Essay about Critical Qualitative Research - 1751 Words

Nordby,K. Kjonsberg, K. Hummelvoll, J.K.(2009) Relatives of persons with recently discovered serious mental illness: in need of support to become resource persons in treatment and recovery.(Appendix 1). Journal of psychiatric and mental health nursing. 17, 304-311. The above article will be critiqued using Caldwell, Henshaw and Taylor’s (2005) critiquing framework as a guide (Appendix 1). The intent is to identify the strengths and weaknesses of the research article and demonstrate knowledge and understanding of research methodology. The title of the above article reflects its contents and is easy to interpret, as Caldwell, Henshaw and Taylor (2005) concur ‘the title should be clear and allow the reader to easily interpret its†¦show more content†¦In this article participants were given written and verbal information about the study and confidentiality, anonymity and withdrawal were reassured. All participants were fully informed and consented. Moreover, as the participant for this design is to permit the participants to ‘open up’ and discuss their experiences. It is crucial that any given time the participant should be permitted to discontinue with the interview if they feel uncomfortable. This is called as process consent, whereby the interview continuously negotiates with the interviewee to determine whether they are comfortable in continuing with the interview, (Polit and Beck, 2006). There are many ethical aspects to consider, the above is just one fraction used as an example, by simply suggesting that ethical guidelines were adhered to, does not illustrate ethical consideration. They did not show how to make the participant safe if they were difficult to manage. The researchers used purposive sample but did not give any explanation as to why this choice sampling was made. It is essential to describe the sampling process in a research where this facilitates the reader to distinguish any bias in the whole sampling process. In studies using participants, the process of how to select, access, inform and retain research participants requires considerable thought. Sampling is a key issue, because it isShow MoreRelatedCritical Appraisal Of A Qualitative Research Essay1373 Words   |  6 Pages Critical Appraisal of a Qualitative Research Article A critical appraisal of the article by Batch Windsor (2015) was completed to assess the value of this qualitative research study. This was accomplished through the Critical Appraisal Skills Programme (CASP). The CASP tool is used to evaluate and clarify if these proposed research topics have merit. The tool resulted in the assessment that this article is useful, particularly within the nursing profession. Nonetheless, portions of thisRead MoreCritical Appraisal Of A Qualitative Research Article863 Words   |  4 PagesCritical appraisal of a qualitative research article. The qualitative article being appraised is by Martin and Woods (2012) using the CASP tool qualitative framework (CASP 2013). These tools have been validated to ensure that studies can be assessed in a consistent way assessing the trustworthiness of the research article (Aveyard, 2014) Qualitative research can often be labelled as biased and anecdotal however Anderson (2010) argues that when carried out rigorously it can be unbiased, in-depthRead MoreQualitative Research Article Critical Appraisal3282 Words   |  14 PagesQualitative Research Article Critical Appraisal Overview A study by Chu, Wodchis, and McGilton (2014) revealed a one year turnover rate as high as 85.5% for Licensed Practical Nurses (LPNs) and 55.4% for Registered Nurses (RNs) in long term care. In addition to this alarming statistic, in North Dakota alone, long term care facilities reported 669 open nursing positions in November of 2016 (NDLTCA, 2016). McGilton, Boscart, Brown, and Bowers (2014) noted that this mounting concern is associatedRead MoreEvaluation Of A Qualitative Research Tool Critical Appraisal1642 Words   |  7 Pages According to Young and Solomon (2009) critical appraisal is a systematic process which can identify both, the strengths and weaknesses of a research study. During this process the reader is able to assess studies’ usefulness and whether or not the findings are trustworthy, it also supports in decision making in terms of whether to apply the study’s results in practice The aim of this paper is to critically appraise two qualitative research papers. The appraisal includes discussion of the authorsRead MoreEssay