Reflective essay: Stroke patient

Reflective essay: Stroke patient ASSIGNMENT FROM MOTHER NA A Reflective Essay on significant patient care event within a multidisciplinary setting. This will be a reflective analysis on a significant event that I have observed and experienced in clinical placements. A reflective model was not used, as it was too restrictive for the event being analysed, critiqued and discussed. My focus on this assignment is on assessment on a stroke patient and prevention of pressure ulcers. This was my first experience to nurse a stroke patient and therefore was very interested to know about the disease and how to make an assessment on patients in this situation. All details that could identify any person, clinical placement or trust have been changed to protect confidentiality, in line with The Nursing and Midwifery Council (NMC) Code of Professional Conduct, Performance and Ethics (2008). Reflection is an active process of witnessing one’s own experience so that we can make an evaluation in order to make a decision. Reflection has its foundations in the discipline off learning and experience in a student (Jasper 2003).Jasper (2003) believes that we learn by doing, and realising what came of what we did. There are so many models of reflection however, these are not meant to use for an inflexible set of questions to be answered but to give a construction on how to go about a problem. While on placement I worked with one of the qualified staff on the ward and looked after a lady aged 84 years. Doris had suffered a stroke which developed to impaired swallowing and speech. She was admitted to the ward due to having an ischemic stroke. A stroke is a disease that affects the arteries leading to and within the brain and categorised as ischemic or haemorrhagic stroke. This occurs when the blood vessel that carries oxygen and nutrients to the brain is either blocked or burst. This results in the brain not getting the oxygen and nutrients that it needs and eventually starts to die (Feigin et al 2003). Because of this patients have a propensity to develop swallowing impairment or speech impairment. Ischemic stroke take place as a result of an impediment within a blood vessel supplying blood to the brain. The original circumstances for this type of obstruction are the development of fatty deposits lining the vessel walls. This condition is called atherosclerosis (Lopez et a l 2006). These fatty deposits can cause two types of obstruction that is cerebral thrombosis or cerebral embolism. In the case of an embolism, a clot breaks loose and enters the blood stream and eventually fails to pass when it reaches smaller brain capillaries. Irregular heartbeats known as atrial fibrillation is another cause for embolism which is likely to form a clot in the heart and later dislodge and travel to the brain (Feigin et al 2003). The National Audit office (2005) report shows that 130,000 of United Kingdom population suffer a Transient ischemic attack (TIA) every year, of which half of the figure the stroke occurs in the people aged above 75yrs, however stroke do happen in all ages (Kwan 2001). Saka et al (2009) explains that the UK economy has to account for  £9 billion per year to cover the costs of stroke related diseases including its management and therefore causing a burden on the economy. Because of the muscle weakness due to a stroke, there’s loose o f control on the bladder sphincter causing incontinence. In addition statistics show that 63% of the population who are hospitalised develop pressure sores over the last 10 years. The figure includes the elderly and patients who have suffered a stroke. Communication was another issue; Doris could not communicate well due to the dysphasia which developed after the stroke and sadly no one in the family or friend had escorted Doris to hospital for health care staff to obtain her past history on admission. Taking a medical history is good practice as it allows health care staff to apply effective assessment which will meet the patient’s needs. It is through effective communication that effective assessment will be implemented. There are other approaches in communication, for example The â€Å"VERA† framework (validation, Emotion, reassure and activity) suggested in a study that it enabled student nurses to counter to elderly patients whose communication and behaviour proved to be difficult. These frameworks give choices to healthcare staff a set of principles to guide them with communication while providing any medical intervention. Childs, Coles and Marjoram (2009) state that the inability to communicate to others cause anxiety and fear. While Happ (2000 cited in Childs et al 2009) think that people who are unable to talk or communicate are â€Å"voiceless† and therefore it increase powerless and isolation in patients. Buckman (2000) emphasised that ‘ effective symptom management is imporsible without effective communication’. . Assessment is a process that involves collecting and organising information and acknowledged as an on-going process associated with the other nursing stages of the nursing process (Thomson and Mathias 2000). Brooker and Waugh (2007) state that decision making and judgement is usually based on information collected. The data is then used to identify the patients nursing problems