Issues Of The Work-Life Conflict

Issues Of The Work-Life Conflict Work-life conflict occurs when time and energy demands imposed by our many roles become incompatible with one another; participation in one role is made increasingly difficult by participation in another. Work-life balance (WLB), from an employee perspective, is the maintenance of a balance between responsibilities at work and at home. When the employees have conflicts between their work life and personal life it creates distractions in their work, preventing employees from performing in their best level, which creates obstacles in the achievement of organizational and individual goals. Therefore failure in managing work-life conflict among the employees could lead to problems within the organization. Hemas Hospital is a newly started hospital in Sri Lanka in the year 2008. It is a multi specialty hospital which caters for the whole family by providing highly specialized medical services according to the highest international standards. Around 100 consultants practice in this hospital. As a newly started hospital working for 24 hours they are confronted with problems of employees struggling to strike a balance between their work and life. Employees commitment to their service is vital to provide to provide a according to the standards. At Hemas Hospital Nurses play a major role. Professional nursing is a highly skilled practice directed towards improving the health status of individuals, groups and communities. Nursing activities encompass promoting health, preventing disease, aiding and supporting people in daily living as well as during recovery and rehabilitation, and helping people to die comfortably and with dignity (Nursing, n.d.). The purpose of this essay is to highlight and discuss on the issues of work life conflict how it affects further to discuss about the solutions that could be applied to tackle the conflicts. Secondary researches have been used in order to support the discussion in an effective way. 2.0 Causes 2.1 Womens Family Commitment Over recent years there has been an enormous increase in the number of women employees entering to the paid workforce labor of Hemas Hospital Wattala. Despite the rapid growth in womens involvement in the paid workforce; it appears that little has changed for women in terms of their family commitments. Culture plays a big role in Sri Lanka in relation to this topic. Traditional gender roles prescribe for women to place the role of wife and mother above all others; men are expected to be the family breadwinner. Given the burden of household responsibilities and child care, women employees (doctors, nurses, receptionists) face the demands of multiple roles, which often go beyond the general three roles working mothers generally take on (wife, mother, and worker) to include responsibilities such as: caretaker of aging parents, sister, aunt, cousin, etc. (Scott Coltrane, n.d.) As a result of these multiple tasks work life conflict has been identified as a common problem among most women employees at Hemas Hospital. 2.2 Personal Health Problems Health is the general condition of a person in all aspects. Having problems is a part of life. Most of the researches have found that effects of stress affect the health. The reason is the stress and health is closely linked. And also they have found that the risk factors for health caused by chronic stress causes as much as 60 to 90% of all illnesses. The impact it has on your health, both physical and mental, can be very harmful. And individuals stress does contribute to high blood pressure, high cholesterol, and other cardiac risk factors such as addictions and obesity. We found that 55% of Hemas hospitals nurses getting sick because of the stress they have. Some of the shifts they have to cover up without taking breaks. Therefore they cannot balance their personal lives with the work they have. So that stress arises and automatically they get ill. 2.3 Tight Work Schedules Workers have to control their working hours to enjoy a better life. Most of time nurses have to do night duty and also they have to do over time work because of this reasons lack of flexible working hours can be arising. Most of times who worked as nurses are young mothers so then they have do their children work, they have to care about children and also their home work. It is very hard to do night duty person who has small child then they might feel time is more important than money after that there can be arise a stress on work place. Organization culture can shape the work life balance. According to our culture most of time mothers are house wifes and also childrens need care of mothers. If mother busy with her job then there will be arises social problem and also family problems. In Hemas hospital every nurse has to do two night duties in each week and then there arises conflict between work life balances. 2.4 Lack of Employee Rewards and Appreciation As a nurse Caring for the sick and dying has never been easy. Though it is a respected, intellectually stimulating, and deeply meaningful career today it offers limited benefits and many challenges. Though its been 2 years Hemas Hospital started their management hasnt introduced proper rewarding system for the nurses. This will directly affect the employees morale; therefore employee productivity would be less. 2.5 Transportation Issues Transportation is one of the main issues that Hemas Hospital employees are facing. Since there are both day and night shifts, the employees main problem will be the transportation. In Sri Lanka with the cultural situations most of the people think in negative way when the females doing the night shifts and/or when they arrives at home in mid night, Since the public transportation is not too safe for female after around 7.30 8.00 pm the transportation will be highly regarded when comes to night shifts. 