about A Critical Appraisal of Qualitative Research1756 Words   |  8 PagesDescribed below is a critical appraisal of a qualitative article by Lisa Booth using the frame-work suggested by Ryan, Coughlan and Cronin 2007 to establish its believability, robustness, credibility and integrity (Ryan, Coughlan Cronin, 2007). Qualitative research is regarded as an inductive process, which within natural settings attempts to produce insights on the subjective experiences, meanings, practices and point of views of those involved (Craig Smyth, 2007). The aim here was to investigateRead MoreCritical Appraisal of Qualitative Research Study1032 Words   |  4 Pagesï » ¿Critical Appraisal of Qualitative Research Study Problem Statement The problem addressed in this study is reported in the work of Carusone, Loeb, and Lohfield (2006) entitled Pneumonia Care and the Nursing Home: A Qualitative Descriptive Study of Resident and Family Member Perspectives. The problem addressed in this study is the fact that nursing home residents are sent to the hospital quite frequently for diagnostic testing and to receive health care services. These transfers are reportedRead MoreA Critical Evaluation of two Research Methods, Qualitative and Quantitative1585 Words   |  7 PagesQualitative Article:A Women s Place is in the Home: Females and Residential BurglaryThis article uses a qualitative research method. Qualitative research involves analyzing and interpreting texts and interviews in order to discover meaningful patterns descriptive of a particular phenomenon (Adler Clarke, 2008, p.13.). The method has been adopted to investigate the research question. The research question is; what involvement do women have in residential b urglaries. This research question is analysedRead MoreEvaluating The Perceptions Of Those Veteran Teachers Affected By High Stakes Testing1689 Words   |  7 Pages Method A phenomenological study will be utilized to determine the perceptions of those veteran teachers affected by the high-stakes testing. This type of qualitative methodology is appropriate for the problem of high-stakes testing because it demonstrates the shared lived experiences of a particular segment of the population. With that, it proves that experience is a conscious process and shows a development of a consensus of ideas from a particular group of individuals. Furthermore, there is aRead MoreQualitative Research Study And Action Research Essay1250 Words   |  5 PagesIntroduction Qualitative research plays an important role in evidenced-based practice. Qualitative research often lay down the platform for added official quantitative studies or a follow up to a broad quantitative study. Qualitative research is a subjective design that investigates exceptional life concepts in a naturalistic setting using narrative descriptions as the findings (Polit Beck, 2017). There are six general types of qualitative research designs, namely phenomenological, ethnographicRead MorePoor Documentation Of Care And Impact On Patient Outcome Essay1371 Words   |  6 Pagesquantitative article includes: How would poor documentation of care have an impact on patient outcome? The exact clinical question used in the search for a qualitative article includes: Does establishing state standardized documentation protocols have an impact on hospitalized in-patients in acute settings? Problem The specific problem this research paper addresses is whether the establishment of state standardized documentation protocols can reduce poor documentation of care in hospitalized in-patients

Decisive Events of the Second World War Free Essays

1. Which side will you be working with? (Central or Allied Powers) Central Powers 2. Identify ten events and/or battles that played a significant role in the events of the war for your side: Battle of Le Cateau Battle of St. We will write a custom essay sample on Decisive Events of the Second World War or any similar topic only for you Order Now Quentin Battle of Mulhouse Battle of Halen Battle of Lorraine Battle of the Ardennes Battle of Charleroi Battle of Mons Siege of Maubeuge Siege of Antwerp Complete the outline map shown below by displaying events/battles. Enter the number of the country where each event/battle occurred. Map will be submitted as a seperate file. Event/Battle: 3a: Battle of Le Cateau Event/Battle: 3b: Battle of St. Quentin Event/Battle: 3c: Battle of Mulhouse Event/Battle: 6a: Battle of Halen Event/Battle: x1: Battle of Lorraine Event/Battle: x2: Battle of the Ardennes Event/Battle: 