on the base of need, which hopefully is brought out or recognised assessment (Thompson and Mathias 2000). Timby (2001) identifies two types of assessment a data base assessment and a focus assessment. The data assessment is the initial information about the patients physical, emotional, social and spiritual health, is lengthily and comprehensive. Database information is obtained during the admission interview and on carrying out physical examination. Field and Smith (2008) demonstrate the importance of person-centred assessment and also the need of multi-agency involvement. An observation was made that all t hese areas were met. Although each discipline had achieved assessment in a different way, they are valued for the assessment they will contribute to patient care. Brooker and Waugh (2007) feel that including integrated care pathways in patients care plan is good. This is a single document of which all the multidisciplinary team are able to record their care. To achieve good patient assessment, there is need to collect information from the past medical history and this will allow care to flow with one another. During the ward round a consultant had suggested that an indwelling catheter was to be inserted for easy flow of urine and to prevent the development of pressure sores. It was when the nurse advised that the catheterisation was to be done after all other works has been done on the ward because she had to carry out an aseptic procedure. Whilst on other placement this observation was not done instead catheterisation was carried out as a clean procedure. This prompted me to question, should all health care settings observe catheterisation as an aseptic technique procedure and when do health care staff identify the need of inserting a catheter. This issue has been brought to light by numerous guidelines and theories that have been published relating to and concerning infection control by the Department of Health. Although it is clear that Doris was vulnerable and likely to develop pressure ulcers, was it really necessary to insert a catheter? All parts of the multidisciplinary team carin g for the patients need to have an understanding of each other’s role, to achieve effective care through collaboration and decision making, but some nurses feel disempowered by more senior staff, for example; doctors; consultants, due to intimidation and hierarchy of roles and so can affect the influence nurses have on the decision making process (Coombs 2003). Nurses may come into conflict when collaboratively making decisions with the multidisciplinary team and patients as their personal and professional values may vary. A study suggests that catheter insertion has a potential off introducing micro-organisms into the bladder (Barford and Coates, 2009). In another study, Pratt et al, (2007) mentions that catheterization should be treated as a skilled aseptic procedure to be carried out by trained and qualified staff in order to reduce infection. Health associated infections are acquired while patients are receiving treatment in a care setting and can prolong hospital stay. These infections include any infection obtained as a result of healthcare whilst in hospital or other healthcare settings and can have an effect on both patients and all aspects of the multidisciplinary team, in addition teamwork means everyone has to be involved in the patient care (Nicholson et al 2010). . The Department of health (2006c) released a broad document which includes the generated acute hospital waste and the community practitioners. What is not known is whether the patient acquired the infection in hospital or not. T he patients’ age matters as infection risk increase in the elderly and young people. Patients whose nutritional status as in the case of Doris affects the ability of the body to fight infection and therefore a broad risk assessment is required (Horton and Parker 2002). Grandies et al., (2003 cited in Field and Smith2008) clarifies that in any assessment, the age, nutrition status, circulatory status, mobility, dependence level and mental awareness are to be taken into account. Patients need to be critically assessed for possibilities of developing pressure sores as the cost is huge to both the organisation looking after the patient and the patient herself. Health care staff needs to identify the existing risk factors already presenting on the patient which may lead to developing pressure sores. Iggulden et al (2009) describes pressure sores as damage to the skin and the underlying tissues caused by shearing, friction and moisture while Bick and Stephen in another study say that physical, and psychological well being including the environment is a factor causing pressure Sores. Mallet and Dougherty (2004) add on to mention that the extent of these ulcers if not properly treated may lead to damage of the involving muscles, tendons and the bone. Skin integrity is important in this situation. Due to illness arterial blood pressure may drop causing obstruction of circulation to the skin and therefore an ulcer will develop. It is clear that Doris was vulnerable and likely to develop pressure ulcers. Pressure ulcers are developed when patients sit or lie in one position for a long time. â€Å"The essence of care toolkit for clinical practice benchmarking has pressure