Abstract
This paper examines how hypothyroidism is a condition that can cause a variety of symptoms in an individual. It looks at how it can be an emotionally trying disease that can impact an individual and their entire family and how, due to the nature of the symptoms, it can have a negative affect on lifestyle, social and personal relationships and activities of daily living. In particular, it discusses how nurses are instrumental in providing the appropriate care and recognizing the client and family's need for support throughout the transition following initial diagnosis. The paper incorporates nursing actions towards the patient as well as coping mechanisms for the family.

From the Paper
"Aside from the blood screening his physician ordered to determine the TSH levels in his blood, there was also subsequent blood tests requested to determine if this was in fact an autoimmune condition such as Hashimoto's disease where the body identifies the thyroid as an invader and begins to destroy it, or if this was a viral condition that would eventually dissipate over time (Hueston, 2001). If the thyroid condition was in fact autoimmune, Julian would be expected to continue drug therapy for the rest of his life. However, if the condition was viral, drug therapy would only last four to six months at which point his thyroid would begin to slowly function normally again."

Tags:blood, patient, hormone, levothyroxine

Abstract
In this article, the writer notes that despite the rapid shift from institutional to community care, limited attention has been given to gauging or evaluating patient safety in the Canadian public sector. This paper sets out to define key terms in patient safety within the public health movement. The writer examines barriers that exist within the public health division and discusses significant patient safety issues. Further, the writer defines strategies for incorporating safety into the community arena and provides examples of current programs within the community that employ patient safety principles. The writer concludes that by preventing illness, injury and disease from adverse events, the sustainability of the publicly funded health care is strengthened as investments in prevention divert pressures over the long term.

From the Paper
"Changes brought on by the strains of the 21st century are revolutionizing the face of health care in Canada. Over the last ten years numerous countries including Canada have begun to focus on safety issues as pressures mount to target and reduce preventable injuries and death amongst patients. The epidemiological investigations that sparked these labors have demonstrated a consistently high level of error, although the spotlight has been almost exclusively on acute care settings. Surprisingly, most research has besieged regulated systems such as hospitals, even though literature shows a growing demand for home care services in Canada. Organized institutions such as hospitals are able to provide care with specialized professionals and support staff however the home care environment is much less controlled. Patient care is often supplied by unregulated healthcare personnel and family members in a location that was intended for living not for health care."

Tags:health, care, community, nurse

Abstract
The paper discusses Canada's primary health care struggles in meeting the needs of children with mental illness. The paper illustrates the challenges faced by nurses but shows how they are endeavoring to to meet these challenges. The paper discusses how nurses will be participating in new roles that encompass early child development, education, social services, child protection and mental disease prevention.

From the Paper
"Canadians requiring health care typically contact a primary health care provider such as a physician, nurse, dietician or social worker who works collaboratively with other professionals. Services that are rendered at the initial point of contact within the health care system are referred to as primary health care services and outline the basis of our Medicare system (Canadian Nurses Association, 1995). A strong primary health care system is vital to sustaining the future. Nonetheless, there are some worrisome health trends in Canada particularly seen in rising rates of obesity, injury, asthma, risky behaviors, sexually transmitted diseases, poverty and mental illness in our children and adolescents (Canadian Council on Social Development, 2006)."

Tags:nurses, providers, acute, episodic, stable, chronic, psychiatrist

Abstract
This paper seeks to better understand what hospice care entails in Canada. It reviews some of the barriers faced by patients, families and palliative nurses with end of life issues. It discusses how quality of care at the end of life has many significant issues. The writer notes that countless citizens who could benefit from palliative care do not receive it or obtain it during the last few days or weeks of their illness. The author touches on strategies for overcoming the existing barriers in community based hospice care as well as how nurses can be leaders in ensuring that appropriate palliative care is received.

From the Paper
"Hospice care is not only for the patient; but for their family and friends as well. Emotional, spiritual, physical and social needs are addressed by the palliative team. Hospice provides tailored services in a caring community where patients and families attain the required groundwork for a death that is satisfactory to them. The nature of dying is one of a kind so that the goal of the hospice team is to be responsive and receptive to the special needs of each individual and family."
"Although hospice-palliative nurses bring expert knowledge and skills to the delivery of comprehensive and empathetic care to persons and families living with advanced illness, studies reveal that due to enormous barriers in end-of-life care in nursing homes and patients' residences, unnecessary suffering occurs at the bedside."

