A Good Teacher Essay Example for Free (#2)

A Good Teacher Essay Choose cite format: APA MLA Harvard Chicago ASA IEEE AMA Haven't found the essay you want? Get your custom sample essay for only $13.90/page ? â€Å"Plants are shaped by cultivation and men by education. We are born weak, we need strength; we are born totally unprovided, we need aid; we are born stupid, we need judgement. Everything we do not have at our birth and which we need when we are grown is given to us by education. † (Jean Jacques Rousseau) It can be seen that education is one of the most important factor of our life. It is the tool that shapes us intellectually, socially, emotionally and personally. The kind of education that we receive depends highly on the educators that we encounter. A positive or negative encounter can impact our entire life. Therefore, if it is intended for today’s students to be responsible citizens of tomorrow’s society, then all teachers should emulate the roles of a â€Å"good teacher†. A good teacher is one who is knowledgeable of learners and their development, knowledgeable of subject matter and curriculum goals, creates a good learning environment and†¦Ã¢â‚¬ ¦. It can be noted that from the interview conducted, Teacher X exemplifies most of the features of a â€Å"good teacher† and is therefore considered as one. Before entering in a classroom, a â€Å"good teacher† should be highly knowledgeable of the subject area they will be teaching and have a clear understanding of how to organize the curriculum in order to meet the need of the students and the objectives of the school. The interview highlighted that Teacher X is one of the chief writers of the curriculum for the examination body of her institution. It will be ones belief that a personnel would not have been bestowed such privilege if she was not competent in her subject area. She also outlined that her learning objectives are based on the knowledge, ability and skill of the students. This further exemplifies her since Darlington-Hammond and Baratz-Snowden (2005) states that based on the learning needs of their students, teachers must make a wide variety of curriculum decisions, ranging from the evaluation and selection of materials to the design and sequencing of tasks, assignments and activities to the assessment of learning to guide further teaching. The development of the curriculum in light of the students’ interest fosters intrinsic motivation and stimulates the students’ passion for learning a specific subject area. If given the opportunity for input, students’ will generate ideas and set goals that even the teacher had not thought of. At this point teachers should embrace the fact that they do not know everything and should be willing to learn from their students’ in the process. A â€Å"good teacher† must take the time to know her students. Know not only their names or facial representations, but their readiness level, learning styles and interest. Students are all individuals who learn at different rates and in different ways. Tomlinson (2001) outlines that students learn better if tasks are a close match for their skills and understanding of a topic (readiness), if tasks ignite curiosity or passion in a student (interest) and if the assignment encourages students to work in a preferred manner (learning style). The classrooms of our society can be extremely diverse, so teachers must be able to differentiate intrsuctions to meet the individual needs of each student. A Good Teacher. (2016, Nov 25).

Business Environment Essay Example | Topics and Well Written Essays - 1750 words - 3

Business Environment - Essay Example It has Banks, supermarket, local supermarkets, online services and stores. LE-PEST C analysis comprises of legal, environmental, political, economical, social, technological and competitive analysis. It is important to analyse the how Sainsbury Company services are being influenced by all these external features. First of all, it is guided by the need to provide the best services to its customers and to ensure that their shareholders earn high financial returns every year. Moreover, it is employee oriented as its goal is to have well rewarded employees who can have the opportunity to expand their knowledge and abilities on the activities they provide for the company. The company also aims at building a very strong relationship with its suppliers. This will definitely ensure that the needs of the customers are highly satisfied. The total number of stores owned is 301 and 455 supermarkets that serve approximately sixteen million people weekly. It has approximately 148000 employees whose work is to deliver food and other products at a very fair price (Killgre n, 2007, pp.34-75). The LE-PEST C analysis recognises the importance of the legal sector in influencing how companies operate. The legal sector can either reduce the competitive nature of a company or increase it. It lays down strict rules to ensure that the general public is safe from any substandard goods and services. The Sainsbury Company has not been left behind as the government of the UK has had a history of strengthening laws that are linked to drinks and foods. The rules target how products are packaged and labelled. Because food and drinks are very sensitive goods and they can cause a lot of destructions in an economy, then it is very important to package food using the right containers to avoid contamination. This helps in enhancing public health. Labelling laws are made to avoid counterfeit goods thus a