6b: Battle of Charleroi Event/Battle: 6c: Battle of Mons Event/Battle: 3d: Siege of Maubeuge Event/Battle: 6d: Siege of Antwerp Compose a detailed description about each of the events, their absolute and/or relative locations, and the significance each event had on the war effort for your side. 3a: The Battle of Le Cateau was fought in Le Cateau-Cambrà ©sis in the department of Nord in France, whose absolute location is 50.103942, 3.544235. On August 26, 1914, the Germans assaulted the English II Corps. At that point, the French Cavalry Corps touched base, under the summon of General Andrà © Sordet, and went about as a shield for the English left flank. The British fifth division was on the right flank on the south side of the Le Cateau-Cambrai street, The third division was in the inside Caudry and Inchy, and the fourth division was on the left flank on the north bank of the Warnelle Stream. This encouraged the Germans to draw near to the British positions. At early afternoon, Regardless of numerous losses, the English right and left flanks started to break, beginning with the right flank. At 11:15 AM, Sixt von Armin, authority of the German IV Corps, gave a request that transformed the task into a midway organized fight. This never happened in light of the fact that the request came as the Germans arrived. 75 percent of the IV Corps troops were at that point connected before they got the request, and many never made it to the combat zone. The Allies withdrew that night to St. Quentin, earning the Germans victory. 3b: The battle of St. Quentin was fought in Guise in the department of Aisne in Hauts-de-France in the northern part of the country, whose absolute location is 49.898014, 3.625057. The French commander-in-chief Joseph Joffre, needed the French 5th Army to hold off the Germans with a counter-attack despite a 4-mile gap between the French forces and the still-retreating British forces. The next day, August 29, The 5th Army attacked St. Quentin with full force. On August 28, the 5th Army turned from north to west towards St. Quentin. The Oise River valley was damp and marshy, making progress slow for both sides. However, the French could take advantage of the 9 mile gap between the inner flanks of the 2nd army, so Bà ¼low ordered the corps in the inner flanks to counter-attack the French X corps. The commander of the 14th division ignored the order and instead chose to order the prepare the 14th division for an advance on a nearby town called Le Fà ©re in order to get behind the 5th Army. Bà ¼low ordered staff officer Alexander von Kluck to send for help. Bà ¼low soon sent infantry parties to cover for the main army to let them rest, and also because of concern that Le Fà ©re blocked the road for more advances, so it would have to be masked while the 1st Army surrounded the French and attacked on September 1. The next 7 battles will be the battles from the Battle of the Frontiers (1914). 3c: The Battle of Mulhouse was the first battle in the Battle of the Frontiers. It was fought near the city of Mulhouse in France, whose absolute location is 47.750839, 7.335888. The French went from Gà ©rardmer to the Schlucht Pass, where the Germans blew up the tunnel. Bonneau retreated towards Belfort. On August 14, a nearby town called Thann was captured. Joffre directed the first and second armies to attack as many German divisions as possible to help the French troops further north.Meanwhile, the French captured 24 guns, 3,000 prisoners, and more. With the Rhine valley and plain, North Alsace was under French control. The French VII corps 14th and 41st divisions, under the direction of General Louis Bonneau, went from Belfort to Mulhouse and Colmar, 22 miles in the northeast. The French consolidated the newly-acquired ground, but the German 7th army threatened the right flank of the French 1st army. On August 18, the VII Corps attacked Mulhouse and captured Altkirch as the north flank went towards Colmar and Neuf-Brisach. The Germans were forced into the Mulhouse suburbs, where a house-to-house battle took place. After being overwhelmed by the French, the Germans retreated through the Hardt forest, arriving in a town called Ensisheim. The streets and houses of Dornach were captured and Mulhouse was eventually under French control again. On August 26, the French withdrew to Altkirch, which provided a more defensible line. The Army of Alsace was disbanded and the 8th Cavalry Division was added to the 1st Army. 6a: The Battle of Halen was fought in the town of