3.0 Effects 3.1 High Absenteeism Absenteeism is an expensive problem in both public and private sector organizations. Over the past decade, there has been increasing interest in the impact of womens family responsibilities, personal health problems and transportation problems on absenteeism. Many women employees at Hemas Hospital find it hard to achieve their desired combination of work and family time. For example, family responsibilities appear to constrain a womans choice of occupation. Women taking leave due to illnesses of children or their elder parents. 3.2 Less productivity Due to personal health problems, lack of rewards and appreciations and tight work schedules employees productivity getting reduced. This situation is not good for a working place like hospital. Productivity is one of the most important factors when it comes to work. When employees are not healthy they are unable to work properly. Therefore their productivity comes down and the job they do cannot be performed properly. When working in a hospital, the employees have to work very effective manner, because they are the savers of patients lives. It will be a big disaster if they forget or neglect to give proper medicine or giving wrong medicine to a patient. This would highly affect to Hemas hospital if they do not work properly up to the standard. 3.3 Dissatisfaction While the majority of reasons for dissatisfaction usually point to elements of the workplace itself such as: management style, environmental conditions or opportunities for growth, lack of rewards and appreciations, tight work schedules etc. (A guide to grow your personal growth, n.d.). It was found that especially nurses are dissatisfied with their job. Due to this they may move towards competitors or leave the job. Therefore Hemas Hospital has to consider ways of minimizing the work dissatisfaction. 3.4 Stress Stress is the most hated part of the job of healthcare employees. This can be occurring due to personal health problems, womens family commitments and tight working schedules. Therefore it leads nurses to be dissatisfied with their work. Due to the dissatisfaction they will not perform efficiently and effectively through less performance. Furthermore their loyalty for the company will be less and will tend to move towards competitors or leave the job. One of the respondents at the Hemas hospital said that, Too much pressure on this shift Scanty facilities very meageryou feel really exhaustedamounting to tensions and conflicts which are often displaced onto people aroundyou knowyelling at colleagues 3.5 High employment turnover This can be happened due to all of the causes mentioned above. More than the cultural influences nursing is a more stressful and challenging job therefore its a must to recognize them as very precious for the hospital to make them retain in the hospital. The impact of turnover has received considerable attention by senior management, human resources professionals, and industrial psychologists. It has proven to be one of the most costly and seemingly intractable human resource challenges confronting organizations. Analyses of the costs associated with turnover yield surprisingly high estimates. The high cost of losing key employees has long been recognized. When consider the Hemas Hospital the situation also same. It appears high employment turnover, especially nurses. 3.6 Work overload for other employees Due to health problems and family commitment some employees cannot perform their duties to the expected level. So others will have to carry out the sick employees work load too. Some times since they havent time to fulfill the work load they might not do even their assigned duties properly. They do not care about the patients very well. Then again it will affect to the overall performance of the Hemas hospital. In addition, inadequate facilities, improper functioning of other employees and neglected responsibilities created pressure and conflict among the personnel. These inadequacies eventually reduced the tolerance threshold, which in turn contributed to the conflict experienced. One of the respondents at Hemas hospital said that, We cant ignore the fact that heavy workload and shortage of skilled human resources affect our performance; despite our effort to get used to the situation, we are limited in coping. When you see that the supervisor stops backing us up and never steps into the ward to listen to us it makes us feel our rights have been violated. 4.0 Solutions 4.1 Paternity leave Paternity leave is the time a father takes off work at the birth or adoption of a child. This kind of leave is rarely paid. A few progressive companies offer new dads paid time off, ranging from a few days to a few weeks. Hemas Hospital can arrange paternity leave for doctors and therefore can avoid the absenteeism and dissatisfaction towards the job. 4.2 Dependent care arrangements Many nurses will be faced with issues of child or adult care giving. Without adequate support, these can create a host of distractions from work. There are many ways that the Hemas Hospital can support their nurses with their personal responsibilities. Some of the ways are on or off site child and adult care centers, lactation programs, dependent care referrals, etc. 4.3 Job sharing Job sharing is a form of permanent part-time work in which a full-time position is divided between two or more people, each of whom shares responsibility for the entire workload. Each job sharer receives conditions of employment and entitlements on a pro-rata basis in proportion to the hours worked. Job share arrangements are suitable for both professional and academic positions. A change from full-time work to a job sharing arrangement does not break continuity of employment. Job share arrangements can facilitate increased workplace flexibility because job sharers can relieve or cover for each other without loss in efficiency and effectiveness. Hemas Hospital also can implement this program and can get the maximum benefit out of it. 4.4 Flexible work schedules A flexible work schedule is a type of