Learning Disability Nurse Reflection

Learning Disability Nurse Reflection Summary reflection –Modules 5 9 Working as a learning disability nurse, poses a career fraught with many interesting and often frustrating challenges. However, this is a population that cannot be ignored or slighted medically just because they present with special needs (DOH 2001). Emerson et al. (2001) state that 2.5 – 3% of the population in the UK are among the learning disabled, with 30% of these individuals presenting with categorically severe or profound learning disabilities. Emerson et al. (2001) also tell us that frequently multiple learning disabilities present in the same individual, including physical and/or sensory impairments, physical or sensory disability and/or behavioural difficulties. The five modules presented an opportunity to explore various aspects of this specialty area and reflect on the experience on a module by module basis. The act of revisiting the individual reflection pieces to present the current summary essay allowed for not only intellectually experiencing what I wrote, but it also allowed me to re-experience each situation and gain a new appreciation for the patients I worked with, the teams I took part in, the pros and cons of each situation and what I have learned that will be immediately applicable to a real world work environment. Importance of reflection Driscoll and Teh (2001) tell us that practitioners can gain a stronger understanding about various interventions and protocols used, as well as reviewing the situation specifics of each incident, through the process of reflection. In particular, Foster (1985) stressed the importance of using a journal for purposes of written reflection on nursing practices and procedures in order to help clarify issues and make them more real and visual. Gardiner and Lawley (1995) believe that self awareness, one of the outcomes of nursing reflection, can enable staff to recognise the skills they employ and add meaning to their interactions with peers, team members and clients/patients. There were many positives and negatives I experienced on a module by module basis, but in summary, these will be presented thematically. Achievements Module Five offered the opportunity to gain insight into the lifestyle experienced by those with learning disabilities. Similarly, Module Seven provided much needed and interesting information on the role of special health needs observed in those with special needs. This enabled me to make a difference for a client with diabetes through the development of a health care action plan that included the client’s smoking cessation; something the social worker assigned to the case was no knowledgeable of. It was quite exciting to improve my communication skills throughout the five modules. For example, I was able to improve my rapport with other colleagues and various multidisciplinary healthcare professionals as well as clients as I achieved Module Nine communication based learning objectives. Godsell and Scarbrough (2006) comment communication skills are essential for healthcare practitioners. I believe they are even more critical for those working with the learning disabled. Another example was the ability to communicate effectively myself and help others, such as residential home management, communicate with a specific autistic client experiencing difficulty in choosing daily activities based on his disability. I was able to include this client in the decisions made which is critical to empowering the client with a sense of self. Similarly, during Module Five, I worked with a cerebral palsy client who was screaming due to discomfort; that was her mode of communication, which at th e time I failed to recognise, but upon reflection now know actions as well as words are important modes of communication for those with learning disabilities. Shortcomings In general, a major negative I encountered was feeling I was used as â€Å"the help† rather than as a student nurse during my placement. This limited my ability to contribute and to grow personally and professionally. This was particularly evident during Module Five. Similarly, during Module Eight I was faced with a situation creating a significant amount of stress with no stress management advice or training opportunities from which to learn how to effectively cope. Contrary to Davidson’s (2001) research, there were no in-house stress management training opportunities to take advantage of. There was a sharp discrepancy in Module Nine when reviewing the Valuing People (2001) discourse in relation to people with learning disabilities (PWLD) between what was written in the document and what I experienced at work; whereas the document stresses the rights inherent for all people be extended to PWLD, it was my experience that daily patients and clients were denied access to services due to budgetary measures rather than expressing interest in people’s rights to quality healthcare and a quality standard of life. Gates (2003) tells us those with learning disabilities have rights and should be encouraged to attain respect