ulcer prevention (department of health 2003). The water low score and Braden (cited in Bergstrom et al 1987) are good toolkits for assessing patients at the risk of pressure sores. However the NICE (2005) guide line instructs nurses not to rely on them alone. Doris’ water low score indicated she was at a risk of developing pressure sores. This was because her mobility and nutrition status were affected after the stroke. There is evidence in study that females are more vulnerable to pressure sores that male. This is because anatomically males are more muscular than females. It is the nurse’s responsibility to ensure patients receive optimal nutrition and good hydration while in hospital. In another study statistics show that 63 % of elderly patients with stroke develop pressure sores due to poor mobility and nutrition in the last 10 years. Doris was at higher risk to develop as she typically lost muscle and subcutaneous tissue due to poor nutrition following her difficulties to swallow, poor nutritional status also makes her more vulnerable. Ongoing assessment at this time is crucial as it will trigger on all the possible barriers of poor nutrition and hydration on patients who require help in feeding and drinking (NHS Choices2010). Nutrition and hydration are important in health but in illness there are certain considerations that have to look into because the body needs nutrients in order to recover mostly in wound healing including preventing infections (Royal collage of Nursing (RCN) 2009). The RCN (2009) clarifies that poor nutrition and hydration is a threat to patients who have suffered stroke as this may cause delayed discharge and other complications like low blood pressure and electrolyte imbalan ce which are likely to cause poor circulation and allow a patient to develop pressure sores. Nutrition and good hydration is fundamental in nursing to promote quick recovery and wound healing. However there are patient’s factor which may affect their nutrition and hydration such as stroke which possibly will reduce their independence to eat freely. According to (Green 2011) by improving patients nutrition and dehydration the patients skin and well being will be promoted and this can be achieved through delegation to healthcare assistants to help with feeding at meal times with nurses ensuring proper meals have been given to patients’ e.g. soft meal, puree, low fat or residue meal which are required for patients with dysphasia or digestive problems in line to prevent pressure sores. All patients are prone to develop pressure sores but the emphasis is on the elderly because basic factors are related to immobility, age and illness .Pressure ulcers are preventable if proper nursing measures are carried out. NICE (2001) guidelines state that all patients likely to develop pressure sores are to be on a pressure relive mattress while in hospital. Therefore a decision was made that Doris needed a pressure relief airflow mattress as her score was high. Evidence based practice is essential in nursing, it has the potential to develop and increase patient care outcomes as it will enable nurses to evaluate and deliver care according to patients needs. The Nursing and Midwifery Council (2008) advocate that nurses should make care of people their first concern. Therefore a broad medical history taking form the patient becomes essential so that an accurate diagnosis can be made for the patient to receive optimal care and treatment (Kale 2001). Nurses have a propensity of commu nicating with patients during intimate intervention and it’s during this time that individuals are likely to speak freely which is why Doris’s mode of communication has to be identified through the speech and language team in order to support her. The need for nurses to know their patients better and understand their problems and specific needs becomes fundamental. Nurses may come into conflict when collaboratively making decisions with the multidisciplinary team and patients as their personal and professional values may vary if proper history was not taken. Lloyd and Craig (2007) suggest that although history taking is the cornerstone of assessment in patients, nurses are sometimes not at ease with taking patients history. History taking is not focused on identifying patients’ signs and symptoms of the illness but to involve the whole person in a holistic way which will help the health care staff to plan and evaluate patients’ care (Department of Health 2001). There is need for nurses to develop their history taking skills as this will allow them to acknowledge social, medical psychological and biographical domains of the patient. Fischer (1995) feels that doctors â€Å"make a history â€Å"instead of â€Å"take history† this process becomes complete when both patient and doctor are both satisfied on the causative problem. However Gask and Usher wood (2002) in the article emphasises that successful history taking is based on skilled and patient -centred communication that a therapeutic relationship will begin betw een nurse and patient. It is through this therapeutic relationship between the patient and the nurse that they will work together to make a collaborative decision and address the problem. Therefore health care staff must act as a patient advocate to protect and respect their