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By J. Kamak. Lourdes College.

Yet a death due to a motor vehicle crash is generally classifed as an accident reglan 10mg on line gastritis sore throat, regardless of whether one or both of the drivers were at fault or caused the crash discount 10 mg reglan with visa superficial gastritis definition. Others would consider it to be an accidental death since the hunter did not intend to kill a human being. Some jurisdictions require that intent to cause one’s own death be a factor in classifying a death as suicide. Others require only that the act leading to death be intentional, regardless of whether or not death was anticipated. Others would agree that the death represents a suicide, but largely because of the high inherent risk of the activity. Deaths due to acute intoxication by ethanol or other drugs are usually classifed as accidents unless suicidal intent is evident. But deaths due to the chronic efects of the same drugs (cirrhosis, endocarditis, etc. Tese are but a few of the inconsistencies and disagreements that may plague a manner of death determination. Subsequently, a panel discussion was convened at a meeting of the National Association of Medical Examiners in 1996 in which fve well-known and respected forensic pathologists discussed their opinions of the cases. Te degree of discordance was striking in both the survey and the subsequent panel discussion. Complete agreement was reached in only one case, and in some cases, the level of disagreement was such that no majority opinion was identifed. Tough it may be assumed that the use of a particular manner of death classifcation schema is based on consistent scientifc principles, it is in fact based more on local tradition and habit, and national consistency has proven to be an elusive goal. Another factor causing difculty in producing consistent manner of death classifcations is the exceptional complexity of various death processes. Each case is quite unique, with many facets of the death process being unknown, partially known, or merely inferred. In such cases, it is extraordinarily difcult to distill this complexity into one of four or fve categories, and if it can be done, some would consider it to be of little practical use. Afer all, categoriz- ing disparate and dissimilar types of deaths together into overly broad and artifcial categories seems to be of questionable value. In fact, however, the manner of death classifcation put forth by the medical examiner is not a legal opinion or criminal charge, nor is it binding to parties in civil disputes. It is, instead, a classifcation scheme for use by state vital records agencies charged with glean- ing epidemiologic data from death certifcates. By way of illustration, consider that if a driver causes a collision by virtue of his recklessness or intoxication, he may be prosecuted for manslaughter even though the medical examiner classifes the death as an accident. Conversely, if a police ofcer shoots and kills a weapon-wielding felon, it will generally be classifed as a homicide by the medical examiner. But if the shooting is considered justifable, no charges of murder or manslaughter may be brought against the ofcer. Te belief that the medical examiner assigns criminal culpability when classifying manner of death is incorrect, but it is ofen a source of misunderstanding. Because of these inconsistencies in the classical manner of death classi- fcation, some experts would prefer to delete this system in favor of a greatly expanded and more useful list of manner of death choices, or a more detailed and fexible narrative statement giving sufcient information so that the events of a death are clear to those perusing the death certifcate.

