What is a Self-injurious Behavior

The incident which I have chosen for my Nursing Project happened on the last day of my learning difficulties placement. It involved a young Autistic man, who I will refer to as ‘John† throughout my assignment. This is to protect the client†s identity, this is in accordance with the UKCC Code of professional conduct (1992) clause 10: â€Å"Protect all confidential information concerning patients and clients obtained in the course of professional practice and make disclosures only with consent, where required by the order of a court or where you can justify disclosure in the wider public interest.† One incident which I believe highlights the problem I will address, involved myself bathing ‘John†. This was not the first time that I had bathed a person during the placement, however, the difference this time was that while I was washing ‘John†, he would display elf-injurious behaviour by slapping his face and then repeating the phrase ‘stop slapping face†. I chose this incident from my clinical diary as I feel that the self-injurious behaviour that ‘John† exhibited is an interesting and difficult Nursing problem and one, which affected my ability to care for him. Rather than focussing on the self-injury specifically related to ‘John†s† case, I will examine the possible ways to manage self-injurious behaviour, especially in persons with learning disabilities. To manage this problem effectively, a multi-disciplinary approach is required, but for the purposes of this essay I will look at the problem from a Nurse†s perspective. I will begin by giving a brief description of self-injurious behaviour and the possible causes. I will then highlight the different techniques available to Nurses for the management of this behaviour. Murphy and Wilson(1985) define this as: â€Å"Any behaviour initiated by the individual, which directly results in physical harm to that individual.† As is apparent in the literature, self-injurious behaviour is referred to as any behaviour that can cause tissue damage, such as bruises, redness, and open wounds. The most common forms of these behaviours include head banging, hand biting, head-slapping, and excessive scratching. There are two main sets of theories on the subject and these concentrate on physiological or social causes. The main physiological theories are: Self-injurious behaviour releases beta-endorphins in the person†s brain. Beta-endorphins are opiate like substances in the brain, which provide the person with some pleasure when released. Sudden episodes of self-injury may be caused by sub-clinical seizures. Sub-clinical seizures are not typically associated with the behaviours of normal seizures by they are characterised by abnormal EEG patterns. May be caused by over arousal such as frustration. Self-injury acts as a release, and thus lowers arousal. Self-injury may be a form of self-stimulatory, stereotypic behaviour. Some people exhibit self-injury to escape or avoid a task. Self-injurious behaviour may be used as an attention-seeking device. An incident that involved ‘John† which illustrated the difficulty in managing self-injurious behaviour, was when an object he was obsessed with, was removed. This was using a punishment strategy which I will discuss later. This was thought to be the best course of action, but it lead to ‘John† being restrained for nearly an hour, followed by him being sedated with an intra-muscular injection of chlorpromazine. What can learned from this is that it demonstrates the need for careful assessment of the individual. As highlighted by Murphy and Wilson(1985): â€Å"The treatment selected will depend on how the self-injurious behaviour originally developed and what factors maintain it.† There are a wide variety of different strategies or factors involved in treating or managing self-injurious behaviour. These include restraint, pharmacotheraphy, behavioural therapy, inter-personal strategies, normalisation and environmental factors. I will now examine in turn each of these strategies or factors. This is the most effective way of dealing with self-injurious behaviour in an emergency but there are a number of problems that can arise. Firstly, restraint raises some ethical questions, such as does someone have the right to injure themselves? This dilemna and others related to this topic are difficult to answer, but in general we make the assumption that the client is not capable of choosing for themselves. Secondly, the use of restraint present devaluing images of the client. Thirdly, they involve the violation of personal space which is usual for everyday social interaction. This can lead to a detrimental effect on the nurse/client relationship. Furthermore, there is the risk of injury to staff and to the client. Also there is the possibility of staff being accused of abuse, this is highlighted by Jones and Eayrs(1993): â€Å"Care staff may well face allegations of client abuse associated with the use of restraint.