dignity. Palliative care is in any illness which is progressive and incurable, therefore there is need for the multidisciplinary team to work together and provide a high- quality end of life stroke care. Although there is evidence that Doris is likely to develop pressure sores catheterisation could not be a solution at this point. The department of health (2003) aim to reduce the risks of health associated infection and indwelling catheters are among the common cause of invasive medical devices used in health care settings and, consequently, are a frequent cause of Health Care Associated Infections. Other than affecting patients, HCAI is also having negative burden on the National Health Service (NHS). Patients like Doris are more prone to infection due to that the body mechanism to fight infection is already compromised. Catheter acquire infection can be very distressful to patients and prolong hospital stay. The possibility of Doris going into palliative care is obvious and therefore there is need to plan for it in her care plan or discharge plan. In this reflection it is noticed on admission that Doris is alone. Loneliness has an impact on elderly people. In a campaign to end loneliness research shows that many people have no peers or friends. It is through the general practitioners and district nurses that support to these people can be offered, all decisions made in the multidisciplinary context have to involve the patients’ family (NHSQIS and the University of Glasgow 2010). All parts of the multidisciplinary team caring for the patients need to have an understanding of each other’s role, in order to make a collaborative decision. In conclusion, while reflecting and making recommendations for different ways of approach on situation in practice, holistic assessment followed by full history taking to allow care to flow should be a priority followed by improving nutrition and hydration in very ill patients. Cauterisation could be a last option in order to prevent pressure sores as there other options to do this. The risks that patients who are immune compromise may be exposed to other infections and how it can be avoided needs to be addressed and it is a constant effort, but is fundamental by all areas of the multidisciplinary team, organisations to reduce rates of infection more and to continue at a lower rate. To improve patient safety and continuum care it is necessary for health care professionals to reflect on nutrition and hydration status of the patient to promote good skin integrity and prevent pressure sores. For reflection to occur, health care professionals need to be aware of the implications that pre ssure sores can have on patients and the importance of education from policies and to comply with relevant procedures.

Bangladesh :: essays research papers

The area know as Bangladesh was a political backwater instead of being involve in any of India political or military events the area which is call Bangladesh now just sat back and watch. Bengal which is what Bangladesh use to be call historians believe that Dravidian speaking people move in the area around 1000 B.C. and they were give the name Bang. This Home land had various names which reflected tribal names like Vanga, Banga, Bangala, Bangal, and Bengal. The first great empire that spread over Bangladesh was the Mauryan Empire, and the ruler was Asoka westeren parts of Bengal achieved some importance during Mauryan period. Buddhism was brought to Bengal by Asoka son when he took over. When Mauryan Period was over in eastern Bengal it became know as the kingdom of Samatata; although politically independent, it was a tributary state of the Indian Gupta Empire. The third great empire was Harsha Empire which drew Samatata into loosely administered political structure. The disunity in this empire allowed a Buddhist chief name Gopala to seize power over Bengal, and he started the first pala dynasty. Him and his succersors provide Bengal with there first stable government. Islamization of Bengal, 1202-1757   Ã‚  Ã‚  Ã‚  Ã‚  The Turkish took over Bengal in the early thirteen century. The take over was a long thought out process that began in Afghanistan with military forays Mahmud of ghazni. Bengal had loosely associated with Delhi Sultanate which was established in 1206. In 1341 they became independent from delhi, and Dhaka and established there independent governors of independent Bengal. The turks ruled for about seven dedcades before the conquest of Dhaka by forces of the Mughal Emperor Akbar the great. Bengal was under Mughal until the decline in the early eighteenth century. Under Mughal power Bengal was one of the richest empires of there time, and also a lot of things were created like there first calendar and also they started collected money on people house, and also there land. The British had a lot influence on there economic in the twentieth century. The country was drained from keeping up Mughals army, and he really did not do anything to help out the people of the count ry because over 40,000 slaves were caught by pirates and use as slaves. The locals had to force him to appoint powerful generals as governors. Although they were not protected well they manage to keep up there Agricultue expanded trade was still encourage, and Dhaka became one of the best textile trade.

