Grief and Loss in Adolescence: Principles, Responses and Challenges

Grief and loss are fundamental aspects of life; they are inevitabilities that stem from our mortality and our natural propensity to form deep emotional bonds with those closest to us—our family, friends and colleagues.Perhaps C. S. Lewis captured the sensation of grief best when he said: â€Å"No one ever told me that grief felt so like fear.  I am not afraid, but the sensation is like being afraid. The same fluttering in the stomach, the same restlessness, the yawning. I keep on swallowing. — C. S. Lewis, A Grief Observed How one physically manifests grief may vary between age groups and cultures but it is a universal occurrence in humans who are of normal cognitive development.In this paper, grief and loss will be reviewed in the context of Worden’s principles and theories; specifically, what these principles say about grief and loss, how they might apply to the adolescence demographic, what challenges the health care provider might expect to encounter when working with a grieving adolescent, and how a health care provider can best respond to a grieving teenager. A series of hypothetical acute care settings will be presented to illustrate how a nurse might best proceed in responding to a grieving adolescent.Death during AdolescenceAdolescence is a transitionary stage of life that poses unique challenges for the individual. Change is the hallmark of this developmental period as teenagers struggle with hormonal changes, newfound desires for independence, confidence issues, and concerns about body image. Grief and loss during this stage of life, whether it be the loss of a parent, relative, or close friend, often greatly exacerbates the emotional state of a teen who is already experiencing the stresses associated with the transition from child to adult.According to Metzgar, typical grief responses of teenagers include anger, depression, withdrawal, frustration, confusion, acting out, and noncompliance (Metzgar, 2002). Unlike young childre n, who often do not fully contemplate the finality of death, adolescents are usually aware that death is final (Freeman, 2005). According to Freeman, adolescents have the mature intellectual development necessary to understand the core concepts of death—universality, non-functionality, irreversibility, and causality—and can elucidate fully the details (Freeman, 2005).This greater understanding of death places adolescents closer to adults on the level of death awareness; however, teens may wonder if a dead person will return; this thinking may include supernatural elements as teens often associate an unexpected death or serious illness with a supernatural event or cause (Brewster, 1982). An adolescents’ grief experience is highly personal in nature, and unlike adults, teens tend to grieve more intensely.Often their grief response is not expressed smoothly or continuously but takes the form of a series of punctuated outbursts; in some cases an adolescent may make a concerted effort to control his or her emotions (Worden, 1996). In attempting to control their emotions, a teen may retreat inwardly by immersing themselves in highly personal activities such as reading, writing, listening to music, or exercising; in other cases, a teen may want to release the anger and sadness associated with their grief; in this case, he or she may act out angry or antisocial behavior (Worden, 1996).Of particular importance from a health care perspective is the recognition that teens often perceive death as something that happens to others even though they recognize that death is a phenomenon that can and will happen to everyone. When a teen is confronted with the death of a close friend or relative, their perception of death as being a phenomenon that is distant from them, is abruptly challenged. In the case of the death of a peer, death is often sudden—in an American study, the three leading causes of death in the 15 to 24 year-old age group are acciden ts, homicide, and suicide (Minino and Smith, 2001).In such cases, a teen’s sense of pseudo-immortality is often shattered (Freeman, 2005). The trauma associated with this may cause a teen to experience an overwhelming sense of helplessness or powerlessness (Aronson, 2005). In the case of the loss of one or both parents, a teen may experience a grief reaction that is unique for their age demographic—an irrational guilt associated with the normal desire to detach from their parents (Freeman, 2005). For the health care worker, it is crucial that this particular grief reaction is considered when helping a teen deal with the loss of one or both parents.Theoretical Principles: Grief and Loss according to Worden.In Grief Counseling and Grief Therapy, Worden conceptualizes the process of grief into a framework of four tasks that he suggests need to be addressed and completed before the process of mourning can be concluded (Worden, 1991). Worden’s four task paradigm cons ists of:Task 1. To accept the reality of the lossTask 2. To work through the pain of griefTask 3. To adjust to an environment in which the deceased is missingTask 4. To emotionally relocate the deceased and move on with lifeAccording to Worden, children and teens, like adults, must acknowledge and accept the reality and finality of death before they can begin to deal with the emotional impact of this loss (Worden, 1991). Generally this is easier for teens than children because their concept of death is more developed and in tune with that of an adult’s. In order to help facilitate acknowledgement of loss, a health care worker needs to explain the circumstances of the loss in a language that is both accurate and age appropriate.Since maturity levels vary within the teen demographic, one must not assume a given maturity level based on age; in this case the carer should make a concerted effort to determine the maturity level of a teen through dialogue and observation (Smead, 199 4). In task two, Worden suggests that the painful emotions associated with grief need to be worked through. By working through, Worden suggests that emotions need to be released in a healthy manner such that a teen is able to cope with the nature of their loss.In this case, the carer needs to assist the teen with opening up—helping the teen discuss their fears and anxieties in a non-judgmental way. Encouraging teens to express their grief through creative arts and by engaging in rituals can be therapeutic in this regard. (Silverman and Nickman, 1999) In Worden’s third task, adjusting to the loss of a deceased peer, sibling or parent requires that the adolescent develop an adaptation to this loss.Adaptation will be heavily influenced by what role the deceased played in the teen’s life; often