Helen in the province of Limburg in Belgium,whose absolute location is 50.948500, 5.111170. The German cavalry didn’t start moving until August 12 because of the horses having fatigue because of the hot summer temperatures and being malnourished due to a lack of oats. Belgian headquarters discovered via wireless messages that the Germans were heading towards where Belgian general Leà ³n de Witte was and sent the 4th Infantry Brigade to help the Cavalry Division. Prussian cavalry general Georg von der Marwitz, who was in command of the German cavalries, sent the 4th Cavalry Division across the Gete river. At 8:45 AM, the 7th and 9th Jà ¤ger battalions advanced. A German scouting party from Herk-de-Stad came under fire from the Belgians, who tried to set up a fortified position in the old brewery in Halen, but the Germans drove them out with field artillery. Belgian engineers tried to blow up the bridge across the Gete river, but only succeeded in blowing part of it up. Thus, the Germans managed to get 1,000 troops to Halen. The Belgians’ main defense line was west of Halen and gave an obstructed view. The German 17th and 3rd Cavalry Brigades assisted the Jà ¤gers in and south of Halen, which enabled artillery to be brought right up to the village. In the cornfields, attacks were driven back with many casualties. The Jà ¤ger were also driven back despite assistance from the 2nd Guards Machine Gun Detachment and dismounted cavalry sharpshooters.At the end of the day, the Germans fled. x1: The Battle of Lorraine was fought in the Lorraine region in France, Germany, and Luxembourg, whose absolute location is 49.033889, 6.661944. On August 14, 1914, the French 1st Army advanced with 2 corps in the Vosges and 2 corps towards Sarrebourg in Moselle. The 2 right-hand corps of the 2nd Army advanced on the left of the 1st Army. The 1st Army withdtrew, but managed to maintain contact with the 2nd Army. On August 15, the German long-range artillery bombarded the French artillery and infantry and the German infantry did more damage. On August 8, the French captured several routes in farther south to protect the southern flank as they went towards Donon and Sarrebourg. The French Army pushed just managed to push back the Germans. On August 20, the Germans counter-attacked, forcing separate battles on the French armies. When the Germans left, the 2nd Army was ordered to head further north, which increased the divergence of the French armies. On August 16, the Germans pushed back the advance with long-range artillery and the next day, the 1st Army reinforced the defense at Sarrebourg. The Germans withdrew during the day and Donon was captured. The I Corps and the 2nd Group of Reserve Divisions advanced towards Morhange in Grand Est. Despite warnings against the divergence, the army needed to head southeast towards the Vosges passes, east towards Donon, and northeast towards Sarrebourg. Intelligence reports reported a line of defense, courtesy of the German 6th and 7th Armies, close to the French troops. On August 22, the right flank was attacked and were forced to withdraw 16 miles from their position on August 14. x2: The Battle of the Ardennes was fought in the Ardennes Region in France and Belgium, whose absolute location is 49.698012, 4.671601. On August 19, the 4th Army of General Fernand de Langle de Cary was told not to progress into Belgium until the German attack started. On August 20, the German troops in the south attacked the French 1st and 2nd Armies and the next day, the 3rd and 4th Armies attacked. The 4th Army crossed the Semois River and went towards Neufchà ¢teau and the 3rd Army of General Pierre Ruffey attacked towards Arlon to guard the 4th Army. South of Verdun, the 3rd Army was renamed Armed force of Lorraine and was sent to search for a German hostile from Metz, which left the rest of the 3rd Army. The French Armies attacked Belgium with 9 infantry corps, but 10 German corps and 6 reserve brigades of the 4th and 5th Armies lay between Metz and northern Luxembourg. The German 4th Army, under the command of Albrecht, Duke of Wà ¼rttemberg, and 5th Army, under the command of Crown Ruler Wilhelm, had gone slower than the 1st, 2nd, and 3rd Armies, and the French attacked them on August 21. The French Armies didn’t know how big the German attack actually was, as the 3rd Army dismissed little German attacks.On 22 August, the V Corps attacked German troops at Longwy at 5:00 AM in a dreadful storm with fog, with no mounted guns bolster. Toward the north the IV