The power of the American president is to persuade. Discuss in Essay

The power of the American president is to persuade. Discuss in relation to recent presidents - Essay Example This is mainly because if the public is convinced that the president is right, it will give him its full support and the members of Congress will have to follow suit because to do otherwise would mean that quite a number of them might lose their seats during elections. The American president has to be eloquent in his speeches so that he can be able not only to persuade his audience but also to pass his point through to those individuals who are against him that his is the right course and they have to support him. Over the past fifteen years, this has been the case among the men who have had the privilege of being the leaders of the most powerful nation in the world. These presidents, namely Clinton, Bush, and currently Obama, have all had to work hard to persuade the American public as well as the American allies that their intentions and actions have been in the latter’s interest. One of the most fascinating episodes where an American president was forced to be persuasive in order to save his presidency was that of President Clinton during his threatened impeachment over the Lewinsky Scandal. Bill Clinton can be considered to have been one of the most popular presidents in modern American history and it is not just because of his charisma, but also because he was also able to connect with many of the baby boomer generation, to which he belonged. This was a period where the American presidency was mired in a scandal which almost brought down the president and it is mainly because of the ability of Clinton to persuade his audience that his actions did not in any way jeopardize his presidency that he managed to remain in office for the remainder of his term (Storey 2010, p.305). When the Lewinski scandal first came to the attention of the media, it generated a lot of shock in the public and the most conservative members of the Republican Party saw it as an oppor tunity to remove a president from a rival party. However,

The Conflict and Struggles in Iraq Essay -- Iraq Iraqi Politics Politi

The Conflict and Struggles in Iraq Throughout history, the United States has attempted to overthrow corrupt government in other areas of the world and instating democracies such as ours. What the United States fails to realize is that reforms in a country’s political structure do not occur overnight, but rather to enforce these new changes, money and time is required. Sometimes the money and time seem to be more than we as a country bargain for, but I am a firm believer that you finish what you start. Right now the conflict is in Iraq, where many Americans are angry at the amount of money and time that we are dedicating to installing a democratic government after the overthrow of their dictatorship. As a country, we should be behind our military and our government in supporting their war efforts and attempts to provide freedom and equality for the people of Iraq. The main problem in Iraq is that their culture is centered around religion. Unfortunately, it is not just one main religion, but rather nineteen provinces and three separate forms of religion. The majority of the population is Islamic, and then broken into three sects of Islam: the Kurds, Shiites, and the Sunnis. To have a true democracy, the culture of Iraq must be adapted to separate religious beliefs from governmental policies. Since the melting pot of religions in America do not infiltrate the government, we as a society do not understand the difficulty of diffusing religion out of Iraqi government. To contribute to this setback, each group has different beliefs within their organization which cause continuing difficulty. As Hubert Locke states in his editorial to the Seattle Post Intelligence, â€Å"Yet at some point, we will ha... ...or we cannot think that Iraq will become a truly independent state until we rebuild their economy and get their government standing on its own two feet. We cannot just be a country that invades and then leaves, the remaining citizens becoming lost. If this happens, of course there will be American resentment in the Middle East! We removed their political stability and now it is our job to restore their country with the benefits of freedom and hopefully more opportunity. Works Cited Lewis, Bernard. The Crisis of Islam. New York: Modern Library Education, 2003. â€Å"Rebuilding Iraq.† Editorial. Patriot News 15 July 2003 A15. â€Å"Iraqi War.† Editorial. Chicago Sun-Times 9 November 2003, pg. 32. â€Å"Bush’s Reconstruction.† Editorial. Seattle Post Intelligence 20 October 2003, A8. â€Å"Post-War Efforts.† Editorial. Orlando Sentinel 23 September 2003 pg. 9.

