Because i could not stop for death&quot Essay Example for Free

Because i could not stop for deathquot Essay Emily Dickinson frequently explores death through her poetry, using her eponomous em dashes to communicate the confusion created by an intelligent and exploratory approach to the afterlife in a mind indoctrinated in Puritan dogma. Death is initially presented in this poem as a very different character from its usual personification as a malign, scythe wielding spirit. Here, as the poem begins, he takes the form of a charming suitor who kindly stops, and maintains his civility throughout their journey. As we progress through the poem, however, the reader becomes increasingly suspicious that the apparently benevolent Death has not, in fact, got Dickinsons best intrests at heart. The fourth stanza marks the change in tone that reveals this; the onset of ominous chill as the carriage passes into darkness highlights how unprepared Death has left her, providing no warning of what is to come. The nervous tone that the poem adopts in this stanza is created both by the breakdown of the previously iambic rythmn and the language of cold shivers that the poet uses; both of which emphasise the quivering nervousness of the unprepared. Dickinsons physical lack of preparation for the afterlife in the poem, her donning of gossamer and tulle for a journey into the night, reflects her lack of spiritual certainty in the real world; something reflected in several of her poems. Despite an upbringing filled with much gesture from the pulpit, doubt, not absolute faith, is the subject of much of her work. She remains steadfast only in her belief that This World is not Conclusion, as while she is confident in the existence of something more, the nature of the afterlife baffles her. This poem is also an exploration of an unusual view of death, as Dickinson inverts the normal metaphor of Death as the end of a journey into Death as a journeys beginning. Life, in this poem, is extrodinarily transient, compressed into the third stanza where childhood, the ripening Grain of middle age and the setting sun of old ages decline are ploughed through in four lines. The poet makes this already short liftime seem even less substantial by the anaphoric use of We passed, which increases the pace of the poem and gives the passage of time an inevitable feel. Where the poems journey of death concludes is unclear, but we do know that there is a pause, perhaps a terminal pause, at a house in the ground. Dickinsons use of imagery here is ingenious, as the readers initial confusion mimics the narrators, until we too surmise that this abode, this swelling in the ground is a grave, thought of only by the deceased as a house. The repetition and ryhme of ground at the end of two lines in this stanza gives it a pounding finality; suggesting perhaps that this, and not the expected Immortality, is to be Dickinsons final resting place. This unexpected turn causes the confusion that the image of the house parallels, and explains the last stanza, in which Dickinsons fear of perpetual existence in a grave has centuries feeling shorter than the day / I first surmised the Horses Heads / Were toward Eternity. The poem is, in fact, unclear, but I would suggest that the grave is to be Dickinsons final resting place; that the carriage paused not because it intended to go on but instead because the narrator has not yet realised her fate. The final dash of the poem, therefore, represents not continuing doubt as it does in This World is not Conclusion. but serves to remind the reader of the unending nature of Dickinsons internment. In light of this, the first stanzas Immortality may seem out of place, but its rhyme with me perhaps reveals its origins, as the narrator is consequently so strongly linked with its presence that we may imagine it is only Dickinson, and not Death, that welcomes immortality to the carriage, and that it is, in fact, only there as a result of her preconceptions. Because I could not stop for Death – is perhaps, as a result, quite a cynical poem, making no promises of salvation or a Christian heaven. It, in some senses, continues a trend set by This world is not Conlcusion. and Behind me – dips Eternity –; a trend of diminishing confidence: Dickinsons once absolute faith in a world beyond our own develops into a confused fear at the nature of the afterlife; it may be a Maelstrom in the sky, surrounded by Midnight, or perhaps just a house in the ground. All this confusion is the product of Dickinsons upbringing; the Tooth that nibbles at the soul is a doubt that was to Puritans damning, and once she admits to herself its existence her future is uncertain and heaven perhaps inachievable. Despite its bleak outlook however, the poem still stands a facinating exploration of the nature of the next world.

