How to Become a Straight a Student Essay Example for Free

How to Become a Straight a Student Essay Introduction â€Å"My friends always wondered why I was never in the library, but instead in the student center socializing, or at a party, or at an event. They said I made it ‘all look so easy. ’† Anna, a straight-A college student This is not your average college study guide. Unlike the titles next to it on the shelf, none of the advice presented here was devised by professors or self-proclaimed academic skills experts. I promise that you won’t find any mention of the Cornell note-taking method, mental map diagrams, or any other â€Å"optimal learning technique† crafted in an office or laboratory—environments far removed from the realities of typical college life. Instead, this book reveals—for the first time—the study habits used by real straight-A college students. All of the advice that follows was distilled from a series of interviews I conducted with a large group of top-scoring undergraduates. These participants were drawn predominantly from the Phi Beta Kappa rolls of some of the country’s most rigorous colleges and universities—including Harvard, Princeton, Yale, Dartmouth, Brown, Columbia, Duke, Amherst, and Skidmore—and they were carefully chosen to represent a wide variety of academic concentrations. In each interview, I asked the student to detail his or her study habits. The questions ranged from the general (â€Å"How do you defeat the urge to procrastinate? †) to the specific (â€Å"What techniques or systems do you use to locate and organize sources for a research paper? †). If the questionnaire revealed the student to be a grind—someone who earns high grades simply by studying an excessive amount—I discarded the responses. I was interested only in students who improved their grades through smarter, more efficient study skills—not through longer hours and more painful study sessions. How did I know such students existed? I am one of them. When I arrived as a freshman at Dartmouth College, I had no idea how to prepare for exams or write college-level papers. Like most students, I left high school believing that to study meant to reread your class notes and assignments as many times as possible and that paper writing required you to sit down in front of your computer and start typing until you finished. The problem, however, is that college is not high school. The material to be mastered is much more complicated and the professors have higher expectations. In the college environment, simple brute force study methods can end up requiring a lot of time and causing a lot of pain. Nevertheless, most students still rely on them. And this is why they find themselves regularly pulling all-nighters and developing an antagonistic attitude toward their courses. The taxing effects and spotty success of these methods also underlie the common belief that only geniuses and grinds can score top grades. When I first entered college, I shared in these beliefs. But soon I became dubious. It didn’t take long for me to decide that there had to be a better way to learn the material. The results of my studying using simple techniques varied widely—I’d spend all night hacking away at an essay and end up scoring a B-, or give what I thought was a frantic last-minute review for a quiz and score an A. I constantly felt like I was behind in my reading, and there always seemed to be new deadlines on the horizon that I had to scramble to meet. It was truly a chaotic existence. But when I looked around, all of my friends seemed to be having the same experience—and none of them seemed willing to question it. This didn’t sit right with me. I wasn’t content to work in long, painful stretches and then earn only slightly above-average grades for my efforts. I wanted to be exceptional. And I wanted to achieve this without having to sacrifice sleep or my social life. To many students, such a goal may sound hopelessly hubristic. But I’m an optimist by nature, and, observing the sorry state of my current study skills, I was convinced that I could do better. It took me most of my freshman year to construct, through repeated experimentation, a toolbox of sufficiently improved study habits. But once I had perfected them, the results were profound. Of the thirty-six courses I took between my sophomore and senior years of college, I scored exactly one A- and 35 perfect As. The most stunning piece of this transformation, however, was how much less time I had to spend on studying. As my strategies became more refined, the hours required were reduced. By my senior year it got to the point where, during finals periods, I would sometimes pretend to be heading off to the library just so I wouldn’t demoralize my roommates, who were preparing for yet another grim all-nighter. What was my secret? Efficiency. The simple truth is that the brute force techniques used by most students are incredibly inefficient. When it comes to exam preparation, passive review is not an effective way to learn complicated concepts. It’s also mentally draining, which further diminishes the rate at which you can absorb and internalize information. For paper writing, this same problem holds. When you approach the task without proper preparation, it becomes incredibly tiring and you can end up spinning your wheels. After a while, even the formation of coherent sentences becomes difficult and time intensive. In contrast, the techniques I came up with were so streamlined that I could learn more material than my classmates and actually spend less time studying. By eliminating stupid habits and wasted effort, I transformed exam prep and paper writing from a dreaded chore to a targeted activity. For a while, I was convinced that I was unique for having discovered such a smart approach to learning. But, alas, this illusion was soon shattered. It occurred during the winter of my senior year, when I was attending a ceremony celebrating my