"Ordinary Men"

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In his book, Ordinary Men, Christopher R. Browning gives readers an in-depth look into the minds of the "ordinary" German men, specifically those of Reserve Police Battalion 101, who became perpetrators in one of the most horrifying events in history; The Holocaust. The question arises; how and why did these ordinary men suddenly become cold-blooded killers? This is the issue Browning explores throughout the reading. The men of Reserve Police Battalion 101 did not begin as bad men or murderers. So, what happened? There are a number of circumstances that can be attributed to what led these ordinary men to aid in Hitler's Final Solution.

The issue of simply following orders proved to be the most frequently stated explanation, given by the perpetrators, for their behavior. Along with the culture of the Nazi dictatorship came extreme obedience and discipline. "Orders were orders, and no one in such a political climate could be expected to disobey them, they insisted" (Browing, p.170). The men of Reserve Police Battalion 101, from the very start, were simply following the orders given to them. When first called to serve, most men were not even fully informed or aware of exactly what they were expected to do. They had no knowledge of the massacres they would later have to take part in. However, many admitted that when they were told by a higher authority to kill, they did because they were ordered to do so. Fear for his own live kept many from backing out or refusing authority.

Another circumstance leading to the contribution of the Final Solution was conformity. To give an example, one can look at the situation at Jozenfow when Major Trapp informed his men, for the first time, of the upcoming massacre they would have to take part in. Trapp offered a way out to any man who did not wish to take part. All he would have to do is step forward and excuse himself. Out of five hundred men, only a dozen responded. Many men later admitted that those who felt they could not handle the task of single handedly shooting the Jews in the back of the neck, killing them at point blank range, were thought of as "cowardly" or "weak". Browning points out many times that most of these men did not agree with, or want any part of, the treatment of the Jewish people. Some refused, but many pushed themselves through their first few rounds to appear strong in the eyes of peers and authority figures. It seems however, that over time, the task had become less difficult. This brings up yet another factor explaining the behavior of the men of Battalion 101.

As the number of murders increased, the traumatizing effect it had on the perpetrators gradually decreased. Reserve Police Battalion 101 became desensitized as time went on, especially when they were not directly participating in the shootings. In many cases, then men would begin to justify their actions at any cost. "Out of sight was truly out of mind. Indeed, for some men of Steinmetz's platoon, the most vivid memory was that they were assigned guard duty in a swampy meadow north of Parczew, where they had to stand all day with wet feet" (Browning, p.0). Even Major Trapp, who wept throughout the first massacre and refused to even be present during the early shootings, "no longer had any inhibitions about shooting more than enough Jews to meet his Quota" (Browning, p. 10) when in the Kick Ghetto. What had at first seemed like a nightmare to the men of Reserve Police Battalion 101 had now become an everyday reality.

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Finally, the issue of careerism played a major part in the driving force that led these men to contribute to Hitler's Final Solution. There were men, such as Lieutenant Buchmann, who had "well established civilian careers to return to" (Browning, p.16). Therefore, being openly opposed to the treatment of the Jews, and refusing to participate in any physical aspect of the project had no negative repercussions on their future. On the other side of the coin were men who hoped for a future in the police, and therefore felt the need to prove themselves by performing over and beyond what was expected. Careerism for these men was the driving force that led to their contribution of Hitler's Final Solution.

In Ordinary Men, Christopher Browning has created a thought provoking and eye-opening perspective on the events of The Holocaust and the Final Solution. His look inside the minds of these men helps to explain why ordinary men would grow to kill innocent people. However, these circumstances do not excuse their actions. What one might find frightening is the fact that they were every day, "ordinary" men. However, as Browning chillingly stated, "If the men of Reserve Police Battalion 101 could become killers under such circumstances, what group of men cannot?"

Ordinary Men

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Noting on the Scarlet Letter

