Feeding tube case study

Feeding tube case study I. Feeding Tube Case Study The two cases in question here have several similarities and differences. The two cases are similar because they are dealing with two elderly patients who are not in a position to take care of themselves. In the first case of Eleanor Dawson who is 92 years old, apart from having a urinary tract infection and developing a large pressure on her coccyx, she is also suffering from senile dementia which is further worsening the case at hand. Senile dementia which is a disease characteristic of old age, affect brain cells and thus resulting to progressive memory loss and mental abilities. There is no known cure for this disease.   As a result, the patient is difficulties in reasoning and accepting new things making her completely incapable of self care including bathing and eating. This is the reason why the doctor the order has ordered that a feeding tube to be used on Eleanor who has ultimately refused. The second case involves Helen Jefferson who is 88 years old and suffering from a t erminal illness (untreatable breast cancer). Her cancer has spread to several parts of her body including bones and lungs. As a result she has given up hope on her life and she is ready to die. Consequently, she refuses to eat and that is the reason why the doctor has ordered a nasogastric feeding tube for her. This makes the two cases similar in that, it involves two elderly women suffering from untreatable diseases. Both of them also have refused to eat and both refuse feeding tubes to be used on them (Newson Aldous, 2005). These two cases are however different in the sense that Eleanor is suffering from senile dementia which means that she cannot reason normally. As a result her rejection of the feeding tube is absolutely normal because patients with that type of disease refuse to accept new things. Helen on the other hand understands clearly the consequences of her actions and she is refusing to eat intentionally which makes her case different from that of Eleanor. These two cases are however very complex due to their legal implications. First, it is a crime to allow someone to die from dehydration or starvation in our state and hence it is a must to report such incidents. Secondly, there is a living will statute in our state which mandates all the nurses and doctors to respect incompetent patients wishes. The last complication in these cases is the fact that both of the patients have living wills stating that they do not wish to be maintained on life support devices such as a ventilator. The appropriate action to take in such a scenario is to report these two incidents to the relevant authorities, explaining the legal complications surrounding these two cases, conclude by asking for permission to be allowed to use feeding tubes on these two patients since they will both die of starvation if not fed through the tubes because they are not in a position to feed themselves (Newson Aldous, 2005) II. Malpractice Case Study In this case, I think the nurse is liable for the patient injury because they would not have occurred if   she had ensured that her assistant had clearly understood what she meant by placing a hot water bottle on the patients left lower leg. Assumption/omission is one of the mistakes nurses should never make in their profession. She would have clearly explained the procedure to the assistant and make a follow up after a while to ensure that the instructions were followed to the letter. Since she omitted giving her assistant the right instructions, the patient was injured hence making her liable for the injury (Dimond, 2005). All elements of malpractice were present in this case because: the care provided by the nurse to the patient did not meet the standard of care required of her (breach of duty of care) secondly the nurse had accepted to care of the patient (Abele, 2004) and hence she was supposed to treat him with care and diligence which she did not do (duty of care), thirdly if standard care would have been followed to take care of the patient injury would not have occurred (proximate cause), and finally whatever happened was careless and inappropriate behavior on the part of the nurse which resulted to injury (injury was proved) (Morissette, 2008). References Abele, J. R. (2004). Medical errors and litigation: investigation and case preparation.   UK: Lawyers Judges Publishing Company Dimond, B. (2005). Legal aspects of nursing. New York: Pearson Longman Morissette, E. L. (2008). Personal Injury and the Law of Torts for Paralegals. New York: Aspen Publishers Online Newson, L., Aldous, J. (2005). The Legal Maze: VCE Units 1 and 2. South Melbourne: Macmillan Education Aus.

The City of Londons Financial Services and Markets :: Essays Papers

The City of London's Financial Services and Markets 1. The City of London’s financial Services and Markets: The City of London is one of the world’s three leading financial centres, along with Tokyo and New York, and is by far the largest in Europe. While New York and Tokyo rely on very large domestic economies to fuel their business, London’s success can be attributed to its international business. Major financial institutions and markets in the City include the Bank of England, the London Stock Exchange, Lloyd’s insurance market, and the London International Financial Futures and Options Exchange. 1.1 Facts and figures of Britain’s financial services industry: ï‚ · There are more overseas banks in London than in any other city in the world: 555 branches, subsidiaries and representative offices at the end of February 1999. ï‚ · Financial services account for almost 7 per cent of Britain’s Gross Domestic Product (GDP). ï‚ · Net overseas earnings of Britain’s financial sector reached a record  £25,200 million in 1997. ï‚ · The London Stock Exchange is the largest market in the world for trading foreign equities, accounting for 63 per cent of global turnover. ï‚ · London is one of the world’s three major international bond centres. Some 70 per cent of international bond trading in the Euromarket take place there. ï‚ · It has by far the biggest foreign exchange market in the world, handling about 32 per cent of worldwide dealing, and with an average daily turnover, which is more than that of New York, and Tokyo combined. ï‚ · It is one of the world’s largest international insurance markets, with a leading share of aviation and marine insurance. ï‚ · It is the largest fund management centre. ï‚ · It is the world’s most important centre for advice on privatisation. Supervision and regulation 2. Financial markets: 2.1 The Stock Exchange: This is one of the world’s oldest marketplaces for the buying and selling of shares, but its advanced trading systems mean it is also one of the most modern. It is the world’s leading marketplace for international shares – more international companies choose to list in London than on any other exchange. It therefore plays a vital role in maintaining London’s position as a major financial centre. The main market is where most British and international shares are listed, while the Alternative Investment Market (AIM), established in 1995, is for younger and fast-growing businesses.