† There are some drawbacks in the use of restraint but it is an essential tool available to the Nurse in the management of Self-injurious or challenging behaviour. A number of drug treatments were used at Woodlands namely Chlorpromazine and Hapliperidol. These were reasonably effective but with these drugs there are serious side effects. As stated by Bernstein et al(1994): â€Å"Serious side effects include symptoms similar to those of Parkinson†s disease, such as muscle rigidity, restlessness, tremor and slowed movement.† These side effects can be treated with anti-Parkinson drugs. When trying to manage inappropriate behaviour using psychoactive drugs they should only be used as an integral part of the client†s programme. For example to combine Pharamacotherapy with other strategies such as behavioural treatments. In general behavioural approaches to treatment seem to be the most effective and long lasting ways of managing violent and aggressive behaviour. A reason for this is suggested by Murphy Wilson( ): â€Å"The fact that the ‘learned behaviour hypothesis† is one of the most convincing hypotheses for explaining the development of self-injurious behaviour.† This term covers a variety of different approaches but some of the main methods are positive reinforcement, modelling, extinction, aversive conditioning and punishment. This means, in the context of my essay, reinforcing or strengthening any behaviour that is not self-injurious. An example of this is raised by Bernstein et al (1994): † Autistic children, who, use very little language, were rewarded with grapes, popcorn, or other items for saying ‘please†, ‘thank you† and ‘your welcome† while exchanging crayons and blocks with a therapist.† This is defined by Bernstein et al(1994) as: â€Å"The gradual disappearance of a conditioned response or operand behaviour due to elimination either of the association between conditioned and unconditioned stimuli or of rewards for certain behaviours.† In the case of treating self-injurious behaviour it can be effective, but it is not always possible to use this method, because, firstly the client may seriously injure himself before the behaviour disappears. Secondly, if the reason for the behaviour is self-stimulation, it may not be possible to remove the source of reinforcement. This is basically a method of therapy in which desirable behaviours are demonstrated as a way of teaching them to clients. This method employs classical conditioning principles to link physical or psychological discomfort with undesirable behaviours. An example of this by Bernstein et al(1994) is: â€Å"Alcoholics might be allowed to drink after taking a nausea-producing drug, so that the taste and smell of alcohol are associated with nausea rather than the usual pleasurable feelings.† This was used extensively at woodlands. The main way in which clients were relaxed was through the use of a ‘sensory room.† This was basically a room that contained various lights, music and tactile objects designed to relax the client. The ‘sensory room† was extremely effective at woodlands and was an invaluable apparatus in the management of violent or aggressive behaviour. This kind of strategy involves penalising any behaviour considered to be inappropriate. These were used at Woodlands, sometimes they were effective, but in one case regarding ‘John† it seemed to make matters worse, leading to him to require to be sedated. In general punishment strategies should be used in conjunction with reinforcement of desirable and non-injurious behaviours. This is an important strategy in the treatment of challenging behaviour. It is the way in which a Nurse communicates verbally or non-verbally with the client. It is recognised that inappropriate behaviour from carers can instigate or maintain aggressive behaviours. The important factors as indicated by my research are eye contact, posture, touch and how the nurse actually speaks to the client. From my research I have found that there is a great deal of contradictory advice when dealing with an aggressive client. For example there is some evidence that remaining calm is the best thing to do but Breakwell(1989) cited by Jones and Eayrs(1993) suggests that: â€Å"The assailant who shouts is shouted at: calm intensity is greeted with equal intensity.† What is obvious is that when dealing with a client, interpersonal strategies are extremely important, but there is no right or wrong way. This is defined by Bank-Mikkelson (1980) cited by Murphy and Wilson(1985) as the need to: † Create an existence for the mentally retarded as close to normal living conditions as possible† This means to make conditions of education, housing, work and leisure to as near normal as possible and to bring greater equality of rights, obligations and responsibilities under law. Although it is not necessarily related with the treatment of someone who presents challenging behaviour, it is an important factor in considering the overall care of the client. This is providing an environment safe from potential factors, which may cause challenging behaviours. Some of these negative environmental factors may be things like loud noise, absence of attention, aggression from other residents, isolation or not enough space.