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There is a disease that tends to affect second-rate actors who achieve sudden and monumental fame, particularly if that fame lasts longer than the aphorisitically-alloted fifteen minutes. After obtaining the fabulous salaries and right-of-first-or-at-least-second-script-refusal characteristic of being on Hollywoods A list, these actors dont know enough to take the money and run. Instead, their disease reaches the terminal phase, one in which they begin to believe their own press clippings. Suddenly, the money and the power just arent enough; they want R-E-S-P-E-C-T, to coin a phrase. These actors become convinced that culture with a capital C is the missing link in their careers. So they find themselves a literary classic and attempt to put their acting imprimatur upon it, envisioning themselves as the next John Barrymore. Unfortunately, the results more often than not owe more to Drews style of acting than to Johns, for the very good reason that the relationship between the elegance and relevance of the work that they seek to interpret and their own abilities belong most definitely to that species of proportional relationships known as the inverse. Harry Zimm (he of Get Shorty) summed up this mindset of the hyper-egotistical and hypo-talented most succinctly Hes the same schmuck who made it on his tight pants and capped teeth, but now all of a sudden he knows everything there is about making pictures. There is a disease that tends to affect second-rate actors who achieve sudden and monumental fame, particularly if that fame lasts longer than the aphorisitically-alloted fifteen minutes. After obtaining the fabulous salaries and right-of-first-or-at-least-second-script-refusal characteristic of being on Hollywoods A list, these actors dont know enough to take the money and run. Instead, their disease reaches the terminal phase, one in which they begin to believe their own press clippings. Suddenly, the money and the power just arent enough; they want R-E-S-P-E-C-T, to coin a phrase. These actors become convinced that culture with a capital C is the missing link in their careers. So they find themselves a literary classic and attempt to put their acting imprimatur upon it, envisioning themselves as the next John Barrymore. Unfortunately, the results more often than not owe more to Drews style of acting than to Johns, for the very good reason that the relationship between the elegance and relevance of the work that they seek to interpret and their own abilities belong most definitely to that species of proportional relationships known as the inverse. Harry Zimm (he of Get Shorty) summed up this mindset of the hyper-egotistical and hypo-talented most succinctly Hes the same schmuck who made it on his tight pants and capped teeth, but now all of a sudden he knows everything there is about making pictures.

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Hannah's Song - Sung by Mary

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The Gospel of Luke, above all books of the New Testament, is about women. It reads as if a woman might have written it. It contains intimate details which would hardly have occurred to most men.

It begins with the birth of John the Baptist, focusing on Elizabeth, his mother. The next major section is Marys story. To her we will shortly return. There follows the prophecy of an old woman named Anna. When the boy Jesus went to the temple to debate with the learned doctors, the only person Luke quotes is his mother.

Many of Lukes stories from Jesus ministry are about women the woman who was a sinner, the woman who wouldnt give up in her quest for a cure, the widow of Nain, the bent over woman, the widow who gave her mite to the offering plate. At the resurrection it is only the women who have the faith to go to the garden of graves. Luke lists Mary Magdalene, Joanna, Mary the mother of Jesus, and other women.

Luke reports that when they told the disciples about the empty tomb these men assumed it was an idle tale and did not believe them. This was of course a culture in which women didnt count and in which their talk was treated as idle tittle tattle.

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Now back to the central character in the birth narrative, and a story only told by Luke, about Mary the mother of Jesus.

Over the years there have been two ways in which I have imagined Mary. I have seen her as a frightened little girl, overwhelmed by events far beyond her control, just a simple, rural, unlettered child whom God had chosen to be the vessel of grace.

That is the kind of Mary we portrait in the Nativity scenes. But the Nativity hardly ever gets the sense of the Birth of Jesus right! There is another way to view Mary, a way more faithful I think, to Lukes text. Here we find a determined, strong, assertive woman; a model for all women - a woman of power and influence educated, sharp, committed. It is the resourceful, competent, clear woman from whom Jesus learned much of what he knew about Gods will for him and for his world.

The key to this understanding of Mary comes from the words at the beiginning of the Magnificat. We identify the poem Mary sung by the Latin translation of its first words, the Magnificat, My soul magnifies the Lord.

What do we know about her from Luke? We know the town where she lived, a dusty obscure village in the north, named Nazareth. Luke doesnt identify her family. They were nobodies from noplace. We know she was engaged to Joseph, a carpenter, whose family had come from the south, from Bethlehem, the city of David.

Beyond that Joseph is a faithful, courageous, loyal husband and father who protects his little family, and takes them out of harms way when Herod the King, in his raging, seeks to destroy the infants of Bethlehem. But Luke reports not a word Joseph spoke, or even what he thought about anything.

We know that one day Mary discovers she is pregnant. And in what must have been difficult family circumstances - Joseph sticks by her..... because they believe that the child she was carrying was a special child.

When she was certain of the pregnancy, Mary does a very interesting and a very feminine thing. She seeks out another woman to talk to. She hears that her cousin, Elizabeth, is also pregnant. Mary makes the very long trip south to the hill country of Judea to visit her friend and her kinswoman. She stays three months, maybe enough time for the scandal to die down..... but there is no record of any of their conversations. We do not know what they discussed.

Had it been a man who had something important to talk about with a male friend, the whole thing would probably have been over in a couple of hours. Western men, you see, are seldom able to talk intimately with other men. Perhaps we are too competitive. Perhaps to talk deeply is to share more about ourselves and our weaknesses than men are comfortable revealing. If somebody knows about whats going on down inside, he may have an advantage over you.

For whatever reasons, it is women who find it easiest to spend hours, days and weeks nestled comfortably in each others souls.

We do know that Elizabeth realizes something important has happened to Mary, that she has found favour with God and is blessed among women and she says so.

