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This book examines the importance of Christianity as an inspiration for political and social behaviour in the nineteenth century, and the forces that undermined both religion and charity in the twentieth. The waning of religion and the growth of government responsibility for social provision were closely intertwined. The book shows how the creation of the modern British state undermined religious belief and customs of associational citizenship. Through a study of four areas of social provision – education, visiting, infant welfare, and nursing – it unravels the complex evolving relationship between voluntarism and the state, and poses a new interpretation of Christian decline and the development of democratic traditions in Britain.

There are three essential differences between this book and most others in the field of ethics. First, instead of focusing on specific issues, it focuses on the process of ethical decision-making. Second, instead of writing for a specific profession, it is written for all mental health professionals working in elementary and secondary schools. Finally, most other books on ethics assume that they are writing for the individual ethical agent, it argues that the best ethical decisions are made in collaboration with others. The books examines a seven-step process for resolving difficult ethical dilemmas in schools: (i) knowing yourself and your professional responsibilities, (ii) analyzing the predicament, (iii) seeking consultation, (iv) identifying courses of action, (v) managing clinical concerns, (vi) implementing the decision, and (vii) reflecting on the process. Each chapter contains real-life scenarios based on real practice or actual cases in the public domain, ethical guidelines for addressing key points, exercises, and relevant internet sites.

This book focuses on changing seventeenth-century English views of maternal nurture and the nation. The revaluation of maternal nursing goes hand-in-hand with the reformation of the nation, especially between 1603 and 1675. Maternal nurture gains new prominence in the early modern cultural imagination at the precise moment when England undergoes a major conceptual paradigm shift — from the traditional, dynastic body politic, organized by organic bonds, to the post-dynastic, modern nation, comprised of symbolic and affective relations. The period’s interlocking reassessments of maternal nurture and the nation also manifest (especially in the case of Milton) English Protestant views of Judeo-Christian relations. The book’s five chapters examine a wide range of reformed-and-traditional, well-known-and-somewhat-obscure texts — including A pitiless Mother, William Gouge’s Of Domesticall Duties, Shakespeare’s Macbeth, Charles I’s Eikon Basilike, and Milton’s Paradise Lost and Samson Agonistes — and such early modern visual images as The power of women (a late sixteenth-century Dutch engraving), William Marshall’s engraved frontispiece to Richard Braithwaite’s The English Gentleman and Gentlewoman (1641), and Peter Paul Rubens’s painting of Roman Charity (1630). The book demonstrates that the idealized figure of the nurturing mother equivocally mediates between customary Judaic/Hebraic paradigms of English kingship and reformed models of England as the new Israel.

The essence of nursing care continually exposes nurses to suffering. Although they bear witness to the suffering of others, their own suffering is less frequently exposed. This book attempts to give voice to the suffering that nurses witness in patients, families, colleagues, and themselves. By making this suffering visible, the book aims both to honor and help solve the problem. The book offers nurses' colleagues in other professions — social workers, psychologists, chaplains, ethicists, and physicians — a window onto what it means to practice nursing.

Over 50,000 children die of medical causes each year in the U.S., and 85% of them do so in hospitals. While great strides have been made in palliative care, many of these children still suffer considerably in the last months of life. Studies have found that pediatricians, who often do not expect to confront death on a frequent basis, and other hospital staff typically feel inadequately trained to manage the situation and are emotionally unprepared for the death. All of the feelings associated with caring for a chronically ill child – guilt, anger, frustration, ambivalence, exhaustion – are magnified when a child's life can no longer be prolonged. This book is based directly on the voices of those who care for children at the end of their lives: the doctors, nurses, social workers, pastoral counselors, and psychologists. Centered on seven cases, the author has elicited and recorded the stories of these professionals about their experiences of caring for patients. The narratives illustrate how clinicians from different professional roles speak about the biological, psychological, spiritual, and social dimensions of caring for terminally ill patients. The author analyzes their ways of making sense of and giving meaning to their difficult experiences, unearthing common and distinct themes and issues across disciplines.

Consultants and nurses in palliative medicine who do not have a background in oncology need to know about the different types of cancer to be able to deal with palliation in these patients. The new edition of this book continues to provide comprehensive coverage of cancer management aimed at palliative care professionals. To aid understanding in the specialty, the format of the book has been thoroughly revised to include numerous tables, figures, algorithms, case histories, and key points to ensure that it will prove an invaluable, practical guide to oncology for all health care professionals involved in the care of patients with malignant disease. It provides a comprehensive overview of the management of malignant disease from the perspective of palliative medicine. The pathology, diagnosis, and management of individual tumour sites are described, with an emphasis on the symptoms produced in advanced disease and the place of oncological treatment in their management. Introductory chapters present the principles of oncological management, and later chapters address specific symptoms from the viewpoint of their pathophysiology and management. Each chapter is enhanced by typical case histories and patient journeys.