English as an Official Language for the US Essay

â€Å"Do we really need another bureaucracy controlling how and what we speak?† (â€Å"English Should Not Be the Official Language of the United States.† n.d.) I think when the government makes English as an official language, people could have a chance to choose what language they want use in their homes. It was surprising to me when I found out that the U.S.A does not have an official language. Although English is many people’s native language, it also often used for business. For me, I think the U.S.A should declare English as an official language for many reasons. When I asked some Americans about their opinion, they said U.S.A is a country of freedom, which means there can be no laws that do anything to take the freedom from American citizens, accordingly they are against making English an official language. I think if the country makes English as an official language, it would not affect the freedom because people can speak another language at home, they just will use English as an official language. English is the global language is one of the reasons to make English as an official language of U.S.A. Around the world people usually learn English in their school. For example, in my country, which is Saudi Arabia, we study English from the fourth year of school until graduation. By making English the official language citizens could still keep their freedom while government declare English as an official language. English is already lingua franca of the United States. Lingua franca means a popular language that is used throughout the country. Many people in U.S.A use English as a first language. Another example, pilots have to learn English to use it when they fly. Another example is in Saudi Arabia, which is my country, the doctors have to learn English and that’s weird how the doctors in other countries, which have Arabic as an official language, must learn English. Being the lingua franca is one of the reasons, which I think it would make sense for the US government to declare English as an official language. The government could save money if they declared English as an official language. â€Å"The report finds that the federal government has spent US$4.5 billion on outsourced language services since 1990.† (â€Å"Common Sense Advisory Home.† 1/10/2011.) Depend to this fact the U.S. could have saved $4.5 billion in translation services from 1990 until 2009 if it had declared English as the official language. This includes translation for 911, hospitals, and other services. Also, the economy could benefit if the United States declare English as an official language because most tourists use English as a second language. The government saves money, is just one more reason to argue for English as an official language in the United States. The US would gain international respect as one of the reasons to argue for declaring English as an official language of the U.S.A. When the international community knows the official language in U.S.A is English they would try to learn English before they come. When the visitors learn English before they come, it would help citizens to be able better understand the visitors. Gaining international respect is one of my reasons to support English as an official language in the United States. In conclusion, the U.S should declare English as an official language because Americans can still keep freedoms while promoting national identity. English is already lingua franca. It would benefit the economy and the U.S would gain international respect. For these reasons the U.S should declare English as an official language.

False Advertising Essay - 610 Words

False Advertising Nowadays television and the advertising displayed in it is a part of everyday life in most households. What many people do not know is that television in many ways is bad. Numerous articles have been written on this. Many surveys and books have been written on this subject as well. The ads in television are what are especially bad. Some television ads are misleading. nbsp;nbsp;nbsp;nbsp;nbsp;Countless articles have been written on false advertising on television. Most of these articles target specific instances of fraudulent behavior, but some do address the television industry as a whole. These articles for the most part seem to be complaining about politicians (more so than the advertisers themselves) and the†¦show more content†¦About three quarters of these books include sections on false advertising (generally large ones), the steps taken in preventing it, and how much of it you see every day. I think John Lahr put it best when he said quot;Society drives people crazy with lust and calls it advertising.quot;. What he meant in my opinion was that advertising is simply meant to tease and really has little bearing on real life (other than to sell the product). That ties directly in with false advertising, because if something has little bearing on real life and the companies are trying to say that it does have bearing on real life, it is falsely advertising the product. A good way to demonstrate this would be if every family in America with a television saw one advertisement which twisted the facts approximately 99% of Americas families will have been sold on a product when they are not getting the absolute truth. nbsp;nbsp;nbsp;nbsp;nbsp; Some television ads are misleading. There should be no doubt in your mind about that now. There have been hundreds of books, articles, and surveys written which help prove this. If you turned on your television right now chances are somewhere on it you would find an ad which significantly twists either the image of what the company is selling or actually twisting what the product itself does. You have to look at the very bottom of the screen with a microscope to see that, for instance theShow MoreRelatedThe Effects of False Advertising1798 Words   |  8 PagesFinal Draft: The Effects of False Advertising Since the evolution of communication, media has been used to transmit informations to those willing to absorb it. Now, using powerful technologies such as television or the internet, information has been made accessible to people in every aspect of our daily lives, trying now to influence our choices more than ever before through advertisement. However, for the most, the goal behind advertising is personal profit. 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Antonin Dvorak was a Pariotic, Classical Music Composer