Task Two Cathy Ann Wilson-Bates Western Governors

Task Two Cathy Ann Wilson-Bates Western Governors University EVIDENCE-BASED PRACTICE & APPLIED NURSING RESEARCH EBP 1 Brenda Luther, PhD, RN January 25, 2012 Task Two Introduction: What I have learned about working with children in a chronic healthcare setting like dialysis is that they are resilient beings with the propensity for rapid changes in their medical condition. Children almost always surprise me in their unique description of symptoms and pain. Depending on their age, they may not be able to describe the symptoms they feel or tell me â€Å"where it hurts†.A simple ear ache may be described as a â€Å"drum in my ear† or may be observed with non verbal cues like tugging on the ear. Acute Otitis Media is seen quite often during the cold and flu season. Recent clinical guidelines suggest waiting twenty four to seventy two hours before beginning antibiotic therapy. Parents of children with symptoms of otitis media are accustomed to receiving a prescription for ant ibiotics before they leave the medical office. Adults as well are preconditioned for the little white slip of paper from their physician. You can read also Coronary Artery Disease Nursing Care PlanWaiting twenty four to seventy two hours to evaluate the need for antibiotics will definitely reduce the over-prescription of antibiotics as well as their efficacy. The waiting and watching of several days may seem like an eternity to a parent caring for a sick and crying child. Educating parents during routine visits to the physician office about the risks of over-prescribing antibiotics will help when the physician needs to discuss the possibility of waiting and evaluating before prescribing antibiotics.Providing a list of comfort measures parents can follow may help relieve the anxiety they have in caring for a sick child. Any comfort measure taken to reduce crying is helpful to the parent of a sick child, but mostly to the child. The following table and paragraphs will share the results of how one group of nurses at an outpatient clinic used clinical evidence to manage this situation. Source |Type of Resource |Source appr opriate or |Type of Research | | |general information, |inappropriate |primary research evidence, | | |filtered, or unfiltered | |evidence summary, evidence-based | | | | |guideline, or none of these | |American Academy of Pediatrics and American Academy of|Filtered |Appropriate |Evidence-based guideline | |Family Physicians. Clinical practice guideline: | | | | |Diagnosis and management of acute otitis media. | | | |Causative pathogens, antibiotic resistance and |Unfiltered |Appropriate |Evidence-based guideline | |therapeutic considerations in acute otitis media. | | | | |Pediatric Infectious Disease Journal. | | | | |Ear, nose, and Throat, Current pediatric diagnosis and|General |Inappropriate |None of these | |treatment. | | | | |Treatment of acute otitis media in an era of |Filtered |Appropriate |Evidence –based guideline | |increasing microbial resistance.Pediatric Infectious| | | | |Disease Journal | | | | |Results from interviews with parents who have brought |Unfilte red |Appropriate |Primary research evidence | |their children into the clinic for acute otitis media. | | | | | | | | | Subcommittee on Management of Acute Otitis Media. (2004). American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guidelines: Diagnosis and Manegment of Acute Otitis Media. American Academy of Pediatrics , Vol. 13 No 5 1451-1465. This article is an evidence-based clinical guideline. It is a systematic review making it a filtered resource which is very appropriate for this situation. The article describes the current, (as of 2004) recommendations for the diagnosis and management of Acute Otitis Media (Subcommittee on Management of Acute Otitis Media, 2004). These guidelines show several different ways to treat acute otitis media depending on the symptoms of the child. It states that sometimes waiting to give antibiotics is good and sometimes waiting to give antibiotics is not good. This article is appropriate and provides clarity on the topic. Block, S. L. (1997).Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media. The Pediatric Infectious disease Journal , Volume 16 (4) pp 449-456. This article discusses antibiotic resistance and describes the bacterial pathogens which are responsible for infections causing acute otitis media. This article is appropriate. It contains a comparison of studies performed based on the different types of bacteria which cause acute otitis media. It stresses the importance of identifying the bacteria causing the infection before giving antibiotics so that number one the bacteria can be eradicated and other bacteria will not become resistant (Block, 1997).PE Kelley, N. F. (2006). Ear, Nose and. In M. L. W. W. Hay, Current Pediatric Diagnoisis and Treatment (pp. 459-492). Lang. This textbook source contains general information on the ear, nose and throat. There is much more information here regarding basic anatomy and