Again, men will hardly offer that gentle kind of affirmation to other men. We might slap each other on the back, but there wont be much tenderness about it. Not so with women. Mutual support, cooperation, kinship, gentleness often lie at the heart of their important conversations - not competition, who is the stronger, richer or smarter.

In the musical, My Fair Lady, it is Rex Harrison who is famous for singing the lines Why cant a woman be more like a man? Im not certain the world now needs a new crop of competitive, masculine women. The world has enough of competition, jousting for honoured places, dog eat dog, crawl, scratch and kick your way to the top of the pile. That lifestyle is what causes war and strife, and always has.

Perhaps the question for our day is, Why cant a man be more like a woman, more cooperative than competitive, more intimate than public, more accepting of others than needing to parade the colours, wave the sword and perpetually seek to prove whos number one?

Whatever the nature of this three-month-long companionship the result, heard from Marys lips, is anything but the song of a frightened, sweet, ignorant, submissive girl. She sings

My soul magnifies the Lord, and my spirit rejoices in God my Saviour.

It is not an original song. Much of it comes from a thousand years earlier. Another strong woman, named Hannah, realizes she is pregnant.

Her child too will change the direction of Israel. She will call him Samuel, and he will finally anoint David as King. Hannah sings

My heart exalts in the Lord; my strength is exalted in the Lord. The bows of the mighty are broken, but the feeble gird on strength. The Lord makes the poor rich, he brings low, he also exalts. He raises the poor from the dust and lifts the needy.

Ten centuries later Mary sings

He has shown strength with his arm, he has scattered the proud ... He has put down the mighty from their thrones, and exalted those of low degree. He has fulfilled the hungry with good things, and the rich he has sent empty away.

Of course Mary knew Hannahs song. So, she is not the illiterate simple girl we have often pictured her as being. She is educated, knowledgeable about the scriptures, aware of the dynamics of history and tuned in to the will and plan of God - thats the Mary of the Magnificat.

Where did Jesus got his view of the world. Did it all drop out of heaven? How is it he identified with the poor, and had such a difficult time with the mighty? Why was he so unmasculine in his rejection of the sword, of violence as the way of the future, of competition as the source of power and wealth? Where did he get the idea that was to be the linchpin of his life; that abundance did not lie in doing well but in doing good?

Where did he come upon the notion that God demanded compassion, gentleness, humility; that the meek would inherit the earth, the merciful obtain mercy, the pure in heart see God and the peacemakers be called Gods children?

Listen to the words of Marys song and you will discover where Jesus got his image of the world and of the will of God. He got it at the knee of his mother. Could it be these were the things Mary and Elizabeth talked about for three months?

How often do we hear of statesmen and world leaders getting together to discuss issues of great import and influence.

But perhaps they do not have an iota of the influence on the world as did two simple women, who met for three months at the home of one of them somewhere in the hill country of Judah, and talked.

From their long conversation comes a song, a reflection of Hannahs song of long ago. And from that song has come to us the ethic of Jesus of Nazareth, peacemaker..... Prince of Peace.

Blessed are you, Mary, blessed are you among women. And blessed is the fruit of your womb, Jesus.

And blessed are all those who hear him, believe him, and follow him in the ways of peace, justice and love.

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Love is Eternal

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"Love is Eternal", or at least that is the message sent from the novel by Irving Stone; it was the inscription Mr. Lincoln had on his wife's wedding ring. Love is Eternal is focused on the life of Mary Todd. From her teen years, until she is widowed when here husband is assassinated. Mary knew and learned to love the man Abraham Lincoln. Their love was not easy, and was plagued with grief and hardship, but through it all, the feeling that love indeed, is eternal shines through. Mr. Lincoln was not a very social man when he met Mary, but with her help and love, the two made it through; from lawyer to President of the United States. Their love was a stormy battle to conquer though, and they had very many trials to prove their love.

Mary met Abraham when she was nineteen. She had always had a heart for politics and accompanied her father to many speeches by political figures. One night, while a Mr. Baker was giving a meeting, Abraham literally dropped from a trap door in the ceiling, and into Mary's life. She knew at once she liked him. He was not social, and hardly anyone knew him. He worked for Mary's cousins law firm, but none of the Todd's were friends with Mr. Lincoln. They discovered a great joy in each others company, and Mary brought up the issue of marriage. Mary was Abraham's first love and because of that, he was not quick to accept the idea of marriage, but she made arrangements anyway. The wedding was set for the New Years, but Abraham never showed. Humiliated, Mary and Abraham separated. For nearly twenty-two months, Mary saw nothing of Abraham. Those were her hardest years ever. She was plagued with sickness and grief. When Abraham finally returned to her, they married, and perhaps the separation strengthened their relationship in the long run, but those twenty-two lost months Mary spent without Abraham were devastating to her.

