Simulation in Nursing Training Article Example | Topics and Well Written Essays - 3500 words

Simulation in Nursing Training - Article Example Simulation also enabled the students to learn and practice procedural skills and develop crisis management skills; it also infuses teamwork spirit among students (Joint Commission Resources, 2008). Simulation based education in nursing became popular because as students the nurses did not get the required clinical educational experience that would prepare them for handling emergencies and other hospital situations (Gaberson & Oermann, 2010). Simulation plays an important role in the training of nurses as it enhances the quality of education by meeting the training needs better. Most institutes have adopted full scale simulation training. Simulation has proved to be a useful learning tool as it supports the theoretical and conceptual background of the nursing education (Campbell & Daley, 2008). In healthcare where the safety of the patients and accuracy of care is given utmost importance, simulation and simulators provide a less threatening environment for practice (Sanford, 2010). Si mulation based teaching in nursing prepares the students for independent practice through technical skill development and advanced clinical learning. It also prepares the nurses for high risk situations such as traumas which may occur infrequently (Gaberson & Oermann, 2010). An interactive and participative environment can be created with simulation and the learners can overcome their weaknesses with the instant feedback provided by most simulators. Although numerous skills can be learnt through simulation, it is an exceptional teaching strategy for critical care nursing. In case of critically ill patients, nurses are required to collect, examine and respond accordingly to the data collected and all these skills can be acquired through simulation. The... This paper approves that both low and high fidelity mannequins are highly useful in developing clinical skills as student nurses collect information such as the history, drugs, allergies, laboratory values and other data about the simulated patient helpful in clinical decision making. The student nurses also learn to access electronic data as well as access the information systems present on the computer. In short these kinds of simulators develop technical and clinical skills in student nurses regarding where to find the patient’s data and how to use it. This report makes a conclusion that the advantages of low fidelity mannequins are restricted to the development of gross psychomotor skills but high fidelity mannequins can be used in the learning of community health, critical care, pediatrics and nurse anesthesia. It enhances critical thinking skills and improves clinical judgment. The use of low and high fidelity mannequins has increased in nurse education and has resulted in a decrease in time. The expense for residency programs and orientation has also decreased. A safer environment for both patients and nurses is also possible because of the high fidelity mannequins. Competency in testing skills is also achieved with high fidelity mannequins. High Fidelity mannequins are those that interact dynamically with the users. These mannequins are computer operated and are manufactured with advanced features such as palpable pulses, chest wall that replicates respiration, breath and bowel sounds and programmable heart.

The Miracle of Life Essay Example | Topics and Well Written Essays - 500 words

The Miracle of Life - Essay Example Life's Greatest Miracle takes the mystery out of reproduction, but leaves plenty of awe in its place. This film is an appropriate scientific adjunct for birds-and-bees discussions with children and teenagers. However, parents may want to preview the birth scene which, although sensitively filmed, may be too intense for younger viewers. The Miracle of Life records human conception for the first time on film, and much more. Living, functioning reproductive systems are laid bare to the camera, and there is so much to explore and absorb that Nova's expert guidance is much needed and appreciated. The viewer is also able to follow an egg from its follicular development in an ovary, through the delicate, flowery fallopian tube for fertilization, and on to the uterus for development and eventual birth. Likewise, the audience follows the shorter journey of millions of sperm as they develop and strive mightily to reach the egg. Among the stunning sequences shot by the photographer is the incredible voyage of the sperm toward the egg.

