Ethical Issues in Mental Health Nursing - 2624 Words

Professional Accountability Analysis of a dilemma in practice â€Å"Sally and the Health Visitor† Dip HE Mental Health Nursing Word count: 1,957. Contents page Introduction | 1 | Autonomy | 1 | Beneficence | 3 | Nonmaleficence | 4 | Justice | 4 | Conclusion | 5 | Bibliography | 6 | Introduction This discussion paper will look at the ethical issues surrounding decision making as nurses, in a given scenario (Sally and the health visitor). Ethics is defined by Johnstone (2008) as â€Å"A way to think about, judge and examine how to tackle moral life. It should help define what we ought to do, by considering and reconsidering actions†. This will be tackled using the ethical framework set out by Beauchamp and Childress (2009), this†¦show more content†¦In terms of moral duty, whatever the Health visitor decides, should be told to Sally to maintain fidelity (Hendrick, 2004) Sally’s feelings of anger and worry may be symptoms of a postpartum depression or a psychosis (ICD-10 v.2010). This possible disorder may have incapacitated Sally from making rationale decisions, as her picture of reality may be distorted (ICD-10 v.2010). DH (2009a) guidelines also state that if decisions are based on a mis-perception of reality, not due to culture or religion for example, then it is said that the person lacks capacity. Johnstone (2009) comments that mental illness can impair ones capacity to make decisions, she cites Brock and Buchanan (1989) stating that when such choices arise, three points should be considered. These points are, protecting and promoting the patients wellbeing; promoting and protecting the patients right to, and interest in exercising self-determining choices; and protecting others who may come to harm by the patients harm-causing choices. It is also noted however, that mental illness does not always cause people to be incapacitated; menta l capacity can fluctuate, and should be tested where there is doubt, at the time of making the decision (MCA, 2005). It would appear, that Sally has some insight that her feelings could be considered a risk, as she has chosen to inform the health visitor of the situation, therefore making her choices autonomous (Beauchamp and Childress, 2009). This paper willShow MoreRelatedThe Importance Of Restraint And Seclusion Of The Mental Health Act ( 1983 )1524 Words   |  7 Pages TAQ3: The use of treatments such as restraint is permitted according to the Mental Health Act (1983), for treating individual suffering from mental health disorder (Mind, 2013). This law can be applied with or without the approval of the person involved as its ultimate goal is to prevent the person from harming himself or others (Royal College of Nursing, 2015). 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Should The Minimum Wage Be Paid - 993 Words

Many case in USA suffering from the very low hourly payment according to Talk poverty: As wages go down, the percentage of workers relying on public assistance gets higher: 60 percent of workers earning less than $7.42—only slightly higher than the $7.25 federal minimum wage—receive some form of means-tested public assistance. Overall, 70 percent of the benefits in programs meant to aid non-elderly low-income households—programs like food stamps, Medicaid, and the Earned Income Tax Credits—go to working families.and it help some people get out of the food stamp Because the low minim wage many low income worker live with their children under a poverty. The first reason for raise the minim wage because it will help the government to save million dollars. As talk poverty state that a new report from the Economic Policy Institute indicates that raising the federal minimum wage to $12 by 2020 would lift wages for more than 35 million workers nationwide and gene rate about $17 billion annually in savings to government assistance programs. By this big saving the government improve the economy by using this money in different investment field, such as education instution, offer a good insurance plan for the middle –class. Addition reason, for raising the minim wage will eliminate the income inequities. According to Waltman, There are two secondary goals of minimum wage policy as well. The first of these is to reduce economic inequality. Since wages and salaries are the majorShow MoreRelatedMinimum Wage Should Be Paid2347 Words   |  10 Pagesthemselves, solely on the income from a minimum wage job. 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Lamb The Gospel According to Biff, Christ’s Childhood Pal Chapter 16 Free Essays