and reach their potential. Challenges/Learning opportunities One of the main challenges I experienced in the module series, particularly with Module Five, was relating theory to practice. However, through additional research and self motivated learning I was able to bridge the gap. I also experienced a number of personal and professional challenges that I believe helped me become a stronger person and future professional. For example, at the beginning of Module Six, my mentor informed me he would not be available to me. This was very frustrating and upsetting as I knew without the help of a mentor, it would be very difficult to achieve the specific learning objectives outlined. However, I was able to turn this situation into a positive by becoming an active contributor to my own educational process by learning, understanding and solving real life problems (Kaufman, Mann Jennet 2000). Similarly, in Module Nine, I found several of the teaching styles challenging, but that helped to develop my research skills and allow me to make contributions in the group and EBL sessions. This also helped to develop my learning and presentation skills. An additional challenge in Module Nine was situation I encountered when viewing a medication administration concern at work. While I informed my manager of the situation, the team had a negative reaction rather than positive which would have been consistent with concern over patient/client care. Thomas, Mason and Ford (2003) tell us it is difficult for workers to become whistleblowers, especially in situations related to patient/client care or maintaining standards of care. This was an even more difficult challenge for me as I was only a student with limited status in the work environment. This was similar to the situation I found myself in during Module Seven when the community care social worker appeared to be neglecting the client’s diabetes, which is inconsistent with the General Social Care Council (2002) code of practices. I felt I was caught in the middle being a student making suggestions and pointing out care inconsistencies. Through the increased communication skills I developed, I was able to participate with the social worker in the role Gates (2003) identified as a learning disability nurse educator and facilitate changes. In conclusion, through the combined effects of achieving the modules’ learning objectives, reflection on the positive and negative events as well as challenges I encountered throughout modules 5 – 9 have enhanced my skill development of working with the learning disabled, improved my problem solving skills, allowed for improved communicative ability both on interdisciplinary teams as well as working with learning or developmentally challenged persons. The added use of written reflection as a tool will further my ability to transfer these skills into practice in my future placement and allow me to be effective in my nursing capacity on day one of my engagement. References Davidson, J. 2001. Stress management: Minute 10 guide. New York: Macmillan, USA. Department of Health. 2001. Valuing People: A new strategy for learning disability for the 21st century. White Paper CM5086. Great Britain. Driscoll, J Teh, B. 2001. The potential of reflective practice to develop individual orthopaedic nurse practitioner and their practice. Journal of Orthopedic Nursing, 5, 95 – 103. Emerson, E, Hatton, C, Felce, D Murphy, A. 2001. Fundamental facts. London: The Foundation of People with a Learning Disability. Gates, B. 2004. Learning disabilities: Towards inclusion (4th ed). London: Churchill Livingstone. General Social Care Council. 2002. Code of Practice for Social Care Workers and Code of Practice for Employers of Social Care Workers. [Online]. Retrieved from: http://www.gscc.org.uk/NR/rdonlyres/8E693C62-9B17-48E1-A806-3F6F280354FD/0/CodesofPractice.doc [Accessed 20 September 2008]. Godsell, M Scarbrough, K. 2006. Improving communication for people with learning disabilities. Nursing Standards, 20(30), 58 – 68. Kaufman, DM, Mann, KV Jennet, P. 2000. Teaching and learning in medical education: How theory can inform practice. London: Association for the Study of Medical Education Monograph. Gardiner, A Lawley, K. 1995. Health and social care: Longman advanced GNVQ test and assessment guide. London: Longman Publishing Group. Thomas, A, Mason, L Ford, S. 2003. Care management in practice for the registered manager award: Essential reading for all care managers (2nd ed). Oxford: Heinemann Educational Publishers

Irish Prison System Essay