Marketing Research Paper Essay Example | Topics and Well Written Essays - 1000 words

Marketing Research Paper - Essay Example The answer lies in the cultural sensitivity of coke on how it position its product to its market at a given time and cultural context. To illustrate, we are going to take the old coke commercial at; http://www.youtube.com/watch?v=tQ0FRW1W3yA&feature=related. At a first glance, the commercial seems banal and corny which is typical of old commercials. It may even seem meaningless because all it has are just singing of scantily clad woman and sets of men. But if we observe closely on its message, this is where coke’s cultural sensitivity lies that made it appealing to all ages. Its value proposition was â€Å"value† with coke being â€Å"big† that every time the consumers in that era buy coke, they get more because coke got â€Å"big†. Their enticement was basically consumers get more with the same price and taste and this is aligned with the cultural preference of people towards value during that time. If the same message will be used today as a value propos ition to push coke in the market, it will surely fail because the preference of the market is different. In those times, people were not yet conscious of the sugar content of coke that could make an individual fat by drinking it excessively. In those times, coke is a delicious soda drink only that the purchasing power of the consumers are not yet as powerful compared today because it was the time of early industrial era where people does not earn much. So, value mattered to them for a delicious drink and health does not yet matter. Thus, coke attacked the cultural vulnerability of its consumers to position itself to its prospective market. Now let us move fast forward and observe its new commercial coke zero at this link http://www.youtube.com/watch?v=_BxDcn3Jw0c. The commercial’s pathos, or emotional persuasion, albeit lacking in ethos or logic, is very powerful because it appeals to the prevailing social desirables such as sexiness, being cool, in addition to its great tast e without the sugar. We can also observe that the new social desirables already changed especially with the necessity of being with a special â€Å"someone†. Coke managed to fill the modern age emotional vacuity by associating itself with an attractive girl who is helplessly attracted to a guy who prefers coke zero. Albeit the approach lacks logic or ethos, coke knew that the audience will overlook it in lieu of the stronger rhetoric of its pathos. Another strong case for capitalizing on the cultural context of a given society is its need to look good in order to become socially acceptable and desirable. Virginia Slims cigarette appeals to this cultural need to be beautiful and advertizes its product as a panacea that could fill that need. Virginia Slims cigarette may not explicitly state this in their advertisements but the use of attractive women who are beautiful by the standard of western society exudes the rhetoric of aesthetic appeal that is connected to filling a need for pathos or emotional fulfillment. The cigarette maker knows that in western culture, particularly America, being loved or desired has the pre-requisite of being physically beautiful in order to attract men. Such, it capitalizes on using women’s image as models which are considered to be beautiful during its particular era that† act as archetypes of beauty and confidence, but also set a standard for such traits, which most women feel

Ethics Paper Essay Example for Free

Ethics Paper Essay Economist Milton Friedman said that â€Å"the only entities who can have responsibilities are individuals. A business cannot have responsibilities. So the question is, do corporate executives, provided they stay within the law, have responsibilities in their business activities other than to make as much money for their stockholders as possible? And my answer to that is no, they do not.[2]† Nowadays, this debate falls into the CSR, or also know as the â€Å"Corporate Social Responsibility† talk points. In [7] Cheers questions: â€Å"What is the business of business†? Should business attempt to solve social issues or should business merely exist to maximize shareholder wealth? My opinion is that corporations and public companies should focus on maximizing stockholder and shareholder wealth, while simultaneously relying on ethical principles. Further reading about Friedman’s conservative stance on business’ business, one can point out that Friedman is quite positive that the social responsibility of a business and the primary focus of those who run the business is to make profit [6]. In business there is a multitude of different scenarios. These scenarios are hardly similar and each of them requires different point of view, perspectives and methods of approach. Is this the right approach? From the other point of view, ethical issues should not be overlooked. As we move towards a more connected world, with social media slowly replacing mainstream news channels, where â€Å"green† is the word and technology of choice, where political correctness is more important than the essence of an issue, ethical mishaps can turn into a publicity nightmare for corporations. While, in my opinion, a lot of ethical and moral issues are overly inflated there are some that must be taken into account, since they directly relate to the business’ business: profits! In the world we live in I think it is fair to say that corporations can still pursue successful paths while pursuing several methods of social responsibilities. I want to focus on three methods.