string(115) " picked up in Kabul and they were comfortable to ride, but more important, none of them had ever tried to bite me\." Chapter 16 We were twelve days into our journey, following Balthasar’s meticulously drawn map, when we came to the wall. â€Å"So,† I said, â€Å"what do you think of the wall?† â€Å"It’s great,† said Joshua. â€Å"It’s not that great,† I said. We will write a custom essay sample on Lamb: The Gospel According to Biff, Christ’s Childhood Pal Chapter 16 or any similar topic only for you Order Now There was a long line waiting to get through the giant gate, where scores of bureaucrats collected taxes from caravan masters as they passed through. The gatehouses alone were each as big as one of Herod’s palaces, and soldiers rode horses atop the wall, patrolling far into the distance. We were a good league back from the gate and the line didn’t seem to be moving. â€Å"This is going to take all day,† I said. â€Å"Why would they build such a thing? If you can build a wall like this then you ought to be able to raise an army large enough to defeat any invaders.† â€Å"Lao-tzu built this wall,† Joshua said. â€Å"The old master who wrote the Tao? I don’t think so.† â€Å"What does the Tao value above all else?† â€Å"Compassion? Those other two jewel things?† â€Å"No, inaction. Contemplation. Steadiness. Conservatism. A wall is the defense of a country that values inaction. But a wall imprisons the people of a country as much as it protects them. That’s why Balthasar had us go this way. He wanted me to see the error in the Tao. One can’t be free without action.† â€Å"So he spent all that time teaching us the Tao so we could see that it was wrong.† â€Å"No, not wrong. Not all of it. The compassion, humility, and moderation of the Tao, these are the qualities of a righteous man, but not inaction. These people are slaves to inaction.† â€Å"You worked as a stonecutter, Josh,† I said, nodding toward the massive wall. â€Å"You think this wall was built through inaction?† â€Å"The magus wasn’t teaching us about action as in work, it was action as in change. That’s why we learned Confucius first – everything having to do with the order of our fathers, the law, manners. Confucius is like the Torah, rules to follow. And Lao-tzu is even more conservative, saying that if you do nothing you won’t break any rules. You have to let tradition fall sometime, you have to take action, you have to eat bacon. That’s what Balthasar was trying to teach me.† â€Å"I’ve said it before, Josh – and you know how I love bacon – but I don’t think bacon is enough for the Messiah to bring.† â€Å"Change,† Joshua said. â€Å"A Messiah has to bring change. Change comes through action. Balthasar once said to me, ‘There’s no such thing as a conservative hero.’ He was wise, that old man.† I thought about the old magus as I looked at the wall stretching over the hills, then at the line of travelers ahead of us. A small city had grown up at the entrance to the wall to accommodate the needs of the delayed travelers along the Silk Road and it boiled with merchants hawking food and drink along the line. â€Å"Screw it,† I said. â€Å"This is going to take forever. How long can it be? Let’s go around.† A month later, when we had returned to the same gate and we were standing in line to get through, Joshua asked: â€Å"So what do you think of the wall now? I mean, now that we’ve seen so much more of it?† â€Å"I think it’s ostentatious and unpleasant,† I said. â€Å"If they don’t have a name for it, you should suggest that.† And so it came to pass that through the ages the wall was known as the Ostentatious and Unpleasant Wall of China. At least I hope that’s what happened. It’s not on my Friendly Flyer Miles map, so I can’t be sure. We could see the mountain where Gaspar’s monastery lay long before we reached it. Like the other peaks around it, it cut the sky like a huge tooth. Below the mountain was a village surrounded by high pasture. We stopped there to rest and water our camels. The people of the village all came out to greet us and they marveled at our strange eyes and Joshua’s curly hair as if we were gods that had been lowered out of the heavens (which I guess was true in Josh’s case, but you forget about that when you’re around someone a lot). An old toothless woman who spoke a dialect of Chinese similar to the one we had learned from Joy convinced us to leave the camels in the village. She traced the path up the mountain with a craggy finger and it was obvious that the path was both too narrow and too steep to accommodate the animals. The villagers served us a spicy meat dish with frothy bowls of milk to wash it down. I hesitated and looked at Joshua. The Torah forbade us to eat meat and dairy at the same meal. â€Å"I’m thinking this is a lot like the bacon thing,† Joshua said. â€Å"I really don’t feel that the Lord cares if we wash down our yak with a bowl of milk.† â€Å"Yak?† â€Å"That’s what this is. The old woman told me.