induction, along with thirty other classmates, into Phi Beta Kappa. This group represented, more or less, the thirty students with the highest G. P. A. s out of my class of over a thousand. Accordingly, I had arrived at the venue prepared to spend the evening with some serious nerds. As it turns out, however, I was in for a surprise. Upon walking through the door that night, I was immediately struck by how many of the other students I knew socially. These were people who, given their level of visibility on campus, I never would have imagined were scoring straight As. They were magazine editors, frat boys, and crunchy environmentalists. I knew them from parties and campus clubs and through mutual friends. They were, for the most part, normal, well-rounded, and interesting—not at all the type of super-grind one might assume would occupy such an elite level of academic achievement. The lesson of that night was obvious: Perhaps I was not, in fact, as unique as I had first imagined. Maybe there were others out there who had discovered similar secrets to academic success. The writer instincts in me soon took over. Fascinated to know exactly how these seemingly normal students had done so well, I sent all of my fellow Phi Beta Kappas a survey about their study habits. Most were happy to share their methods and I quickly confirmed that my suspicions were true. Not only were many of them using innovative, homegrown study strategies, but many of these strategies were surprisingly similar to those that I had developed during the previous few years. At the time I had just finished editing the manuscript for my first book, How to Win at College, so I wasn’t exactly eager to get started right away with another massive writing project. But after seeing these initial survey responses, I knew I had stumbled onto something big. While most college students toil arduously through the study and paper-writing processes, there exists an elite group of undergrads who have discovered unconventional strategies for earning much higher grades in much less time. I wanted to share these secrets with other students, and thus the idea for this book was born. Soon I was sending out more questionnaires to more straight-A students at colleges around the country, until I gathered enough responses, from students with enough different backgrounds and majors, to distill the advice presented in this guide. In the pages that follow, you will discover the details of these often surprising study strategies. I’ve included examples and case studies throughout the book to demonstrate how to apply the advice in many different reallife academic situations. You will learn how to: †¢ Manage your time and deal with the urge to procrastinate. †¢ Take targeted notes in class. †¢ Handle reading assignments and problem sets with ease. †¢ Prepare efficiently for exams. †¢ Master the art of exam-taking. †¢ Write incisive critical analysis essays. †¢ Conduct thorough research. †¢ Write standout term papers. Remember, this advice comes from real students and was honed, through trial and error, in real college classrooms. This distinction is important. It’s what separates this book from the many existing study guides that sit next to it on the bookstore shelf. As mentioned, most study guides are written either by professors or academic skills experts, many years separated from their own college experience. The result is that the authors of these guides are disconnected from the realities of undergraduate life. For example, How to Study, by college professors Allan Mundsack, James Deese, and Ellin K. Deese, suggests that students wake up at 7 A. M. each morning, go to sleep by 11 P. M. each night, and on many days schedule only a single hour of â€Å"recreation,† with the rest of the time dedicated to attending class, eating, or working. One gets the feeling that these professors haven’t spent much time socializing with students lately. Even their plan for Friday—the biggest party night of the week—has the student working until 10 P. M. , taking a one-hour break, then turning in by eleven. Student Success Secrets, written by Eric Jensen, a learning expert and professional public speaker, offers equally out-of-touch suggestions. His tips to help you remember concepts learned from a reading assignment include â€Å"put it in a picture or poster—use intense colors,† â€Å"act out the material or do a fun role play in your own room,† or â€Å"create or redo a song; make a rap. † Just try to imagine a sophisticated liberal arts major attempting to make a rap about her recent reading assignment concerning post-structuralist interpretations of pre-Victorian English literature! (Key question: What word rhymes with â€Å"Foucault†? ) The granddaddy of all unrealistic study guides, however, just might be What Smart Students Know, by Princeton Review cofounder Adam Robinson. In this best-selling guide, Robinson suggests—and I swear I am not making this up—that students approach a reading assignment as a twelve-step process! That’s right, twelve separate steps. Before you even crack the actual assignment, Robinson suggests that you jot down questions about the importance of the reading and then take notes on what you know about the topic, what it reminds you of, and what you want to learn. He then asks you, among other things, to read the assignment a total of three separate times, write and then rewrite your notes, represent the information in picture form, construct â€Å"question charts,† and devise mnemonics to help you memorize the concepts. Needless to say, this approach to a simple reading assignment is humorously unrealistic. I even did a little math. For a typical college-level liberal arts course, a student might be assigned an average of two hundred pages of reading a week. In his book, Robinson provides a one-page sample reading and describes twenty-three different questions that students might ask about it. At this rate of twenty-three questions