this adaptation requires an extended period of adjustment (Worden, 1991). In this case, the health care worker’s role is to help the teen adapt to the loss of old role s (roles associated with the deceased) and adjust to the emergence of new roles (roles previously associated with the deceased now taken up by other individuals). In Worden’s final task, the deceased are relocated—they are placed in an appropriate emotional place such that the bereaved can move on with their lives.For many bereaved individuals, relocation may involve the pondering of existential questions: Where did the deceased go? Why did they die? Is there a Heaven? Children and teens are often more open to supernatural explanations, and in this case, belief in an afterlife can be therapeutic as it helps the individual maintain a healthy and tangible link to the deceased—it may give the bereaved a sense that the deceased is watching over me from Heaven (Silverman, Nickman and Worden, 1992).Grief and Loss in the Acute Care Setting: A Nurse’s RoleWhen a nurse is expected to provide emotional care to a bereaved teen, he or  she must consider a number of factors that may influence the grieving process. These may include: age, level of maturity, psychological state, physical state, and circumstances of the loss. In the following hypothetical case studies, a nurse will offer emotional support directed specifically at teens whom are experiencing different stages of grief as outlined by Worden. The question to be answered in each case is this: What would be the most appropriate nursing response? In each case, as the attending nurse, you will note the individual’s age, statements, stress level, and physical demeanor.Case Study One – The immediate loss of a best friendTom is an 18 year old who has been admitted to a hospital emergency room after a traumatic car accident. His best friend Bret was a passenger and has been killed in the accident. Tom has minor physical injuries that you are tending to. He has just been informed that his best friend died at the scene. Emotional and in disbelief, he yells: â€Å"You’re a ll lying! Bret is not dead! He can’t be dead! He can’t be! It’s my fault!† Bret is shaking.Response:Using compassionate but clear and direct language you reaffirm that Bret has died. You show empathy to Tom but avoid making value judgments for him that offer explanations for the death or attribute blame. When interfacing with Tom’s parents you explain to them the stage of grief their son is going through and how best to assist him through it.Case Study Two – Working through the loss of a parentSarah is a somewhat rebellious 17 year-old with a strong sense of independence. She doesn’t always see eye to eye with her mother, Jenifer. Six months previous, Jenifer died suddenly in car accident. Since the accident, Sarah has suffered major anxiety attacks and has been plagued by guilt. At school she has been involved in arguments and fights with other girls; on this occasion she is in the school infirmary after fighting with another girl. Af ter initially appearing angry, Sarah breaks down in tears  and says: â€Å"Why did my Mom have to die! I didn’t really want her out of my life!†Response:You consol Sarah, and listen to her—you let her release her emotions without restraining or judging her. You reassure Sarah that it is ok and normal to feel fear, guilt and doubt, and that is ok to express her feelings. You tell Sarah that she can come and share her feelings with you whenever she feels the need. If interfacing with Sarah’s father, explain to him what Sarah is experiencing, and offer helpful suggestions that are in line with Worden’s model for task two grief.Case Study Three – Adapting to the loss of a siblingJanet and Karen are sisters close in age, 15 and 17 respectively. They were inseparable and enjoyed doing things together such as sports, shopping and talking about boys. Janet looked up to Karen who she thought of as being her pillar of strength and confidant. Last ye ar Karen died suddenly from a rare form of meningitis. Janet has accepted the loss but has had a hard time readjusting to life without her sister. She is in the hospital being attended to for self inflicted cuts on her arms. Janet states that life is unexciting now because her sister is gone.Response:With empathy you help Janet recognize and reassign the emotional roles filled by her sister. You may suggest ways to help Janet remember Karen in a desensationalized way such that the memory of Karen is retained and respected but that recognizes that life must go on. The suggestion of doing activities (previously done with Karen) with friends or classmates might be helpful. This information should be relayed to Janet’s parents to help them understand how they might be able to assist Janet adjust to life without Karen.Case Study Four – Relocating a deceased grandparentFourteen year old Ben loved fishing with his grandfather. Granddad was Ben’s best friend. Earlier th is year Ben’s granddad died suddenly from a heart attack. Ben accepted that granddad was gone, and he knew that there would be no more fishing. Ben was admitted to the hospital to receive stitches for a fall; Ben asks you: â€Å"Miss, where do dead people go? My Granddad died this year you know.† In a melancholy tone he continues, â€Å"I’ll never have a friend like him again.†Response:In a compassionate tone reply that you are not sure where people go when they die and that it is one of life’s great mysteries. You may suggest that many people have different ideas as to where people go after death. Suggest to Ben that life is about continuing to develop special moments with people we associate with in life. Keep in mind that grief resolution involves reflecting on the meaning of a deceased person’s life, and keeping this as a pleasant memory. It is not meant to focus on the death itself.ConclusionsGrief is a fundamental aspect of life. Adole scence, being a major transitional stage in human growth and development brings with it unique emotional challenges. These challenges need to be addressed by the health care worker if he or she is to effectively assist a teen who is grieving for a deceased peer, sibling or parent. Worden suggests a four step paradigm for the grieving process that can serve as a guide for elucidating the stage of grief an individual may be experiencing.Knowledge of this model can assist the health care worker in grief stage recognition, and in making informed decisions that will ultimately help a teen deal with challenges involved in the of grieving process. With the support and encouragement of health care workers, peers, and relatives, adolescents can learn to successfully manage grief and loss, and move forward with their lives.