Didions Some Dreamers of the Golden Dream Essay examples -- Didion Dr

Didion's "Some Dreamers of the Golden Dream" In "Some Dreamers of the Golden Dream," the author Didion uses fiery imagery to parallel the San Bernardino Valley to hell.   It is a place where the "hills blaze up spontaneously," and "every voice seems a scream." (p.3)   Didions hellish descriptions of the geography reflect the culture of San Bernardino Valley.   It is "where the hot wind blows and the old ways do not seem relevant, where the divorce rate is double the national average." (p.4)   In this culture, the importance of   the "old ways," such as a long-lasting marriage, are devalued.   It is a society where the "dream [is] teaching the dreamers how to live," (p.17) and where reality doesnt hamper peoples obsessions and greediness.   In the essay "Some Dreamers of the Golden Dream," the San Bernardino Valleys self-indulgent culture devaluates societys morals and ethics such as religion, law, love, and life. In the San Bernardino Valley, tele-evangelism, Christian gospel spread through television, is prominent.   It is "the California where it is easy to Dial-A-Devotion, but hard to buy a book." (p.4)   It is a society where anyone with money can buy a devotion to God with the dialing of a number.   The usage of religion as a money-making business defiles the sanctity of societys most sacred and cherished belief.   However, money is made so morals and ethics are ignored.   Another example of this immorality is Edward Foley, Lucilles Millers attorney.   He sa...

Research Utilization Project †Fecal Transplantation Essay

Clostridium difficile (C-difficile) is a common bacterium that is a frequent cause of infection in the colon and effects numerous patients. Clostridium difficile increases the hospital costs associated with inpatient care, including identification of the organism as well as treatment. The most common cause of C-difficile infection is the elimination of normal intestinal flora caused by antibiotic use. Standard treatment of C-difficile infection includes the use of oral (Flagyl) and intravenous (Vancomycin) antibiotic therapy. The use of fecal transplantation to treat C-difficile infection is increasing in popularity. Research regarding fecal transplantation dates back to 1958; however, the efficacy of fecal transplant for the treatment of C-difficile are rapidly emerging with noted benefits for patients. The mere thought of presenting fecal transplantation for the treatment of a C-difficile infection is often dismissed because of limited available evidence and the concerns about using someone else’s stool to treat the infection. The necessity to educate patients with C-difficile is an additional challenge. Potential donors and recipients need to be assured of minimal risks associated with the screening and transplantation process. The ability to educate society on the results of evidence-based practice regarding the treatment of C-difficile with fecal transplantation should minimize concerns and enhance patient outcomes. The creation of a patient education programs is increasingly beneficial when multiple health care professionals and interdisciplinary teams are involved. Thus, a project objective in implementing an educational patient program for fecal transplantation is the creation of an informative brochure for potential use in the Endoscopy Department at Sharp Memorial Hospital by December 2014. The treatment regimen for initial and chronic C-difficile with fecal transplantation is inexpensive and noted as extremely effective. The articles reviewed consistently reveal efficacy rates greater than 85%. Fecal transplantation for the treatment of C-difficile continues to illicit multiple verbal and non-verbal responses and is not considered a standard of care for patients, families, communities, and hospital staff. The implementation of an informative educational brochure will minimize fears, hesitations, and reluctance for the treatment of C-difficile with fecal transplantation. The central theme of transplanting feces from a selected healthy donor to the recipient with C-difficile is often met with resistance. The fecal transplantation brochure will encompass aspects of fecal transplantation with the expectation of educating patients, families, and communities. Additionally, the brochure would enhance awareness of hospital staff providing an opportunity to educate units or departments. The application of Kurt Lewin’s change model for the implementation of an educational brochure for fecal transplantation will be employed. The current treatment modalities for C-difficile and the methods of transmission are increasingly becoming expensive for health care organizations. The financial goals of the organization are to decrease the rates of C-difficile and possibly entertain the concept of fecal transplantation. A dichotomous survey will be used to measure awareness and use of fecal transplantation for the treatment of C-difficile. The interdisciplinary team employed to create the brochure would prove beneficial in developing standardized procedures in performing fecal transplantations. The Southern California Society of Gastroenterology Nurses and Associates is an excellent venue for potentially validating and communicating the results. The two possible grant funding sources for the fecal transplantation brochure is the American Gastroenterological Association (AGA) and