The Newport Coast Structure :: Architecture Architects Building Essays

The Newport Coast Structure The Newport Coast structure that sits on the corner of Pacific Coast Highway and Newport Coast Dr. is one of many examples of Mediterranean-inspired architecture in Southern California. The building is clearly influenced by Roman architecture and stands out among the standard Spanish-looking villas and mission-type buildings. The structure lies near one of California's wealthiest neighborhoods, Newport Beach and acts as sort of a grand entrance to Newport Coast Dr. There are two of these structures which sit on opposite sides of Newport Coast Dr., framed by only a few palm trees and evergreens. Drivers passing along Southern California's coastline can catch a quick glimpse of these impressive buildings. The Newport Coast structure is constructed of concrete and painted a light beige. Eight thick columns support the extremely large entablature-like face of the structure. As architecture in a typically conservative Orange County, the Newport Coast structure dominates its surroundings. The Newport Coast structure is clearly a representation of Roman architecture in general, but more specifically, the sturdy columns and enlarged entablatures are reminiscent of the Tuscan order. Although the simplified columns may at first glance appear to be rather doric in their style, upon closer inspection they prove to be more similar to the less renowned Tuscan order. This in fact, does not diminish the influence the doric temples of Greek architecture had on the Etruscan invention of the Tuscan temple, but rather demonstrates yet again how one culture can inspire another artistically. The Tuscan order refers to "the variation that resembles the doric order, with an unfluted shaft and a simplified base, capital, and entablature" (Stokstad, 227). Like architecture of the Tuscan order, the Newport Coast structure's entablature is very plain and geometric in its form. The Tuscan order was originally used by the Etruscans around the time of 700-509 BCE and was later adopted by the Romans. Even though the Newport Coast structure and the Tuscan temple function differently in terms of public use, for the Tuscan temple was used by the Etruscans for religious purposes, their appearances prove to be strikingly similar. Not only does the Newport Coast structure resemble architecture of the Tuscan order, it makes use of the Roman round arch as well. The round arch in the Newport Coast structure has elements that are very similar to the Roman round arch. Outlined by wedge-shaped voussoirs, it looks like a simpler, more modern version of the Arch of Constantine.

Swot of Disneyland

SWOT – HOW DISNEYLAND HK CAN RELATE TO THE EMERGENCE OF ANOTHER DISNEYLAND IN SHANGHAI IN COMING DECADES : HOW HONG KONG CAN FURTHER STRENGTHEN THE EXISTENCE OF DISNEYLAND IN HK FOR BREAKEVEN SAKE: WHAT OTHER STRENGTH HK DISNEYLAND CAN SUSTAIN TO SURIVIVE FOR SHANGHAI DISNEYLAND BEING OPENED IN FEW YEARS LATER WITH DECREASE OF VISITORS FROM MAINLAND . WHAT IS THE WEAKNESS OF HONG KONG DISNEYLAND THAT CANNOT ATTRACT ENOUGH VISITORS TO MAINTAIN BREAKEVEN WITHOUT SUBSIDY FROM HK GOVERNMENT FOR EXAMPLES, POOR INFRASTRUCTURE FACILITIES IN DISNEYLAND, LIKE LITTLE FOOD CHOICES OPEN TO FIT FOR DIFFERENT PEOPLE . SPACE IS SMALL AND THE AMUSEMENT FACILITIES DID NOT UPDATE FREQUENELTY. MOVEROVER,THE ROAD SHOW LAST FOR SEVERAL MONTH WITHOUT CHANGE. THE TRANSPORATION FARES IS ABNORMALLY HIGH WHICH DETER HONGKONGESE TO VISIT AGAIN . OPPORUNTITIES : RE-BRANDING OF DISNEYLAND,MORE NEW THEME DRAMA , ROAD SHOW AND MUSICAL SHOW AND INNOVATIVE ADVERTISING AND PROMOTIONAL ELEMENTS THERE . THREAT – COMPETITION FROM HK OCEAN PARK BECAUSE LOWER ENTRANCE FEES AND BETTER TRANSPORATION NETWORK AND FARES. MORE LOCAL AND MULTI-CULTURAL ELEMENTS EMBEDDED INTO THE FACILITES AND VISUAL AIDS. MOST IMPORTANT IS THE EMERGENCE OF SHANGHAI DISNEYLAND . BASED ON ABOVE 4 ELEMENTS TO SEE WHEHTER THERE IS A DRASTIC CHANGE TO EXISTING HK DISNEYLAND MARKETING GLIMMSPE. IF HK GOVERNMENT NEED TO HAVE COLLATERAL CONTRACT WITH US DISNEYLAND, THERE IS NO DOUBT THAT HK SHOULD BOUND THE AGREED PERIOD OF TIME TO REPRESENT DISNEYLAND TO PROVIDE MINIMAL LEVEL OF SERVICE TO VISITORS. AFTER THE EXPIRATION OF ALL THE CONTRACT SERVICING PERIOD, HK WOULD CHANGE THE STRUCTURE/MARKETING STRATEGIES BY WHATEVER MEANS.

