting the Bruce, and realizing the need for a larger army to continue the cause, Wallace went to the residence of the Bruce alone and unarmed. Unknown to both Robert the Bruce and William Wallace, the other members of the Council, through the guidance of Robert the Bruce’s father, made arrangements to hand William Wallace over to the King of England (â€Å"Braveheart†). William Wallace was tried for high treason against the King of England and was sentenced to be executed the fol lowing day. Knowing about this, the Princess of France begged for the life of William Wallace to the King of England as he lies on his deathbed.When the king refused to grant the request of the princess, she then made it known to the dying king that she was pregnant with the child of William Wallace, his mortal adversary (â€Å"Braveheart†). Wallace suffered a horrendous and slow death through a process called hung, drawn and quartered. With his last breath, he shouted with all his might the word â€Å"Freedom†, a cry that stirred the hearts of his comrades who witnessed his execution in the crowd. After he was beheaded, the body of William Wallace was cut into pieces and placed in different locations to serve as a warning to anyone who tries to go against the King of England.His head was situated on London Bridge, while his arms and legs were sent to the four corners of England. The movie ends with the narration on how instead of deterring any form of resistance towar ds the crown of England, the opposite had actually happened. In the year 1314, despite the Scottish army headed by Robert the Bruce were lacking in resources and heavily outnumbered, had won the freedom of their land from English rule in the battle that occurred on the field of Bannockburn (â€Å"Braveheart†). Analysis of the Accuracy of â€Å"Braveheart†

Assessment and Care Planning: Holistic Assessment

Introduction This essay deals with the holistic assessment of a patient who was admitted onto the medical ward where I undertook my placement. Firstly, the relevant life history of the patient will be briefly explained. Secondly, the Roper, Logan and Tierney model of nursing that was used to assess the care needs of the patient will be discussed, and then the assessment process will be analysed critically. Identified areas of need will be discussed in relation to the care given and with reference to psychological, social, and biological factors as well as patho-physiology. Furthermore, the role of inter-professional skills in relation to care planning and delivery will be analysed, and finally the care given to the patient will be evaluated. Throughout this assignment, confidentiality will be maintained to a high standard by following the Nursing and Midwifery Council (NMC) Code of Conduct (2008). No information regarding the hospital or ward will be mentioned, in accordance with the Data Protection Act 1998. The pseudonym Kate will be used to maintain the confidentiality of the patient.The PatientKate, a lady aged 84, was admitted to a medical ward through the Accident and Emergency department. She was admitted with asthma and a chest infection. She presented with severe dyspnoea, wheezing, chest tightness and immobility. Kate is a patient known to suffer from chronic chest infections and asthma, with which she was diagnosed when she was young. She takes regular bronchodilators and corticosteroids in the form of inhalers and tablets. Kate lives on her own in a one bedroom flat. She has a daughter who lives one street away and visits her frequently. Her daughter stated that Kate has a very active social life; she enjoys going out for shopping using a shopping trolley.Assessment of the PatientAssessment TheoryIn this ward, the Roper, Logan and Tierney model of nursing, which reflects on the twelve activities of living, is used as a base for assessing patients (Alabaster 2011). These activities are â€Å"maintaining safe environment, communication, breathing, eating and drinking, elimination, personal cleansing and dressing, controlling body temperature, mobility, working and playing, sexuality, sleeping, and dying† Holland (2008, p.9). Elkin, Perry and Potter (2007) outlined nursing process as a systematic way to plan and deliver care to the patient. It involves four stages: assessment, planning, implementation and evaluation. Assessment is the first and most critical step of the nursing process, in which the nurse carries out a holistic assessment by collecting all the data about a patient (Alfaro-Lefevre 2010). The nurse uses physical assessment skills to obtain baseline data to manage patients’ problems and to help nurses in the evaluation of care. Data can be collected through observation, physical assessment and by interviewing the patient (Rennie 2009). A complete assessment produces both subjective and objective findings (Wilkinson 2006). Holland (2008) defines subjective data as information given by the patient. It is obtained from the health history