Corps advanced in mist and experienced German troops dove in Virton and were pushed back a with. On the southern Flank, the VI Corps was pushed back.Meanwhile, the II Corps on the right flank figured out how to keep level with the Third Armed force toward the south, but wasn’t ready to go any further. The Provincial Corps on the left was attacked at the Clash of Rossignol and had 11,646 casualties. However, the 5th Pilgrim Corps on the left effectively captured Neufchà ¢teau before being attacked, with numerous losses. The XII Corps continued north, but the XVII Corps was outmaneuvered and the 33rd Division lost the majority of its cannons. On the north flank, the XI and IX corps were not engaged. 6b: The Battle of Charleroi was fought near Charleroi in the province of Hainaut in Belgium, whose absolute location is 50.412033, 4.443624. It is also called the Battle of the Sambre. By August 20, the 5th Army, under the command of General Charles Lanrezac, was focusing on a 25 mile front along the Sambre River, focusing on Charleroi and stretching out east towards the Belgian stronghold of Namur. The French had 15 divisions, after transfers of troops to Lorraine, facing 18 German divisions from the 2nd Army, under the command of General Karl von Bà ¼low, and the 3rd Army, under the command of Colonel-General Max von Hausen, moving southwest from Luxembourg to the Meuse River. The Cavalry Corps, under the command of General Andrà © Sordet, covered the 5th Army’s left flank and the convergence of the British Expeditionary Force at Mons. However, the I Corps stopped the Germans with a counter-attack. On August 21, French Commander-In-Chief Joseph Joffre answered to Lanrezac that German troops were heading west.On the French right flank, General d’Espà ¨rey told the 1st Corps troops to plan an attack. The 3rd and 4th Armies further south had to move towards Arlon and Neufchà ¢teau, then try to attack adversary powers in Belgian Luxembourg.With the desolation of Namur and news of the 4th Army withdrawal from the Ardennes, Lanrezac requested the 5th Army to retreat or be be surrounded and cut off from whatever remains of the French Army. In a report the next morning, On the 3rd Corps front, stations of the 5th Division was attacked around 15:00.The 3rd Army crossed the Meuse River and attacked the French right flank, held by the I Corps. 6c: The Battle of Mons was fought in Mons in the province of Hainaut in Belgium, whose absolute location is 45.680320, -73.785520. On August 23, at approximately 9:00 AM, the Germans attacked the British troops at Mons. Although the Germans were more powerful, they didn’t really make good use of it, and the British regiments survived six long periods of shelling and attack. Because Lanrezac arranged a general withdraw of the French 5th Army at Charleroi, the BEF was at risk of being overcome by the Germans, and the troops were pulled back ASAP. When the fight was done, around 35,000 British troopers had been involved, with 1,600 casualties to boot. 3d: The Siege of Maubeuge took place in Maubeuge in the province of Nord in France, whose absolute location is 50.280228, 3.967400. It was the last battle in the Battle of the Frontiers. On August 25, Maubeuge was attacked by the Germans. On August 29, they bombed Boussois Stronghold. On September 1, the French tried to counter-attack, but their infantry was pushed back. Maubeuge lost contact with the French, but luckily, on September 4, a carrier pigeon informed them of the attacks on the Les Sarts, Boussois, and Cerfontaine forts by the Germans. On September 6, the French detonated German weapons and took back Boussois. The French also took back Les Sarts and started attacking Cerfontaine, by which point, the entire town of Maubeuge had been set ablaze. General Fournier was determined to save the town, but on September 7, Post Leveau was bombed heavily and by late morning, a white flag was flying from the church. They officially surrendered on September 8. 