Even for the most experienced healthcare professional, managing the last few days of life can be difficult. This book provides guidelines for the care of the dying based on the Liverpool Integrated Care Pathway for the Dying Patient (LCP). Developed at a hospice, the information can be disseminated and adapted to fit different settings such as hospitals and nursing homes. The LCP is a multiprofessional document that incorporates evidence-based practice and appropriate guidelines related to care of the dying. It provides a template that describes the process of care, which is generally delivered in a clinical situation and incorporates the expected outcome of care delivery. The LCP replaces all other documentation in this phase of care. Care pathways can provide a potentially powerful aid to professionals involved in palliative care. Basic principles of treatment are translated into daily practice, including bedside documentation systems, policies and procedures, standards of practice, continuing education, and quality improvement programmes. The book also includes chapters on symptom control, ethical issues, communication skills, and spiritual care.

The past 30 years has seen a huge expansion in the provision of palliative care services. Because palliative medicine is a multidisciplinary specialty – combining the expertise of oncologists, anaesthetists, nurses, and many other therapeutic groups – the effectiveness of such treatment can be very difficult to measure. Additionally, research involving terminally ill patients and their carers can also present a number of practical and ethical problems. In spite of this, current health policy demands evidence of the effectiveness and value for money of health service interventions at all levels of complexity, including the service level. This book provides an introduction to the theory and practice of the evaluation of palliative care services. It examines the methodological issues involved in the evaluation of palliative care and outlines a practical approach that is readily applicable to many other health care interventions. In particular, research issues involving terminally ill patients and their carers are analysed and discussed, and approaches suggested for future work.

Even for the most experienced healthcare professional, managing the last few days of life can be difficult. This book provides guidelines for the care of the dying based on the Liverpool Care Pathway for the Dying Patient (LCP). Developed at a hospice, the information can be disseminated and adapted to fit different settings such as hospitals and nursing homes. The LCP is a multiprofessional document that incorporates evidence-based practice and appropriate guidelines related to care of the dying. It provides a template that describes the process of care which is generally delivered in a clinical situation and incorporates the expected outcome of care delivery. The LCP replaces all other documentation in this phase of care. Care pathways can provide a potentially powerful aid to professionals involved in palliative care. Basic principles of treatment are translated into daily practice, including bedside documentation systems, policies and procedures, standards of practice, continuing education, and quality-improvement programmes. This book includes chapters on symptom control, ethical issues, communication skills, and spiritual care, which underpin the use of the LCP.

Most people with far-advanced illness wish to be cared for at home for as long as possible. The challenge of providing good palliative care at home is therefore of major importance for family doctors, nurses, and all those committed to maintaining the highest possible quality of life for the dying person. As modern specialist palliative care has raised both standards of care and also public expectations of family doctors and community nurses, this book helps to place specialist care in context. As palliative care is a major responsibility for teams providing care at home, the book provides a definitive guide on how to provide effective care for people with far-advanced disease. It has been written by two palliative specialists, both of whom have been family doctors. The book deals with all the physical, emotional, spiritual, and social problems that will be encountered by family doctors and community nurses caring for patients and relatives in a home setting. It deals in detail with emergencies, communications, and ethical issues, and emphasises throughout the importance of team work.

The new edition of this book has been updated to incorporate recent advances in both the approach to, and treatment of, the terminally ill. Based on many years of monitoring clinical practice and research at St Christopher's Hospice, the author presents practical, balanced advice on the general ethical and medical principles of caring for dying patients. This will continue to be an invaluable handbook for all hospice physicians and nurses as a compassionate source of factual information.

This is the fourth volume in an international, multi-contributed series aimed at providing practical, clinical guidance on how to deal with difficult symptoms related to specific cancer sites. In it, the editors bring together palliative care with oncological treatment for patients with advanced breast cancer. The book is presented in a user-friendly handbook format, with the use of tables and algorithms to ensure that it is portable, accessible, and can be read and referred to on, or before going to, the ward, or before a domiciliary visit. Specialists in palliative care and oncology settings, working in the acute sector and in hospices, will find the book useful. It will also appeal to consultants as well as specialist registrars, clinical nurse specialists, and nurse practitioners in palliative care and oncology. The Palliative Care Consultations series is primarily aimed at individuals working in an acute hospital cancer centre and/or tertiary referral centre. The books are designed to give the busy clinician advice on clinical problems, both those rarely encountered and those that are very common but difficult. The volumes are site-specific and each encompasses a review of oncological or haemato-oncological management of advanced disease with symptom-control advice.

During the Jim Crow era, Florida’s public health nurses, mostly white and a few black women, tackled the state’s public health issues born of race, climate, geography, and poverty. These pioneering professional women were often the only ones available to deliver current health improvement information into the homes of people who were out of the reach of modern medical care. From Florida’s Panhandle to the Everglades and on to the Keys, they faced a number of challenges to reach both white and African American people in rural communities. Like the nurses in other states of the South and the North, they drew strength from their professional identity, but in confronting Florida’s unique challenges, their determination to save lives set them apart as they battled the state’s daunting environmental and cultural obstacles. They found innovative ways to build a bridge between the communities they served and public health policies, both state and federal, that addressed the threats of infection and the high infant and maternal mortality levels. Competing cultural constructions of health shaped their groundbreaking efforts to reach and serve underprivileged members of each race, whether to prevent illness and disease or to improve childbirth and general wellbeing.