He tendency for human beings to copy one another is shown in the popularity of fashion and goods Essay

The tendency for human beings to copy one another is shown in the popularity of fashion and goods. Agree or disagree. Agree – Economic urge – Easy to copy Disagree – Not easy to copy due to complicated procedures – Other fields are easier to be copied Fashion and goods are becoming more similar between brands. Some people think that manufacturers are copying ideas of each other in such products while others claim that this is hardly necessarily reflected mostly in fashion and goods. I believe that in any field, people can copy from other and sometimes, fashion and consumer goods are far from easy imitation. First of all, it is thought that copying the style of fashion and goods is easier than other types of imitation. Just a glance at design is sufficient enough to provide other competitive brands to follow and manufacture right after the original item comes into being. Nevertheless, people’s desire is to enjoy products with good appearance and quality at the same time. Despite the copying trend of outstanding appearance, if the quality of products is below expectation of consumers, for instance, short durability and high price, the latter ones will shun away these items soon. Second of all, people mostly need goods in their daily life. The rate of consumption in daily goods adds up to billions of dollars for producers, which motivates them to copy each other. Yet, when it involves the assembly line and advanced technological applications, it is far from easy to follow suit. Technological goods need expertise, significant investment and long-term research. Hence, though goods may look like each other, they are rarely products of pure emulation and mass- consumed. Chinese products, for instance, in spite of being believed to be of lower price and copy others in the world, are still not as attractive as original ones as created in America and Japan due to their unfashionable design and short-time durability. In addition, copying trend is noticeable in other fields. In arts, the musical style of one nation borrows greatly from that of other countries to enrich cultural heritage of each nation while products of high intellectuality such as writing styles are somehow similar to each other. Even in choice of life, when a person has little inkling about what he or she does in life, it is more likely that he or she will travel the same journey as predecessors to be on the safe side. When it comes to work environment where competition is higher, to ingratiate oneself with bosses, employees are possible to copy ideas of others, which actually proves easier than to imitate the complicated business models to generate fashion designs or consumer goods. â €“ written by lena pham-

Understanding the Lord’s Prayer

Understanding the Lord’s Prayer â€Å"Our Father in heaven, hallowed be your name. Your kingdom come, your will be done, on earth as it is in heaven. Give us today our daily bread. Forgive us our debts, as we also have forgiven our debtors. And lead us not into temptation but deliver us from the evil one† (Matthew 6:9-13). Most people, religious or not, are familiar with this prayer. Some call it a prayer, some call it a chant, and some call it a meaningless set of words. No matter what the opinion is regarding the prayer, breaking it down can be thought provoking and difficult to fully understand.On the surface it is very simple, but below the surface the words have very deep theological implications. According to the New International Version Bible, Jesus said in Matthew 6:9, â€Å"This, then, is how you should pray. † However, a problem arises out of this interpretation. The actual Greek to English translation is â€Å"Make your prayers go like this. † In other words, the prayer is actually a template of how prayers should go (Rhodes). Often, the prayer is mistaken for something that should be recited word for word.It is not wrong to recite the prayer verbatim, however, God did not intend for people to recite the words as a meaningless ritual. Praying using Jesus’ template shows the following way to form prayers: To acknowledge who God is, to pray for his work to be done on earth, to ask for what is needed, to ask for forgiveness, and lastly, to ask for a way to deal with temptation and opposition (Rhodes). The words â€Å"Our Father,† in Matthew 6:9 are two of the most powerful words in the prayer. The definition of the word â€Å"Our† is: â€Å"Belonging to or associated with more than one person† (www. oogle. com). The body of Christ is a group of believers