and relates to sensations or symptoms, for example pain. Subjective data also includes biographical data such as the name of the patient, address, next of kin, religion etc. Holland defines objective data as observable data, and relates it to signs of the disease. Objective data is obtained from physical examination, for example of blood pressure or urine. Before assessment takes place, the nurse should explain when and why it will be carried out; allow adequate time; attend to the needs of the patient; consider confidentiality; ensure the environment is conducive; and consider the coping patterns of the patient (Jenkins 2008). The nurse should also introduce herself to help reduce anxiety and gain the patient’s confidence. During assessment, the nurse needs to use both verbal and non-verbal communication. Using non-verbal communication means that she should observe the patient, looking at the colour of the skin, the eyes, and taking note of odour and breathing. An accurate assessment enables nursing staff to prioritise a patient’s needs and to deal with the problem immediately it has been identified (Gordon 2008). Documentation is also very important in this process; all information collected has to be recorded either in the patient’s file or electronically (NMC, 2009b).Carrying out the AssessmentKate was allocate d a bed within a four-bed female bay. Her daughter was with her at the bedside. Gordon (2008) stated that understanding that any admission to hospital can be frightening for patients and allowing them some time to get used to the environment is important for nursing staff. Kate’s daughter was asked if she could be present while the assessment was carried out, so that she could help with some information, and she agreed. Alfaro-Lefevre (2008) recommended that nursing assessments take place in a separate room, which respects confidentiality, and that the patient be free to participate in the assessment. Although there was a room available, Kate’s daughter said it was fine for the assessment to take place at the bedside because her mother was so restless and just wanted to be next to her. The curtains were pulled around the bed, though William and Wilkins argued that it ensures visual privacy only and not a barrier to sound. NMC (2009a) acknowledges this, along with the n eed to speak at an appropriate volume when asking for personal details to maintain confidentiality. The assessment form that was used during Kate’s assessment addressed personal details and the twelve activities of living. A moving and handling assessment form was also completed because of her immobility. First, personal details such as name, age, address, nickname, religion, and housing status were recorded. Information was also recorded about any agency involved, along with next of kin and contact details, and details of the general practitioner. Holland (2008) stated that these details should be accurate and legible so that, in case of any concerns about the patient, the next of kin can be contacted easily. The name and age are also vital in order to correctly identify the patient to avoid mistakes. Knowing what type of a job the patient does or the type of the house she lives in helps to indicate how the patient is going to cope after discharge. Holland also insisted that religion should be known in case the patient would like to have some privacy during prayers, and thi s should be included in the care plan. The second assessment to be done focused on physical assessment and the activities of living. Barrett, Wilson and Woollands (2009) suggested that when enquiring about the activities of living, two elements should be addressed: usual and current routines. Additionally, identifying a patient’s habits will help in care planning and setting goals. During physical assessment, when objective data was collected, Kate demonstrated laboured and audible breath sounds (wheezing) and breathlessness. Use of accessory muscles and nose flaring was also noted. She was agitated and anxious. Her vital signs were: blood pressure 110/70; pulse 102 beats /min; respirations 26/min; temperature 37.4 degrees Celsius; oxygen saturation 88%; peak flow 100 litres; weight 60kg; and body mass index 21. Taking and recording observations is very important and is the first procedure that student nurses learn to do. These observations are made in order to detect any signs of deterioration or progress in the p atient’s condition (Field and Smith 2008). Carpenito-Moyet (2006) stated that it is important to take the first observations before any medical intervention, in order to assist in the diagnosis and to help assess the effects of treatment. Kate’s initial assessment was carried out in a professional way, taking account of the patient’s particular circumstances, anxieties and wishes. After the baseline observations were taken, the twelve activities of living were analysed and Kate’s needs were identified. Among the needs identified, breathing