† â€Å"Well, sin or not, I’m not eating it. I’ll just drink the milk.† â€Å"It’s yak milk too.† â€Å"I’m not drinking it.† â€Å"Use your own judgment, it served you so well in the past, like, oh, when you decided we should go around the wall.† â€Å"You know,† I said, weary of having the whole wall thing brought up again, â€Å"I never said you could use sarcasm whenever you wanted to. I think you’re using my invention in ways that it was never intended to be used.† â€Å"Like against you?† â€Å"See? See what I mean?† We left the village early the next morning, carrying only some rice balls, our waterskins, and what little money we had left. We left our three camels in the care of the toothless old woman, who promised to take care of them until we returned. I would miss them. They were the spiffy double-humpers we’d picked up in Kabul and they were comfortable to ride, but more important, none of them had ever tried to bite me. You read "Lamb: The Gospel According to Biff, Christ’s Childhood Pal Chapter 16" in category "Essay examples" â€Å"They’re going to eat our camels, you know? We won’t be gone an hour before one of them is turning on a spit.† â€Å"They won’t eat the camels.† Joshua, forever believing in the goodness of human beings. â€Å"They don’t know what they are. They think that they’re just tall food. They’re going to eat them. The only meat they ever get is yak.† â€Å"You don’t even know what a yak is.† â€Å"Do too,† I said, but the air was getting thin and I was too tired to prove myself at the time. The sun was going down behind the mountains when we finally reached the monastery. Except for a huge wooden gate with a small hatch in it, it was constructed entirely of the same black basalt as the mountain on which it stood. It looked more like a fortress than a place of worship. â€Å"Makes you wonder if all three of your magi live in fortresses, doesn’t it?† â€Å"Hit the gong,† said Joshua. There was a bronze gong hanging outside the door with a padded drumstick standing next to it and a sign in a language that we couldn’t read. I hit the gong. We waited. I hit the gong again. And we waited. The sun went down and it began to get very cold on the mountainside. I rang the gong three times loud. We ate our rice balls and drank most of our water and waited. I pounded the bejezus out of the gong and the hatch opened. A dim light from inside the gate illuminated the smooth cheeks of a Chinese man about our age. â€Å"What?† he said in Chinese. â€Å"We are here to see Gaspar,† I said. â€Å"Balthasar sent us.† â€Å"Gaspar sees no one. Your aspect is dim and your eyes are too round.† He slammed the little hatch. This time Joshua pounded on the gong until the monk returned. â€Å"Let me see that drumstick,† the monk said, holding his hand out through the little port. Joshua gave him the drumstick and stepped back. â€Å"Go away and come back in the morning,† the monk said. â€Å"But we’ve traveled all day,† Joshua said. â€Å"We’re cold and hungry.† â€Å"Life is suffering,† the monk said. He slammed the little door, leaving us in almost total darkness. â€Å"Maybe that’s what you’re supposed to learn,† I said. â€Å"Let’s go home.† â€Å"No, we wait,† said Joshua. In the morning, after Joshua and I had slept against the great gate, huddled together to conserve warmth, the monk opened the little hatch. â€Å"You still here?† He couldn’t see us, as we were directly below the window. â€Å"Yes,† I said. â€Å"Can we see Gaspar now?† He craned his neck out the hatch, then pulled it back in and produced a small wooden bowl, from which he poured water on our heads. â€Å"Go away. Your feet are misshapen and your eyebrows grow together in a threatening way.† â€Å"But†¦Ã¢â‚¬  He slammed the hatch. And so we spent the day outside the gate, me wanting to go down the mountain, Joshua insisting that we wait. There was frost in our hair when we woke the next morning, and I felt my very bones aching. The monk opened the hatch just after first light. â€Å"You are so stupid that the village idiots’ guild uses you as a standard for testing,† said the monk. â€Å"Actually, I’m a member of the village idiots’ guild,† I retorted. â€Å"In that case,† said the monk, â€Å"go away.