The next big storm that rolled into their life, grew up little by little. One could say it was like a gradual cloud storm that rose, undetected and then lingered in the air. No rain falling, but the insinuation of it always was lurking about their heads. What was this stormy weather, that dampened the Lincoln's life? That existed but was never brought to light? The one thing Abraham loved, though never stated aloud, was his mistress Politics. Abraham loved this mistress. He worked with his law firm for long days. He would leave his wife and eventually children for months while he rode circuit, giving speeches. He and his mistress, hand and hand, were unstoppable. At times he became so intimate with his mistress he would neglect his wife and children for months. It caused suspicion among friends; who was it that Abraham was with? His true love Law. This one factor is ever present throughout the Lincoln's early marriage, but finally Mary overcomes the mistress. Pushes her aside until she is first and foremost, and the mistress then being pushed back, behind their children and behind their love.

The final, most potent storm that tears through their lives is the inauguration of Mr. Lincoln as the president of the United States of America. While this fulfills dreams in both Mary and Abraham, it also reawakens nearly every nightmare they ever had. They are immediately plunged into the Civil War, which strips much happiness from their life. Ridicule projected to Mary Lincoln by the press is unforgivable to her. The failures of the Unions armies only dampens their gaiety. Once Abraham is elected into a second term as president, and the union defeats the South in the Civil War, it looks as if their hardship in the presidency is over. That is, until, President Lincoln is assassinated. This destroys their love, doesn't it? Mary is widowed, and Abraham dead. What has she to live for now? The storm cloud finally open and pour relentlessly on them, saturating them in icy rain. Surely now, the events are tragic. The storminess of their love is washed away by the flooding waters. Yet, there, Mary still finds a light. Her wedding ring and the inscription, Love is Eternal. Abraham was right; that was what she had to live for. Love.Order custom research paper on Love is Eternal

All in all, their relationship was torn and scattered; Mary's time alone without Abraham for twenty-two months. Her battle with his mistress, which she ultimately won and stood triumph over, and lastly, the election of Lincoln as President. They weathered it all however, together. Once Lincoln was killed, Mary found little to live for, save her love for him. That was the only thing she could cling to. Her love for him, her love for her sons, because everything else had been taken from her, and there was nothing left that she could solidly cling to. Except love. Love is Eternal.

Love Is Eternal, by Irving Stone

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Cheerleading, a sport…Fact or Opinion?

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Cheerleaders around the nation unite in a competition for the first place title.

Stunts come fast and furious to impress the judges with only minutes of time.

Girls tossed 0 ft. into the air, synchronized back handspring sequences, two girls

Write your Cheerleading, a sport…Fact or Opinion? research paper

held high overhead by one of their male counterparts, one on each hand. It's good

enough for one of cheerleading's major organization and indicative of the evolution

it's bringing along with it. The athleticism and daring now commonly on display

has sparked debate over whether cheerleading should be considered a sport. Other

people's views changed so much, it used to be an extra curricular activity now it's at

the peak of being the most competitive ever.

The U.S. Office of Civil Rights classifies cheerleading as a support activity, so

does the state Education Department. Cheerleading is more of an exhibition than a

competition. Theyre spirit teams, so to speak. These days, female cheerleaders had

better know how to throw their bodies around. Take everything you need for every

other sport and put them all together. There is much more to cheerleading then yelling

and clapping your hands. You have to have self-esteem, fitness, eating, coordination,

and sportsmanship mastered.

There is such a stereotype on cheerleading. It is thought that cheerleaders are

out there to look pretty or be popular, when in fact there are countless hours that go

into the preparation of an awesome routine. I challenge all those who think

cheerleading is not a sport to go to one practice of a highly competitive squad that is

known for their abilities and see if they dont change their mind real quick.

According to a national study conducted at Carolina, cheerleading has developed into

one of the nation's most hazardous physical activities. In 1, cheerleaders made

15,600 trips to hospital emergency rooms and have annually increased each year.

The days of simple cheerleading routines may be gone, but if cheerleading is to be

considered a sport it should be conducted within the limits of safety. Fear of

overregulation is a primary concern.

As a cheerleader myself, I've had the feel for both worlds. I've participated on

activities that are considered legal sports and have put forth effort just as much as I do

with cheerleading. All the elements to a sport are the same. Many hours are put in for

only a couple critical moments. If something goes wrong there's consequences, just as

any other competition. Why should modern squads be penalized for past judgments?

Shouldn't an athletic team have some goal to shoot for? Nation-wide cheerleading's

goal is to be accepted as a sport for it's high ability. Just as much time and practice is

put in to accomplish things as any other sport.

Please note that this sample paper on Cheerleading, a sport…Fact or Opinion? is for your review only. In order to eliminate any of the plagiarism issues, it is highly recommended that you do not use it for you own writing purposes. In case you experience difficulties with writing a well structured and accurately composed paper on Cheerleading, a sport…Fact or Opinion?, we are here to assist you. Your persuasive essay on Cheerleading, a sport…Fact or Opinion? will be written from scratch, so you do not have to worry about its originality.