that are brothers and sisters in Christ. The first word â€Å"Our† suggests being a part of this body of Christ (Ruffin). The second word â€Å"Father† is the one whom is being addressed. A prayer should always start by recognizing that the Lord our God is the one being prayed to, but God also wants to be approached as a child approaches their loving father (Pastor Mike) because God desires intimacy (AllDeaf. com). God wants to be addressed as â€Å"Father† out of love and humility (Pastor Mike).The child needs to recognize their position as so, and God’s position as Father. â€Å"Hallowed be your name† (Matthew 6:9). This portion is acknowledging God’s worthiness and greatness (Ruffin) because â€Å"Hallowed† literally means: â€Å"To make holy† or â€Å"To demonstrate as holy. † When praying the words â€Å"Hallowed be your name,† it is praising His holy and worthy name. God is not a buddy or friend whom should be carelessly addressed, but neither is He distant (Pastor Mike). This concept is loosely related to why God is addressed as Father. Your kingdom come, your will be done, on earth as it is in heaven† (Matthew 6:10). This section of the template is praying for God’s work on earth (Rhodes). The word’s â€Å"Your kingdom come,† is praying for the Lord’s guidance (Ruffin) on behalf of God’s kingdom (AllDeaf. com) to do everything unto the Lord. â€Å"Your will be done, on earth as it is in heaven,† is declaring that God is really in charge of everything. The word â€Å"Will† means the same as â€Å"Desire,† so praying for God’s will to be done is also praying for all the God desires to be done (Pastor Mike).These words are also asking the Lord to take over so that His children can operate by His answers and not their own because the key words is â€Å"Your will be done,† not â€Å"Our will be done† (Ruffin). â€Å"Give us today our daily bread† (Matthew 6:11). These words are asking for God to provide what is needed in order to sustain spir itual and daily needs (Ruffin). God may not give everything that is wanted, but he gives everything that is truly needed because God cares for His children. This line also points back to when God was leading His people out of Egypt and every morning He gave them enough manna to last through the day.God did not give them more than one day’s worth of manna, however, so that they would continue to rely on Him to provide (Pastor Mike). That is why the prayer is not, â€Å"Give us this week our weekly bread. † The prayer is â€Å"Give us today our daily bread,† so that God is continually relied on to provide. â€Å"And forgive us our debts, as we also have forgiven our debtors† (Matthew 6:12). Forgiveness is surrender (AllDeaf. com); God does not want His children to carry their own weight. That is why He created prayer. God created His children in His image, so as a forgiving God, His children must also be forgiving.In doing so, it shows love to one another a nd Christ. On the surface, it cannot get more straight forward than asking God to forgive sins, but below the surface something that is not so straight forward is the concept of fairness. Nowhere else in the bible does God talk about fairness. Looking at the verse the words, â€Å"Forgive us our debts,† is not the only thing that is said. It is phrased as a condition. It says, â€Å"Forgive us our debts, as we also have forgiven our debtors. † Meaning God will forgive the sins of His children, if His children forgive each other. And lead us not into temptation, but deliver us from the evil one† (Matthew 6:13). This is the section of the template asking for a way to deal with temptation and opposition (Rhodes). This is asking the Lord to carry away the evil, and anything that represents evil. God wants His children to pray this, so they won’t succumb to the evil temptations of the world. Some people believe as though sin is the cause of the fall, but really sin is just the victim of temptation. Temptation is the true culprit, because that is what leads God’s children into sin. â€Å"Our Father in heaven, hallowed be your name.Your kingdom come, your will be done, on earth as it is in heaven. Give us today our daily bread. Forgive us our debts, as we also have forgiven our debtors. And lead us not into temptation but deliver us from the evil one† (Matthew 6:9-13). Some call it a prayer, some call it a chant, and some call it a meaningless set of words. Most people, religious or not, are familiar with this prayer, but the body of Christ lives and breathes this prayer. Repeat it and it becomes a meaningless ritual (Rhodes), pray the words and it becomes the foundation to the relationship shared with Christ.