Comparison Contrast Between Iphone and Blackberry Essay Example for Free

Comparison Contrast Between Iphone and Blackberry Essay My world and Ray Bradbury’s world has some similarities and some differences. Both of our worlds have characters that agree with the negative effect of technology and the positive effect of it. To me I would agree with the positive effect of technology because without it people wont be the same as today. Have you ever thought of living without an iPod, laptop, cell phone, car, or a TV? Just take a second and imagine. Well, I can’t and I never could imagine that because ever since I was young, my whole life was based on technology. To me, technology is everything and without it I would feel lost, bored, and confused. Manny people would think that technology is the reason why were living, this is because its impact on everything we do. Like communicating, transporting, and being happy, However Technology is important because it is rapidly changing the way people are living. When I was in fifth grade my first electronic device that I used was a T-Mobile phone that my dad got me. I was so excited about, that I use to hold it in my hand 24/7 just to show off with it like I’m holding an iPhone. The phone was pretty, it was pink and it had some flowers on it. I use to always text my only one friend that I had on my phone, until my dad took it back from me and regret giving it to me, because I wasn’t ready for it. I was sad at that time, but then I realized that it’s not worth it. Staying up all night talking to your friend when she goes to the same school, now that’s just stupid. Later in the years I became more mature, and I got to explore on more stuff about technology that would just blow my mind off. An IPod touch came to my mind I felt like this is the most remarkable thing that have ever been invented. I told my dad that I wanted it and so he got it for me as a graduation present from elementary. I was so happy about it, that all I could remember is that I download 2 thousand songs as if I was going to listen to all of them. And I noticed that I wasted my time doing that, just for fun when I don’t even like listening to music that much. Currently my dad got me a Toshiba laptop, of course I loved it and at that time and I was so excited about it. But then when I got into school we started using Macbook, and I realized that its so much better then mine. So I started hating the one that I was using currently, and I begin to dislike everything about such as the word document and so on. And that’s because I wanted the better and newer one. I mean look at how fast technology can get, it changed my mind view of my new laptop that I just got to a newer one that I used in school for a couple of days. These days, technology is taking over us with out us knowing. Technology has influenced us in so many ways, we now think that the Internet is our first priority and we stopped spending time with our family like we use to do in the good ol’ days. I found that sad even though I do it myself with out knowing. The Internet is getting better, but worse at the same time, me, myself, and I try to take the good things from it and just ignore the other stuff. When I finished reading Fahrenheit 451, I noticed that there were many similarities and differences between my world and their world. The main thought that stood out for me was that my community in this world like to know about things but in Fahrenheit 451, they don’t really care about socializing or knowing stuff. I also found that in my world people love technology 99% of them cant even live with out it including me. But what I’m trying to say here is that in Fahrenheit 451 they all have negative effect about technology. One of the differences in my world is that when you go anywhere you would find books. In my world books are used to research a project, or to learn about life and so much more other stuff. Although I think these days not many use them as much as they use the Internet to find out stuff. But talking about Fahrenheit 451 they are not allowed owning a book. When there is hidden forms of information, opinion, or sense of understanding, that makes the society becomes unsuccessful, which show the necessity of books. Without the steady current of Information that books offers, the world of Fahrenheit will create weakness in society. People, in the novel, are left not knowing what true happiness because of the empty knowledge. Second reason that is similar in my world is the Parlor wall. In the novel, Mildred has a family on the television, which he uses to replace his own family with media, since it offers more happiness and less investment of her time, which is quicker than in real life. This wall is a flat screen kind of looking thing that would get people together for hours and make them communicate with each other even though they don’t know each other. This is the same in our world; Because people now a days would just ignore sitting with family, witch is the most important thing in life, and they would just create there own fun people that they would talk to 24/7 instead of setting with there family. Over all, you can see that our world and Fahrenheit 451 world is like total difference. And in my point of view I think our world is so much better. Technology in my world has a better use, we some use actually work with it, but the other half would actually just use it for entertainment just like what they do in Fahrenheit 451. In conclusion, I would say that technology has a huge impact in anyone’s life. It is part of who we are today. Facebook, MySpace, Skype, Twitter is now necessity to the world. Our world is growing bigger and smarter. We now have everything that you have never thought of when you were young. And that is where it all comes from â€Å"Technology†.