and personal hygiene (cleansing) will be explored.Identified Care NeedsBreathingWilkinson (2006) states that a nursing diagnosis is an account about the patient’s current health situation. The normal breathing rate in a fit adult is 16-20 respirations/minute, but can go up to 30 due to pain, anxiety, pyrexia, sepsis, sleep and old age (Jenkins 2008). In old people, muscles become less efficient, resulting in increasing efforts to breathe, causing a high respiratory rate. On assessment, Kate’s problem was breathing that resulted in insufficient intake of air, due to asthma. She was wheezing, cyanosed, anxious and had shortness of breath. Wilkinson (2006) explained that a goal statement is a quantifiable and noticeable criterion that can be used for evaluation. The goal statement in this case would be for Kate to maintain normal breathing and to increase air intake. The prescription of care for Kate depended on the assessment, which was achieved by monitoring her breathing rate, rhythm, pattern, and saturation levels. These were documented hourly, comparing the readings with initial readings to determine changes and to report any concerns. The other part of the plan was to give psychological care to Kate by involving her in her care and informing her about the progress, in order to reduce anxiety. Barrett, Wilson and Woollands (2012) stated that it is very important to give psychological care to patients who are dyspnoeic because they panic and become anxious. Checking and recording of breathing rate and pattern is very important because it is the only good way to assess whether this patient is improving or deteriorating, and it can be a very helpful method for nurses to evaluate whether or not the patient is responding to treatment (Jamieson 2007). Mallon (2010) stated that, if the breathing rate is more than 20, it indicates the need for oxygen. Blows (2001), however, argued that this can happen even after doing exercise, not only in people with respiratory problems. Griffin and Potter (2006) stated that, respirations are normally quiet, and therefore if they are audible it indicates respiratory disease. Nurses needs to be aware of these sounds and what they mean, for example a wheezing sound indicates bronchiole constriction. Kate’s breathing was audible and the rate was also above normal and that is why breathing was prioritised as the first need. Oxygen saturation level was also monitored with the use of a pulse oximeter. The normal saturation level is 95-99% (British National Formulary ((BNF)) 2011a). Nevertheless the doctor said that 90-95% was fine for Kate, considering her condition and her age. Kate was started on two litres of oxygen and she maintained her oxygen saturation between 90 and 94%. The peak expiratory flow was monitored and recorded to identify the obstructive pattern of breathing that takes place in asthma (Hilton, 2005). This is another method that is used to assess the effectiveness of the medication (inhalers) the asthmatic patient is taking, and this test should be carried out 20 minutes after medication is administered. It is the Trust’s policy to do hourly observations on patients who have had one, two or three abnormal readings, until readings return to normal. Kate was observed for any blueness in the lips and tongue and for oral mucosa as this could be a sign of cyanosis. All the prescribed nebulisers, inhalers, bronchodilators, corticosteroids, antibiotics and oxygen therapy were administered according to the doctor’s instructions. Bronchodilators are given to dilate the bronchioles constricted due to asthma, and corticosteroids reduce inflammation in the airway (BNF 2011b). Kate was also started on antibiotics to combat the infection because, on auscultation, the doctor found that the chest was not clear. Kate was nursed in an upright position using pillows and a profiling bed in order to increase chest capacity and facilitate easy respiratory function by use of gravity (Brooker and Nicol, 2011). In this position, Kate was comfortable and calm while other vital signs were being checked. Pulse rate and blood pressure were also being checked and recorded because raised pulse can indicate an infection in the blood.CleansingDue to breathlessness and loss of mobility it was difficulty for Kate to maintain her personal hygiene. Hygiene is the practice of cleanliness that is needed to maintain health, for example bathing, mouth washing and hair washing. The skin is the first line of defence, so it is vital to maintain personal cleansing to protect the inner organs against injuries and infection (Hemming 2010). Field and Smith (2008) stated that personal cleansing also stimulates the body, produces a sense of well-being, and enables nurses to assess the patient holistically. Personal hygiene is particularly important for the elderly because their skin becomes fragile and more prone to breaking down (Holloway and Jones 2005). Therefore this need was very