physiology as well as characteristics of the ear nose and throat. The information regarding otitis media is basic and not an appropriate source of research in this situation for three reasons. Number one, the information is very basic, number two, it does not give any up to date information on how to treat this type of infection, and number three there is too much non-relevant information.McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. The Pediatric Infectious Disease Journal , Volume 17(6) pp576-579. This article is a review of the known etiologies that may cause acute otitis media. The article gives up to date information on therapeutic approaches when selecting an appropriate antibiotic therapy. We don’t practice â€Å"cookie cutter† medicine. The same prescription is not always right for all patients or all communities where some bacteria’s may be more prevalent than others (McCracken, 1998). This is appropriate information f or this group of people or community. media, P. o. (n. d. ).Interviews. (C. nurses, Interviewer) This set of interviews is simply raw data. General information can however provide great insight as to what is happening out in the community. For example, this information might shed light on the fact that if the parents are willing to hold off on antibiotics for example, would they be more likely to follow up and come back into the clinic when asked? The reaction of parents is dependent upon other several basic factors like finances, a belief system and possibly the ability to obtain transportation. Knowing how the community is going to respond to their choice may have a great effect on the decisions they make.When evaluating the findings of these sources cumulatively, one must first determine the causative pathogens infecting patients in this given community with acute otitis media. After pathogen determination we can determine which antibiotics may be most useful in eradicating the g iven bacteria. Careful selection of antibiotic therapy will reduce the propensity for antibiotic resistance. Watchful waiting may be a good thing from the perspective of increasing microbial resistance however we must always evaluate patients on their individual needs or on a patient by patient case. One size doesn’t always fit all. Patient education is the key to keeping the public informed of current practice.Physicians and Nurses need to be consistent in the lesson plan shared with patients and remain true to our scope of practice. Communication is essential between the physician, nurse and other multidisciplinary team members in order to provide the best care. There are many considerations in assessing if patients are able to withstand the waiting and evaluation period. Low income families are one example of how the waiting and watching method might not work. Parents may have to take time off work to come to clinic with a sick child. They might struggle finding money for the additional return trip to the clinic and may risk losing their job if they take more time off work.Many low income families may have already waited before seeking help thus creating their own watchful waiting period. They also may not be able to afford antibiotics and as a result may not give the full dose if symptoms have subsided. The perception is that they will save the medication for the next time symptoms arise. Confidentiality might be an issue in smaller communities. People tend to be concerned about neighbors and co-workers and some may not care to share their experience with others. This may be an issue for parents who don’t share custody as in the case of divorce. It is a greater issue when parents or partners don’t share the same fundamental values, especially those related to healthcare. Conclusion:Watchful waiting like the nurses in this clinic are looking at may be useful for some of the patients, but not all. Again, a one size fits all philosophy is not always appropriate in healthcare. Tools like algorithms may be helpful in determining the appropriateness for watching and waiting versus immediate action as determined by physical findings and social circumstances like parental adherence for follow up and ability to afford treatment. Whatever course you choose, watchful waiting or immediate antibiotics the best practice remains a plan of care based on the individual needs of our patients. References Block, S. L. (1997). Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media.The Pediatric Infectious disease Journal , Volume 16 (4) pp 449-456. McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. The Pediatric Infectious Disease Journal , Volume 17(6) pp576-579. media, P. o. (n. d. ). Interviews. (C. nurses, Interviewer) PE Kelley, N. F. (2006). Ear, Nose and. In M. L. W. W. Hay, Current Pediatric Diagnoisis and Treatment (pp. 459-492). Lan g. Subcommittee on Management of Acute Otitis Media. (2004). American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guidelines: Diagnosis and Manegment of Acute Otitis Media. American Academy of Pediatrics , Vol. 113 No 5 1451-1465.