† I cursed eloquently in five languages and was beginning to tear at my hair in frustration when I spotted something large moving in the sky overhead. As it got closer, I saw that it was the angel, wearing his aspect of black robe and wings. He carried a flaming bundle of sticks and pitch, which trailed a trail of flames and thick black smoke behind him in the sky. When he had passed over us several times, he flew off over the horizon, leaving a smoky pattern of Chinese characters that spelled out a message across the sky: SURRENDER DOROTHY. I was just fuckin’ with you (as Balthasar used to say). Raziel didn’t really write SURRENDER DOROTHY in the sky. The angel and I watched The Wizard of Oz together on television last night and the scene at the gates of Oz reminded me of when Joshua and I were at the monastery gate. Raziel said he identified with Glinda, Good Witch of the North. (I would have thought flying monkey, but I believe his choice was a blond one.) I have to admit that I felt some sympathy for the scarecrow, although I don’t believe I would have been singing about the lack of a brain. In fact, amid all the musical laments over not having a heart, a brain, or the nerve, did anyone notice that they didn’t have a penis among them? I think it would have shown on the Lion and the Tin Man, and when the Scarecrow has his pants destuffed, you don’t see a flying monkey waving an errant straw Johnson around anywhere, do you? I think I know what song I’d be singing: Oh, I would while away the hours, Wanking in the flowers, my heart all full of song, I’d be gilding all the lilies as I waved about my willie If I only had a schlong. And suddenly it occurred to me, as I composed the above opus, that although Raziel had always seemed to have the aspect of a male, I had no idea if there were even genders among the angels. After all, Raziel was the only one I’d ever seen. I leapt from my chair and confronted him in the midst of an afternoon Looney Tunes festival. â€Å"Raziel, do you have equipment?† â€Å"Equipment?† â€Å"A package, a taliwacker, a unit, a dick – do you have one?† â€Å"No,† said the angel, perplexed that I would be asking. â€Å"Why would I need one?† â€Å"For sex. Don’t angels have sex?† â€Å"Well, yes, but we don’t use those.† â€Å"So there are female angels and male angels?† â€Å"Yes.† â€Å"And you have sex with female angels.† â€Å"Correct.† â€Å"With what do you have sex?† â€Å"Female angels. I just told you.† â€Å"No, do you have a sex organ?† â€Å"Yes.† â€Å"Show me?† â€Å"I don’t have it with me.† â€Å"Oh.† I realized that there are some things I’d really rather not know about. Anyway, he didn’t write in the sky, and, in fact, we didn’t see Raziel again, but the monks did let us into the monastery after three days. They said that they made everybody wait three days. It weeded out the insincere. The entire two-story structure that was the monastery was fashioned of rough stone, none larger than could have been lifted into place by a single man. The rear of the building was built right into the mountainside. The structure seemed to have been built under an existing overhang in the rock, so there was minimal roofing exposed to the elements. What did show was made of terra-cotta tiles that lay on a steep incline, obviously to shed any buildup of snow. A short and hairless monk wearing a saffron-colored robe led us across an outer courtyard paved with flagstone through an austere doorway into the monastery. The floor inside was stone, and though immaculately clean, it was no more finished than the flagstone of the courtyard. There were only a few windows, more like arrow slits, cut high in the wall, and little light penetrated the interior once the front door was closed. The air was thick with incense and filled with a buzzing chorus of male voices producing a rhythmic chant that seemed to come from everywhere and nowhere at once and made it seem as if my ribs and kneecaps were vibrating from the inside. Whatever language they were chanting in I didn’t understand, but the message was clear: these men were invoking something that transcended this world. The monk led us up a narrow stairway into a long, narrow corridor lined with open doorways no higher than my waist. As we passed I could see that these must be the monks’ cells, and each was just large enough to accommodate a small man lying down. There was a woven mat on the floor and a woolen blanket rolled up at the top of each cell, but there was no evidence of personal possessions nor storage for any. There were no doors to close for privacy. In short, it was very much like what I had grown up with, which didn’t make me feel any better about it. Nearly five years of the relative opulence at Balthasar’s fortress had spoiled me. I yearned for a soft bed and a half-dozen Chinese concubines to hand-feed me and rub my body with fragrant oils. (Well, I said I was spoiled.) At last the monk led us into a large open chamber with a high stone ceiling and I realized that we were no longer in a man-made structure, but a large cave. At the far end of the cave was a stone statue of a man seated cross-legged, his eyes closed, his hands before him with the first fingers and thumbs forming closed circles. Lit by the orange light of candles, a haze of incense smoke hanging about his shaved head, he appeared to be praying. The monk, our guide, disappeared into the darkness at the sides of the