important for Kate; she needed to maintain her hygiene as she used to, before she was ill. The goal for meeting this need was to maintain personal hygiene and comfort. The care plan prescribed involved first gaining consent from Kate, explaining what was going to be done. Hemming (2010) recommended that identifying the patient’s usual habit is very important because each individual has different ideas about hygiene due to age, culture or religion. Identifying usual habits helps individuals to maintain their social life if things are done according to their wishes. Though Hemming said all human beings need personal hygiene, Holland (2008) argued that it is important to ask patients how they feel about being cleaned, especially in private areas. Kate indicated that she didn’t mind being assisted with washing and dressing. She preferred washing daily, shower and a hair wash once a week, and a mouth wash every morning and before going to bed. Kate was assisted with personal care 5-10 minutes after having her medication, especially the nebuliser. Individuals with asthma experience shortness of breath whenever they are physically active (Ritz, Rosenfield and Steptoe 2010). After having medication Kate was able to participate during personal hygiene. According to NMC guidelines on confidentiality (2009a), privacy and dignity should be maintained when giving care to patients. Therefore, whenever Kate was being assisted with personal care, it was ensured that the screens were closed and she was properly covered. Field and Smith (2008) suggested that assisting a patient with personal hygiene is the time that nurses can assess the patient holistically. Since Kate was immobile, it was very important to check her pressure areas for any redness. She was also checked for any pallor, jaundice, cyanosis or dry skin that needed attention. The care was always carried out according to her wishes.The Role of Inter-Professional SkillsConsi dering Kate’s age and condition, she needed multi-professional teamwork. NMC (2008) encourages teamwork to maintain good quality care. Kate was referred to the respiratory nurse who is specialised in helping people with breathing problems. Since Kate was on oxygen since admission, the respiratory nurse taught her the importance of healthy breathing and taught her some breathing exercises to help wean her from oxygen. Kate was also referred to the physiotherapist who did breathing exercises with her. Kate was not able to walk without aid so she was also referred to the occupational therapy department to assess how she was going to manage at home, or if she required aids to help her manage the activities of living. Upon meeting together, all the multi-disciplinary team agreed that Kate needed a care package, as she could no longer live without care. She was referred to social services so that they could assess this aspect of Kate’s future. After one week Kate was medically fit but could not go home because she was waiting for the care package to be ready. Her nurse shared information with the multi-disciplinary team in order to establish continuity of care for Kate. The team prepared for her discharge: the occupational therapy staff went to visit her home to check if there was enough space for her walking frame; social services arranged for a care package; and her nurses referred her to the district nurse to help her with her medication and make sure it did not run out.OutcomeKate responded well to the medication she was prescribed; normal breathing was maintained, her respirations became normal, ranging from 18 to 20 respirations per minute, and her oxygen saturation ranged from 95% to 99%. Kate was able to wash and dress herself with minimal assistance. She was discharged on a continuous care package comprising care three times a day, and the district nurse helped her with the medication to control her asthma.Evaluat ionThe model of the twelve activities of living was followed successfully on the whole. The nurse collected subjective and objective data, allowing a nursing diagnosis to be formulated, goals to be identified and a care plan to be constructed and implemented. Privacy is very important in carrying out assessments, and this was not achieved fully in Kate’s assessment. However, this lower level of privacy has to be balanced against causing anxiety to the patient. Kate’s daughter thought that the bedside assessment would be more comfortable for her mother, and therefore cause least anxiety. This was very important because of the effects of potential panic on breathing; therefore, this was the correct balance to strike. A multi-disciplinary team was involved in meeting Kate’s care goals. This is a good example of the use of inter-professional skills, as a number of different departments were involved in creating and implementing the care plan. However, the system was not as efficient as it should have been: Kate spent unnecessary time in hospital after recovery