Business Ethics and the Role of the Corporation Essay

Business Ethics and the Role of the Corporation - Essay Example For years, questions are raised on compliance of ethical values whereby many that violate laws, regard to have done so due to a loophole in the law. In this case, their defenses majors on strict compliance with laws that ignores ethical issues of fairness and honesty. Experts such as Dr Michael Novak provide insightful thoughts towards this discussion as he explore on business ethics and the role of the corporation. In examining this, I will answer the following questions as I seek to expound on Dr Novak views on business ethics and the role of the corporation. 1. Why does Dr. Novak have two sets of responsibilities for his definition of business ethics In his thought, Dr. Novak has two sets of responsibilities, which explore on the discussion of business ethics, which involves meeting the responsibilities of small businesses and corporations. The main reason why the Dr. Novak has two sets of responsibilities for his definition of business ethics is because they are vital behaviors t hat augment success. Business ethics regards an individual who has mastered habits required to fulfill his or her objectives. In his discussion, Dr Novak affirms that, a business serves the common good of the community it serves. In other words, it an economic association that seeks to satisfy customers with their commodities, increase profit margin, creates jobs opportunities and new wealth, and create a pleasing working environment where substantial work is rewarded to generate economic growth. It is considerable to discern that a business corporation falls under that category of augmenting economic growth, customer and employee satisfaction, and serving the community in honesty. Accordingly Dr Novak states that, a business ethic entails creating and imaging a World based on values of individuals, community, realism, creativity, and virtues of enterprises. In involves respecting individual rights to their own creativity and economic initiative. In this light, it means having a cul ture worth of the benefit of people, the needy, the business and community, and the maker. In a business set up, Dr, Novak regard ethics as the responsibilities of the small business and corporation to promote virtues of enterprise that initiate on creativity and economic initiative. 2. What does Dr. Novak say about the rule of law and its relationship to businesses? In his discussion, Dr. Novak creates notable insights on the rule of law and its relationship to business. He outlines that, the rule of law demands individuals or participants who have mastered habits required for business imperative. The rule of law of business springs its nature towards increasing customer satisfaction with commodities of values; augment a reasonable return on the Business Corporation and economic growth through economic initiatives such as creating job opportunities. This involves promoting ingenuity, invention, and progress through human enterprise, mind, and invention. Still, the statute of the la w majors on economic interests of citizens, establish a sense of community, respecting individuals rights hence, shaping a business culture that fosters virtues. With this in mind, the imperative of the law demands people in business to encourage their employees, shareholders to perceive policy issues and political ideas seriously, retires, and participating to electoral campaigns to vote. Following this, business cannot exist without the rule of law. Its relationship to the business entails the following. When individual rights are respected this would increase employee satisfaction, which increases work performance, and eventually boost economic growth. For success, businesses depend on individuals ready to work as a team. Contracts depend on the fulfillment of respect