Does the idea of a patriotic classical music composer sound a little odd? Believe it or not, the talented Antonin Dvorak was one such composer. Born in Czechoslovakia, his works were largely inspired by the multitude of folk music presented in his home land, and also by the incredible Christian Reformer John Huss. Even though he was a Czech, he did live in America for about 3 years, and from here he created one of his best works: From the New World symphony. Overall, he can be considered a very key composer in the Romantic period of music. The famed Czech composer, Antonin Dvorak, was born in a Bohemian village of Czechoslovakia on September 8th, 1841 (Carlson Smith, 154). After several years of living and learning music in his home village, eventually Dvorak moved to Prague at the age of 16 to continue his education in music. Pursuing his studies diligently, and after working various odd jobs, he eventually became a professor of music at the Prague Conservatory (Pogue Speck, 64) . While in Prague, he married his lovely wife Anna Cermakova in the November of 1873, and was happily married for the rest of his life to her (Encyclopedia Britannica). Performing all over Prague, eventually Dvorak’s incredible work was discovered by the famed composer Johannes Brahms, who recommended Dvorak to Brahms’ publisher Simrock. Simrock took to liking Dvorak’s works so much, that he agreed to publish works like the Moravian Duets in 1876, and the Slavonic Dances in 1878. These works

The War Of The Revolutionary War - 1078 Words

The most fascinating subject to learn about in History is spies. With the ideas of secret ink and leaving important documents at Dead Drops would be someone’s dream to live. That does not mean that every story of a spy ended up that way. Several spies during the Revolutionary war were hanged if caught. Though, one major traitor in the United States did not get hanged. He escaped to England. The life of spies is quite different then what people imagine. Even the founding fathers of the United States of America played such a drastic role in spying. Like John Jay considered the ‘Father of Counter Intelligence†. George Washington is known for creating the most successful operatives. Overall, the interesting parts in regard to spy is that of Sir Walsingham, the founding fathers, and that of Benedict Arnold, a traitor. Sir Walsingham began the major influence of spying for the later generations in England and Revolutionary America. He spied for Queen Elizabeth during her reign. His major attributes were to find out who tried to threaten Elizabeth’s life. Many assassination attempts are set in action when she is queen. Under Willingham many spy network in foreign countries will be established. Not only this, but many people will have worked underneath him. Walsingham is a man that made sure Queen Elizabeth’s life is safe. Through his massive spying in the ‘Babington Plot, Walsingham uncovered a message a attempt to threaten Elizabeths life. The letter will The founding fathersShow MoreRelatedThe War Of The Revolutionary War1182 Words   |  5 PagesIn battling the British in the Revolutionary War, the American rebels did just as the great French military and political leader, Napoleon Bonaparte advised, â€Å"Never interrupt your enemy when he is making a mistake†. 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Incorporate Exclusion Clause in Comic †Free Samples to Students