Task Two Cathy Ann Wilson-Bates Western Governors

Task Two Cathy Ann Wilson-Bates Western Governors University EVIDENCE-BASED PRACTICE & APPLIED NURSING RESEARCH EBP 1 Brenda Luther, PhD, RN January 25, 2012 Task Two Introduction: What I have learned about working with children in a chronic healthcare setting like dialysis is that they are resilient beings with the propensity for rapid changes in their medical condition. Children almost always surprise me in their unique description of symptoms and pain. Depending on their age, they may not be able to describe the symptoms they feel or tell me â€Å"where it hurts†.A simple ear ache may be described as a â€Å"drum in my ear† or may be observed with non verbal cues like tugging on the ear. Acute Otitis Media is seen quite often during the cold and flu season. Recent clinical guidelines suggest waiting twenty four to seventy two hours before beginning antibiotic therapy. Parents of children with symptoms of otitis media are accustomed to receiving a prescription for ant ibiotics before they leave the medical office. Adults as well are preconditioned for the little white slip of paper from their physician. You can read also Coronary Artery Disease Nursing Care PlanWaiting twenty four to seventy two hours to evaluate the need for antibiotics will definitely reduce the over-prescription of antibiotics as well as their efficacy. The waiting and watching of several days may seem like an eternity to a parent caring for a sick and crying child. Educating parents during routine visits to the physician office about the risks of over-prescribing antibiotics will help when the physician needs to discuss the possibility of waiting and evaluating before prescribing antibiotics.Providing a list of comfort measures parents can follow may help relieve the anxiety they have in caring for a sick child. Any comfort measure taken to reduce crying is helpful to the parent of a sick child, but mostly to the child. The following table and paragraphs will share the results of how one group of nurses at an outpatient clinic used clinical evidence to manage this situation. Source |Type of Resource |Source appr opriate or |Type of Research | | |general information, |inappropriate |primary research evidence, | | |filtered, or unfiltered | |evidence summary, evidence-based | | | | |guideline, or none of these | |American Academy of Pediatrics and American Academy of|Filtered |Appropriate |Evidence-based guideline | |Family Physicians. Clinical practice guideline: | | | | |Diagnosis and management of acute otitis media. | | | |Causative pathogens, antibiotic resistance and |Unfiltered |Appropriate |Evidence-based guideline | |therapeutic considerations in acute otitis media. | | | | |Pediatric Infectious Disease Journal. | | | | |Ear, nose, and Throat, Current pediatric diagnosis and|General |Inappropriate |None of these | |treatment. | | | | |Treatment of acute otitis media in an era of |Filtered |Appropriate |Evidence –based guideline | |increasing microbial resistance.Pediatric Infectious| | | | |Disease Journal | | | | |Results from interviews with parents who have brought |Unfilte red |Appropriate |Primary research evidence | |their children into the clinic for acute otitis media. | | | | | | | | | Subcommittee on Management of Acute Otitis Media. (2004). American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guidelines: Diagnosis and Manegment of Acute Otitis Media. American Academy of Pediatrics , Vol. 13 No 5 1451-1465. This article is an evidence-based clinical guideline. It is a systematic review making it a filtered resource which is very appropriate for this situation. The article describes the current, (as of 2004) recommendations for the diagnosis and management of Acute Otitis Media (Subcommittee on Management of Acute Otitis Media, 2004). These guidelines show several different ways to treat acute otitis media depending on the symptoms of the child. It states that sometimes waiting to give antibiotics is good and sometimes waiting to give antibiotics is not good. This article is appropriate and provides clarity on the topic. Block, S. L. (1997).Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media. The Pediatric Infectious disease Journal , Volume 16 (4) pp 449-456. This article discusses antibiotic resistance and describes the bacterial pathogens which are responsible for infections causing acute otitis media. This article is appropriate. It contains a comparison of studies performed based on the different types of bacteria which cause acute otitis media. It stresses the importance of identifying the bacteria causing the infection before giving antibiotics so that number one the bacteria can be eradicated and other bacteria will not become resistant (Block, 1997).PE Kelley, N. F. (2006). Ear, Nose and. In M. L. W. W. Hay, Current Pediatric Diagnoisis and Treatment (pp. 459-492). Lang. This textbook source contains general information on the ear, nose and throat. There is much more information here regarding basic anatomy and