per page, spending thirty seconds on each query, we would end up spending around forty hours a week (i. e. , a full-time job’s worth of time) simply completing one of the twelve steps on the reading assignments for just one class. Sounds like a great plan! These examples highlight the simple truth that the advice in most existing study guides—written by â€Å"experts,† not students—is often impractical and time consuming. How to Become a Straight-A Student, on the other hand, is the first guide based on the experiences of real college students, and it was written to provide an alternative to the other titles on the market. In the pages that follow, you will find homegrown strategies that are compatible with the demands of your day-to-day student life. They may not be as elaborate as the intricate systems devised by the â€Å"experts,† but they’re easy to implement—and they get the job done. Best of all, when you start putting these strategies into practice, you will experience immediate results. Keep in mind: If you find a piece of advice that doesn’t quite fit your needs or circumstances, that’s okay. In fact, you should expect this. Each of the students I interviewed for this book had his or her own unique take on the best way to study. Follow their lead and, when stuck, experiment. Replace techniques you don’t like with ones that seem better. If these new techniques work, keep them; if they fail, replace them with something else. The key to improving your grades without becoming a grind cannot be found in any single study habit. It is, instead, rooted in the big picture decision to reject rote review once and for all and begin the flexible search for strategies that work better for you. Above all, remember that college is a multifaceted experience, of which grades are just one of many important pieces. It’s my hope that this book will help you painlessly conquer this one piece so you can have more time and energy to explore all of the others—the friends, the unburdened idealism, the heroic beer consumption—that make these four years so rich. A common complaint I hear from students is that they never seem to have enough time to finish all of their work. They vent about how many hours they spend—late nights reviewing in the library, weekends sacrificed to paper writing—but no matter how hard they try, there always seems to be something else due. As Matthew, a straight-A student from Brown, explains, it’s easy for college students to become â€Å"stuck in a state of permanent catch-up. † Understandably, these students feel like they have reached their academic limit; they believe that unless they forgo sleep or any semblance of a social life, there are simply not enough hours in the day to stay on top of all their schoolwork. Let’s start by getting one thing clear: This belief is false. The problem here is not the amount of available hours, but rather how each hour is spent. I know this from firsthand experience. While researching this book, I spent time with some of the country’s most accomplished students, and I can assure you that no matter how diligent you think you are, there is a Rhodes scholar out there who fits in three times the amount of work and activities you do and probably still manages to party harder than you would ever dare. I don’t mean to imply that everyone should aim to become a drunken Rhodes scholar (though it would certainly be fun to try); rather, my point is that a surprising amount of work, relaxation, and socializing can be extracted from a single twelve-hour day. A lack of time, therefore, isn’t enough to explain why so many students feel overwhelmed. So what does explain this phenomenon? The answer, as it turns out, has much more to do with how we work than what we’re trying to accomplish. As humans, our minds have evolved to prefer short-term tasks such as â€Å"run away from that lion† or â€Å"eat food. † Therefore, when you walk into the library on a Sunday morning with the goal of finishing all of your homework and writing a paper, your brain isn’t happy. The idea of spending eight consecutive hours trapped in a study carrel is dispiriting. Plus, it’s hard to focus for that long, so pretty soon fatigue will set in, your concentration will wander, and every distraction will suddenly seem impossibly appealing. Before you know it, the day will be over and you’ll realize that you haven’t accomplished much productive work at all. The next day, new assignments will pile onto those you didn’t finish on Sunday, and the tedious process starts all over again. Jason, a straight-A student from the University of Pennsylvania, uses the term â€Å"pseudo-working† to describe this common approach to studying. The pseudo-worker looks and feels like someone who is working hard—he or she spends a long time in the library and is not afraid to push on late into the night—but, because of a lack of focus and concentration, doesn’t actually accomplish much. This bad habit is endemic on most college campuses. For example, at Dartmouth there was a section of the main library that was open twenty-four hours a day, and the students I used to see in there late at night huddled in groups, gulping coffee and griping about their hardships, were definitely pseudo-working. The roommate who flips through her chemistry notes on the couch while watching TV is pseudo-working. The guy who brings three meals, a blanket, and six-pack of Red Bull to the study lounge in preparation for an all-day paper-writing marathon is also pseudo-working. By placing themselves in distracting environments and insisting on working in long tedious stretches, these students are crippling their brain’s ability to think clearly and efficiently accomplish the task at hand. The result is fatigue headaches and lackluster outcomes. The bigger problem here is that most students don’t even realize that they’re pseudo-working. To them pseudo-work is work—it’s how they’ve always done it, and it’s how all of their