Service management Essay Example | Topics and Well Written Essays - 2000 words - 1

Service management - Essay Example The three organizations are then evaluated to outline specific activities that are examples of excellent service management. Service refers to the interactions that occur between customers and service providers. These service providers are usually employees of organizations that provide services as their main focus of business (Patti, 2008). Services are usually different from products in several aspects. This makes their management different compared to product selling management. One aspect that makes the management of services different is that they are produced and consumed simultaneously, in the presence of customers. The presence of consumers of services during their production requires perfection since unlike products; there is no time for testing their effectiveness. Service encounters refer to the points of interaction when service providers are delivering services to the customers. The effectiveness of service delivery in satisfying customers results from excellent service management. Excellent service refers to the activities that lead to customers having the best experiences beyond their expec tation. Successful management of these activities to ensure their continuity is referred to as excellent service management. This report will examine these activities in three organizations (John Lewis, Jocobite experience Loch Ness and Citizen M Hotel) and evaluate how they qualify to be excellent service management. For a service encounter to be termed excellent, it must be viewed as a package and not as fragmented components (Smith, 2004). Viewing as a package will enable the service providers to take a holistic approach, ensuring that all aspects of service delivery that makes a good customer experience are enhanced. All the components of a service package must be uniform in the image they portray to the customers. Customers always derive experience from the

Social Engineering (ethical hacking ) Essay Example | Topics and Well Written Essays - 2000 words

Social Engineering (ethical hacking ) - Essay Example However, while the internet has been a blessing to humankind, along with its bounties and huge number of facilities, it has brought a few risks as well. Studies (Erickson, pp. 49-56) have indicated that stealing of valuable information, corruption, and vanishing of computer systems are some of the major risks associated with the utilization of internet. Although in the past, it was an understanding that information locked in a file cabinet is more vulnerable than the existence of that information in electronic mode. However, things have changed now, and people are again relying on file cabinets to keep their records due to huge amount of issues related to information systems security on the internet. In this regard, internet has resulted in commencement of various beneficial things such as electronic commerce, e-mail, e-advertisement, and e-education; however, along with such technological advancements, there is one major issue among the various IS security related issues; hacking (McClure & Shah, pp. 20-26). In other words, a huge number of issues and threats exist in the world of information systems; however, hacking is one of the major issues that have been deteriorating the security of information security systems, which will be the focus of this report in detail. Analysis of different sources (Harris & Ness, pp. 49-63) has indicated that until today, the computer industry is using the term of hacking or hacker for dual purposes. In the beginning, hacker would be an individual who was interested in learning new things about the computer systems, and was keen to discover new capabilities of the computer networks unlike usual users of the computers who were interested in learning only standard usage of the computers. In other words, enthusiastic programmers were hackers, and as the time passed, skillful programmers continued to

BUS303 MODULE 1 Assignment Example | Topics and Well Written Essays - 750 words

BUS303 MODULE 1 - Assignment Example Additionally, defamatory statements should be avoided because the company will take them with a lot of seriousness. This may entail filling a court suit against employees who tend to use defamatory statements when sending their emails, the company may further terminate the services rendered by employees who continue violating company email announcement policies. This means that they should disclose their contact details such as names, employee pin address, phone numbers, email address and the subject of their emails. The company will not accept emails containing graphics because the company would consider them less formal and unprofessional. Any email received from employees and all the stakeholders will be maintained in the company data base for future references and communication. Incase of clarity and quick responses employees are advised to follow the procedure of filling the forms available in the company website. Connectively, employees are advised to close check their emails b efore they press a sent button in order to clarify any unclear issue. On the contrary, XYZ company will ensure that all email sent by employees comply with the company email policies. In above connection, email sent will be treated with a lot of confidentiality and that no email sent by employees will be disclosed to any third party without the consent of the recipient. Additionally, after the company has received an email from employees or any other stake holder, an automatic email notification will be sent within twenty four hours to show the recipient that the XYZ Company is in receipt of an email sent. Afterwards, the relevant department will review the email sent and provide necessary feedback within two to five business days whereby, weekends and holidays will not be considered as business days. During the review the relevant department will assess whether the email sent is in compliance with the company email policy guidelines as provided in the book let. The company is looki ng forward to supply email policy booklet that provide a comprehensive discussion of the email policy guidelines. Incase of any assistance, employees are encouraged to seek for the advice in order to ensure that email policies are followed to the latter. Therefore, employees are advised to read the XYZ Company email policy guidelines and adhere to them until further announcements are made. From the Managing Director, XYZ Company Signature Summary on email policy announcement The main aim of adopting new email announcement policies is because the XYZ Company is contemplating global expansion to diversify its portfolio into other nation across the world. Therefore, the company wants to be more professional unlike before when dealing with its employees and all the relevant stakeholders (Christensen, Para, 3). This is because by being professional the company will attract numerous investors from the diaspora as many investors would have confidence with the company (Christensen, Para, 3- 5). The policy of ensuring that an email addressed to XYZ Company are precised and to the point may help to capture the necessary information without much strain and therefore, efficiency and effectiveness in communication will be enhanced (Johnson, PP.14-17). Connectively, the policy of using non defamatory statement aims at ensuring that the information