flexible work arrangement that allows employees to vary when they begin and end their work day to accommodate their individual and family needs. This flexibility greatly eases the burden of busy employees as they try to juggle their work and home lives Flexible work schedules benefits both employees and organization it self. For employees Increased satisfaction and productivity, reduced stress and health care costs, decreased absenteeism and reduced commuting time. For organizations improved retention and reduced turnover, higher levels of loyalty and commitment ,no change in managers supervisory time, attracts diverse employees who may not be able to conform to rigid schedules (i.e., disabled) 4.5 Incentives As a result if the hospital is not rewarding nurses well the Sri Lankan culture influences them to be not loyal towards hospital and as well to perform poorly. If an employee appreciated or rewarded it will influence them to work hardly than the before and also motivate to keep the work and personal life in a balance. For that reason this is the best time for Hemas to start an appropriate rewarding and appreciation system for their nurses to make them satisfy and happy situation between work and life. 5.0 Recommendations 5.1 Short Term Out of the number of solutions available, according to the situation, a strategy needs to be developed according to the problem but this would consume lots of time and energy to be done, So till a proper strategy is developed, in the short term the hospital can reward employing workers with an incentive programmed to facilitate them to balance their work /life.Hemas Hospital can reward financial non financial incentives to encourage their work force. Under financial incentives they can grant child vouchers and can have a special funding system for employees children. Furthermore the management of Hemas Hospital can introduce a transportation allowance system for the employees who come from distance areas. Under non financial incentive system Hemas Hospital can arrange family friends benefits or annual trips or get together, so that they have sometime to spend their leisure time with their colleagues. Furthermore nurses can be given promotions, scholarships or they can select best nur se annually to encourage nurses. 5.2 Long Term But in the long term proper strategy should be developed to address this problem, because incentives cannot be a solution for all the problems of the employees. While developing strategies the different situations of nurses need to be considered to facilitate them. Providing a flexible work options is a good method that could be developed, because job satisfaction is directly connected to a persons work schedule, especially to a nurses healthy mentality it is very important when dealing with patients. A variety of schedule options could be made available to fit their priorities and life styles. Full-time Options include: Three 12-hour shifts Five 8-hour shifts A combination of 8 and 12-hour shifts Part-time Options include: 8-hour shifts 12-hour shifts A combination of 8 and 12-hour shifts Weekend Program This program is an appealing option for nurses who are in school or who care for children during the week. This option provides short-term disability coverage. Weekend nurses work 24 hours each weekend They receive pay equivalent to 32 or 36 hours The schedule begins Friday at 7:30 a.m. and ends Monday at 7:30 a.m. Casual This option is appealing to nurses who want to work fewer hours but maintain a relationship with their unit and with Northwestern Memorial Hospital. Casual nurses work 40 hours during a 6-week schedule Float Pool Nurses may choose the flexibility and variety of working on multiple units through the Float Pool. Float Pool nurses are required to work two weekend shifts per month. Options include: Full-time work Part-time work Dynamic scheduling to accommodate personal work requirements. Schedule Choices Many nursing units offer nurses a Self Schedule option. They are able to select the days on the upcoming schedule they want to work. When their manager creates the schedule, he or she will balance the schedule requests with current patient needs in the unit (Careers, n.d.). The best recommendation would be to make available lots of flexible work schedule options and offer the nurses with a self schedule option, so that they can use choose a schedule according to their life style. These work options should be for the mutual benefit of both the employee and the employer so that employee can fulfill their responsibility towards their work place and as well as their families. 6.0 Conclusion There is a big difference between doing things and getting something done. Most work-life efforts by HR and work-life balance teams fail despite lots of doing. The problem is that all the doing didnt get anything done. If the organization wants to get something done that produces strong positive results and feedback, it should be start by taking an action in order to ensure success. Good work-life balance seems to be something that well-run firms in competitive markets do naturally. They need to treat their employees well to keep them if not; their competitors will hire them away. Government policies on work-life balance should take this into account. Whether the organization just introducing a work-life program or making an already great one better, the organization will be substantially improving its bottom line results and changing individuals lives for the better. To be an effective worker he/she has maintain a better balance in between work life and the personal life. We can see that there is a clear link between causes for the conflicts and effects of them. So that if Hemas can implement the above mentioned recommendations we think that Hemas can be the best hospital by getting the maximum use of their employees while providing them a conflicts free work life environment. Hence the entire organization and employees will be proud of the results.