physiology as well as characteristics of the ear nose and throat. The information regarding otitis media is basic and not an appropriate source of research in this situation for three reasons. Number one, the information is very basic, number two, it does not give any up to date information on how to treat this type of infection, and number three there is too much non-relevant information.McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. The Pediatric Infectious Disease Journal , Volume 17(6) pp576-579. This article is a review of the known etiologies that may cause acute otitis media. The article gives up to date information on therapeutic approaches when selecting an appropriate antibiotic therapy. We don’t practice â€Å"cookie cutter† medicine. The same prescription is not always right for all patients or all communities where some bacteria’s may be more prevalent than others (McCracken, 1998). This is appropriate information f or this group of people or community. media, P. o. (n. d. ).Interviews. (C. nurses, Interviewer) This set of interviews is simply raw data. General information can however provide great insight as to what is happening out in the community. For example, this information might shed light on the fact that if the parents are willing to hold off on antibiotics for example, would they be more likely to follow up and come back into the clinic when asked? The reaction of parents is dependent upon other several basic factors like finances, a belief system and possibly the ability to obtain transportation. Knowing how the community is going to respond to their choice may have a great effect on the decisions they make.When evaluating the findings of these sources cumulatively, one must first determine the causative pathogens infecting patients in this given community with acute otitis media. After pathogen determination we can determine which antibiotics may be most useful in eradicating the g iven bacteria. Careful selection of antibiotic therapy will reduce the propensity for antibiotic resistance. Watchful waiting may be a good thing from the perspective of increasing microbial resistance however we must always evaluate patients on their individual needs or on a patient by patient case. One size doesn’t always fit all. Patient education is the key to keeping the public informed of current practice.Physicians and Nurses need to be consistent in the lesson plan shared with patients and remain true to our scope of practice. Communication is essential between the physician, nurse and other multidisciplinary team members in order to provide the best care. There are many considerations in assessing if patients are able to withstand the waiting and evaluation period. Low income families are one example of how the waiting and watching method might not work. Parents may have to take time off work to come to clinic with a sick child. They might struggle finding money for the additional return trip to the clinic and may risk losing their job if they take more time off work.Many low income families may have already waited before seeking help thus creating their own watchful waiting period. They also may not be able to afford antibiotics and as a result may not give the full dose if symptoms have subsided. The perception is that they will save the medication for the next time symptoms arise. Confidentiality might be an issue in smaller communities. People tend to be concerned about neighbors and co-workers and some may not care to share their experience with others. This may be an issue for parents who don’t share custody as in the case of divorce. It is a greater issue when parents or partners don’t share the same fundamental values, especially those related to healthcare. Conclusion:Watchful waiting like the nurses in this clinic are looking at may be useful for some of the patients, but not all. Again, a one size fits all philosophy is not always appropriate in healthcare. Tools like algorithms may be helpful in determining the appropriateness for watching and waiting versus immediate action as determined by physical findings and social circumstances like parental adherence for follow up and ability to afford treatment. Whatever course you choose, watchful waiting or immediate antibiotics the best practice remains a plan of care based on the individual needs of our patients. References Block, S. L. (1997). Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media.The Pediatric Infectious disease Journal , Volume 16 (4) pp 449-456. McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. The Pediatric Infectious Disease Journal , Volume 17(6) pp576-579. media, P. o. (n. d. ). Interviews. (C. nurses, Interviewer) PE Kelley, N. F. (2006). Ear, Nose and. In M. L. W. W. Hay, Current Pediatric Diagnoisis and Treatment (pp. 459-492). Lan g. Subcommittee on Management of Acute Otitis Media. (2004). American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guidelines: Diagnosis and Manegment of Acute Otitis Media. American Academy of Pediatrics , Vol. 113 No 5 1451-1465.