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Care Planning

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Society is full of different people of different ages, races, languages, jobs and backgrounds and each of these people have different personalities, do things differently and react to things differently. These differences do not change when we get ill or are injured and it is therefore very important that each different person get health care which is suited to these differences.

Anna is just one of these people who requires such health care. She has cancer which she has been told by her Consultant is more advanced than they had thought. She has already had one course of chemotherapy and radiotherapy which was followed by a phase of remission. She has recently been staying in a Marie Curie hospice but has decided that she would rather go home as her children didnt like to visit her there and she misses her home and the things there.

Anna is a music teacher, though she hasnt been able to work for a few months, she is married to Mike, a self-employed builder, and she has two children, twin boys of nine.

In this assignment I will take on the role of the District Nurse who is drawing up a care plan for Anna prior to her decision to leave the hospice and return home.Order custom research paper on Care Planning

A Care Plan is a statement of the service being provided and its goals

(Oxford Concise Medical Dictionary, 18)

CARE PLAN CYCLE

In order to produce a good care plan which explores every area of care and covers every need of each individual patient there are several stages to go through. This is called the care plan cycle and it consists of nine stages shown below.

I will now go through each of these nine stages explaining what they are and how this will relate to Anna in her care planning.

PROVIDE INFORMATION

This is the first stage of the cycle and it refers to the initial investigation into what services are available. During this stage options are discussed with the client and more information on these options is collected. It is then decided which options are suitable for the specific client and which of these options the client has access to and is eligible for.

In Annas case she will need to find out about community services which are available to her in her home and whether she will need to pay for these services. She will need to find out what services are provided by her local GP practice and whether she can receive help from her local district nurse and whether she can receive help from an outside organisation such as the Marie Curie Foundation.

REFER FOR ASSESSMENT

Once it has been established which available services are suitable for the client it will be necessary to get assessment from these services. Unfortunately service providers have limited staff and resources and therefore not everyone can get an assessment. Service providers must consider, amongst many things, the urgency of the clients need. They must also address the practicalities i.e. where the client is and whether they have any additional difficulties not covered by their particular service, such as communication difficulties. Many service providers also like to know if the client has used any of their other services or has been in contact with them before.

Annas situation is of some urgency and it is very important to both her and her family that her future care is arranged so that she can concentrate on her husband and children. The hospice which Anna stayed in was run by Marie Curie and therefore she has had contact with the organisation before though not their community services. The hospice she stayed in was near to her home and she has no other difficulties not related to the cancer so practically their help would not be difficult.

ASSESS NEED

Assessment by the different service providers will have highlighted the particular needs of the client and it is now necessary to relate these needs to the particular organisations. The relevant organisations will talk to the client in order to understand his or her needs and provide the best care possible. The needs are then prioritised into the ones which need to be addressed urgently as soon as possible and the ones which can wait until the urgent needs are dealt with.

Annas needs are quite basic and relate to the fourteen activities of daily living which are Maintaining a safe environment, Communicating, Breathing, Eating and drinking, Body functions, Personal cleansing and dressing, Maintaining normal body temperature, Mobility, Working and playing, Sexuality, Resting and sleeping, Learning, Religion and Dying. Anna understands and accepts that she cannot care for herself and that her husband cannot fulfil all her needs by himself but she does not want to continue her hospice care. She misses her home and her family and friends are not comfortable visiting her there especially not her children. Anna needs someone to come in the mornings to help her wash and dress so that her husband can go to work and she needs someone to come and sit with her during the night so that her husband and children can sleep. She is currently on morphine pain relief and this will need monitoring and updating as will her care.

IDENTIFY SERVICES ALREADY PROVIDED

By establishing what services are already being provided for the client some care can be implemented quicker. This is because the professionals from this service are already involved in the clients case and therefore have knowledge of the clients situation making it easier for them to modify or update the care. This also means that the professionals needed are probably already involved.

Anna has recently been cared for in a Marie Curie Hospice and therefore it is going to be a lot easier for her to gain access to their community services. She will also have had prior contact with her GP due to her cancer and he will be aware of her decision to return home from the hospice.

PLAN CARE

With all the information collected and arrangements made in the previous four steps of the care planning cycle the actual care plan can now be drawn up.

A care plan should contain

the overall objectives

the specific objectives of the user, the carer and the service providers

the criteria for measuring the achievement of the objectives

the services to be provided by whom

the cost to the user and the contributing agencies

the other options considered

any point of difference between the user, care planning practitioner or other agency

details of any unmet needs with reasons

the named personnel responsible for implementing, monitoring and reviewing the care plan

the date of the first review

Department of Health Care management and assessment- practitioners guide

A care plan for Anna is included within this assignment. The main points of this care plan are

that a care assistant from a private company which Anna will have to pay for comes every morning at approximately 8 am to help her wash and dress

that a Marie Curie nurse will come every night at 10 p.m. and sit with Anna through the night.

that the District nurse will visit regularly after the care assistant has been and GP will be in regular contact with her to address any issues she may have and to monitor her care.

that she is to be given morphine pain relief in a syringe driver which she can boost if she feels the need to. This will be monitored so that Anna can be allowed to administer higher levels as the cancer progresses.