friends do it. It never crosses their mind that there might be a better way. Straight-A students, on the other hand, know all about pseudo-work. They fear it, and for good reason. It not only wastes time, but it’s also mentally draining. There is just no way to be wellbalanced, happy, and academically successful if you’re regularly burning through your free hours in long, painful stretches of inefficient studying. The students I interviewed for this book emphasized again and again the importance of avoiding this trap. In fact, when asked what one skill was most important in becoming a non-grind straight-A student, most of them cited the ability to get work done quickly and with a minimum of wasted effort. So how do these students achieve this goal? A big part of the solution is timing—they gain efficiency by compressing work into focused bursts. To understand the power of this approach, consider the following simple formula: work accomplished = time spent x intensity of focus Pseudo-work features a very low intensity of focus. Therefore, to accomplish something by pseudo-working, you need to spend a lot of time. The straight-A approach, on the other hand, maximizes intensity in order to minimize time. For example, let’s rank intensity on a scale of 1 to 10 (with 10 being the most intense). Assume it takes ten hours to finish studying for a test by pseudo-working with a low intensity score of 3. According to our formula, this same amount of work can be accomplished in only three one-hour bursts, each with an intensity of 10. The work that took you all day Sunday to complete could instead be finished by studying an hour after breakfast, an hour after lunch, and an hour after dinner—the rest of the day being free for you to relax! With this formula in mind, you can begin to understand why many straight-A students actually study less than their classmates: They replace long, low-intensity stretches of work with a small number of short, high-intensity sessions. Of course, this is not the whole story behind their success; what straight-A students actually do in these short bursts is also crucial—technique is just as important as timing. Part Two (Quizzes and Exams) and Part Three (Essays and Papers) of this book are dedicated to these technical details. But learning how to follow an efficient schedule, and banishing pseudo-work from your college experience for good, is a crucial first step toward your academic overhaul. To accomplish this transformation, however, you will need to gain control over your lifestyle—and that’s often no small task. For example, you will need to spread out the intense work sessions so that you have time in between to recharge. This requires basic time-management skills. You’re also going to have to overcome your urge to procrastinate, because scheduling your work is meaningless if you don’t actually work in the time you set aside. This requires self-motivation. Finally, to obtain the highest possible levels of intensity, you need to choose the right locations, times of day, and durations to study. If you aren’t careful about how you select these three factors, you can unintentionally sabotage your ability to focus. This requires a smart planning strategy. Part One will teach you how to satisfy these requirements. It begins with the presentation of a simple timemanagement system, customized for the busy college lifestyle. Don’t be frightened, the system is incredibly lightweight—it’s designed to require only five minutes a day of planning and can survive periods of neglect. Part One then continues with a collection of battle-tested strategies to help you fight procrastination. This advice comes straight from the experiences of real students and has been proven to work amid the chaos and distractions of the typical undergraduate lifestyle—it is simple, easy to apply, and surprisingly effective. This part concludes with a discussion of when during the day, where on campus, and for how long to study to maximize your productivity. The students interviewed for this book experimented extensively to find the right answers to these key questions, and, in this final step, I pass these answers on to you. Together, these basic skills are the foundation upon which all the advice in this book is built. Without them, you’ll be unable to implement the specific study techniques described in the parts that follow. Master them, however, and you will experience improvements in all aspects of your life—not just grades. You’ll have more free time, you’ll get the sleep you crave, you’ll party harder, and you’ll be able to devote more energy to your extracurricular interests. So relax. You are about to take your first step toward a much more enjoyable and productive college experience. Step 1. Manage Your Time in Five Minutes a Day Real straight-A students, like most reasonable students, hate time management. After all, college is supposed to be about intellectual curiosity, making new friends, and becoming obsessed with needlessly complicated drinking games. An overwhelming interest in time management is best left to harried business executives (or, perhaps, premeds). At the same time, however, you can’t abandon all attempts to keep tabs on your schedule. As mentioned in the introduction to Part One, all of the techniques described in this book require some ability to control your schedule. Ignore this skill, and you doom yourself to four long years of playing catch-up with your work. As Doris, a straight-A student from Harvard, states: â€Å"Time management is critical—it’s a skill that you absolutely must develop over the course of your time at college. † Most students, however, misunderstand the purpose of time management—they believe it’s used only to cram as much work as possible into the day. But this is not the main motivation behind controlling your schedule. As it turns out, a little planning goes a long way toward reducing your daily stress levels. Having deadlines