The Historical Context of Terrorism and Our Next Steps :: September 11 Terrorism Essays

The Historical Context of Terrorism and Our Next Steps    As the horrific tragedy of September 11 settles into permanent corridors of our conscious life, our reactions as a society are manifold. There is shock, grief, anger and other emotions that we have not fully understood or found words to describe. As we search for explanations, our sages in government, the media and the academy try to help us articulate what we have experienced. We have been told that our innocence is gone, that the third world war has begun and that we are confronting a new and more lethal form of terrorism than the world has ever seen.    There is no doubt that our life as a nation will be altered by the destruction of that day. The thousands of lost lives cannot be restored, and their loss cannot be explained to those left without them. Fear will become a presence that increased security can never really dispel. Sacrifices will be made if our government chooses to seek retribution by war, as seems now to be the case.    We are urged to resume normal life, as both a healing mechanism and a tactic in the war against terrorism. Sports events resume and we will cheer for another kind of victory, movie theaters will again draw crowds to view digitalized specters of violence, mayhem and terrorism, and our daily routines of earning a living, providing food for our families, and seeking temporary escape in front of televisions, at bars and in restaurants with friends will go on. The firebomb that brought down the World Trade Center will be a memory.    In historical perspective, the terrorist attacks on the World Trade Center and the Pentagon are not really new; they are part of an evolutionary pattern that continues to metastasize into the social fabric of the Western world. Modern terrorism began in a democracy: In 1793, the French government, after four years of experimenting with the problems of establishing a democratic republic, inaugurated a self-proclaimed "reign of terror" in which tens of thousands of citizens were victimized and executed as "enemies of the revolution." Terror from below began with the Italian Carbonari, small cells of Italian patriots who killed French officers during the occupation of Europe under Napoleon. In 1849, Karl Heinzen wrote the first manifesto on modern terrorism in which he justified the killing of "the barbarians" in government as the only means of ending the injustice and brutality of monarchical rule.

Intramuscular Injection Techniques Essay

The synthesis of art and science is lived by the nurse in the nursing act JQSEPHINE e PATERSON If you would like to contribiito to the art and science section contact: Gwcn Clarke, art and science editor, Nursing Standard, The Heights, 59-65 Lowlands Road, Harrow-on-the-Hill, Middlesex H A l 3AW. email: gwen.clarkeva rcnpublishing.co.uk Intramuscular injection techniques Hunter J (2008) Intramuscular injection techniques. Nursing Standard. 22, 24,35-40. Date of acceptance: October 29 2007 Summary The administration of intrairiLiscLitar (IM) injections is an important part of medication management and a common nursing intervention in clinical practice, A skilled injection technique can make the patient’s experience less painful and avoid unnecessary complications. Intramuscular injections AnIM injection is chosen when a reasonably rapid systemic uptake of the drug (usually within 15-20 minutes} is needed by the body and when a relatively prolonged action is required. The amounts of solution that can he given will depend on the muscle bed and range from 1 -5ml for adults. Much smaller volumes are acceptable in children (Rodger and King 2000, Corben 2005). The medication is injected into the denser part ofthe muscle fascia below the subcutaneous tissues. This is ideal because skeletal muscles have fewer pain-sensing nerves than subcutaneous tissue and can absorb larger volumes of solution because ofthe rapid uptake ofthe drug into the bloodstream via the muscle fibres. This means that IM injections are less painful when administered correctly and can be used to inject concentrated and irritant drugs that could damage subcutaneous tissue (Rodger and King 2000, Greenway 2004). Examples of drugs administered via this route are analgesics, anti-emetics, sedatives, immunisations and hormonal treatments. It is important to recognise and understand potential complications associated with IM injections and that rapid absorption of the drugs may increase these risks (Foster and Hilton 2004). The administration of any medication can present a risk and, therefore, the nurse must be able to recognise the signs of an anaphylactic (allergic) reaction, with signs of, for example, urticaria, pruritus, respiratory distress, shock or even cardiac arrest. Inappropriate selection of site and poor technique can increase the risk of patient injury and lead to pain, nerve injury, bleeding, accidental intravenous administration and sterile abscesses caused through repeated injections at one site with poor blood flow (Rodger and King2000). Author Janet Hunter is lecturer in adult nursing, City Community and Health Sciences, incorporating St Bartholomew School of Nursing and Midwifery, City University, London. Email: j.a.hunter@city.ac.uk Keywords Clinical procedures; Drug administration; Injection technique Tliese keywords are based on the subject headings from the British Nursing Index. Tliis article has been subject to double-blind review. For author and research article guidelines visit the Nursing Standard home page at www.nursing-standard.cD.uk. For related articles visit our online archive and search using the keywords. THE NURSING and Midwifery Council’s (NMC’s) (2007) Standards for Medicines Management state that administration of medicines ‘is not solely a mechanistic task to be performed in strict compliance with the written prescription of a medical practitioner (now independent/supplementary prescriber). It requires thought and the exercise of professional judgement.’ Therefore, the administration of intramuscular (IM) injections requires the healthcare practitioner to possess the knowledge and rationale of the guiding principles that underpin these clinical skills. It is essential that all aspects of these techniques -anatomy, physiology, patient assessment, preparation and nursing interventions – are evidence based so that the nurse can perform safe and accountable practice (Shepherd 2002, NMC 2007). The aim of this article is to update the nurse’s knowledge and skills on injection techniques. This article describes the practical, step-by-step approach for administering IM injections, which will assist nurses to perform this skill safely and competently. NURSING STANDARD Intramuscular injection sites There are five sites that can be considered for IM february 20 :: vol 22 no 24 :: 2008 35 art & science clinical skills: 37 injections (Figure 1). The two recommended sites for IM injections are the vastus lateralis and the ventrogluteal sites (Donaldson and Green 2005, Nisbet 2006). However, when the patient is obese, rhe vastus laterahs is a better option (Nisbet 2006). When choosing an appropriate site for administration, the nurse needs to ensure that the medication will be absorbed. The nurse needs to consider whether the patient is receiving regular ]M injections because the site will need to be rotated to avoid irritation, pain and sterile abscesses. Choice will also be influenced by the patient’s physical condition and age. Active patients are more likely to have a greater muscle FIGURE 1 Sites for intramuscular injections (IM) Mid-deltoid site The mid-deltoid site is easily accessible but due to the size of the muscle the area should not be used repetitively and only small volumes shouid be injected. Tlie maximum volume should be 1ml (Rodger and King 2000). Tlie denser part of the deitoid must be used. It is Lisef j l to visualise a triangle whereby the horizontal line is located 2.5-5cm below the acromial process and the midpoint of the lateral aspect of the arm in line with the axilla forms the apex. The injection is given about 2.5cm down from the acromiai process, avoiding the radial and brachial nerves (Workman 1999, Rodger and King 2000). Dorsogluteal site Tliis a’&3. is used for deep IM and Z-track injections. Up to 4mi can be injected into this muscle (Workman 1999, Rodger and King 2000). Commonly referred to as the outer upper quadrant, it is located by using imaginary lines to divide the buttocks into four quarters. To identify the gluteus maximtis, picture a line that extends from the iiiac spine to the greater trochanter of the femur. Draw a vertical line from the midpoint of the first line to identify the upper aspect of the upper outer quadrant This location avoids the superior gluteal artery and sciatic nerve (Workman 1999, Small 2004). Rectus femoris site This site is used for deep I M and Z-track injections. Between mass than older or emaciated patients, so individuals will need to be assessed to see if they have sufficient muscle mass. If not, the muscles may need to be ‘pinched’ up before the injection (Workman 1999, Rodger and King 2000). Any area or presence of inflammation, swelling or infection should be avoided (Workman 1999). Patient preparation It is important to explain the procedure so that the patient fully understands and is able to give his or her informed consent and co-operation. The discussion should include the choice of site for the injection and information about the medication, action and side effects. The patient can then express any concerns or anxieties relating to the procedure and the patient’s knowledge can be l-5ml can be injected, although for infants this would be 1-3 mi. The rectus femoris is a large and well-defined muscle and is the anterior muscle of the quadriceps. I t is located halfway between the superior iliac crest and the patella (Workman 1999), Vastus lateralis site The vastus lateralis site; used for deep IM and Z-track injections. Up to 5ml can be administered (Rodger and King 2000). The muscle forms part of the quadriceps femoris group of muscles and is located on the outer side of the femur. If is foLind by measuring a hand’s breafh from the greater trochanter and the knee joint, which identifies the middle third ofthe quadriceps muscle (Workman 1999). There are no major blood vessels or structures which could cause an injury in this area (Rodger and King 2000). Ventrogluteal site This site is used for deep IM and Z-track injections. This site is located by placing the palm ofthe nurse’s hand on the patient’s opposite greater trochanter (for example, the nurse’s right palm on the patient’s left hip), then extending the index finger to the anterior superior iliac spine to make a ‘V. The injection is then given into the gluteus medius muscle, which is the centre of fhe V (Workman 1999, Rodger and King 2000). Evaluated. It is important to check whether the patient has any known allergies to identify potential reactions to the medication. FVeparation ofthe equipment All the necessary equipment shouid be prepared before commencing the procedure to avoid any delays or interruptions during rhe procedure. The equipment required for administering IM injections is listed in Box I and preparation of rhe equipment is described in Box 2. The techniques used for administering IM injections are outlined in Box 3. Skin cleansing There are inconsistencies regarding skin preparation for IM injections. It is known rhar cleansing the injection site with an impregnated alcohol swab before an IM injection reduces rhe number of bacteria on the skin (Workman 1999, Lister and Sarpal 2004). However, if rhe injection is given before rhe skin is dry this procedure is ineffective and rhe patienr may experience pain and a sdnging sensation from rhe antiseptic. This may allow entry of bacteria inro rhe injection site and cause local irritation (Workman 1999, Lister and Sarpal 2004). Therefore, when using an alcohol swab ro prepare the skin it should be used for 30 seconds and then allowed to dry (Lister and Sarpal 2004). Some local policies no longer recommend skin cleansing ifthe patient’s skin is physically clean (Little 2000, Wynaden et al2005) and the nurse maintains rhe required standard of hand washing and asepsis during rhe procedure (Workman 1999). Equipment for intramuscular injections I 2. 