the American Society of Gastroenterology Nurses and Associates (SGNA). The creation and implementation of an educational brochure for patients considered for fecal transplantation would enhance community education and minimize fears in treating C-difficile with fecal transplantation. Keywords: fecal transplantation, clostridium difficile, fecal micobiota transplantation Problem Identification The traditional treatments for patients diagnosed with infections of the colon are antibiotics. However, many antibiotics kill the normal healthy bacteria of the colon. This results in an overwhelming increase in the risk for developing a C-difficile infection. Medicine. Net (2012) stated, â€Å"Patients taking antibiotics are at risk of becoming infected with C. difficile as antibiotics can disrupt the normal bacteria of the bowel, allowing C. ifficile to become established in the colon† (para. 1). The potential for implementing the use of fecal transplantations for the treatment of C-difficile among the general population is questionable. The mere thought of presenting fecal transplantation for the treatment of a C-difficile infection is often dismissed because of limited available evidence and the concerns about using someone else’s stool to treat the infect ion. Rohlke and Stollman (2012) stated, â€Å"Cure rates of > 90% are being consistently reported from multiple enters. Transplantation [fecal] can be provided through a variety of methodologies, either to the lower proximal, lower distal, or upper gastrointestinal tract† (p. 403). An additional consideration is the perception of fecal transplantation within the community. The necessity to educate patients with C-difficile is an additional challenge. Potential donors and recipients need to be assured of minimal risks associated with the screening and transplantation process. Current research supports and discusses a comprehensive approach to identification and screening for potential fecal donors, donor preparation, and transplantation procedures. The procedure for donor selection and screening is comprehensive to prevent the transmission of infection. According to Hamilton, Weingarden, Sadowsky, and Khoruts (2012), â€Å"The [donor] history includes assessment of infectious risk, including identification of known risk factors for HIV and Hepatitis, current communicable diseases, and recent travel to areas of the world with a higher prevalence of diarrheal illnesses† (p. 3). In educating patients, families, and the community at large, the rigor associated with the screening process must be emphasized to reduce fear. The project objective in implementing an educational patient program for fecal transplantation is the creation of an informative brochure for potential use in the Endoscopy Department at Sharp Memorial Hospital by December 2014. The brochure will be created using a collaborative approach by employing endoscopic nursing champions. The goal is for the brochure to be patient specific and encompass appropriate information to decrease fears and answer questions associated with fecal transplantation. Additionally, the development of a patient posttest associated with the brochure will be created to evaluate the effectiveness of content delivery and adjusted accordingly to meet patient needs and desired outcomes. The proposed solution will minimize the ambiguity and fears associated with fecal transplantation for the treatment of C-difficile. Solution Description The proposed solution for teaching potential recipients and donors about fecal transplantation for the treatment of C-difficile is to diminish infection rates. By creating and implementing a comprehensive nursing educational approach patients and donors can be well informed on this innovative treatment modality. â€Å"In many areas of clinical decision making, research has demonstrated that â€Å"tried and true† practices taught in basic nursing education are not always best† (Polit & Beck, 2012, p. 25). The ability to educate society on the results of evidence-based practice regarding the treatment of C-difficile with fecal transplantation should minimize concerns and enhance patient outcomes. The creation of a patient education program is increasingly beneficial when multiple health care professionals and interdisciplinary teams are involved. The importance of evidence-based practice is to ensure the evidence about fecal transplants has been collected, evaluated, and implemented to establish the best practice and approach. The main premise for patient safety is to ensure donors have been thoroughly screened to minimize the potential for the transmission of other diseases with feces. According to Rohlke and Stollman (2012) on donor selection, â€Å"There have not yet been any adverse events reported that can be conclusively or directly attributed to [fecal microbiota transplantation] FMT, and proper donor screening is essential to avoid transmitting communicable diseases from donor to recipient† (p. 406). Individuals with recurrent C-difficile infections are moderately self-educated regarding treatment modalities and are receptive to the idea of fecal transplantation. The emphasis on educating patients, families, and communities regarding fecal transplantation as the initial treatment regimen is the focus. Hospital and individual associated costs in administering antibiotic therapy for the treatment of C-difficile could be drastically reduced by using fecal