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Nightingale sustained there reglan 10mg fast delivery gastritis diet , experiences that ce- There were no pillows discount 10mg reglan amex gastritis symptoms list, no blankets; the men lay, with mented her views on disease and contagion, as well their heads on their boots, wrapped in the blanket or as her commitment to an environmental approach greatcoat stiff with blood and filth which had been their sole covering for more than a week. The men in the corri- than 1000 men suffering from acute diarrhea and dors lay on unwashed floors crawling with vermin. In this filth lay the men’s food—Miss Nightingale saw the skinned carcass of a sheep lie in a wardallnight... Nightingale’s reply: “The strongest will be wanted at the wash tub” (Cook, 1913; Dolan, 1971). Although the bulk of this work continued to be cleansed sewers, limewashed walls, tore out shelves done by orderlies after Nightingale’s arrival (with that harbored rats, and got rid of vermin. The com- the laundry farmed out to the soldiers’ wives), it mission, Nightingale said,“saved the British Army. Because no antidote to infection existed at this Her spirituality involved the sense of a presence time, the provision—by Nightingale and her higher than human presence, the divine intelli- nurses—of cleanliness, order, encouragement to gence that creates, sustains, and organizes the uni- eat, feeding, clean bed linen, clean bodies, and clean verse, and an awareness of our inner connection to wards, was essential to recovery (Summers, 1988). Through this inner connection Mortality rates at the Barrack Hospital in flows creative endeavors and insight, a sense of pur- Scutari fell. For Miss Nightingale, spiritual- the prime minister had sent to the Crimea a sani- ity was intrinsic to human nature and was the tary commission to investigate the high mortality deepest, most potent resource for healing. Beginning their work in March, they de- Nightingale was to write in Suggestions for Thought scribed the conditions at the Barrack Hospital as (Calabria & Macrae, 1994, p. The commission cleared “556 handcarts and ness to unity with the divine was an evolutionary large baskets full of rubbish... There were four miles of beds in the Barrack Hospital at Scutari, a suburb of Constantinople. A letter to the London Times dated February 24, 1855, reported the following: When all the medical officers have retired for the night and silence and darkness have settled upon those miles of prostrate sick, she may be observed, alone with a little lamp in her hand, making her Image rights unavailable. In April 1855, after having been in Scutari for six months, Florence wrote to her mother, “[A]m in sympathy with God, fulfilling the purpose I came into the world for” (Woodham-Smith, 1983, p. Henry Wadsworth Longfellow authored “Santa Filomena” to commemorate Miss Nightingale. Miss Nightingale slipped home quietly, arriving but she had left her heart on the battlefields of the at Lea Hurst in Derbyshire on August 7, 1856, after Crimea and in the graveyards of Scutari” (Huxley, 22 months in the Crimea and after sustained illness 1975, p. The In watching disease, both in private homes and next morning, a peal of the village church bells public hospitals, the thing which strikes the expe- and a prayer of Thanksgiving were, her sister wrote, rienced observer most forcefully is this, that the “‘all the innocent greeting’ except for those pro- symptoms or the sufferings generally considered to be vided by the spoils of war that had proceeded her— inevitable and incident to the disease are very often a one-legged sailor boy, a small Russian orphan, not symptoms of the disease at all, but of some- and a large puppy found in some rocks near thing quite different—of the want of fresh air, or Balaclava. At this point in time, in the mid-nineteenth cen- To gain a better understanding of Nightingale’s tury, there were two competing theories regarding ideas on nursing, one must enter the peculiar world the nature and origin of disease. One view was of nineteenth-century medicine and its views on known as “contagionism,” postulating that some health and disease. Considerable new medical diseases were communicable, spread via commerce knowledge had been gained by 1800. The strategic conse- anatomy was well known; chemistry promised to quences of this explanatory model was quarantine, throw light on various body processes. Vaccination and its attendant bureaucracy aimed at shutting against smallpox existed. There were some estab- down commerce and trade to keep disease away lished drugs in the pharmacopoeia: cinchona bark, from noninfected areas. Certain major diseases, such emerging merchant classes, quarantine represented as leprosy and the bubonic plague had almost dis- government interference and control (Ackernecht, appeared. It postulated that disease resulted from local envi- Yet physicians at the turn of the century, in 1800, ronmental sources and arose out of “miasmas”— still had only the vaguest notion of diagnosis. It was this shift in thought—a paradigm William Farr, another Nightingale associate and shift of the first order—that gave us the triumph of avid anticontagionist, was Britain’s statistical super- twentieth-century medicine, with all its attendant intendent of the General Register Office.

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Applying Parse’s the- of Toronto generic reglan 10 mg otc chronic gastritis support group, 550 University Avenue buy reglan 10mg cheap gastritis diet oatmeal cookies, Toronto, Ontario, Canada ory to perioperative nursing: A nontraditional approach. Nursing research: becoming theory in practice in an acute care psychiatric set- Qualitative methods. Nursing Science Quarterly, 6, for nurses teaching and learning Parse’s theory of human be- 130–139. The global context of nurs- coming theory: A manual for the teaching-learning process. Hope: An international human becoming per- guided research on the lived experience of hope. Nursing Science Quarterly, human becoming hermeneutic study of a theme from 10, 124–130. The lived experience of feeling loved: A Qualitative inquiry: The path of sciencing (pp. Beyond objectivism and relativism: Illuminations: The human becoming theory in practice and re- Science, hermeneutics, and praxis. Comparison of three Parse method stud- of life and the human becoming theory: Exploring disci- ies on feeling very tired. The nurse theorists: Portraits of excellence: York: National League for Nursing Press. The lived experience of health for hospitalized the oldest old living in Scotland: A phenomenological study. The American Nurses Association code Behavioural Research Unit, Toronto-Sunnybrook Regional of ethics: A reflection on the ethics of respect and human dig- Cancer Centre, Toronto, Canada. Development of gerontological nursing the- approach to Parse’s theory-based practice. Human subjectivity: The cocreation of with nurses guided by Parse’s theory of human becoming. The Parse research method minations: The human becoming theory in practice and research through music. The lived experience of restriction- Caring frameworks and the human becoming theory. Philosophy in a new key: A study in the symbol- New York: National League for Nursing Press. Creating traditions: The art of putting it to- Patient-focused care and human becoming thought: gether. Patient-focused care on a complex con- nursing administration: Theory, research, education, and prac- tinuing care dialysis unit: Rose’s story. The human becoming theory and its re- Education: A Call for Substance: Preparing Leaders for Global search and practice methodologies. Illuminations: Newsletter for the International Consortium of Parse Scholars, Newsletter for the International Consortium of Parse Scholars, 11(3/4), 1. Nursing sionals can do to move toward a more personal and meaning- Science Quarterly, 14, 273. An ethical framework for nursing prac- Newsletter for the International Consortium of Parse Scholars, tice: Parse’s human becoming theory. Introducing the Theorist I don’t like deceiving, withholding, or treating people as subjects or objects. The foundation for the theory of Health as I don’t like acting as an objective non-person. Expanding Consciousness was laid prior to the I do like interacting authentically, listening, under- time Margaret Newman entered nursing school at standing, communicating freely.


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