cave and Joshua and I approached the statue cautiously, stepping carefully across the rough floor of the cave. (We had long since lost our surprise and outrage at graven images. The world at large and the art we had seen in our travels served to dampen even that grave commandment. â€Å"Bacon,† Joshua said when I asked him about it.) This great room was the source of the chanting we had been hearing since entering the monastery, and after seeing the monks’ cells we determined that there must be at least twenty monks adding their voices to the droning, although the way the cave echoed it might have been one or a thousand. As we approached the statue, trying to ascertain what sort of stone it was made from, it opened its eyes. â€Å"Is that you, Joshua?† it said in perfect Aramaic. â€Å"Yes,† said Joshua. â€Å"And who is this?† â€Å"This is my friend, Biff.† â€Å"Now he will be called Twenty-one, when he needs to be called, and you shall be Twenty-two. While you are here you have no name.† The statue wasn’t a statue, of course, it was Gaspar. The orange light of the candles and his complete lack of motion or expression had only made him appear to be made of stone. I suppose we were also thrown off because we were expecting a Chinese. This man looked as if he was from India. His skin was even darker than ours and he wore the red dot on his head that we had seen on Indian traders in Kabul and Antioch. It was difficult to tell his age, as he had no hair or beard and there wasn’t a line in his face. â€Å"He’s the Messiah,† I said. â€Å"The Son of God. You came to see him at his birth.† Still no expression from Gaspar. He said, â€Å"The Messiah must die if you are to learn. Kill him tomorrow.† â€Å"‘Scuse me?† I said. â€Å"Tomorrow you will learn. Feed them,† said Gaspar. Another monk, who looked almost identical to the first monk, came out of the dark and took Joshua by the shoulder. He led us out of the chapel chamber and back to the cells where he showed Joshua and me our accommodations. He took our satchels away from us and left. He returned in a few minutes with a bowl of rice and a cup of weak tea for each of us. Then he went away, having said nothing since letting us in. â€Å"Chatty little guy,† I said. Joshua scooped some rice into his mouth and grimaced. It was cold and unsalted. â€Å"Should I be worried about what he said about the Messiah dying tomorrow, do you think?† â€Å"You know how you’ve never been completely sure whether you were the Messiah or not?† â€Å"Yeah.† â€Å"Tomorrow, if they don’t kill you first thing in the morning, tell them that.† The next morning Number Seven Monk awakened Joshua and me by whacking us in the feet with a bamboo staff. To his credit, Number Seven was smiling when I finally got the sleep cleared from my eyes, but that was really a small consolation. Number Seven was short and thin with high cheekbones and widely set eyes. He wore a long orange robe woven from rough cotton and no shoes. He was clean-shaven and his head was also shaved except for a small tail that grew out at the crown and was tied with a string. He looked as if he could be anywhere from seventeen to thirty-five years old, it was impossible to tell. (Should you wonder about the appearance of Monks Two through Six, and Eight through Twenty, just imagine Number Seven Monk nineteen times. Or at least that’s how they appeared to me for the first few months. Later, I’m sure, except that we were taller and round-eyed, Joshua and I, or Monks Twenty-one and Twenty-two, would have fit the same description. When one is trying to shed the bonds of ego, a unique appearance is a liability. That’s why they call it a â€Å"uniform.† But alas, I’m getting ahead of myself.) Number Seven led us to a window that was obviously used as a latrine, waited while we used it, then took us to a small room where Gaspar sat, his legs crossed in a seemingly impossible position, with a small table before him. The monk bowed and left the room and Gaspar asked us to sit down, again in our native Aramaic. We sat across from him on the floor – no, that’s not right, we didn’t actually sit, we lay on the floor on our sides, propped up on one elbow the way we would have been at the low tables at home. We sat after Gaspar produced a bamboo staff from under the table and, with a motion as fast as a striking cobra’s, whacked us both on the side of the head with it. â€Å"I said sit!