In 2012, the average cost of imprisonment per prisoner in Ireland was â‚ ¬65, 404. The current prison population is 4, 306. That’s an estimated 282, 000,000 of the tax payers money spent on prisons in Ireland per annum. Introduction This Irish prison system consists of 15 different institutions. This is made up of eleven traditional ‘closed’ prisons, two ‘open’ prisons, a training prison and a prison for young offenders. All of our prisons are termed medium-low security, apart from Portlaoise prison; a male only prison and our countries only high security prison. The purpose of a prison is to retain those legally committed of a crime as punishment or whilst they await trial. ‘The mission of the Irish prison service (as stated in their 2010 Annual Report) is to provide safe, secure and humane custody for people who are sent to prison. The Service is committed to managing custodial sentences in a way which encourages and supports prisoners in their endeavouring to live law abiding and purposeful lives as valued members of society.’ This essay will examine the capital which is currently spent on the Irish prison system and assess if the Irish prison system merits the money which it expends. Is â‚ ¬65,404 a reasonable amount to spend on the legal punishment of one individual, and are the systems in place effective in providing our prisoners with rehabilitation and social regeneration? Utilising these findings the discussion will attempt to offer alternative systems of punishment to imprisonment. Poor Conditions The European Convention for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) carried out an examination of Irish prison conditions in January- February 2010. The report described ‘degrading’ behaviour and ‘un-hygienic’ conditions. An examination of Portlaoise prison’s E-block discovered inadequate and unacceptable sanitary facilities. The cells were small (6m ²) and some of them were dilapidated with broken windows and dirty walls. None of the cells had in-cell sanitation and, at night, if a prisoner had to defecate he was likely thereafter to wrap up the faeces in a parcel and sometimes throw it out of the window. A typical day for a prisoner is made up of 16  ½ hours of ‘lock up’, those under severe confinement can endure 18 hours or more of being restricted to their cell. In extreme cases some prisoners may not even get to spend one hour a day outside of their cell. The CPT concluded that: ‘†¦ 23-hour lock-up should only be considered as a temporary respite, whereas in the Irish prison system it has developed into a general measure.’ The Prisoner’s Life Whilst research presents the inhumane conditions that exist in some of our prisons we also hear reports of recreationally facilities that some law abiding working class citizens do not even have access too. In 2009 journalist with the Evening Herald, Cormac Looney states that a sum of almost â‚ ¬200,000 was spent on sports equipment for prisoners in Ireland. He notes that Mountjoy Prison received â‚ ¬36,388 worth or sports, gym and recreational equipment, while inmates of the high-security Portlaoise prison which include former gang lord John Giligan received â‚ ¬28, 214 in sports equipment. Fiach Kelly of the Irish Independent informed us in 2010 that members of the Irish prison service had signed an additional â‚ ¬200,000 contract to upgrade our prisons for the subsequent three years. Kelly quotes Fine Gael’s then spokesman on public spending, Brian Hayes. â€Å"I fully accept the prisoners need proper gym facilities,† he said. â€Å"The question is why are they being kitted out again at this cost. I find it quite extraordinary the IPS (Irish Prisoners Service) signed off on this lavish expenditure item.† The IPS justified these expenses, claiming the equipment was of good value for the agreed price. An IPS spokesperson maintained that the provision of a gym would in the long run help prisoners to take control of other areas of their lives. Surely our prison systems main priority should be acting in accordance to their mission statement as stated in their three year strategic plan (2012-2015), adhering to the guidelines set for protecting basic human rights and meeting the prescribed health and safety standards. Our Mission: Providing safe and secure custody, dignity of care and rehabilitation to prisoners for safer communities. Our Vision: A safer community through excellence in a prison service built on respect for human dignity. A Case Study – Inside the Joy Little do Irishmen know the wretchedness of imprisonment. (John K. Casey, Fenian prisoner, Mountjoy Prison) Much ‘no-holds-barred’ writings exist on the inside stories of Mountjoy prison. They reveal what life is really like as an inmate; from desperation and depression, to bullying, beatings and the drugs network. The 2010 report by the CPT describes the ill-treatment of prisoners by staff members. An inmate of Mountjoy prison claims he was physically assaulted by a number of prison officers; A prisoner at Mountjoy Prison alleged that on 15 October 2009 he was physically assaulted in his cell by several prison officers, in the course of which he claimed he was thrown on the floor and repeatedly stamped and hit on the chest, arms and head. He also alleged that he was punched in the ribs while being escorted down the stairs to the basement of B Block 9. The photographic evidence of the injuries contained in the medical record is consistent with repeated injury to the chest wall; extensive bruising of the outer aspect of the left arm is not consistent with simply having been restrained. Former Governor of Mountjoy John Lonergan provides an insight into the