3. 4. 5. 6. 7. 8. 9. Prescription chart. Prescribed drug to be administered. If required, diluent for reconstitution. Clean tray or receiver for equipment, Syringe of appropriate size (2-5ml), Sterile 21G (green) needle for adult patients. Alcohol-impregnated swab with isopropyi alcohol 70%. Gloves. Tissue or clinical wipe. 10. Clinical sharps container. Preparation for intramuscular (IM) Injection administration The following steps describe the procedure when preparing the equipment for an I M injection. †¢ Wash and dry hands thoroughly with bactericidal soap and wafer or use bactericidal handrub to prevent any contamination of the equipment or medication. Put on gloves. Gloves are required for all invasive procedures including IM injection (Pratt etal2Q07). Check the patient’s prescription chart and determine the: – Drug that is to be administered. – Required dose. – Route for administration. – Date and time of administration. – Prescription is legible and signed by an authorised prescriber. These actions ensure that any risk to the patient is minimised and that the patient is given the right dose of medication at the correct time by the prescribed route (Jamieson et al 2002, Lister and Sarpal 2004). If any errors are noticed withhold the medication and inform the medical team. Check the drug against the prescription chart. As all medications deteriorate over time, check the expiry date – this shows when a drug will no longer be guaranteed to be effective. To prepare the syringe for medication: (a) Check all packaging is intact to retain sterility. Check the expiry date. If any packaging is damaged or has expired, discard. (b) Open the packaging of the syringe at the plunger end and remove the syringe. Make sure that the plunger moves freely inside the barrel. Take care not to touch the nozzle end to prevent contamination. (c) Open the needle packaging at the hilt (coloured) end. Hold the syringe in one hand and then attach the needle firmly onto the nozzle of the syringe. Loosen the sheath but do not remove it. Place the syringe on the tray. This prevents contamination or any potential injuries. †¢ Examine the solution in the ampoule for cloudiness or sedimentation. This may show that the medication is contaminated or unstable. Make sure that all the contents are in the bottom o f t h e ampoule by tapping the neck gently. To prevent injury, splashing or contact with the medication use a clinical wipe or tissue to cover the neck of the ampoule and break it open. Observe the solution for any glass fragments because these pose a risk to the patient if injected. Discard the ampoule and contents if any foreign matter is visible. !f you are using a plastic ampoule, break the top off, making sure not to touch the top. †¢ Pick up the syringe and allow the sheath to fall off the needle onto the tray and insert the needle into the solution of the ampoule. Avoid scraping the needle on the bottom of the ampoule, because this wilt blunt the needle. †¢ Pull back the top of the plunger with one finger on the flange and draw up the required dose. I t may be necessary to tilt or hold the ampoule upside down to make sure the needle remains in the solution to prevent drawing in air (Figure 2). Take care not to contaminate the needle. †¢ Re-sheathe the needle carefully using the aseptic non-touch technique to to maintain sterility (Figure 3). †¢ Expel the air. Hold the syringe upright, at eye level and let any air rise to the top of the syringe To encourage air bubbles fo rise, lightly tap the barrel ofthe syringe. Slowiy, push the piunger to expel the air until the solution is seen at the top of the needle. Needles Re-sheathing a needle betore the medication is administered to a patient is safe. This method is achieved hy using the aseptic non-touch technique (Figure 3) and prevents droplets of the medication from heing sprayed onto the skin or inhaled when air is heing expelled from the syringe (Nicol etal 2004). When giving an !M injection a ‘green’ or size 21 gauge needle is used for all adult patients to ensure that rhe medication is injected into the muscle. This also applies to patients who are cachectic or thin, except that the needle is not inserted as deeply. If a smaller gauge needle is used the nurse needs to apply more pressure to inject the solution, which will increase the patient’s discomfort (King 2003). Single and multi-dose powder vials Some medications come in single or multi-dose vials and need to he reconstituted before heing drawn up and mjected. The following steps should be undertaken when administering I M injections to patients: †¢ Take the tray with the syringe, ampoule, impregnated alcohol swab, tissue, prescription and sharps container to the patient’s bedside. Re-check the prescription and medication with the patient’s name band according to local policy. Draw the curtains for privacy and assist the patient into a comfortable position to allow access to the injection siteandto make sure that the identified muscle group is