IMPLEMENT CARE

Once the care has been planned in detail focus must be put on putting this planning into action in the clients care. The care planner must ensure that the care plan is being followed by both the care professionals and the client him or herself.

Annas care professionals must be committed to following her care plan so that she is able to live her life as normal as possible. If Anna has friends coming to visit and the care assistant does not turn up until say 11 am meaning that she is not dressed when her friends come this means that she will miss out on valuable time with them. It is also important to Anna that she is able to spend time with her husband and children which she likes to do by listening to music or watching television in the evenings after school / work. If the District nurse decides to come at 8 p.m. one night instead of the morning and there is something Anna needs to discuss with her then she misses time with her family.

MONITOR PROGRESS

To ensure that the care plan is being followed and that the care plan is working its progress is monitored closely this is done by talking to both the client and the care professionals to make sure they are satisfied with the care received/given. All aspects of the care plan are monitored from whether the aims of the care plan are being met to whether the client can afford to continue the current care.

It will be important to monitor Annas care to prevent the situations mentioned in the previous section on implementing care. Also, due to the nature of Annas illness, her condition could deteriorate or change quite quickly and it is important that her care mirror this.

REVIEW AND EVALUATE

MODIFY CARE PLAN

All care plans are reviewed on a regular basis whether there have been problems or not. Reviews involve talking to all the people who are involved in all aspects of the care plan. Clients are asked if they are satisfied with their care or if there is anything they would like to change. Care professionals are asked to assess whether or not they feel that the care is adequate and whether or not they feel it is working and if not what they feel could be done to improve it or make it work. These views are brought together and discussed in review meetings where the care plan is scrutinised in great deal and any issues which have arisen are addressed and the modifications to the care plan contemplated.

A review of Annas care plan may find that her morphine dosage is no longer dealing with the pain and therefore the care planners will discuss increasing her dosage and how much she can boost using her syringe driver. The review could find that she needs more round-the-clock care perhaps while her husband and children are away at work/school and if she doesnt have any friends visiting on that day. They may find that her condition has deteriorated and that she is having trouble eating, for instance, in which case they would need to arrange some alternatives. Problems may not be related to her medical condition and may be financial perhaps Anna and her family can no longer afford to pay for the care assistant to help her wash and dress in the morning in which case they may need to look into outside funding.

Once it has been decided whether there are any issues which need to be addressed and these issues have been discussed in detail it then has to be decided how to introduce these into care plan. To do this we go back to the fifth stage of the cycle PLAN CARE where the changes are put into a new revised care plan which then needs to go through the same stages of IMPLEMENT CARE, MONITOR PROGRESS, REVIEW AND EVALUATE, MODIFY CARE PLAN, PLAN CARE and so on which is why they call the stages a care planning a cycle.

On the following pages is the care plan which I have prepared on behalf of the district nurse for Anna.

THE PRACTITIONERS INVOLVED IN ANNAS CARE

As you have seen from the care plan cycle and the care plan many practitioners are involved in Annas care from people who deal with her emotional needs such as her family and friends to people who deal with her medical needs such as her GP, there are also people who deal with her personal routine needs such as the Care Assistant. Along with all these people there are also many other people who could have been involved such as Counsellors. The next page is a chart showing all the involved practitioners and all those who could have been involved and what area of care they were related to.

I will discuss the contribution each person had in terms of Annas care and explain how the people who I suggested could have been potentially involved fit in.

As you can see from the chart on the previous page I have split Annas care into two branches cancer care and additional care. The branch entitled cancer care leads to the medical area of Annas care such as the chemotherapy and radiotherapy whereas the branch entitled additional care leads to the more personal areas of Annas care such as her family and friends.

CANCER CARE

MARIE CURIE FOUNDATION

The Marie Curie Foundation provide two branches of care their hospice care, which provides residential 4 hour care and their community care which provides care in the home. Anna has used both these services spending time in her local hospice and also using the community services in which a Marie Curie Nurse who visits her in her home, sitting with her and caring for her during the night allowing Annas husband to sleep.

The input of the Marie Curie Foundation on Annas care has been quite substantial. Without the foundations services Anna might not be as comfortable and happy with her care as she is. Their community services with Marie Curie Nurses means that Anna is able to get care in her home without putting pressure on her family and friends, being at home also encourages visits from friends or family who perhaps were not comfortable visiting her in the care settings especially her two children. The hospice care means that, if Anna or her family feel the need, Anna can receive respite care giving her family a break and taking the strain off her personal relationships.