Task Two Cathy Ann Wilson-Bates Western Governors

Task Two Cathy Ann Wilson-Bates Western Governors University EVIDENCE-BASED PRACTICE & APPLIED NURSING RESEARCH EBP 1 Brenda Luther, PhD, RN January 25, 2012 Task Two Introduction: What I have learned about working with children in a chronic healthcare setting like dialysis is that they are resilient beings with the propensity for rapid changes in their medical condition. Children almost always surprise me in their unique description of symptoms and pain. Depending on their age, they may not be able to describe the symptoms they feel or tell me â€Å"where it hurts†.A simple ear ache may be described as a â€Å"drum in my ear† or may be observed with non verbal cues like tugging on the ear. Acute Otitis Media is seen quite often during the cold and flu season. Recent clinical guidelines suggest waiting twenty four to seventy two hours before beginning antibiotic therapy. Parents of children with symptoms of otitis media are accustomed to receiving a prescription for ant ibiotics before they leave the medical office. Adults as well are preconditioned for the little white slip of paper from their physician. You can read also Coronary Artery Disease Nursing Care PlanWaiting twenty four to seventy two hours to evaluate the need for antibiotics will definitely reduce the over-prescription of antibiotics as well as their efficacy. The waiting and watching of several days may seem like an eternity to a parent caring for a sick and crying child. Educating parents during routine visits to the physician office about the risks of over-prescribing antibiotics will help when the physician needs to discuss the possibility of waiting and evaluating before prescribing antibiotics.Providing a list of comfort measures parents can follow may help relieve the anxiety they have in caring for a sick child. Any comfort measure taken to reduce crying is helpful to the parent of a sick child, but mostly to the child. The following table and paragraphs will share the results of how one group of nurses at an outpatient clinic used clinical evidence to manage this situation. Source |Type of Resource |Source appr opriate or |Type of Research | | |general information, |inappropriate |primary research evidence, | | |filtered, or unfiltered | |evidence summary, evidence-based | | | | |guideline, or none of these | |American Academy of Pediatrics and American Academy of|Filtered |Appropriate |Evidence-based guideline | |Family Physicians. Clinical practice guideline: | | | | |Diagnosis and management of acute otitis media. | | | |Causative pathogens, antibiotic resistance and |Unfiltered |Appropriate |Evidence-based guideline | |therapeutic considerations in acute otitis media. | | | | |Pediatric Infectious Disease Journal. | | | | |Ear, nose, and Throat, Current pediatric diagnosis and|General |Inappropriate |None of these | |treatment. | | | | |Treatment of acute otitis media in an era of |Filtered |Appropriate |Evidence –based guideline | |increasing microbial resistance.Pediatric Infectious| | | | |Disease Journal | | | | |Results from interviews with parents who have brought |Unfilte red |Appropriate |Primary research evidence | |their children into the clinic for acute otitis media. | | | | | | | | | Subcommittee on Management of Acute Otitis Media. (2004). American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guidelines: Diagnosis and Manegment of Acute Otitis Media. American Academy of Pediatrics , Vol. 13 No 5 1451-1465. This article is an evidence-based clinical guideline. It is a systematic review making it a filtered resource which is very appropriate for this situation. The article describes the current, (as of 2004) recommendations for the diagnosis and management of Acute Otitis Media (Subcommittee on Management of Acute Otitis Media, 2004). These guidelines show several different ways to treat acute otitis media depending on the symptoms of the child. It states that sometimes waiting to give antibiotics is good and sometimes waiting to give antibiotics is not good. This article is appropriate and provides clarity on the topic. Block, S. L. (1997).Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media. The Pediatric Infectious disease Journal , Volume 16 (4) pp 449-456. This article discusses antibiotic resistance and describes the bacterial pathogens which are responsible for infections causing acute otitis media. This article is appropriate. It contains a comparison of studies performed based on the different types of bacteria which cause acute otitis media. It stresses the importance of identifying the bacteria causing the infection before giving antibiotics so that number one the bacteria can be eradicated and other bacteria will not become resistant (Block, 1997).PE Kelley, N. F. (2006). Ear, Nose and. In M. L. W. W. Hay, Current Pediatric Diagnoisis and Treatment (pp. 459-492). Lang. This textbook source contains general information on the ear, nose and throat. There is much more information here regarding basic anatomy and