Question: Discuss about the Incorporate Exclusion Clause in Comic. Answer: Introduction: The clause mentioned on the docket received by Jane can be described as an exclusion clause. An exclusion clause is used to eliminate or to restrict liability of a party to the contract. An exclusion clause is also a relevant term of the contract (L'Estrange v F Graucob Ltd., 1934). However, the party may rely on an exclusion clause if it follows the statutory requirements and is also in a position to establish that the clause in fact, forms a part of the contract. Therefore, when the parties have signed a contract and an exclusion clause is a part of such contract, then the parties are legally bound by the clause, even if the other party claims that it has not read the clause or did not understand the terms of the contract (Parker v South Eastern Railway, 1877). In the present case, the clause was not effectively incorporated into the contract. The reason was that although the parties have signed the document, but the law also requires that in order to incorporate an exclusion clause in a contract comic is also required that the presence of such sluicing clauses should be brought to the notice of the other party before or while the parties are going to enter into the contract (Thornton v Shoe Lane Parking Ltd., 1970). Even if the clause has been incorporated in the contract in this case, but the law provides that when the signature to an exclusion clause has been obtained on account of a misrepresentation, the party making such representation cannot rely on the clause. If the receipt would not be signed by the parties, it cannot be said that the clause was a part of the contract. The reason is that if the receipt was not signed, it cannot be said that the clause has been incorporated in the contract because it was mentioned at the back of the docket and in small print. In the present case, the representative had assured Jane that the clause is applicable only if the dress would have been made of Satin as it tends to change color after dry cleaning. As Jane's dress was not made of 100% satin, the representative said that there should be no problem. However, this was not true, and the exclusion clause had been incorporated by the store for excluding its liability regarding any type of damage that may be suffered by the clothes of the customers. In this way, the representative had made a misrepresentation and as a result, the store cannot rely on the exclusion clause. The four corners rule has been adopted in Australia as against the idea of fundamental breach. In this case, the court presumes that the parties to the contract will not exclude the liability for any loss caused by the acts that have not been authorized by the contract. On the other hand, if the negligence has taken place during the authorized acts, then the exclusion clause will be applicable (The Council of the City of Sydney v. West, 1965). In this way this rule provides that when a document appears to be complete on the face of the, no outside evidence may be produced to challenge the document. However, the rule is not applicable in the present case because a misrepresentation has been made. References Carlill v Carbolic Smoke Ball Company [1892] EWCA Civ 1 Harvey v Facey [1893] UKPC 1 Hyde v. Wrench (1840) 3 Beav 334 L'Estrange v F Graucob Ltd [1934] 2 KB 394 Parker v South Eastern Railway [1877] 2 CPD 416 Pharmaceutical Society of Great Britain v Boots [1953] 1 QB 401 The Council of the City of Sydney v. West (1965) 114 CLR 481 Thornton v Shoe Lane Parking Ltd [1970] EWCA Civ 2