transplantation as the initial therapy. Brandt (2012) stated in reply, â€Å"Do patients typically accept fecal transplantation as a treatment option? Yes †¦patients typically respond with interest, and they are generally positive about trying it and they do not typically react with disgust† (para. ). The current research base associated with fecal transplantation demonstrates high cure rates while minimizing the reoccurrence of C-difficile. Rohlke and Stollman (2012) stated, â€Å"Cure rates of > 90% are being consistently reported from multiple centers† (p. 403). The review of current literature demonstrates that patient education for fecal transplantation is performed by a gastroenterologist and not the gastrointestinal (GI) nurse. Patient education provided to patients from physicians typically entails a one-way communication style. In this scenario, the gastroenterologist sends the information to the patient, and there is little discussion with the receiver. Thus, patients commonly seek out more information from the registered nurse. The ability to educate patients regarding fecal transplantation using the proposed brochure would facilitate a commonality and minimize fears. The feasibility of implementing the brochure into endoscopic departments would be perplexing and centered on nursing knowledge of fecal transplantation. Brodine and Kellogg (2013) stated, â€Å"All patients infected or colonized with C. ifficile must be educated about this bacterium, proper disease management, and transmission prevention. The nurse should use patient-centered communication—free of jargon and appropriate to the patient’s health-literacy level† (para. 13). The health care organization must employ educational programs specific to the needs of the patients and desired outcomes. â€Å"The Joint Commission recommends using the â€Å"teach-back† and â€Å"show-back† methods to educate patients; that is, ask the patient to â€Å"teach back† the information provided or demonstrate understanding by â€Å"showing† a skill†¦Ã¢â‚¬  (Brodline & Kellogg, 2013, para. 3). The organizational culture at Sharp Memorial Hospital for nursing is centered on the American Nurses Credentialing Center (ANCC) Magnet Recognition Program ®. The nursing strategic plan is developed by nursing leaders with input from nursing staff based on the hospital strategic plan. Additionally, nurse leaders emphasize that innovation is a core value and part of the nursing process. Nurse leaders encourage innovation through training, resources, and role modeling (Beyond Excellence, 2013). The roposed solution of implementing patient education for fecal transplantation is supported by Sharp Memorial Hospital because it involves introducing new knowledge regarding innovative, evidence-based treatment modalities. Research Report Clostridium difficile infection remains a constant struggle for hospitals. The standard treatment regimen of antibiotics commonly results in relapses. Research on fecal transplantation is continuing to emerge as a promising alternative approach in treating chronic C-difficile infections. Numerous studies demonstrate positive outcomes with the administration of fecal transplant in the treatment of C-difficile (Rohlke & Stollman, 2012). Fecal transplantation has shown through research studies to be a useful treatment for C-difficile infection via the restoration of intestinal normal flora (Brandt, 2012). The most common sign reported by patients diagnosed with C-difficile is chronic diarrhea. Johnson (2012) stated, â€Å"The administration of antibiotics can alter the balance of normal colonic flora to permit the overgrowth of pathogenic C. ifficile strains that produce toxins which cause diarrhea and associated symptoms† (para. 5). In an article published in the Alimentary Pharmacology and Therapeutics, the authors reported 17 of 22 fecal transplantations for the treatment of C-difficile were effective (Landy, Al-Hassi, MLaughlin, Walker, Nicholls, Clark, & Hart, 2011). The substantiated results of the review article highlighted major differences in patients, donors, screening, methods of administration, and the definition of treatment responses (Landy et al. , 2011). The multiple factors highlighted in this review of treating C-difficile with fecal transplantation review across the spectrum using a standard approach is essential to supporting increased use of this treatment modality. Landy et al. (2011) stated, â€Å"Standardized controlled studies are necessary to ascertain the most effective treatment regimen as well as the most acceptable method of treatment† (p. 414). Grehen, Borody, Leis, Campbell, Mitchell, and Wettstein (2010) published a study, â€Å"to demonstrate the benefits of fecal biotherapy and the role of new therapeutic strategies for the treatment of gastrointestinal conditions† (p. 51). The study included 10 patients treated with fecal transplantation and monitored the progress of bacterial population of the colon pre and post transplantation for a 24 week period. Grehen et al. (2010) found the following: At intervals of 4, 8, and 24 weeks after the procedure, the bacterial populations in the patients’ fecal samples consisted predominantly of bacteria derived from the health donor samples. Comparisons of similarity at 4, 8, and 24 week samples to the donor-infused sample were made and each recipient’s baseline sample was statistically significant with Friedmen test. p. 551) Rohlke and