Problem Oriented Policing Pros and Cons

Problem Oriented Policing Pros and Cons Problem Oriented Policing What, exactly, is problem oriented policing? Critically discuss its potential benefits. Policing in the UK and many other countries play an extremely vital part in helping to reduce different forms of crime. The police have a major impact on what becomes defined as a crime, which offences are prioritized, and which sections of the community are portrayed as ‘dangerous’ or ‘troublesome’. (Waddington, 2000:156). There are a number of different approaches to reducing crime; however my main focus throughout this essay will be on problem oriented policing. Problem oriented policing has its advantages as well as disadvantages in preventing crime. In this essay I will discuss whether problem oriented policing has potential benefits in order to prevent crime in society. Police in the UK today is seen as a civil service that helps to solve and tackle the problem of crime. The police are faced with many problems everyday and do their best to deal with it within the restrictions of law, there are a number of different policing strategies used to tackle and prevent the problem of crime. Policing is a social institution which involves maintenance, peacekeeping, crime investigation, prevention and the rule of law enforcement which involves having a certain amount of power to serve their purpose (Jones and Newburn, 1998). To understand the current situation of policing it is essential to look at the background and history how crime was reduced in the past and what changes have been made in order to help reduce and prevent crime today. Although policing has some core features globally (Bayley, 1985; Mawby, 1999; Waddington, 1999a: 3-4), the exact forms that it takes vary widely, even within particular localities. Modern British policing, for example, with its ‘omnibus role’ incorporating ‘crime prevention, detection, peacekeeping, public order maintenance and the preservation of state security (Reiner, 1994a:755) emerges from several very different historical strands. The occupation of patrolling to prevent crime and apprehend offenders emerged from the functions of the medieval constable and watchmen, while ‘riot control’ emerged from the role of military in suppressing disorderly crowds (Rawlings, 2002; Vogler, 1991). These differing traditions, and the ideologies and practices they have given rise to, represent continual tensions in policing. Crime in the past was not as a great deal as it is in today’s society. There have been a lot of social changes as a result the way in which the state was controlled differed as there weren’t a lot of opportunities to commit crimes in the past. In today’s society, there are many different forms of policing as there are a number of different offences that need to be dealt with in a diverse way. In 1829 Sir Robert Peel established one of the well recognized policing systems which were the Metropolitan police. People hoped that the political system would improve aspects of society because in the 19th century, crime rates were increasing and the home office and government needed to act quickly upon this problem or things would get worse. Also there is a criticism of the role of policing as it is only concerned with crime and the enforcement of law which has restrictions and limits only to a certain extent to prevent crime (Goldstein, 1979). Goldstein argued that a new strategy needed to be developed as most crimes are in the same place and committed by the same individuals. Developing new strategies for preventing crime came about because of social, cultural, economic changes and growth of the state over the years. The criminal justice system as an approach on its own didn’t seem to have a great deal of an effect in controlling crime as it was made up of prosecuting, sentencing and punishing those who had offended. As a result when addressing the problem of crime, it was seen as a suitable way to use an additional approach alongside the criminal justice system which in this case is problem oriented policing (POP). In the 1980’s a new idea was introduced to the police in order to reinforce primary crime prevention. ‘This idea was called problem-oriented policing (POP), which was developed in America by Herman Goldstein’ (Goldstein, 1979; 1990) it’s purpose was to seek the main route of the crime and analyse it in order to understand why the crime had happened. POP became a success in the UK and North America. (Pease, 1997). It involves rank and file officers becoming pro-active in solving root causes of reoccurring problems in relation to the type of offender, localities and victims (Tilley, 1996). Problem oriented policing is a type of pro-active policing strategy and has become increasingly influential in the UK and addresses problems systematically in an ongoing process. The development of POP was based on perception that demands placed upon the police service meant that key issues of community to the community were often neglected (Tiley, 2003:318) ‘thus the active involvement of the community and external agencies is often vital to the identification of problems and the development of strategies to solve them’ (Leigh, Reid and Tilley, 1996:5). Crime prevention in Britain has constantly been seen as being the duty of the police. The British crime survey in 1982 showed that crime was four times higher than police had recorded it. (Walklate, 1996.) And more recently Barclay, (1995) found that only 3% of government expenditure on crime and criminal justice matters was spent on crime prevention. (Pease, 1997.) This showed that that the police alone could not combat such a level of crime. The basic premise of POP ‘is that the core of policing should be to deal effectively with underlying police-recurrent problems rather than simply to react to incidents calling for attention one by one as they occur’ (Bullock and Tilley, 2003:1). ‘This approach places the application of scientific methods at the heart of policing’ (Ekbolm, 2002; Bullock and Tilley, 2003: 5-6; John and Maguire, 2003:38) and involves: ‘identifying and analysing recurrent problems’ ‘interrogating their underlying sources’ ‘finding some points of intervention that will block caused and risk factors’ ‘Implementing the initiatives that have been devised’, ‘evaluating the success of initiatives put forward to respond to identified problems.’ An example of this would be in Clarke and Goldstein, 2002, which was a study done on a construction site that concerned theft. The crime was understood to be easy access to valuable products being available where the site was poorly safeguarded. With police assessment and knowledge of the problem, the construction site followed guidelines and some procedures where the police monitored compliance in order for it to be tracked. The results showed that the reaction the police got was successful as the analysis focused on understanding the circumstances that caused the problem to occur in the first place. In this sense it could be seen as a successful way to help prevent crime as no power was used, no arrests were made and it solved the problem quickly and effectively saving the police and company time and money. This is a successful way to monitor how different companies can protect themselves by doing a straightforward task such as getting appropriate equipment to guard property such as alarms, and then offenders will think twice before wanting to carry out a crime if the opportunity is not there. Problem oriented policing also engages in problem analysis triangle (PAT) and scanning, analysis, response and assessment (SARA). In a two year research project conducted in Leicestershire, there was training based on PAT and SARA which provided officers with knowledge of what the job involves. This was an experiment which involved tackling specific problems. The research project makes use of the strategies by identifying a problem, using knowledge and data to look further into the problems and causes of crime. It also teaches officers how to respond in an effective way by working with the community to assess if the solutions worked and what has been learnt. Problem oriented policing has gone further by being introduced in Thames Valley policing in 1997, Merseyside and other police forces. This shows that the approach used is a wide geographical spread, long term prevention program that is successful in tackling the underlying causes of problems. This project builds an idea how it would be successful to deal with problems and help prevent crime by working together and finding a solution that will prevent problems. It also shows how PAT and SARA is used to prevent crime and solving community problems. Problem oriented policing is therefore examining patterns of crime to identify and prevent underlying problems within the community. Oriented policing has shown to of had a great impact on the United States and is becoming more influential in the UK. The government and home office have implemented and introduced several different laws and agencies to help reduce crime. However, it is open to discussion to say what it is regarding problem oriented policing that has made it more significant in the UK and does it work? There are many merits as well as drawbacks to the benefits of problem orientated policing. There are a number of benefits of problem oriented policing, these include: ‘Decentralisation, POP attempts to move the focus of police decision making away from managers and towards front-line officers who are in a better position to understand the causes and possible solutions for problems’( John and Maguire,2003:65). It has been argued that ‘officers must know the underlying issues locally, be in contact with the community, have information to help understand the nature of the problems that generate clusters of incident, be supported by senior offices in attempting to solve problems imaginatively and tailor problem-solving to emerging local issues’ (Jordan, 1998:73). This should enable police resources to become more directly related to community needs. ‘Enhances the status of neighbourhood officers, POP envisages a significant role for local police officers whose status in the police service are likely to rise’ (Blair, 2005). ‘A shift away from law enforcement, POP involves activities to solve crime-related issues which are undertaken by agencies other than the police and by local communities’ an example of this is the burglary reduction initiative on a large housing estate in Stockport. (Bratby, 1999: 28-9). ‘Emphasises the importance of intelligence to police work, POP places considerable emphasis on the gathering and analysis of intelligence as the basis of society’s response to crime. The emphasis is on eliminating problems in the future as opposed to reacting to past incidents’ (Joyce, 2006:130). However a drawback of this point is it could be argued that the scanning and analysis of the data collected may not be accurate as it is community biased so is the data collected true and who is benefiting from the work carried out. It could be looked at in a sense that the community need to help themselves address issues as well as with the help of the police. For example when addressing the trouble of gang activities, the community need to get involved by disciplining their children and if gangs are making a nuisance of themselves then the community need to tackle this problem together. Even though there