prison. Even Lonergan maintains it was still a kip when he retired in June 2010. Paul Howards ‘tell-all’ account of a prisoner’s life in Mountjoy unveil stark revelations of the desperate conditions Irelands’ criminals endure. Prisoners are limited to one shower a week and one change of underwear per week. We learn of the littlest things that bring joy to the inmates such as a radio-show by Father Michael Cleary and the effects that using a privilege like the use of the library have on prisoners. Problems with Irish Prisons The Irish Prison System leaves a lot to be desired, outlined below are two of the major problems the system faces. * Overcrowding An over-reliance of the Irish criminal system on imprisonment as a form of punishment is just one explanation but forward in an attempt to explain the vast number (4,306) of criminals sentenced to imprisonment. The number of individuals sent to prison for not paying fines has increased by 10.5%, resulting in an estimated 18 non-fine payers occupying prison cells on any one day. Findings of the CPT report over-crowding in all the major prisons. The report questions the progress of Mountjoy’s Thornton Hall complex which the Irish authorities had originally optimistically stated would be complete and ready for occupancy in 2010, this date has now been pushed back to 2015. Besides building new cells and providing additional sleeping arrangements our only option is to reduce the number of individuals admitted to our prisons. Tackling the crime rate is another problem so for now we should look at providing petty criminals with punishment other than imprisonment. The Irish Prison Services Annual Reports for 2002 and 2003, noting the expense of keeping an individual in prison stress that ‘imprisonment must remain the sanction of last resort.’ * Staffing Issues In 2010 the Irish Examiner amongst other national publications alleged that Northern Ireland’s prisons had more staff than inmates. Particular reference was made to Maghaberry prison, a high security prison in Co. Antrim. Statistics presented showed that Northern Ireland’s 1,500 prisoner population was staffed by approximately 2,300 persons. A well-staffed prison is not sufficient if it can’t recognise its’ inmates basic human rights and provide facilities which satisfy these. â‚ ¬282,000,000 Worth of Expenses If overcrowding is common, and basic sanitary facilities are not being provided then why is the Irish Prison System expending an overwhelming amount of capital? While the figures are high expenditure has actually de-creased in recent years, this is not due to a fall in the number of prisoners but more to do with the issue of overcrowding which reduces the cost of bed space. Again we need to look at those responsible for the management of staffing and finance. It seems the Irish Prison System, like much of the State’s governing bodies need a lesson in financial management. What is the Alternative? There is no question that prisons are an integral part of any functioning society, but in order to provide basic facilities for criminals who require such punishment we need to look at the crimes that may not require punishment of that extent. We need to look at alternative means of punishment for the likes of non-fine payers and similar offenders. The Evening Herald tells us that just less than 200 individuals were punished with prison sentences for not paying court fines linked to TV licenses in 2011. The article shows that 25 people a day are now being sent to prison for failing to pay court fines. There were 1, 680 women sent to prison in 2011 and 1, 300 of those were due to their failure to pay court ordered fines. An obvious alternative punishment for non-fine payers and similar offenders is community service, no real threat to society as a whole and humiliation and inconvenience would be effective punishment for such crimes. Community service could be in their local area so as to increase the humiliation therefore deter individuals from re-offending and encourage others to pay such charges. Another suggestion is the introduction of manual labour into the prison system. The Irish Prison System outlined the need for exercise for prisoners, instead of spending capital on the provision of state-of-the-art fitness and training equipment serious offenders could be forced to participate in tasks such as the cleaning, up-keep and refurbishing of prisons. While a prisoner’s intrinsic rights and health must always be foremost in decision making a reduction in some more lavish recreational facilities may reduce the number of re-offenders when they have extremely negative experiences in prison. The number of prisoners committed to prison more than once in 2010 stood at 3,421. In More Streetwise: Stories from Irish Prisons editor and part-time prison teacher Neville Thompson suggests the provision of a back-up system for prisoners when they are released. He describes a touring theatre company which he hopes to set up; â€Å"What a Waste Productions.