Ethical Dillemma Worksheet

1. What is the ethical issue or problem? Identify the issue succinctly.The ethical issue develops when the truth is altered in the second or â€Å"signed off† report. The officer altered the report to state that they had actually witnessed the husband drive and park the car, although they had not.2. What are the most important facts? Which facts have the most bearing on the ethical decision presented? Include any important potential economic, social, or political pressures, and exclude inconsequential facts. The fact that the first report had said the officers only felt the vehicle with a warm hood, and only witnessed the husband walk up to the home. Is the first report really had not been signed off it may have been because they would not have a case given that the officers did not witness the husband actually driving the vehicle. Given that, the husband would have won the case and socially and politically it would show weakness within the department, because the officers mad e an arrest without meeting certain criteria for arrest. The second report had stated different, that the officers witnessed the husband driving and park as they pulled up.3. Identify each claimant (key actor) who has an interest in the outcome of this ethical issue. From the perspective of the moral agent—the individual contemplating an ethical course of action—what obligation is owed to the claimant? Why? Claimant(key actor) Obligation (owed to the claimant) Perspective (What does the claimant hope will happen?) The officers Fidelity, justice The officers hope they will win the case of DWI, although they did not witness the husband driving. The husband Fidelity, beneficence Hopes to stay out of jail and win the case against him since he was not witnessed driving while intoxicated. The wife Fidelity, beneficence Hopes to keep her husband out of jail. society justice Hopes that criminal justice personnel and system will be able to keep offenders off the streets as to n ot cause harm to innocent citizens. prosecutor Justice, non-injury Hopes to gain the truth of the matter as to not cause flaws in the justice system, and achieve absolute justice for all parties involved.Evaluating Alternatives4. What are two alternatives for the scenario? One alternative can be a wild card that you ordinarily may not consider an option because of potential implications. Both should be within free will and control of the same moral agent. Alternative AAlternative B Keep report number one and not file charges against the husband. Follow through with report number two, and file charges against the husband. 5. Respond to the following questions based on your developed alternatives.Alternative A Alternative BWhat are the best- and worst-case scenarios if you choose this alternative? Best-the husband will take this opportunity as a draw of luck and rehabilitate. The department and officers will not look bad for making an arrest without proper protocal. Worst- the husband continues to drive while intoxicated and harms another person, the first arrest may come to light and the prosecutor may be reprimanded for not perusing charges the first time Best-the husband will be taken off the streets and not allowed the opportunity to drive while intoxicated potentially causing harm to himself  and others. Worst- the truth will come to light and prosecutors and police officers are reprimanded for not telling the truth to begin with. Will anyone be harmed if this alternative is chosen? If so, how will they be harmed? Consider families and derivative effects.Yes, citizens can be harmed if accidents occur should the husband continue to drive while intoxicated. The wife may continue to be battered by the intoxicated husband. The family may be harmed if the husband is arrested and he is the only source of income. The department may be harmed should the truth be known. Would honor an idea or value— such as personal, professional, or religious—make t he alternative invalid? Professionally it may allow for an intoxicated driver to be on the streets, causing public harm.Professionally, religiously, and personally, it would be wrong to move forward with a falsified report.Applying Ethical Guidelines6. Consider each ethical guideline and explain whether it would support or reject your alternative. Guidelines based on the action itself Alternative A Alternative B Should this alternative become a rule or policy that everyone in this situation should follow in similar situations in the future? (Kant) Yes No Does this alternative result in using any person as a means to an end without consideration for his or her basic integrity? (Kant) Yes Yes Is the intent of this action free from vested interest or ulterior motive? (Kant’s good will) Yes No Does this alternative demonstrate a genuine concern for others affected by the decision, and is the moral agency responding to a perceived need? Yes No Guidelines based on consequences Alte rnative A Alternative B Is the good that results from this alternative outweighed by the potential harm that might be done to others? (Mill’s harm principle) No No Is any harm brought about by anyone other than the moral agent? (causal harm) YesYes Will anyone be harmed who can be said to be defenseless? (paternalism) Yes Yes To what degree is this alternative based on the moral agent’s own best interest? (ethical egoism)Which alternative will generate the greatest benefit—or the least amount of harm—for the greatest number of people? Select only one alternative. (utilitarianism) Alternative number one generates the greatest benefit or least harm.Ethical Decision Making7. Choose to proceed with either Alternative A or Alternative B and explain the reasons for your decision. Alternative A allows the husband to make better choices, as well as keeps the police officers and the prosecutor from lying. The truth will be known and it will not make the police dep artment look irresponsible for not taking proper steps to arrest with sufficient evidence.