Grand Rounds: Dr. Bearing

Vivian’s physical suffering is caused by her illness, which slowly deteriorates her identity. In W;t, Vivian’s physical character is enhanced by her power through Language and it’s discourse. As time progresses, cancer slowly cause’s her to suffer physically, and therefore inverts her powerful identity. On page 25, Vivian’s body is clinically deconstructed, the

There are many ways of forming a relationship and gaining the trust and respect of the patient and I had to work out the different things that make a good therapeutic relationship. According to Hinchliff et al (2003) there are a number of important elements that make a good therapeutic relationship, but it is important to make clear that a therapeutic relationship is a formal relationship between a medical professional and patient. The Nursing and Midwifery Council (2008) maintains that at all times nursing staff must maintain appropriate professional boundaries in the relationships they have with patients and clients.

For the most part, hospitals are places where one comes for healing and it is place where our clients should feel safe and away from harm. Nurses have an important role as a patient advocate and are to provide all clients with safe, compassionate, and quality care at all times. Nonetheless, the hospital can also be a dangerous place for inpatients. It is a foreign environment to clients and there may be alterations in their medical condition in regards to their physical and/or mental status. With this said, there is a need to improve upon how we care for our clients, especially those who are at most risk for various incidents.

developing a rapport with ones patients and that a little compassion and understanding can mean the world to a

In Margaret Edson’s play, W;t, tells the story of Vivian’s experience with her cancer treatment. Through her treatment, Vivian recognizes her humanity and her lack of understanding life and death. By recognizing that being incredibly smart was not the answer to everything, Vivian looks back on her life and is able to reflect on her character. Edson’s use of aside, flashback, exposition, foreshadow, irony and foil allows Vivian to explore different themes. Through the use of these dramatic devices, Edson is able to convey themes of language, death and humanity.

However, when Dr. Posner seems to exhibit this same attitude towards her when he is discussing her treatment, she begins to wish she hadn’t been so difficult because she now wishes that he would be more personal and accommodating towards her. It is here that Vivian really begins to re-evaluate her life and choices and further develops her attitude. She becomes a bit more lighthearted, even sharing a laugh here and there, and develops a close relationship with her nurse, Susie. After consciously having no visitors, Dr. Ashford comes to see her. It is revealed through flashback that Dr. E.M. Ashford is the one person who Vivian’ regards with the upmost care and respect. She is a former professor of Vivian’s, who was very tough on her. Vivian feels as though she helped turn her into the scholar she is today. Her close connection with the professor is apparent when Dr. Ashford becomes her only visitor. By the time she arrives, Vivian is not her former self. She is extremely sick, and very weak. Vivian tells Dr. Ashford that she “feels so bad” and then she begins to cry (1122). Dr. Ashford comforts her, and begins to read a children’s book to Vivian in an attempt to calm her. Through this she manages to lull Vivian asleep. When it is time to go, she leans over to give Vivian a kiss goodbye and leaves. It is after that scene, that Vivian’s heart gives out and she

Despite the discussed pre-cancer life that Vivian lives, she later relates with numerous people in the hospital who make her appreciate the negativity in overemphasis of intelligence over emotional and social growth. Before her death, she accepts the fact that she has been living a negative life and makes efforts to redeem herself from this sort of life. She was rude and arrogant to her students and initially at the hospital, she enjoys giving her doctorate title, and she does not relate well with doctors and

Although Vivian has used her intellect and her dry wit as a shield to carry her through life, these are of little value in the face of death. She sees her reliance to concepts and her apathy to others mirrored in the actions of Jason Posher an ambitious clinical fellow working under Dr. Kelekian. He comes in and out of the movie and seems to treat Vivian as “un-human.” Throughout the whole movie he asks her “how are you feeling today Vivian,” but the way he says it is so unfeeling and cold. At the end of the movie when she is actually dead he asks, it just shows how much doctors really do not have any attachment what so ever to patients in today’s medical model.