flexed and relaxed. †¢ Clean the skin with an impregnated alcohol swab for 30 seconds and then allow to dry to minimise the risk of infection (Lister and Sarpal 2004), or alternatively it should be cleansed in accordance with local policy, †¢ With the non-dominant hand stretch the skin slightly over the chosen injection site to displace the underlying subcutaneous tissues and to aid the insertion of the needle. †¢ With the dominant hand hold the syringe like a dart Having informed the patient, quickly and firmly in a ‘dart-like’ motion insert the needle into the patient’s skin at a 90 ° angle until approximately 1cm of the needle is left showing (Nicol et al 2004, Corben 2005) (Figure 4). †¢ Hold the skin with the ulnar edge of the hand and with the thumb and index finger hold the coloured part of the needle to maintain stability and prevent movement. †¢ Withdraw the plunger slightly to confirm that the needle is in the correct position and has not entered a blood vessel. If blood is not present, depress the plunger and carefully inject the solution at a rate of 1ml per 10 seconds until the syringe is empty to allow the tissues to expand and absorb the solution (Workman 1999, Lister and Sarpal 2004). This rate also reduces patient discomfort. If blood is present stop the procedure and withdraw the needle and syringe. Start again with new equipment and drug and explain to the patient what has happened to reduce patient anxiety. †¢ Wait ten seconds to allow the drug to diffuse into the tissues then quickly and smoothly withdraw the needle. Use a tissue to apply pressure to the injection site or until any bleeding ceases. It is not necessary to massage the area because this may cause the drug to leak from the injection site and cause local irritation (Rodger and King 2000). †¢ Discard the needle and syringe immediately into the sharps container to prevent any injury. Do not re-sheathe the needle. Remove gloves and wash hands, †¢ Record the administration of the medication on the prescription chart to show that the drug has been given. Report any abnormalities or complications. †¢ Replace any clothing and make sure that the patient is comfortable. Return to the patient after 15-20 minutes to observe and check the effectiveness ofthe medication, especially anti-emetics and analgesics. Observe the injection site within two to four hours for signs of local irritation {Rodger and King 2000), involves some key principles to ensure safe practice. †¢ Before reconstiruting any medication, the nurse should first read rhe manufacturer’s information sheet. †¢ It is important that the powder is at the bottom of the vial so thnt all the medication is dissolved. †¢ The cap must be cleaned with an alcoholimpregnated swah and allowed to dry to prevent bacterial contamination. * It is vital that the correct volume of diluent is used according to the manufacturer’s recommendations to provide the most therapeutic concentration. †¢ The diluent should be injected slowly into the vial so that the powder Is wet before mixing. †¢ When mixing, ensure the needle remains inside the vial to maintain sterility. If there is pressure In the vial hold the plunger down while doing this to avoid the separation ofthe needle and syringe from the vial {Nicol etal 1004}. To mix the medication, agitate or roll the vial until the powder has dissolved. For some powder multi-dose vials, a needle is inserted into the cap before adding the diluent because this allows air to escape and releases the vacuum in the vial. Then with a second needle and syringe, inject the diluent into the vial. Remove the needle and syringe and place a sterile swab over the venti ng need le to prevent contamination ofthe drug and the atmosphere. Agitate or roll the ampoule until the powder has dissolved (Jamieson etal2002., Lister and Sarpal 2004). All solutions need to be inspected for precipitation and cloudiness. Continue to agitate until the powder and diluent have fully mixed to form a solution. †¢ Todrawuprhedrug, hold the ampoule upside down to avoid drawing in air, insert the needle so that it is below the level ofthe solution and pull back the plunger to withdraw the correct amount of solution. For multi-dose vials, clean the cap with an impregnated alcohol swab and allow to dry before inserting the needle and syringe to prevent bacterial contamination.

Symptoms And Diagnosis Of Dementia - 987 Words

An estimated 47.5 million people suffer from dementia. Every 4 seconds one new case of dementia is diagnosed. Dementia is a term that describes certain symptoms such as impairment to memory, communication and thinking. It is a group of symptoms and not just one illness. Even though one‘s chance of getting dementia increase with age, it is not a part of aging. Dementia is usually diagnosed after a series of assessments that includes a physical evaluation, memory tests, imaging studies and blood work. It affects three aspects of one’s mental function, cognitive dysfunction (Problems with memory, language, thinking and problem solving), psychiatric behavior (changes in personality, emotional control, social behavior and delusions) and difficulties with daily living activities (driving, shopping, eating and dressing). â€Å"The median survival time in women is 4.6 years and in men 4.1 years† (Warren, 2016). Dementia symptoms most commonly observed by people wo uld be memory loss and an inability to complete simple mental activities such as adding or subtracting or remembering where things were placed, or a difference in a person’s normal behavior. There are times that a person without dementia will experience similar symptoms but, the difference is if these symptoms persist and do not go away after a period of time. Dementia isn’t something that happens quickly it is an illness that gets progressively worse