6d: The Siege of Antwerp took place in Antwerp in the province of Antwerp in Belgium, whose absolute location is 51.219448, 4.402464. After the Germans invaded Belgium, a huge chunk of the Belgian Army fell back to Antwerp. Even though the German 1st Army bypassed it to get into into France, the Belgian troops in the city were a burden on the Germans. General Hans von Beseler’s III Reserve Corps, which was chosen to attack Antwerp, had five understrength divisions, but had been given 173 heavy artillery pieces. On September 28, German ordnance started to attack and annihilate the external strongholds that protected Antwerp. The British fulfilled the Belgians’ request for reinforcements and provided naval infantry, and the recently 4th Division would follow. As the Germans closed in on Antwerp, the Belgian officers abandoned the city. October 7, before the British 7th Division even set off, the Belgians transferred from Antwerp to Ostend to continue the battle in open territory. After two days, the attack was finished. All of these battles were important to the Central Powers because they gave the Central Powers a head-start in the war, early on. After the Battle of the Frontiers, however, the Germans were weakened, and the Allied Powers started to get the advantage. Document your sources! Wikipedia contributors. â€Å"Battle of Le Cateau.† Wikipedia, The Free Encyclopedia. Wikipedia, The Free Encyclopedia, 10 Jun. 2018. Web. 26 Jul. 2018. Wikipedia contributors. â€Å"Battle of St. Quentin (1914).† Wikipedia, The Free Encyclopedia. Wikipedia, The Free Encyclopedia, 24 Jun. 2018. Web. 27 Jul. 2018. Wikipedia contributors. â€Å"Battle of Mulhouse.† Wikipedia, The Free Encyclopedia. Wikipedia, The Free Encyclopedia, 16 Apr. 2018. Web. 30 Jul. 2018. Wikipedia contributors. â€Å"Battle of Halen.† Wikipedia, The Free Encyclopedia. Wikipedia, The Free Encyclopedia, 7 Jun. 2018. Web. 31 Jul. 2018. Wikipedia contributors. â€Å"Battle of Lorraine.† Wikipedia, The Free Encyclopedia. Wikipedia, The Free Encyclopedia, 12 Jun. 2018. Web. 27 Aug. 2018. Wikipedia contributors. â€Å"Battle of the Ardennes.† Wikipedia, The Free Encyclopedia. Wikipedia, The Free Encyclopedia, 9 Apr. 2018. Web. 27 Aug. 2018. Wikipedia contributors. â€Å"Battle of Charleroi.† Wikipedia, The Free Encyclopedia. Wikipedia, The Free Encyclopedia, 29 Mar. 2018. Web. 28 Aug. 2018. â€Å"Battle of Mons†. History.com. A+E Networks. Web. 31 August 2018. https://www.history.com/this-day-in-history/battle-of-mons â€Å"The Siege of Maubeuge†. Northernfrance.com. Didier Paris. Web. 3 September 2018. http://www.remembrancetrails-northernfrance.com/history/battles/the-siege-of-maubeuge-25-august-to-8-september-1914.html â€Å"Siege of Antwerp†. Brittanica.com. Adrian Gilbert. Web. 4 September 2018. https://www.britannica.com/event/Siege-of-Antwerp-1914 How to cite Decisive Events of the Second World War, Papers

Case Study of Tom Free-Samples for Students Myassignmenthelp.com

Question: Disucss the Case Study of Tom. Answer: Summary of family distress Tom is a 55-year-old man hospitalized with advanced lung cancer and multiple metastases. He is under morphine/midazolam syringe driver that he heavily contested. His daughter Carina, who claims to have power of attorney, wants the morphine withdrawn, something better to be administered and everything to be done to save him. Jimmys son disputes the power of attorney claims and argues that Toms wife Cec is the sole guardian and that his father did an advanced care paper. Although not sure of this, he believes that this would override the guardian issue. Main issues Several ethical dilemmas and medical issues arise in the provision of palliative care for Tom. The main issue in this case relates to the treatment of patients under palliative care. The first overriding issue is respecting the rights of patients. The autonomy pillar of medical ethics argues that the patient has a right to refuse or choose any given type of treatment. In the case of John, the administration of morphine/ midazolam syringe driver was done against his contestation of the treatment raising ethical concerns regarding failure to respect his right to choose or refuse treatment. Another key issue is the place of the power of attorney and its place in the provision of palliative care. The power of attorney regarding palliative care is a legal document in which the patient appoints someone to make decisions for him/her regarding medication, surgery or any other medical procedures. By claiming to have power of attorney, Carina has the authority to make decisions for her father. She has a right to stop any medication and demand treatment for her father, but she must act in the best interest of the patient. Given her authority, Carina makes demands, which I must consider as a nurse, including stopping the morphine treatment and introducing a better treatment and doing whatever is possible to save her father. Nevertheless, the legality of the power of attorney claims is questionable since Jimmy raises a dispute concerning the same. An ethical dilemma