is optimistic perspectives in the benefits of problem oriented policing. Problem oriented policing has changed the work of some police forces so it makes it easier to refer to other cases and they have knowledge of what is going on. Officers will find it easier to respond to problems and know what they are dealing with so that the main cause of the problem is solved, reducing the risk of it happening again. It is obvious to state that the police must work with the community to know what issues must be addressed, however, how much are people in the community willing to participate. It has been seen that progress in applying a problem-oriented approach to policing was patchy (HMIC, 1998) and many were identified as being a long way off from implementing it fully (HMIC, 2000). The reason for the relatively slow progress includes: ‘The need to respond to incidents, much police work is demand led, having to respond to calls for help made by members of the general public’, ‘Complexity, considerable social skills are required in connection with problem identification, the analysis of their causes and the evaluation of the strategies to respond to these issues. These skills are not readily found within the police service, these activities are time consuming’. (Goldsteing, 2003; Matassa and Newburn, 2003:213). It has been argued that ‘POP is interpreted and implemented in too many ways to permit any firm conclusion’ (Stockdale and Whitehead, 2003:244) it has been further argued that the assessment of outcomes in monetary terms is insufficiently developed to be able to assess whether POP is cost effective Stockdale and Whitehead, 2003:249). It can also be argued that problem oriented policing deals with minor incidents such as theft and ignores other major problems. By focusing on such a minor problem is not going to be benefiting the community as there are other crimes that need to be addressed and the police will sooner or later deal with the problem by enforcement. A small amount of attention is paid to the oriented policing approach in dealing with problems it is likely that with policing they tend to naturally think enforcement. Oriented policing is interpreted and implemented in a number of ways; it is difficult to implement it. Also officers may not take the approach seriously due to the hassle of paperwork and following that procedure sometimes does not fit in with the police forces routine so there is the drawback of the approach not being used. Culture is another drawback within the police force as most officers have the principle that crime can only be solved if actual force is used. If officers are following this belief then no problems will get solved because the origin cause will not be solved, offenders will keep committing the same offence and officers will take action by using enforcement. It is clear to see that problem oriented policing has its drawbacks but this is the situation with most crime prevention strategies. Every strategy that has been implemented will always have its pros and cons. Research shows that this approach would work if it was encouraged more and used more effectively within the day to day routine of the officers. The police forces find it straightforward and easy to use enforcement. Other strategies involved in reducing crime, such as intelligent led policing and community policing. They work in a different way compared to problem oriented policing. Even though these three models are pro-active strategies there job roles cannot be correlated to work collectively as they have different means and different functions. The proactive approach has an impact on crime reduction as it produces a compelling solution and reduces the underlying causes of crime without being too reactive. There are a number of factors that make up problem oriented policing and it has a lot of benefits. The benefits of problem oriented policing are clear to see that it involves a better served public, convenient demands on the police because underlying problems are solved such as reducing replicate emergency calls and officers with greater job satisfaction from being successful in meeting the communities objectives. Overall it seems that Goldstein’s approach was not successfully used as it was planned. The main reason being the police force are involved in tackling the cause of problems but there is no time for it as police forces are so complex. The objectives of policing are set nationwide and there are no serious circumstances of implementing problem oriented policing, I have outlined many advantages and disadvantages to this approach throughout this essay, and it seems to show that the benefits are lower than the disadvantages of this approach for this approach many things do need to change also other agencies need to be involved as it cannot solely be up to just the police force to battle the problem of crime. On the whole, problem oriented policing has its implications but it has delivered some benefits and the approach is still undertaken today so to a degree it is beneficial to the community in some way. Referencing list Goldstein, H. (1990) Problem-Oriented Policing, New York: McGraw-Hill Joyce, P. (2006) Criminal Justice, An Introduction To Crime and The Criminal Justice System. Chapter 3 (page119) Policing: methods, structure and organisation Lecture 7 Handout, Proactive/Problem Oriented/Zero-Tolerance Policing Maguire Mike, Morgan Rod and Reiner Robert, 2002, The Oxford Handbook of Criminology, chapter 26, Crime Reduction. Newburn, T. (2003) Handbook of Policing, Cullompton: Willan Tilley, N. (2005) Handbook of Crime Prevention and Community Safety, Cullompton: Willan Walklate, S. (Ed. By McLaughlin Muncie) (1996) Controlling Crime. London: Sage.