The building of a positive relationship is described as showing warmth, respect and empathy however to provide effective communication between nurse and patient the nurse needs to be aware of and identify the patient’s physical, social and psychological barriers. A nurse can use these tools to build trust, mutual respect and confidence with the patient as these are needed for

Bearing, a hard teacher of poetry. Vivian could see herself in Kelekian. In their separate fields they both held doctorates. But in each profession there are words that one outside of the field would believe that their meaning of particular words mean something different. The passage, “Insidious means undetectable at an-….Insidious means treacherous” (Edson, 8) Dr. Bearing interrupts Dr. Kelekian because she is used to being around her students, and being known as the one who knows everything. Which is also what she believes to be to in everything. Here, she is still seen as the ‘teacher’ or the one who has more influence and power over the other in this particular moment in the play. The go back and forth on the idea about learning as much as you can, and in the end Vivian wins out. As the chapter progresses we can see Vivian explaining her position and why people should look up to her. “I am, after all, a scholar of Donne’s Holy Sonnets….And I know for a fact that I am tough. A demanding professor. Uncompromising. Never one to turn down a challenge…” (12). This quote sets up the idea that Vivian, as just coming into the hospital, still has the authority and influence over others. She still holds the knowledge above everything else, which is also all that she

A nurse-patient relationship is the basic requirements in all practice settings. Its usage is to manage communication between an organization and a public while maintaining boundaries in the therapeutic relationship. Based on Peplau’s interpersonal theory, communication takes place in a nurse-client relationship where therapeutic process occurs involving complex factors such as environment, attitudes, practices, and beliefs in the dominant culture (seu.edu, 2015). The actions of each person in a nurse-patient relationship is measured on the collaboration of their thoughts, feelings, and experiences. Nurse’s work to attain, maintain, and restore the patient’s health until patient have fulfilled the health care needs. Patient must be guided and provided a well-respected environment until a better health and specific needs are fully considered in the relationship. In this kind of setting, nurse’s must create relationship with patients by communicating receptivity, assimilating the concepts of empathy, trust, genuineness, respect, and confidentiality into their interactions.

Patients seek medical attention for preventative measures, as well as, diagnostic measures. Patients must have a trusting rapport with their collaborative medical team, as the nurses and the doctors are the people who they trust their lives with. Patients do not always present to hospitals, urgent cares, walk-in clinics, or even doctor’s offices only when they are sick; patients visit to ensure their good health will continue, treatment regimens are of benefit, changes that may be needed in regimen. When someone thinks of a patient they may think of some of these characteristics: illness, disease, hospital, medications, health, and prevention.

Vivian recalls undergoing tests by various medical technicians and being the subject of grand rounds. She remembers sharing a love of language and books with her father. She flashes back to her experiences as a student of Dr E. M. Ashford, an expert on John Donne. Bearing later finds herself under the care of Dr Jason Posner, an oncology research fellow who has taken her class on John Donne. At the hospital, she recognizes that doctors are interested in her for her research value and, like her, tend to ignore humanity in favor of knowledge. Gradually, she realizes that she would prefer kindness to

Vivian’s character goes through a transformation throughout each stage for her cancer. In the beginning of the movie/play she is presented with the horrible news that she has stage 4 metastatic ovarian cancer. She seems to handle the news fair well (professionally) and even agrees to a “new” aggressive 8 month treatment at a full dose level; that will be researched. After her treatments begin in the hospital we start to see her having flashback. These flashback show her being callousness towards two of her former students, “You can come to this class prepared, or you can excuse yourself from this class, this department, and this university. Do not think for a moment that I will tolerate anything in between”. As the treatments continue she see she is looking for a more personal level of communication with others; she seems to find a little bit in Susie (senior nurse) assigned to take care of her.

In this assignment I will throw light on my first clinical week that I had to observe the effective communication skills on the med surgical floor. As I started my day, the charge nurse was assigning patients to the dayshift. As the patients were assigned, the nurses started their shift report from the night shift in the break room. In this report, they discussed the patients diagnosis, previous medical history, labs and all pertinent information about each assigned patient. On the med surg floor, we get the opportunity to experience all areas of patient care with patients coming from surgery, emergency department, direct admit, and transferred from