† he said. Then we sat. â€Å"Jeez,† I said, rubbing the knot that was swelling over my ear. â€Å"Listen,† Gaspar said, holding the stick up to clarify exactly what he meant. We listened as if they were going to discontinue sound any second and we needed to stock up. I think I even stopped breathing for a while. â€Å"Good,† said Gaspar, laying the stick down and pouring tea into three simple bowls on the table. We looked at the tea sitting there, steaming – just looked at it. Gaspar laughed like a little boy, all the graveness and authority from a second ago gone from his face. He could have been a benevolent older uncle. In fact, except for the obviously Indian features, he reminded me a lot of Joseph, Joshua’s stepfather. â€Å"No Messiah,† Gaspar said, switching to Chinese now. â€Å"Do you understand?† â€Å"Yes,† Joshua and I said in unison. In an instant the bamboo stick was in his hand and the other end was bouncing off of Joshua’s head. I covered my own head with my arms but the blow never came. â€Å"Did I strike the Messiah?† Gaspar asked Joshua. Joshua seemed genuinely perplexed. He paused, rubbing the spot on his head, when another blow caught him over his other ear, the sound of the impact sharp and harsh in the small stone room. â€Å"Did I strike the Messiah?† Gaspar repeated. Joshua’s dark brown eyes showed neither pain nor fear, just confusion as deep as the confusion of a calf who has just had its throat cut by the Temple priest. The stick whistled through the air again, but this time I caught it in mid-swing, wrenched it out of Gaspar’s hand, and tossed it out the narrow window behind him. I quickly folded my hands and looked at the table in front of me. â€Å"Begging your pardon, master,† I said, â€Å"but if you hit him again, I’ll kill you.† Gaspar stood, but I was afraid to look at him (or Joshua, for that matter). â€Å"Ego,† said the monk. He left the room without another word. Joshua and I sat in silence for a few minutes, thinking and rubbing our goose eggs. Well, it had been an interesting trip and all, but Joshua wasn’t very well going to learn much about being the Messiah from someone who hit him with a stick whenever it was mentioned, and that, I supposed, was the reason we were there. So, onward. I drank the bowl of tea in front of me, then the one that Gaspar had left. â€Å"Two wise men down, one to go,† I said. â€Å"We’d better find some breakfast if we’re going to travel.† Joshua looked at me as perplexed as he had at Gaspar a few minutes before. â€Å"Do you think he needs that stick?† Number Seven Monk handed us our satchels, bowed deeply, then went back into the monastery and closed the door, leaving Joshua and me standing there by the gong. It was a clear morning and we could see the smoke of cook fires rising from the village below. â€Å"We should have asked for some breakfast,† I said. â€Å"This is going to be a long climb down.† â€Å"I’m not leaving,† Josh said. â€Å"You’re kidding.† â€Å"I have a lot more to learn here.† â€Å"Like how to take a beating?† â€Å"Maybe.† â€Å"I’m not sure Gaspar will let me back in. He didn’t seem too pleased with me.† â€Å"You threatened to kill him.† â€Å"I did not, I warned that I’d kill him. Big difference.† â€Å"So you’re not going to stay?† And there it was, the question. Was I going to stay with my best friend, eat cold rice, sleep on a cold floor, take abuse from a mad monk, and very likely have my skull split open, or was I going to go? Go where? Home? Back to Kabul and Joy? Despite the long journey, it seemed easier to go back the way I had come. At least some level of familiarity would be waiting there. But if I was making easy choices, why was I there in the first place? â€Å"Are you sure you have to stay here, Josh? Can’t we go find Melchior?† â€Å"I know I have things to learn here.† Joshua picked up the drumstick and rang the gong. In a few minutes the little port opened in the door and a monk we had never seen before stuck his face in the opening. â€Å"Go away. Your nature is dense and your breath smells like a yak’s ass.† He slammed the hatch. Joshua rang the gong again. â€Å"I don’t like that whole thing about killing the Messiah. I can’t stay here, Joshua. Not if he’s going to hit you.† â€Å"I have a feeling I’m going to get hit quite a few more times until I learn what he needs me to know.† â€Å"I have to go.† â€Å"Yes, you do.† â€Å"But I could stay.† â€Å"No. Trust me, you have to leave me now, so you won’t later. I’ll see you again.† He turned away from me and faced the door. â€Å"Oh, you don’t know anything else, but you know that all of a sudden?† â€Å"Yes. Go, Biff. Good-bye.† I walked down the narrow path and nearly stumbled over a precipice when I heard the hatch in the door open. â€Å"Where are you going?† shouted the monk. â€Å"Home,† I said. â€Å"Good, go frighten some children with your glorious ignorance.† â€Å"I will.† I tried to keep my shoulders steady as I walked away, but it felt like someone was ripping my soul through the muscles of my back. I would not turn around, I vowed, and slowly, painfully, I made my way down the path, convinced that I would never see Joshua again. 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