physiology as well as characteristics of the ear nose and throat. The information regarding otitis media is basic and not an appropriate source of research in this situation for three reasons. Number one, the information is very basic, number two, it does not give any up to date information on how to treat this type of infection, and number three there is too much non-relevant information.McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. The Pediatric Infectious Disease Journal , Volume 17(6) pp576-579. This article is a review of the known etiologies that may cause acute otitis media. The article gives up to date information on therapeutic approaches when selecting an appropriate antibiotic therapy. We don’t practice â€Å"cookie cutter† medicine. The same prescription is not always right for all patients or all communities where some bacteria’s may be more prevalent than others (McCracken, 1998). This is appropriate information f or this group of people or community. media, P. o. (n. d. ).Interviews. (C. nurses, Interviewer) This set of interviews is simply raw data. General information can however provide great insight as to what is happening out in the community. For example, this information might shed light on the fact that if the parents are willing to hold off on antibiotics for example, would they be more likely to follow up and come back into the clinic when asked? The reaction of parents is dependent upon other several basic factors like finances, a belief system and possibly the ability to obtain transportation. Knowing how the community is going to respond to their choice may have a great effect on the decisions they make.When evaluating the findings of these sources cumulatively, one must first determine the causative pathogens infecting patients in this given community with acute otitis media. After pathogen determination we can determine which antibiotics may be most useful in eradicating the g iven bacteria. Careful selection of antibiotic therapy will reduce the propensity for antibiotic resistance. Watchful waiting may be a good thing from the perspective of increasing microbial resistance however we must always evaluate patients on their individual needs or on a patient by patient case. One size doesn’t always fit all. Patient education is the key to keeping the public informed of current practice.Physicians and Nurses need to be consistent in the lesson plan shared with patients and remain true to our scope of practice. Communication is essential between the physician, nurse and other multidisciplinary team members in order to provide the best care. There are many considerations in assessing if patients are able to withstand the waiting and evaluation period. Low income families are one example of how the waiting and watching method might not work. Parents may have to take time off work to come to clinic with a sick child. They might struggle finding money for the additional return trip to the clinic and may risk losing their job if they take more time off work.Many low income families may have already waited before seeking help thus creating their own watchful waiting period. They also may not be able to afford antibiotics and as a result may not give the full dose if symptoms have subsided. The perception is that they will save the medication for the next time symptoms arise. Confidentiality might be an issue in smaller communities. People tend to be concerned about neighbors and co-workers and some may not care to share their experience with others. This may be an issue for parents who don’t share custody as in the case of divorce. It is a greater issue when parents or partners don’t share the same fundamental values, especially those related to healthcare. Conclusion:Watchful waiting like the nurses in this clinic are looking at may be useful for some of the patients, but not all. Again, a one size fits all philosophy is not always appropriate in healthcare. Tools like algorithms may be helpful in determining the appropriateness for watching and waiting versus immediate action as determined by physical findings and social circumstances like parental adherence for follow up and ability to afford treatment. Whatever course you choose, watchful waiting or immediate antibiotics the best practice remains a plan of care based on the individual needs of our patients. References Block, S. L. (1997). Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media.The Pediatric Infectious disease Journal , Volume 16 (4) pp 449-456. McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. The Pediatric Infectious Disease Journal , Volume 17(6) pp576-579. media, P. o. (n. d. ). Interviews. (C. nurses, Interviewer) PE Kelley, N. F. (2006). Ear, Nose and. In M. L. W. W. Hay, Current Pediatric Diagnoisis and Treatment (pp. 459-492). Lan g. Subcommittee on Management of Acute Otitis Media. (2004). American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guidelines: Diagnosis and Manegment of Acute Otitis Media. American Academy of Pediatrics , Vol. 113 No 5 1451-1465.