Tags:palliative, hospice, care, caregivers

Abstract
In this article, the writer defines cultural competence and explains the Culturally Competent Model of Ethical Decision Making Framework. Subsequently the writer analyzes a culturally defined, ethical predicament experienced by the writer in a clinical setting. The writer makes use of the 'Culturally Competent Model of Ethical Decision Making Framework" to examine the dilemma. Through this vignette, the writer discusses the setting in which the event occurred, those members involved and how the different stakeholders perceived the dilemma. In addition, conflicting values and beliefs at individuals, societal or organizational levels that influenced perceptions and interactions between the patient and caregivers are identified. Further, any power relations that may have existed between the participants and safety implications for the patient are reviewed. The writer explores the concepts of discrimination and disadvantage in a cultural context.

Outline:
Cultural Competence and Ethics
A Framework for Thinking Ethically
Vignette
Defining the Ethical Dilemma, the Key Stakeholders involved with Mr. H.
Worldviews, Organizational Views, Health Care Provider Views, Patient and Family Views
Redefining the Problem using the 'Culturally Competent Model of Ethical Decision Making'
Discrimination in Health Care
Conclusion

From the Paper
"Many members of the healthcare team failed Mr. H. on personal, ethical, cultural and organizational levels. Mr. H. was a man, a husband, a Mexican, a grandfather or otherwise known in Spanish as abuelo. He was loved by his family and was much missed back home in Mexico. He had not been in Canada long when he had his stroke. He had brought his family here in hopes of providing them with a better life, to be closer to his children who had immigrated a year earlier. His sons had been employed in a construction business and the family was cohabitating together to make ends meet. His hospital stay was nothing short of dreadful and frightening for him and undoubtedly for his family as well. Not one member of the health care team thought it abnormal that he was constantly restrained in his bed or wheelchair. Those members included nurses, social work, physiotherapy, and occupational therapy, physicians and speech and language pathology."

Tags:health, care, therapeutic, relationship, moral

Abstract
In this article, the writer illustrates the development and progress of nursing as a discipline to date. Furthermore, the writer demonstrates the research paradigms that continue to contribute to the growth of nursing knowledge. Moreover, the writer articulates the strengths and weaknesses of those paradigms through critical analysis while comparing their philosophical and epistemological assumptions. The writer concludes that nursing curriculum and nursing practice have moved to a humanistic caring, visionary approach.

Outline:
Background: The Evolution of Research Paradigms
Empiricism and Interpretive Paradigms
Totality Paradigm
Simultaneity Paradigm
The Need for a Paradigm Shift
A Humanistic Theoretical Approach: Present Day Nursing
Conclusion

From the Paper
"Nursing has made extraordinary strides in the last century that has lead to its acknowledgment as an academic discipline and profession. The writer maintains that this shift to theory-based practice has made modern-day nursing more meaningful and significant by transferring its focus from a trade to a well-thought out, structured profession. The need for empirical guidance in nursing was recognized in the first half of the twentieth century. Hence, numerous conceptual and theoretical nursing models were developed with the intent of providing knowledge, guiding research and curriculum and categorizing goals to improve nursing practice. Nursing as a professional discipline has materialized most notably over the last decade. Seeing as the need for best practice, inductive reasoning and quality care continues to be nursing's core concerns, theoretical matrix is essential for nurses regardless of one's position as researcher, clinician, specialist or administrator. Advancement in nursing knowledge continues to evolve into a specialized body of skill and authority. This maturation of our metaparadigm and epistemological underpinnings has laid the foundation for the dawn of nursing as its own science."

Tags:profession, practice, nurses, health, care

Abstract
This paper reviews the writer's personal philosophy of care and individual ethics in a case scenario of a patient (referred to as Mr. Smith) with advanced Alzheimer's and dementia. The writer discusses how the family often appeared indifferent and unconcerned with their father's condition especially at his untimely demise, which proved difficult for the nursing staff as they cared profoundly for the patient. The writer explores the specific ethical principles involved, including autonomy, justice, beneficence, and nonmaleficence and links the clinical situation to a specific theory of grief, loss and bereavement. The writer suggests alternative actions which could have led to a more satisfying and ethical outcome in the case of Mr. Smith, his family and the nurses concerned.

Outline:
Introduction
My Philosophy of Care in my Nursing Practice
Autonomy, Justice, Beneficence and Nonmaleficence
Related Theory of Grief, Loss, and Bereavement
Suggested Alternative Solutions
Conclusion

From the Paper
"Ethics in healthcare is fundamental in the day-to-day care provided to patients' particularly in nursing and certainly with end of life issues. Essentially, the code of ethics for registered nurses is a declaration of commitment to those we serve, it is a guideline that sets out behaviors expected of us, and it advocates for quality care and serves as a self-reflection tool (Canadian Nurses Association, 1998). The codes of ethics and the standards of care made available by our governing body ensure that the best nursing practices will be provided to our patients (Aiken, 2005). Part of our nursing practice is to assist in life-threatening situations. Coping with death is challenging for nurses since the ability to cope with one's own grief or beliefs highly depends on the relationship of the healthcare provider to the patient, to their families and to their own experiences with death."