† The company would engage in writing, music, acting, set design and production. This idea could reduce the number of re-offenders. With too much time to think and very little space in which to do it prisoner’s very often resort to writing or poetry, involvement in something positive which helps them discuss and come to terms with their experiences in prison may discourage prisoners from returning to crime. Thompson envisages the production company eventually becoming self-supporting but justifies initial government financial input in these terms; It now costs â‚ ¬85,000 to keep a prisoner inside. God knows how many prisoners rob before they are caught again. However, we are looking to get â‚ ¬20,000 per prisoner for the projects we have in hand. At first instance, taking the projects we have in place it would cost us â‚ ¬200,000 to keep our project afloat for a year as opposed to â‚ ¬850,000 to keep them incarcerated. Conclusion While the idea that prisons’ are a complete waste of money is generally as result of ignorance the large amount of capital that the Irish Prison System expends is not justified when we look at the failure of Irish prisons to deliver basic facilities to inmates. We need to sentence those who need to be dealt with in such a way and look at an alternative means of punishment for those who don’t require such punishment. Much media coverage tells us of the lavish lifestyles which inmates such as Sean Quinn lead. This glamourises prison life and needs to be tackled in order to promote a less-appealing system and make the Irish prison system what it should be; a threat to discourage individuals from committing crimes. The suggestion that tackling media portrayal of life in prison would greatly reduce the number of offenders is highly idealistic but coupled with an effective program for criminals coming out of prison may at least reduce the number of re-offenders. References Books: * Carey, T. 2000. Mountjoy: The Story of a Prison. Cork: The Collins Press. * Howard, P.1996. The Joy. Dublin: The O’Brien Press. * Lonergan, J. 2010. The Governor. Dublin: Penguin Ireland. * O’Donnell, I. and O’Sullivan. E. 2001. Crime Control in Ireland: The politics of Intolerance. Cork: Cork University Press. * O’Mahony, P. 2000. Prison Policy in Ireland: Criminal Justice versus Social Justice. Cork: Cork University Press. * Thompson, N. 2007. More Streetwise: Stories from Irish Prisons. Mullingar: Killynon House Books Ltd. Government Publications: * Irish Prison Service 2012. Three Year Strategic Plan [Online] Available from: http://www.drugsandalcohol.ie/17473/1/ips_three_year_strategic_plan.pdf [Last Accessed 09 May 2013] * The European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment 2010. Report to the Government of Ireland on the visit to Ireland carried out by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment [Online]. Available from: http://www.cpt.coe.int/documents/irl/2011-03-inf-eng.pdf [Accessed 09 May 2013]. * The Irish Prison Service 2010. Irish Prison Service Annual Report [Online] Available from:http://www.justice.ie/en/JELR/Irish_Prison_Service_2010_Annual_Report.pdf/Files/Irish_Prison_Service_2010_Annual_Report.pdf [Accessed 09 May 2013] Newspaper Articles: * Kelly, F. 2010. Prisons to spend â‚ ¬200,000 on ‘lavish’ equipment for gyms. The Irish Independent: Ireland [Online], 13 October. Available from: http://www.independent.ie/irish-news/prisons-to-spend-200000-on-lavish-equipment-for-gyms-26689415.html [Accessed 09 May 2013]. * Lavery, M. 2013. 121 women are sent to jail for failing to pay TV licence fines. The Evening Herald: Ireland [Online], 15 December. Available from: http://www.herald.ie/news/121-women-are-sent-to-jail-for-failing-to-pay-tv-licence-fines-28963049.html [Accessed 09 May 2013]. * Looney, C. 2009. â‚ ¬200k for prison gyms as garda budget slashed. The Evening Herald: Ireland [Online], 05 March. Available from: http://www.herald.ie/news/200k-for-prison-gyms-as-garda-budget-slashed-27903752.html [Accessed 09 May 2013]. * O’Keefe, C. 2013. Prison bosses urge to kick football spend to touch. The Irish Examiner Ireland [Online], 10 January. Available from: http://www.irishexaminer.com/ireland/pri son-bosses-urged-to-kick-football-spend-to-touch-219146.html [Accessed 09 May 2013]. * The Irish Examiner, 2010. North’s prisons ineffective ‘despite having more staff than prisoners’. 14 December. Available from: http://www.irishexaminer.com/breakingnews/ireland/norths-prisons-ineffective-despite-having-more-staff-than-prisoners-485592.html [Accessed 09 May 2013]. Websites: * The Irish Penal Reform Trust 2013. Facts and figures [Online]. Available from: http://www.iprt.ie/ [Last Accessed 09 May 2013]. * The Irish Prison Service 2013. Prisons [Online] Available from: http://www.irishprisons.ie/index.php/joomlaorg [Last Accessed 09 May 2013]. Other: * Jesuit Centre for Faith and Justice 2012. The Irish Prison System Vision, Values, Reality. Dublin: Jesuit Centre for Faith and Justice. * Matthews-Lynch, C. 2010. Are prisons a waste of money? [Online] BA, Dublin City University. Available: http://carlymatthews.me/writings/college/2nd-year/cm261-crime-the-media/ [Last Accessed 09 May 2013].