Stollman (2012) noted that C-difficile rates continue to rise with greater intensity and severity. The treatment of C-difficile with fecal transplantation is an emerging and accepted intervention in patients with recurrent C-difficile. Rohlke and Stollman (2012) stated, â€Å"Cure rates of >90% are being consistently reported from multiple centers. Transplantation can be provided through a variety of methodologies, either to the lower proximal, lower distal, or upper gastrointestinal tract† (p. 403). The review by Rohlke and Stollman (2012) analyzed reports validating the factors of â€Å"donor selection, appropriate patient criteria, and the preparations and mechanisms of fecal microbiota transplant delivery available to clinicians and patients† (p. 403). The internal validity of the research articles reviewed demonstrates moderate samples were randomly selected. The current literature validated the need for more randomized controlled studies to determine established guidelines for the implementation of fecal transplantation. Additionally, the treatment regimen for initial and chronic C-difficile with fecal transplantation is inexpensive and noted as extremely effective. The independent variable of the effectiveness of fecal transplantation for the treatment of C-difficile remained a consistent theme. The articles reviewed consistently reveal efficacy rates greater than 85%. The external validity of the study articles revealed fecal transplantation processes are varied in the process of which patients are treated, the donor selection criteria, donor screening protocols, and the methods of delivery. The outcomes of the results reported are moderately consistent; however, the ability to generalize a standardized treatment pathway is ambiguous and larger multi-organizational and multi-disciplinary studies are essential. Rex (2012) found the following: Several studies of fecal transplantation have demonstrated high cure rates. The latest and largest to date is a retrospective case series involving 70 patients in Finland (mean age, 73; 86% outpatients). Overall, 94% of these patients had symptom resolution during the first 12 weeks after transplantation, including 32 of the 36 infected with the O27 strain of C. ifficile and all 34 of those infected with other strains. No immediate complications occurred. (para. 1) Fecal transplantation in the treatment for C-difficile has proven to be highly successful in a limited number of studies. In determining if fecal transplantation should be the standard of treatment for C-difficile infection, larger controlled studies are required. Additionally, a standard process related to donor screening, implantation techniques, transplant follow-up, and regularly documenting patient outcomes are essential in establishing standardized fecal transplantation protocols.

Social Networking and Effects on Society - 1326 Words

Social Networking and Effects on Society Wouldn’t you say that online social networking has changed the way society interacts with friends, family and perfect strangers. When someone exposes themselves to these sites, they open the door to allow these people into their lives. Some of them you would have passed on the street and not even thought of befriending. These people you have chosen to interact with, whether they are in your city, another state, another country or just someone you met online have now become a part of your circle. This form of communication will eventually turn their social interaction into non-existence. Social networking has a negative effect on society impacting physical interaction with people. The first way†¦show more content†¦You don’t have to provide any personal information about yourself and individuals are able to lead a double life. Based upon information that was obtained from an article written by Arnold Brown, he stated, â€Å"More and more people regard the virtual world as a place where they can establish and maintain safer, less demanding relationships on their own time. Ease, flexibility, and relative anonymity will continue to be three key components of online social networking and dating (Brown, 2011, p. 30)†. Online social network sites are more convenient for those that prefer to stay home than to frequent outside establishments. For some it will allow them to remain anonymous and can carry on an online relationship with less stress of dating. The third way social networking has a negative effect on society impacting physical interaction with people is it can slowly break down someone’s self-esteem. This should be one of society’s major concerns for the future of our children and young adults. John A. Bargh and Katelyn Y.A. McKenna wrote in an Yale University article, â€Å"Several scholars have contended that internet communication is an impoverished and sterile form of social exchange compared to traditional face-to-face interactions, and will therefore, produce negative outcomes (loneliness and depression) for its users as well as weaken neighborhood and community ties (Bargh amp; McKenna, 2004).