Integration of the Police Force Essay Sample free essay sample

The local constabulary sections along with the Erie County Sherriff’s are shortly excessively integrated into one force. This paper will speak about three jobs that will originate from this integrating and so three solutions for each one of these jobs. With that there will be drastic alterations. from rank construction. to pay classs. to how they will run as one force instead than different precincts. This means that they have to happen a manner of traveling about this drastic alteration. They live in Erie County were there are New York State Police. Eire County Sherriff’s. and so all the single town. small town. and metropolis constabulary sections. When they switch to Metro Police Department. they will be all one force ( with the exclusion of State Police ) . That means that constabulary officers will be allowed to traverse town lines and patrol anyplace ( with-in ground ) in Eire County. and would non hold to bespeak permission to traverse town lines. We will write a custom essay sample on Integration of the Police Force Essay Sample or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page They can salvage the constabulary section money by interrogating the sections into one. This paper will state how they will carry through this integrating with minimal troubles. This paper will speak about three jobs that will originate from this integrating and so three solutions for each one of these jobs. The first job is with all the sections being meshed into one rank construction is traveling to be messed up. The solution will be that they will merely hold one Chief of Police. but presently have a few twelve. The manner they will come up with the Chief is the individual with the best service record and who has the highest degree of senior status will be the Chief of Police. who will be at Headquarters in Buffalo. NY. Then they will hold three Deputy Chiefs. These three will be formed by the following three Chiefs with the best service record and senior status. They will be broke down into three subdivision of Erie County. One Chief will be stationed in Amherst. NY. another in Buffalo. NY. and so the 3rd and concluding Chief in Hamburg. NY. Each one of these Deputy Chiefs will hold one Police Commander and one Police Captain under them. They will make up ones mind which of the constabulary captains will take the musca volitanss. Any excess heads can travel down to Lieutenant or they will give them their pensions and they will take an early retirement with a little fillip for their grudges. All from there on down all forces will take a demotion a bulk will be demoted to Police officer. Promotions will be based on Seniority and their service record. Each Metro Police precinct will be run by a Lieutenant. The 2nd job with incorporating all the constabulary sections into one is the wage class. There will be maximal overtime of three hours a hebdomad for each officer. Each constabulary officer will work eight hours every twenty-four hours. There will merely be a one-fourth of the officers on the dark displacement compared to the twenty-four hours displacement. Without overtime this means that it is easy to maintain a low budget and salvage money which means that more officers will be employed with less cost than holding fewer officers who are on overtime. Each officers pay will reflect his or her rank in the force. All constabulary officers will be paid the same. all Sergeants will be paid the same. same with all Lieutenants. and so on. This is so we have less convulsion within our force because there will be no issues with wage persons rank. Third job with the integklration of the County and local constabulary sections is how to maintain unity. professionalism. authorization. and order within the force and in public. With the Eire County Sherriff’s. and all local constabulary sections being integrated into one we need new rigorous ordinances to be added to old 1s. First set of new Torahs are that no 1 will state degrading things to another constabulary officer or to a citizen based on gender. race. gender. age etc. Any issues whether it be in house or in public will be addressed by no 1 below the rank of Lieutenant. Anything that is either degrading to or good to anyone publically or in house based on gender or sexual penchants will non be tolerated. If it does go on it will be dealt with thoroughly and is evidences for remotion from the force. Professionalism is everything in the public constabulary force. it shows the citizens that we are a force to cover with if any offenses are committed and it tells them that we will protect them from force no affair what it is. So no vulgar linguistic communication or obscene gestures in public because it shows immatureness and sloppiness which is non what we should hold the public image us as. Each officer will be given a psych rating every two months to prove whether he or she is capable to work with in the force. If for any ground he or she is deamed non suit for responsibility the Lieutenant will read the study ( s ) and will speak to the Psychologist every bit good as the officer and will do the determination to either continue to allow the officer wo rk in the field. delegate him to desk responsibility. take a paid leave of absence for one hebdomad or to allow the officer go. A officer may non utilize his pervious sections rank or rubric to give foreman others around. so if a head is demoted to Lieutenant he may non stamp people around who are higher because that does non travel with rank construction. Any sexual torment and sexual assault will non be tolerated and any officers who are involved will be on wage leave till the job is solved. The Deputy Chief will cover personally with any sexual torment or sexual assault instances that are in house. If a officer is found to hold been wronging person. with due procedure of the jurisprudence. he or she will be let go of instantly. we will non digest this and will prosecute to the fullest extent. If a sexual torment or assault is found to hold been a prevarication so the individual who made the acquisition will be released from the force and will be arrested for a false charge. The local constabulary sections along with the Erie County Sherriff’s are shortly excessively integrated into one force. This paper has named and told how to work out three major jobs that will originate from this integrating and so three solutions for each one of these jobs. This is of import information because in the instance that a constabulary section does acquire integrated into onethere are three jobs listed with their solutions that you can utilize to repair them.