LOCAL HEALTH CENTRE

Annas local heath centre has provided and has the potential to provide many services through many practitioners. Her GP provides her with all the palliative care that is not possible for nurses to give her. For example the GP has the power to increase Annas pain relief which is a big part of how good or bad she feels and is therefore a huge part of her overall care and how well she can cope with each day.

The local health centre will also be responsible for the services of the District Nurse who is a key practitioner in Annas care not least because the District Nurse is in charge of drawing up Annas care plan. The District Nurse visits Anna every day to discuss the care plan and any changes that need to be made to it and also to talk about any other issues that Anna wishes to bring up. He/she is therefore an essential part of the care in terms of support and advice.

However as the illness progresses Annas needs in terms of support and advice may go beyond the District Nurses scope and there is then potential for a Counsellor to become involved in her care. The Counsellor will have more time to talk to Anna without having to worry about Annas medical needs and may therefore allow her to talk more deeply about her feelings and what she wants.

HOSPITAL

The hospital is very much part of Annas cancer care though their input is decreasing as Annas illness progresses and there is less and less they can do to help her. However in the initial stages of Annas cancer they would have had a huge input on her care.

It would have been her Consultant at the hospital who confirmed the diagnosis of cancer and decided what course of action / treatment would be their next step. The Consultant would have then followed her care through this course of action / treatment which at some point involved the expertise of the Therapeutic Radiographer who would have been in charge of the administration of both the chemotherapy and the radiotherapy.

PHYSIOTHERAPIST

There is potential for a Physiotherapist to become a part of Annas care plan in the future. As her illness progresses she may become weaker and unable to maintain her mobility then she may develop problems with her muscles as they are not being used and therefore become stiff. A Physiotherapist could come maybe two or three times a week to stretch these muscles and therefore these muscles would not be as stiff and Anna would not have to cope with muscle cramps on top of everything else.

ADDITIONAL CARE

FAMILY AND FRIENDS

Annas family and friends have been an integral part of her care from day one and will continue to be throughout her illness their input is the largest of all the practitioners and people involved. In particular her husband and children have been of paramount importance to her. It is very important that her home/family life remain as normal as possible if not for Anna but for her children who at nine years old will find this whole situation very difficult to deal with. Anna enjoys sitting down with her husband and children at night and watching TV, listening to music and generally spending time together. As Anna is no longer able to do the house work her husband and children need to do it this cuts the time that they can spend with their mother/wife here there may an opportunity to introduce another person in to the care plan. Some kind of Domestic help who would do all the cleaning around the house and perhaps the washing up would allow the family more time together. As you can see from my flow chart Annas Friends are a very important part of her care. It is important for Anna to be healthly on the inside as well as on the outside and this will be accomplished by keeping her life as normal as possible and helkping her to feel good about herself. Annas friends are a big part of normality for her and also play a big part in making her feel good about herself. Things such as clothes shopping which she would usually do with her friends should not be abandoned and in fact should be encouraged as it combats both these areas. By shopping with her friends Anna can feel as normal as possible and she can buy clothes to help her feel good. Anna can also feel good by visiting the hairdresser and/or beautician, or having these people come to her house.

Anna really enjoys the music that herself and her family sometimes listen to at night and before she got ill she was, in fact, a music teacher. She finds that the music helps her to think of other things and this need brings in potential for yet another practitioner. Music Therapists, who often work with people with brain damage, use music as a sort of therapy and their services would be ideal for Anna in order for her to relax and sort things out in her head.

CARE ASSISTANT

Every morning a Care Assistant comes to help Anna get washed and dressed this is very important to Anna and her family. Just because Anna is ill and is not going out does not mean that being clean and presentable is not as important to her as it is to anyone else. However she is now unable to do this completely by herself and needs help. Although her husband or friends could do this it is very uncomfortable for them and embarrassing for Anna and could cause problems in her relationships with them. The Care Assistant coming means that Anna does not have to go through this, it also means that she can be ready if any of her friends or family drop round. As we talked about in the section on physiotherapists as her illness progresses Anna may loose some mobility and this may cause problems when bathing or showering. This suggests a need for another health professional, an Occupational Therapist, this professional can arrange for bath or shower aids among many other things which will allow Anna to carry on having a wash every day. The Care Assistant will also help Anna with her breakfast however he/she would leave after that and unless a friend drops round Anna would be left alone for lunch. This is a problem as Anna is unable to get downstairs without help and will not be able to get herself lunch. To solve this problem it may be an idea to include the services of Meals on Wheels who can deliver the food to Anna.

As you can see the main emphasis of Annas care at this point has been put on making her as comfortable as possible by ensuring that she is not in pain either physically or mentally and also ensuring that she spends as much time as possible with her family and friends. This is opposite to putting the main emphasis on her medical treatment by putting her through more tests and trials and therefore wasting the time she has left with the people close to her.