Tags:grief, loss, bereavement, autonomy, justice, beneficence, nonmaleficence

Abstract
This paper observes the changing role of women in society, specifically in Canada, as a result of World War I. It explains that women's roles as military nurses in The Great War were quite contradictory to conventional women's roles. The paper details the way that this specific duty in the war helped open doors to other advances for women in Canadian society, in particular, and the world, in general.

From the Paper
"As military nurses in The Great War, Canadian women took on many tasks and roles, some familiar, some new; however, all of these tasks and roles would be carried out in a distinctively non - traditional setting. These passages from the diaries of Ella Mae Bongard and Clare Gass, two Canadian nurses whom served overseas in The Great War, serve the purpose of bringing forth the general role of the nurses in World War one. Nurses were generally responsible for hundreds of patients each day, each one a totally unique case. Nurses were responsible for keeping the soldier's spirits up, repairing the soldier physically, repairing enemy prisoners of war, and essentially, watching young men die, among other various lesser tasks. As is obvious, the nurses were faced with the grim, grotesque realities of war and the realization that their countrymen were being killed and wounded in epic proportions. Upon undertaking such a multitude of tasks one would assume that these nurses were quite competent, strong individuals, broken free of all societal gender barriers but historians tend to disagree over the issue of whether or not gender stereotypes were effectively challenged or actually solidified during the war. According to Linda Quiney, women nurses cared not about breaking gender stereotypes but rather "they came to serve the men and they were proud of their service,"3 in reference to the attitudes of young women nurses in The Great War. This comment would seem to suggest that the nurses themselves viewed their experiences in the war as simply a way to support the male population, the same way it has traditionally been. The soldiers who were brought into the hospitals and nursing stations during the war were quite often very sick, mortally wounded, demoralized, and even quite lonely as one might expect. According to Mann, the nurses "displayed a female version of esprit-de-corps. Friendship, humorous escapades - whether in work or play the nurses combined seriousness of purpose with sheer delight."4 In saying this, Mann intends to stress the fact that the nurses not only served to repair the ailing soldiers physically, but mentally as well. Also according to Mann, soldiers still viewed the nurses overseas as "the protected"5 and in return for physical protection the army expects quick repairs of all its soldiers.6 From this perspective, one would be led to believe that women were, indeed, supporting the traditional stereotypes of a gender distinct society in which women carried out "maternal" tasks such as healing and nourishing and the men took upon the duties of providing for and defending his family. In Mann's intro to Clare Gass' diary she specifically states several duties that Gass is responsible for in the hospital: making beds, stocking the kitchen, changing bandages/gauzes, entertaining patients, etc. In short, the nurses were responsible for sustaining the spirit of the men "with a smile, a pat, a cig., treat, or chat." "

Tags:canadian, change, female, rights, role, social, war, woman, workd

Abstract
The paper evaluates Stephen Kermode's article "Is Nurse Education Sexist - An Exploratory Study". The paper discusses key topics of research with reference to the three methods of investigation; quantitative, qualitative and outcomes method research. The paper examines the article's relevance to nursing and reviews Kermode's methodological approach. The paper focuses on his research through eight components of a quantitative research study.

Outline:
PART "A": Rationale for Research Area
Methodological approach
Part "B": Problem Definition
Literature Review
Research Design
Sampling Protocols
Data Collection Strategies
Data Analysis Strategies

From the Paper
"Formal research builds knowledge in a discipline. In nursing, practitioners embark on discovering the best data to enhance clinical practice. Promoting nursing as an empirical, scientific profession based on evidence versus tradition, provides credibility, ensures nurses are meeting their social responsibilities and influencing organizational and government policies (Rafael, A. 2000). Nursing generates many questions. Best research evidence answers these questions through methodologically sound and pertinent investigations."

Tags:quantitative, qualitative, research, gender, biases, discrimination

Abstract
This paper presents a detailed examination of Dorothy Johnson's behavioral system model. The writer explores the model itself and then uses case study examples to apply the theory to real life situations in a critical care nursing role. It presents the positive outcomes for nurses and family members, of using the model in critical care nursing.

Table of Contents:
Introduction
Johnson's Life
The Model
Case Study
Conclusion

From the Paper
"One of the most well known nursing theorists in modern history was Dorothy Johnson. Johnson ideas about the field of nursing and how that field relates to the care of individual patients, including her well known Behavior Model theory (Fruschwirth, 2000). The theory encompasses many of the medical systems in the human body and how they relate to behaviors of individuals to provide a measurable blueprint as to how to apply those functions and behaviors to the everyday practice of nursing. To understand how the Behavioral System Model was conceived and developed and how it pertains to today's nursing profession it is important to have a basic understanding of nursing itself and the life of Johnson."

Tags:critical, care, nursing, burden