I wonder if Princeton should be poorer Essay

â€Å"l wonder if Princeton should be poorer. † BY akp1993 If you’re a high school senior trying to seduce the admissions officer reading your application essay, this may not strike you as the ideal opening line. But Shanti Kumar, a senior at the Bronx High School of Science, went ahead anyway when the university prompted her to react in writing to the idea of â€Å"Princeton in the nation’s service and in the service of all nations. † Back in January, when I asked high school seniors to send in college application essays about money, class, working and the economy, I wasn’t sure what, if anything, ould come in over the transom. But 66 students submitted essays, and with the help of Harry Bauld, the author of â€Å"On Writing the College Application Essay,† we’ve selected four to publish in full online and in part in this column. That allowed us to be slightly more selective than Princeton itself was last year. What these four writers have in common is an appetite for risk. Not only did they talk openly about issues that are emotionally complex and often outright taboo, but they took brave and counterintuitive positions on class, national identity and the application process itself. For anyone looking to inspire their own children or grandchildren who are seeking to go to college in the fall of 2014, these four essays would be a good place to start. Perhaps the most daring essay of all came from Julian Cranberg, a 17-year-old from Brookline, Mass. One of the first rules of the college admissions process is that you don’t write about the college admissions process. But Mr. Cranberg thumbed his nose at that convention, taking on the tremendous cost of the piles of mail schools send to potential students, and the waste that results from the effort. He figured that he received at least $200 worth of pitches in the past year or so. â€Å"Why, in an era of record-high student loan debt and unemployment, are colleges not reallocating these ludicrous funds to aid their own students instead of extending their arms far and wide to students they have never met? † he asked in the essay. Antioch College seemed to think that was a perfectly reasonable question and accepted him, though he will attend Oberlin College instead, to which he did not submit the essay. â€Å"It’s a bold move to critique the very institution he was applying to,† said Mr. Bauld, who also teaches English at Horace Mann School in New York City. â€Å"But here’s somebody who knows he can make it work with intelligence and humor. † college that sent him a DHL â€Å"priority’ envelope, noting inside that he was a priority to the college. â€Å"The humor here is not in the Jokes,† Mr. Bauld added. â€Å"It originates in a critical habit of mind, and the kind of mind that is in this essay is going to play out extremely well in any class that he’s in. † Admissions professionals often warn people not to think that they can write their way into the freshman class. The essay is one document that, even in the best of circumstances, is written by an individual telling one story,† said Shawn Abbott, the assistant vice president for undergraduate admissions at New York University. â€Å"l don’t believe that any one writing sample should trump what they did over four years. † Still, he acknowledged that his staff had been taken with the story told by Lyle L’, a 19-year-old Brooklyn resident who applied this year. He wrote about his familys restaurant and his mother, an immigrant from China who once wanted to be a doctor and now works behind a cash register. When I visit my friends, I see the names of elite institutions adorning the living room walls,† wrote Mr. Li, a senior at Regis High School in Manhattan. â€Å"l am conscious that these framed diplomas are testaments to the hard work and accomplishments of my friends’ parents and siblings. Nevertheless, the sight of them was an irritating reminder of the disparity between our households. I was not the upper-middle-class kid on Park Avenue. Truth be told, I am Just some kid from Brooklyn. Instead of diplomas and accolades, my parents’ room emits a smell from the restaurant uniforms they wear seven days a week, all year round. â€Å"

Families And Families Of The 21st Century - 819 Words

Families are the basic unit of a well structured society. The way a family functions, â€Å"ensures a society survival† (Parson and Bales, p. 6). On one side of the spectrum, a person can agree that today s families have become dysfunctional or even out of touch with one another because of the perplexities in their family. This can be a decisive factor in why our society today is facing dilemmas all so frequently. This perception can emerge the idea that families is now declining. However, families today have faced tremendous amounts of changes throughout the decades which certainly resulted in eminence in families. Particularly fathers, have shifted their roles in families. Not to mention, mothers and children, are thriving in families today. The structure of families is now changing for the better. Families today can be seen as resilient because of it. Declining and resilience of families are vast components that can be applied in families of the 21st century. One can assume that families are now declining. For families to be considered declining, there has to be disincentive in the family or some hindrance apparent. It can be suggested that families have somehow drifted apart. Barbara LeBey (2005) stated â€Å"american families are drifting apart†( p. 7). LeBey also reveals that there are numerous reasons why families are drifting apart: â€Å"petty grievances to deep-seated prejudices, misunderstandings to all-out, jealousies, sibling rivalry, inheritance feuds, family businessShow MoreRelatedThe 21st Century Modern Family1912 Words   |  8 PagesThe 21st Century Modern Family The 21st Century Modern Family Let us review a global institution. The family is an institution found in every culture of society on earth. Families around the world live, love and work in uniquely different ways depending upon their cultural norms. Vissing says that over the life course every person has a family – even if it is a family of one (Vissing, 2011). 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