as time passes. When a person that is effected with these symptomsShow MoreRelatedAnalysis and Description of Dementia Essay1741 Words   |  7 PagesDementia is characterized as a condition where the mental processes of cognition and memory start to deteriorate. It is described as a syndrome that hinders the daily lives of those who have it and is characterized by memory and thinking impairment. The most common form of dementia is Alzheimer’s Disease and the second most common is vascular dementia. Dementia is a syndrome occurring usually, but not limited, to people over the age of 40 and is due to brain damage caused by natural deterioratingRead MoreRole Of General Practitioners And Primary Care Providers1681 Words   |  7 Pagesgeneral practitioners/primary care providers in diagnosing dementia Primary care physicians (PCP) play a crucial role in dementia diagnosis. Older patients receive healthcare primarily from their general practitioners (GPs). [51, 52] Most patients and carers prefer their GPs to be the first source of professional help when dealing with dementia. [53-55] The Australian guidelines advocate early diagnosis by timely exploration of symptoms raised by patients and carers. [14] It would be reasonable forRead MoreSymptoms And Symptoms Of Dementia935 Words   |  4 Pagesâ€Å"Worldwide, 47.5 million people have dementia and there are 7.7 million new cases every year† (WHO). Dementia is not a specific disease. Instead, it is a broad term used to describe a wide range of symptoms that impact one’s daily functioning (ALZ). These symptoms are associated with memory, thinking, and social abilities (Mayo Clinic). While signs and symptoms of dementia can differ based on the cause, there are several common cognitive and psychological changes that occur. Common cognitive changesRead MoreEarly Signs Of A Progressive Dementia784 Words   |  4 Pagesprogressive dementia often bring discord to families, because siblings disagree on what is really wrong and chalk up the changes they are seeing to depression, boredom, a recent illness or even â€Å"allergies†. One of the family members usually suspects something like â€Å"Alzheimer’s† but the other disagree thus diagnosis is delayed. Early dementia is also known as MCI (Mild Cognitive Impairment) and only about half of those with this diagnosis move on to one of the more progressive dementias. So, it isRead MoreDiagnosing and Living with Dementia737 Words   |  3 Pagesthe first symptoms of dementia such as memory loss or problems with language lead to a diagnosis of the illness over varied amounts of time. It is not possible to get medication before the diagnosis. Therefore, diagnosing dementia early enables to have access to treatment, information and care. Yet according to the Department of Health, only 46% of the population living with the illness is diagnosed in the UK. The borough of Islington has an especially high rate of dementia diagnosis, with aboutRead MoreThe Differences Between Dementia And Alzheimer s Disease1162 Words   |  5 PagesWhen a lot of people think about dementia or Alzheimer’s disease, they usually use the two interchangeably and think they have to do with memory. It is tr ue that they have to do with memory, but there are major differences between dementia and Alzheimer’s disease. Misconceptions and lack of knowledge can lead to death or injury, which is why initiatives like Healthy People 2020 are so important. Dementias and Alzheimer’s affect a person’s daily life in many ways and it can be dangerous or deadlyRead MoreEssay on Understanding Dementia in the Elderly532 Words   |  3 PagesDepression, and Dementia are some of the most common psychological diagnoses in the elderly today. The three D’s are difficult to differentiate between in older adults because they overlap with each other and can all exist in the same patient at once. Delirium, Dementia, and Depression all affect the elderly’s quality of life and often increase the risks for one another (Downing, Caprio Lyness, 2013). For the purpose of this paper I will be focusing primarily on the diagnosis of Dementia, the preventionRead MoreDiagnosis And Tre atment Of Alzheimer s Dementia1329 Words   |  6 PagesAbstract Alzheimer’s Dementia is one form of dementia. It affects over five million people in the U.S. alone (Latest Facts Figures Report, 2014). Alzheimer’s is a group of symptoms caused by diseases or disorders. Every 67 seconds someone develops Alzheimer’s in the U.S. (Latest Facts Figures Report, 2014). Alzheimer’s can take 7-10 years to fully develop. During development the brain reduces in size. Being diagnosed with Alzheimer’s changes the patient’s life significantly. He or she must makeRead MoreUnit 14 P3 M11314 Words   |  6 Pagesthe investigations that are carried out to enable the diagnosis of these physiological disorders. For the merit this assignment will assess possible difficulties involved in the diagnosis from their signs and symptoms. P3 There are a range of tests and diagnostic procedures  is needed to diagnose dementia, but there are several that are fairly commonly used to diagnose dementia. A GP might refer a person to a specialist to help with the diagnosis. For example, they may be referred to a clinical psychologistRead MoreSymptoms And Treatment Of Frontotemporal Dementia995 Words   |  4 Pagesappropriately labeled as Dementia. However, not all areas of Dementia are reserved for the elderly. Frontotemporal Dementia (FTD) is a rather extreme case of the all-encompassing term Dementia. FTD is caused by loss of neurons in frontal and temporal regions of the brain (Kring Johnson, 2015). The loss of these neurons actually causes the affected regions of the brain to shrink and ultimately leads to death; death usually occurs within five to ten years of the onset of symptoms (Mayo Clinic, 2014;