† This tells me that internet communicationShow MoreRelatedSocial Networking And Its Effect On Society1303 Words   |  6 Pagestechnology, online social networking has taken on society by storm. Twitter, Facebook, Tumblr, and Instagram are just to name a few of the objects of mass consumption and insatiab le obsession. Those online social network sites have become an influential and integral aspect in our daily lives. They have a tremendous impact on society through its persistently active users, whether or not it is directly or indirectly. In fact, the stability and wellbeing of society revolve around social media due to itsRead MoreSocial Networking And Its Effect On Society917 Words   |  4 PagesAdvancing technology has played a part in the new methods of communication and with being very social creatures, who experiment with new ways of socializing, have found a new way to connect. Social Networking websites have changed how the world connects with friends and family, changing from the traditional ways of connecting with others like face-to-face connections. Many concerned themselves that social networking friendships centered on expectations that sites such as Facebook, Myspace, Twitter, andRead MoreSocial Networking And Its Effects On Society2163 Words   |  9 PagesSocial networking is an online community of people with a common interest who use a website or other technologies to communicate with each other and share information and resources, according to Webster. There are countless social networking sites that make it possible to establish connections between people. Some of the most popular sites are Facebook, Twitter, Instagram and YouTube. These social sites make it easier for people to find and communicate with others that share the same network. AlthoughRead MoreSocial Networking And Its Effect On Society1997 Words   |  8 Pagesmodern times, technological advancement has greatly improved the social benefits within society. A vastly growing percentage of young people across America are growing more proficient in using the internet for communication across their country to international regions. In the year 2009, a national survey was conducted for individuals between the ages of eight to eighteen years, where the average time adolescents s pent on any form of social media was more than 7.5 hours of a day. Once the average timeRead MoreSocial Networking And Its Effects On Society3236 Words   |  13 Pages When we hear the word â€Å"social networking† what comes to mind is: Facebook, Twitter, Instagram, Myspace, OoVoo and so on. While accessing these trendy resources, we can interact with others by messaging, video chatting, live streaming, instant chatting and overall fast pace communication. Society as we know it has evolved tremendously in regards to the way we communicate and interact with one another. There is a significant difference between the way we used to get in touch with our families andRead MoreSocial Networking And Its Effects On Society988 Words   |  4 Pagesaccounts on multiple social networking sites and they spend a lot of time on updating the developments in their daily life and uploading various media like pictures and videos. People really enjoy doing this kind of activity, to be able to communicate with their friends, family members, and also meet new people. For certain people who use social networking as a marketing forum, this is an effective method. However social networking comes with its own share of negative effects on people. It is indeedRead MoreThe Effects Of Social Networking On Society1317 Words   |  6 PagesThe Effects of Social Networking Intro Over half of the world uses the internet. 2.2 billion people actively use any kind of social networking. There were 176 million new users of social media just last year (Regan 1). With the influence of so many people a pressing question: Is the impact of social media harmful or beneficial in its effects? Social networking is one of the biggest reports of online traffic. So, if so many people are using these networking sites, what are the effects on us? The â€Å"first†Read MoreThe Effects Of Social Networking On Society1545 Words   |  7 PagesSheena Gonzales Instructor Mushett Eng-123 10 June, 2015 The Effects of Social Networking Social networking websites (further referred to as SNS) are web based platforms in which people connect to other individuals that they already have a real-life connection to, locate individuals they have shared interests with, and they allow users to share information with others such as photographs, life events and thoughts. Being able to keep current with one s personal group quickly and easily is one ofRead MoreThe Effects of Social Networking upon Society1100 Words   |  5 Pagesï » ¿Introduction: Social networking is a network of sites is very effective in facilitating social life among a group of acquaintances and friends , and enable old friends to connect to each other and after a long year , and enable them to also communicate the visual and audio and share images and other possibilities that solidified social relationship between them. Featured social networking such as : ( Facebook – WatsApp - Twitter – Skype - MySpace - LIVE Boone - Hi- Five - Orkut - Tagd - YouTubeRead MoreThe Effects Of Social Networking On Society1767 Words   |  8 PagesThe Effects of Social Networking Social networking websites (further referred to as SNS) are web based platforms in which people connect to other individuals that they already have a real-life connection to, locate individuals they have shared interests with, and they allow users to share information with others such as photographs, life events and thoughts. Being able to keep current with one s personal group quickly and easily is one of the reasons SNS have become so mainstream (McKensie 436)