that arises here is determination of the validity of the Carinas power of attorney authority and considering conflicting information from the family members. Clearly, this conflict raises concerns regarding the validity of the power of attorney in this case. Moreover, Tom raises another ethical issue concerning enduring guardianship and provision of palliative care treatment. The Guardianship Act 1987 (NSW) makes it possible for a patient to appoint an enduring guardian to make decisions for him/her in the event of incapacitation. The authority of the guardian continues even when the patient is incapacitated (New South Wales Government 2016). In the case of Tom, an ethical dilemma arises when Jimmy claims that his father signed advance documentation granting his wife enduring guardianship authority. Finally, the palliative care medical team comprises physicians, nurse practitioners, nurses, social workers, chaplains and other medical practitioners. This multidisciplinary team works closely with patients and their families to provide the best care for the patient. The NFR, not for CPR and not for ICU admission are important and necessary orders in the provision of healthcare in Australia (Sidhu, Dunkley and Egan, 2007). The purpose of these orders is to support the autonomy of the patient while preventing the implementation of non-beneficial medical interventions (Yuen, Reid and Fetters, 2011). These signed notes from the team raises a range of ethical dilemmas in making decisions regarding provision of palliative care for Tom. Establish Decision-making goals A better understanding of the medical ethic would play a critical role in making decisions and providing adequate care for the terminally ill patients (Hallenbeck, 2006). My first goal would be to determine consent in providing treatment for Tom. It is important to attain informed consent before commencing the provision of palliative care for Tom. The patient has a legal right to make treatment decisions and must make consent for the decisions involving the provision of his/her medical care. In case of Tom, there was a clear violation of his right to informed consent given that morphine was administered regardless of his protestation. It is important to determine the capacity of the patient to make informed decisions. When the patient is incapacitated, a substitute decision maker, probably the immediate family member assumes the authority and responsibility of making the treatment decision on their behalf (Australian Government 2016). The Guardianship and Management of Property Act19 91(ACT) for each state and territory provides guidelines and outlines providing alternative or substitute decision maker in the event the patient is incapable to make treatment decisions. Regardless of the decision maker, the law requires that the person be provided with adequate information and support to make appropriate decisions concerning their treatment (Lamba et al., 2013). In provision of palliative care, informed consent should entail information concerning the benefits, risks and consequences of a given treatment intervention. It is important to determine whether Tom was given adequate information concerning the importance of morphine administration in order for him to offer informed consent regarding treatment. My second goal would be to establish the validity of the power of attorney. It is important for me to establish exactly under what circumstances the power of attorney in NSW apply and if it is valid in Toms case. According to the Powers of Attorney Act 2003,(NSW),the attorney, who is appointed by the principle in writing, is only allowed to make any financial transactions and decisions with the principles money,assets,real estate or shares among others. The Act does not provide for the attorney making any personal decisions concerning the principle, which includes medical or health care decisions. Consequently, Carina in this case is not allowed to decide the medical fate of her father and therefore as a nurse, I am not allowed to act as per instruction. My third goal would be to determine the validity of the issues regarding the enduring guardianship that were raised by Jimmy. Jimmy claims that Tom did appoint his wife Cec as his enduring guardian, and that in this capacity, her decision should be considered in Toms administration of treatment. The Guardianship Act 1987 (NSW), allows for a person in their right capacity to appoint an enduring guardian, who has legal authority to make decisions regarding