The Day I Decided I Didnt Want to be a Doctor :: Personal Narrative Medicine Papers

The Day I Decided I Didn't Want to be a Doctor We've got one unconscious 14-year old male, struck by a train. Breathing is labored and shallow. A weak carotid pulse is 42. BP is 80 over 60. Skin is cyanotic, moist, and clammy. Pupils are dilated and non-reactive. Multiple complicated injuries: broken ribs protruding through left side, tension pnuemothorax, distended abdomen with obvious internal bleeding, fractured humerus, and pelvis. Massive injuries to head and face: lacerated nose, fractured zyogos, fractured cranium with obvious ecchymosis around eyes, hemorrhaging and leaking cerebrospinal fluid from ears and cranium. Have the trauma team ready when we arrive. I chose to do my clinical on a Friday night because I wanted a big messy injury like the ones in our class videos; but so far it's been a rather uninteresting evening. The only injuries, a fractured arm, an avulsed finger, a lacerated chin, and, of course, herds of complaining geriatrics. Just my luck. Being enthusiastically bored with these trivial injuries, I stroll up to the central call-in desk and slump down on a wooden, three-legged stool and insipidly finger the plastic ID badge clipped to my front collar. WAIT, what is this. The trauma team has assembled and is impatiently waiting by the accordion glass door. Something big must have happened. Through the glass door, brightly flashing red and white lights ignite the emergency room. An ambulance has just arrived. The glass doors fold open and a sea of blue and teal scrubs frantically attacks the wheeled stretcher. This is it; this is the big one I've been waiting for. A spark of excitement shoots down my veins. Adrenaline jump- starts my heart and my mind is immediately racing. I launch from my stool and shuffle around the swarming sea of blue and teal. A blaring voice rattles off the patient's latest diagnosis: a 14-year old struck by a train. BP is 68 over 40, pulse is 34, broken ribs, tension pnuemo, fractured cranium . . . The stretcher is wheeled to an isolated back room. A boy's tattered body lay quiet and still. Two, latex-gloved male nurses grasp each end of the spine board on which the boy is strapped and lift it onto a rectangular, white padded bed. A football-sized pool of bright red blood remains on the white padded stretcher where the boy once lay. The small body, stripped of all clothing except for a small white towel covering his genitalia, is grotesquely deformed.