Mrs. Smith As A Teacher - 992 Words

Mrs. Smith is a teacher who has found out that she will have a classroom of thirty students for this up and coming school year. This year also Mrs. Smith will have four students who have a disability, and to assist her the school administrators have given Mrs. Smith a paraeducator (Para) to assist her. Mrs. Smith and the Para have had some conversation’s introducing each other and it seems the two have some interest with similar personalities and philosophies. Neither it seems has ever done this job before so this year seems to be interesting. I am going to try to give a few rules, techniques and some boundaries that both will need to follow for success. At the top of the paper I have already given the Mrs. Smith and her Para a goal for what I hope that their collaboration purpose can detail. As we understand for the students to be successful the two teachers must work to be on the same page so that they can get the academic results from all of the students that will be in the collaboration class. In that statement the key words are â€Å"our and teamwork†. The word â€Å"our† means the two teachers will work together to produce â€Å"teamwork† out of the students. These things can only happen if the teachers are willing to put all personal stuff behind to create a great inclusion classroom. The first thing that I want to give Mrs. Smith and the Para is just a few rules and expectations for the students because without rules the train will run off the track. The students must respectShow MoreRelatedA Reflection Of Teaching For Children In The Classroom905 Words   |  4 PagesDiscussion First and foremost, I am impressed with Mrs. Smith’s first-grade classroom and her educational style. 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Equality diversity within healthcare Free Essay Example, 1500 words

Prejudice and Discrimination as causes of Disempowerment of Individuals How Prejudice and Discrimination leads to the Disempowerment of Individuals Prejudice and discrimination like sexual harassment lower self-esteem of the victims. The act leads social, psychological, and economic disempowerment of the victims. The discrimination lowers the quality of service offered by victims in their lines of duty. Psychological torture and loss of self-worth leads to associated health complications through stress. The psychological instability lowers the quality of socialization and service delivery to clients. Prejudice and discrimination cause unrest and lack of respect amongst individuals. A working environment with unrest compromises client relations, thereby lowering the quality of service delivery to the patients. According to Knifton (2012, p. 293) mental instability leads to stigmatization that may discourage patients or clients from seeking health care services. The consequence is a reduction in exploitation of health facilities that affects the economic growth negatively. Therefore, the government should incur costs in anti stig matization campaigns to ensure that it retains a healthy nation (Knifton 2012, p. 293). Prejudice and discrimination lead to negative feelings such as hurt and confusion amongst individuals. We will write a custom essay sample on Equality & diversity within healthcare or any topic specifically for you Only $17.96 $11.86/pageorder now The individuals extend to reflect to upon peers, colleagues, and individuals. Health practitioners who operate under psychological instability may be reckless leading to associated accidents that end up in deaths. Discrimination compromises the quality of service delivery as unqualified professionals are hired to offer health services. Markkanen and Harrison (2013, p. 410) through their research reveals the negative influence that racial discrimination pose on an individual’s socio-economic status. Prejudice and discrimination compromise equality and diversity (Scott & Byrd 2012, p. 427). Lack of diversity is a cause of race-based wars and unrests. The result of this is wars that lead to deaths. The disharmonious state denies others from working in the region’s leading to reduced economic power in the individual. Gender-based discrimination leads to self-devaluation that discourages extra effort to instill a difference within the healthcare. Individuals from the discriminated gender tend to feel inferior lowering collaboration in research and innovative initiatives within the healthcare. The inferiority feeling denies the individuals the right to exploit and exhibit their free will and potential towards work.