health and lifestyle on behalf of that person. This may include the type of health care the person receives, where they may live and agreeing to medical treatment among others. This means that the case of Tom,Cec can make decisions on the palliative care to be administered to Tom, including treatment. However, her capacity as Toms guardian,Cec is required to consider Toms past wishes and views. She is also required to consider the views of the medical practitioners and important people in Toms life before making any decisions. She is Toms substitute decision maker and I should by all means work in consultation with her towards restoring Toms condition. My fourth goal would be to determine the validity of the issue regarding the advance care paper also raised by Jimmy. According to The Common Law of NSW, Advance Care Directives are accepted and legally binding. The NSW Supreme Court confirmed this in 2009.Advance care directives are instructions given by a person while in their right capacity about their desired future medical care. In the event that a person is not able to make medical decisions on their own, doctors, health care professionals and family members are required to act as per the patients advance care directives.In this case of Tom,his advance care directive should be consulted as a guide in the administration of treatment. It amounts to upholding the patients rights to consent or refuse medical treatment even at the point of death(Advance Care Planning 2015). My filth goal is on how to address the NFR, not for CPR and not for ICU admission instructions made by the medical registrar with consulting team. Often times, Cardiopulmonary resuscitation(CPR) is administered as a default treatment to patients whose heart stops beating, in the absence of a withhold order( Waldron et al,2016).For Tom, the instruction, not for CPR,was rightly administered. This is the case for Not for resuscitation(NFR),which in most countries is used bar the use of CPR on patients in cases where it will be of no help or where the patient refuses.ICU is administered to patients who are seriously ill, whose body fails to function normally. For example chronic respiratory failure, infections and renal failure among others. Tom did not qualify for ICU admission since his body could still support the various function at this particular time. Therefore, the instructions were all valid. Select a course of action Based on findings of the decision making goals, first I will not withdraw the administration of morphine treatment to introduce a better treatment as requested by Carina, who is only an attoney.Instead I will require to be served with the advance care paper that Tom had signed in order to honor his right to choose his medical treatment and care. The advance care directive will also serve to unite the family in decision making. Secondly, together with other medical practitioners; we will take Cec, Toms wife, through all the available medical options for Tom and give her an opportunity to decide on the best way forward References Australian Government, 2016. 10. Review of State and Territory Legislation: informed consent to medical treatment. [Online]. Accessed 3 May 2017 https://www.alrc.gov.au/publications/10-review-state-and-territory-legislation/informed-consent-medical-treatment Guardianship and Management of Property Act1991(ACT) ss 32B, 32D;Mental Health Act2009(SA) ss 56, 57. Hallenbeck, J., 2006. A Palliative Ethic of Care: Clinical Wisdom at Lifes End. Lamba, S., Bonanni, M., Courage, C.A., Nagurka, R. and Zalenski, R.J., 2013. When a patient declines curative care: management of a ruptured aortic aneurysm.Western Journal of Emergency Medicine,14(5), p.555-558 New South Wales Government, 2016. Guardianship Act 1987 No 257. [Online]. Accessed 3 May 2017. https://www.legislation.nsw.gov.au/#/view/act/1987/257 Sidhu, N.S., Dunkley, M.E. and Egan, M.J., 2007. " Not-for-resuscitation" orders in Australian public hospitals: policies, standardised order forms and patient information leaflets.Medical journal of Australia,186(2), p.72-75 Waldron, N, Johnson, C, Saul, P, Waldron, H, Chong, J, Hill, A, Hayes, B 2016, 'Development of a video-based education and process change intervention to improve advance cardiopulmonary resuscitation decision-making', BMC Health Services Research, 16, pp. 1-10. Yuen, J.K., Reid, M.C. and Fetters, M.D., 2011. Hospital do-not-resuscitate orders: why they have failed and how to fix them.Journal of general internal medicine,26(7), pp.791-797.