As you have seen from this breakdown of Annas care Anna and her family have been consulted throughout and their views and family situation (i.e. two young children) has definitely been incorporated. However in many cases these things are not considered and the practitioners take over. In order to stop this from happening and to encourage the client and his/her family to be involved there are many activities which could be introduced to the care planning process. It may be a good idea for the client and her family to make a care plan of their own which they can then present to whoever is drawing up the care plan who can then discuss this care plan with them. In discussion they would decide the viability of some of the ideas, how they could be implemented or perhaps modified. This activity would produce a viable care plan with all the clients and their familys ideas down in writing which could then be consulted by the person drawing up the care plan.

This assignment demonstrates the importance of care plans in relation to health care. They provide a complete outline of the whole multidisciplinary care which is especially important in cases such as Annas where there is a number of different professionals involved. The care plan allows each of these professions to see what the others are doing in order to provide a better quality of care.

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Russian revolution

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Treat of the Causes of the 105 Revolution in Russia

The causes of the 105 revolution in Russia can be traced back as far as 1861. The Tsars who ruled in Russia were firm autocrats in an era where the nearby Europe was transforming to liberalism and republicanism. The influence of these groups, as well as internal problems and foreign policy were all causes of the revolution.

In the 1th century, Russia was very much Medieval in its ways, and this is especially highlighted by the fact that Serfdom still existed. The Serfs were little more than slaves of the Tsars and had no rights. Alexander II was the first to recognise this and in 1861 he granted Emancipation to the Serfs. He felt it better to abolish Serfdom from above than to wait for the Serfs to liberate themselves from below. ALthoughwith hindsight it cacn be said that this action caused more problems than it solved, it was a major step in dragging Russia forward from Medievalism. This granting of limited freedom to the Serfs lead to growing unrest as they called for further rights, and so it can be said it was a long term cause of the revolution.

Alexander also set up limited local authorities known as Zemstva. The main action of these groups was to draw up reports on agricultural conditions. This lead to greater awareness and a liveral class of Intelligencia was set up. They opposed the autocracy and later became known as the Kadets. The opposition of the Kadets to the sar was also a long term cause of Revolution.

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During Alexanders reign extremist opposition to the autocracy also fermented. The Narodniks attempted to rally the peasants against the Tsar, but failed because of classes differences. However, the Narodniks were to progress desipte this initial failure and they became very influencial in the 0th centruy in the form of he Bolsheviks.

Alexander III did not agree with his fathers reforms and when he came to power in 1881, he set about suppressing the peasants and all opposition to the Tsars. His Russification policy forced Russian culture on the 50 million non-Russians in the empire. The Jews also suffered greatly under his reign Pogroms were organised organised attacks on the Jews which forced many to emigrate. Censorship was also increased and the freedom of universities was reduced. Alexanders mistakes lay in the fact that the people had got a taste of freedom under his father, and now he was taking it away again. Revolution was impending.

Opposition to the Tsars continued to grow during Alexander IIIs reign. The Social Revolutionaries rallied the support of the peasants. They hoped tha tif they killed the Tsar, the whole system would topple. The Marxists concentrated on the workers in the cities. The growth of socialism marked the arrival of leaders such as Lenin and Trotsky. The Kadets also contined to grow. All that was now needed for a revolution was a spark to light the fire and bring all opposing groups together.

This occured under the reign of the last Tsar, Nicholas II. A strict autocrat, he told those who hoped for local governments in the form of Dumas that they were carried away by senseless dreams. His German Tsarina, Alexandra, was disliked by the people, as was their mutual devotion to the actions of the suspicions monk Rasputin. Growing opposition and urban and rural unrest was commonplace.

When war with Japan was impending, Nicholas saw it as an opportunity to rally loyalty to the empire once more. However his major error was that he under-estimated the strength of the Japanese. Describing them as little yellow monkeys, he believed his fleets would crush them. However, the Japanese defeated the Russians and destroyed all her fleets, even the Baltic fleet who made a last attempt to save face for Russia. The defeat in this war and the expense it incurred were direct causes of the revolution which occured just a few weeks later. A general strike in Russia occurred in 105, with both urban and rural owkers protesting together. Father Gapon lead a group of workers to the Winter palace with a petition for reforms for the Tsar. The protest was a peaceful one and the workers carreid portraits and candles for the Tsar. However, the guards shot at the people, killing one thousand and injuring thousands more. This action completely alienated the people and their loyalty to the Tsar was no more. It was the political activation of the masses. This massacre was the spark that started the 105 revolution.

Although the outcome of the revolution saw the settings up of the Duma, these were controlled to reign as an autocrat. However this revolution was an indication of the power of the people and it can be said that it was a dress rehersal for the February and October Revolutions of 117.

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