Devolution - British Government Essay Example | Topics and Well Written Essays - 1000 words

Devolution - British Government - Essay Example Devolution is operated in United Kingdom in the very same manner i.e. the power and decision making authorities of its Parliament are transferred to the three main states of Scottish parliament, the National Assembly for Wales and the Northern Ireland Assembly. This came into being after a series of issues that started arising in early 1970s in the United Kingdom (Britannica n.d.). The people of Scotland and Wales demanded a separate parliament to run their states and policies. Therefore, a referendum was held by the Labour Party government and parties of Scotland and Wales i.e. Scottish National Party and Plaid Cymru, respectively (Britannica n.d.). Initially, this referendum was rejected but during 1980s and 1990s its need was aroused once more. And finally, the Labour government of Tony Blair proposed a devolution scheme in 1998 which offered the following authorities to both Scotland and Wales: A Scottish Parliament that will have hold on setting its own rules and policies and ta xation rates (Britannica n.d.). ... (HM Government 2013). was approved by both and hence both Scottish Parliament and Welsh Assembly came into being in 1999. Moreover, Northern Ireland Parliament was also implemented later on. In this way, the present states of Scotland, Wales and rest of United Kingdom shows granting of real â€Å"say over their own affairs† after this devolution (BBC 1998). This enables them to run their local affairs more effectively within strong Britain government. The effect of devolution on Scotland and rest of United Kingdom can be well explained by examining its consequences and relation of Scotland and United Kingdom after the devolution act. The devolution assigns certain reserved provisions which can only be administered by UK government. They are â€Å"U.K. Constitution, foreign policy, national security, fiscal policy, international trade policy, nuclear safety, social security, employment policy and health policy (Young 2001)†. Similarly, it assigns several devolved provisi ons which can only be administered by Scottish Parliament. They are â€Å"education, local government, housing, tourism, civil and criminal law, emergency services, economic development, agriculture, and sports (Young 2001)†. According to HM Government (n.d.), the state of United Kingdom provides devolution in such a way that the Scottish parliament is authorized to take charge and control its policy, health and educational needs. It grants full freedom to Scotland to devolve their policies reflecting their preferences (Devolution n.d.). In addition to this, devolution also provides mutual decision making in which Scottish Parliament and UK government makes decision by full collaboration. This results in better welfare of the people and society. It helps in providing

The United States education Essay Example for Free

The United States education Essay I studied in Korea for 14 years. But, now I have been studying in US. Knowledge of the United States education can be helped to understand US culture. There are similarities and differences between Korea and US educations. Korea and US educations have similarities. First, we study almost the same subjects like English, Math, Science, and P. E. So some Korean students who had studied in Korea’s school can understand pretty well in USA College, even though their English skill is not so high. Second, Korea and USA classroom have almost the same equipment (especially college). There are chairs and desks, blackboard, chalks, and backboard for some notices. However, both educations have a lot of differences. First, Korea’s class is bigger than US class. Korea’s class usually has 40~50 students. But US class has just 15~20 students. So US teachers have more attention than Korea teachers to the students. Second, Most Korean students usually studied alone in the classes. But, now we have to discuss with our classmates in US classes. Discussions require to student more activity. So most American students are more activity than Korean students. Finally, the biggest difference between Korea and the United States is teacher’s teaching skills. Most Korean teachers want to memorize the textbook for all students. So, Korean students try to memorize the textbook. But US teachers require summarizing information from textbook. US teaching skill help students to be more creative and active. In conclusion, US education requires to students to be creative and active but, Korea education want to be same for all the students. That makes competition between students. This competition can be helpful, but actually it makes a lot of problem. Korea education has to change more creative and active like US education.