because the care plan was not yet in place. Assessment can also take a long time, especially with the elderly who are usually slow to respond. Therefore, more time is needed to be sure that the necessary progress has been achieved before taking further steps. However, poor staffing also affects performance in this area, an observation supported by the Royal College of Nursing (2012). In conclusion, the assessment of this patient was completed successfully, and the deviation from best practice recommendations (the lower level of privacy) was justified by the clinical circumstances. Progress from assessment to care goals was good, and at this point an inter-disciplinary team was used successfully. However, the one flaw in this process was delays, caused partly by the difficulties of working across different departments, and partly, it seems, by staff shortages. Reference List Alabaster, C.S (2011) ‘Care and rehabilitation of people with long term conditions’ in Brooker, C. and Nicol, M. (eds) (2011) Alexander’s Nursing Practice (4th ed). London: Churchill Livingstone.. Chapter 32 Alfaro–LeFevre, R. (2008) Critical thinking and clinical judgment: A practical approach to outcome-focused thinking (3rd ed.). St. Louis, MO: Saunders. Barrett, D., Wilson, B. and Woollands, A. (2009) Care Planning: A Guide for Nurses (2nd ed). Harlow: Pearson Education. Chapter 2. Blows, W. T. (2001) The Biological Basis of Nursing: Clinical Observations. London: Routledge. British National Formulary (2011a) Oxygen. London: British Medical Association and the Royal Pharmaceutical Society of Great Britain. British National Formulary (2011b) Corticosteroids. London: British Medical Association and the Royal Pharmaceutical Society of Great Britain. Brooker, C. and Nicol, M. (eds) (2011) Alexander’s Nursing Practice (4th ed). London: Churchill Livingstone. Carpenito-Moyet, L. J. (2006) Handbook of Nursing Diagnosis (11th ed). Philadelphia: Lippincott. Doughty, L. and Lister, S. (eds) (2008) The Royal Marsden Hospital Manual of Clinical Nursing Procedures (student edition) (7th ed). Oxford: Wiley Blackwell. Elkin, M. K., Perry, A. G. and Potter, P. A. (2007). Nursing Interventions and Clinical Skills. Philadelphia: Mosby. Field, L. and Smith, B. (2008). Nursing Care (2nd ed). Harlow: Pearson Education. Gordon, M., (2008). Nursing Assessment and Diagnostic Reasoning. Philadelphia: F.A. Davis company. Griffin, A., Potter, P. (2006) Clinical Nursing Skills and Techniques (6th ed). Philadelphia: Mosby Hemming, L. (2010). ‘Personal Cleansing and Dressing’ in I. Peate (ed) Nursing Care and the Activities of Living. (2nd ed). Oxford: Wiley Blackwell. Chapter 9. Hilton, A. (2003) Fundamental Nursing Skills. London: John Wiley & Sons Holland, K., (2008) ‘An introduction to the Roper-Logan-Tierney model for nursing, based on Activities of Living’ in Holland, K., Jenkins, J., Solomon, J. and Whittam, S. (eds). Applying the Roper, Logan and Tierney Model in Practice. London: Churchill Livingstone. Chapter 1, pp.9-10. Holloway, S. and Jones, V. (2005). ‘The importance of skin care and assessment’ in the British Journal of Nursing Dec 2005-Jan 2006 14(22): 1172-6. Jamieson, E. Whyte, L. A. and McCall, J. A. (2002) Clinical Nursing Practices. London: Churchill Livingstone. Jenkins, J., (2008) ‘Breathing’ in Holland, K., Jenkins, J., Solomon, J and Whittan, S. (eds) Applying the Roper, Logan and Tierney Model in Practice. London: Churchill Livingstone. Chapter. 5. Mallon, S. (2010) ‘Breathing’ in I. Peate (ed) Nursing Care and the Activities of Living (2nd ed). Oxford: Wiley Blackwell. Chapter 8. Nursing and Midwifery Council (2008) The Code of Conduct. London: NMC. Available at: http://www.nmc-uk.org/Publications/Standards/The-code/Introduction/ Accessed 24/05/2012 Nursing and Midwifery Council (2009a) The Code of Conduct: Confidentiality. London: NMC. Available at: (http://www.nmc-uk.org/Nurses-and-midwives/Advice-by-topic/A/Advice/Confidentiality/) Accessed 24/05/2012 Nursing and Midwifery Council (2009b) Record Keeping: Guidance for Nurses and Midwives. London: NMC. Available at: http://www.nmc-uk.org/Documents/Guidance/nmcGuidanceRecordKeepingGuidanceforNursesandMidwives.pdf Accessed 24/5/2012 Rennie, I. (2009). ‘Exploring approaches to clinical skills development in nursing education’ in Nursing Times 105: 3, 20-22. Available at: http://www.nursingtimes.net/exploring-approaches-to-clinical-skills-development-in-nursing-education/1973990.article Accessed 14/05/2012 Ritz, T., Rosenfield, D. and Steptoe, A. (2010) ‘Physical activity, lung function, and shortness of breath in daily life of asthma patients’ in Chest 138(4), 913-918. Royal College of Nursing (2012) Safe staffing for older people’s wards. Available at: http://www.rcn.org.uk/__data/assets/pdf_file/0010/439399/Safe_staffing_for_older_people_V3.pdf Accessed: 24/05/2012 Wilkinson, J. M. (2006) Nursing Process and Critical Thinking. (4th ed). New Jersey: Pearson Prentice Hall.