and  obligations floating around in your mind is exhausting—it makes it impossible to completely relax, and, over time, can lead you down the path toward a breakdown. However, once you figure out what work needs to be done and when, it’s like a weight being lifted from your shoulders. The uncertainty vanishes: When you work, you can fully concentrate on the assignment in front of you, and when you relax, you can do so without any anxiety. â€Å"I don’t believe in giving up anything,† says Jenna, a straight-A student from Princeton. â€Å"Not my social life, not my extracurricular activities, not my academic success. † Basic control over your schedule breeds balance. This is why time management, as Doris stated earlier, is the key to getting the most out of all aspects of your college experience. The goal of Step #1 is to present a time-management system that helps you achieve this stress-free balance without requiring you to sacrifice the spontaneity and excitement of college. Specifically, we present a system tailored to the typical undergraduate lifestyle that meets the following criteria: 1. Requires no more than five to ten minutes of effort in a single twenty-four-hour period. 2. Doesn’t force an unchangeable minute-by-minute schedule on your day. 3. Helps you remember, plan, and complete important tasks before the very last moment. 4. Can be quickly restarted after periods of neglect. We will cover the details of this system in a few simple steps and then conclude with a detailed case study so you can see how it works in a realistic setting. What You Need This system requires two pieces of equipment. 1. A calendar: It doesn’t matter what type of calendar, and it’s not something that you have to carry around with you. It can be Microsoft Outlook or iCal on your computer, a cheap day planner, or one of those advertisement-laden freebies they hand out at orientation. It just has to be something that you can reference every morning that has enough space to record at least a dozen items for each day. 2. A list: Some piece of writing material that you can update throughout the day. This you do have to carry around with you, so make it something simple, like a sheet of paper ripped out of a notebook each morning. The Basic Idea Record all of your to-dos and deadlines on your calendar. This becomes your master schedule, the one place that stores everything you need to do. The key to our system, however, is that you need to deal with your calendar only once every twenty-four hours. Each morning, you look at it to figure out what you should try to finish that day. Then, throughout the day, whenever you encounter a new to-do or deadline, simply jot it down on your list. The next morning, you can transfer this new stuff from your list onto your calendar, where it’s safe. And we’re back where we started. That’s it. Pretty simple, right? The whole system can be summarized in three easy steps: (1) Jot down new tasks and assignments on your list during the day; (2) next morning, transfer these new items from your list onto your calendar; and (3) then take a couple of minutes to plan your day. Now, we’ll examine these steps in a little more detail. In particular, we need some strategies for how to plan your day each morning using your calendar and what to do when unexpected events interfere and turn that plan upside down (trust me, this will happen more often than not). Update Your Calendar Each Morning This is where the magic happens. Every morning, spend a few minutes to update your calendar and figure out what you should try to accomplish. This is the only serious time-management thinking you have to do for the whole day, so the demand is pretty reasonable. This updating process should proceed as follows: Find your list from the day before. It will probably look something like the example described in Figure 1. Don’t worry too much about how this list is formatted; we will discuss that shortly. For now, focus on the â€Å"things to remember† column, which contains the new to-dos and deadlines that were jotted down throughout the day. Figure 1. Sample List Tuesday—1/24/06 Today’s Schedule †¢ 10:00 to 12:00 Econ class †¢ 12:00 to 1:00 Lunch with Rob †¢ 1:00 to 1:45 Government reading †¢ 2:00 to 4:00 Government class †¢ 4:00 to 5:30 Finish government reading. †¢ 5:30 to 6:30 Start French essay Things to Remember †¢ Econ study group, Thur. at 9 P. M. †¢ French quiz moved to Friday. †¢ Laundry †¢ Start researching summer internship opportunities. Transfer these new items onto your calendar. Write the deadlines on the appropriate dates, and write the todos on the days when you plan to complete them. Following the example of our sample list, you would first jot down the econ study group time under Thursday’s date and the French quiz under Friday’s date. You would then choose a day to do laundry and jot down a reminder under that date, and choose a day to start internship research and  jot down a reminder under this date . You can move these items around on your calendar as many times as you want, so don’t worry too much about which date you initially choose for a new to-do. However, try to use some common sense. For example, if Wednesday afternoon and evening are packed with meetings and work, this might not be the best day to schedule doing your laundry. Similarly, if you have a big test Monday morning, don’t schedule a lot of annoying errands for Sunday; you’ll need your concentration for studying. If something is not especially time sensitive, such as the internship research example from above, don’t be afraid to put it on a day far in the future, at a point when you know you will be less busy—such as right after midterms or at the beginning of a new semester. Next, move the to-dos that you planned for yesterday, but didn’t complete, to new days on your calendar. In our sample list from Figure 1, the Today’s Schedule column describes to-dos planned from the day before. As you can see, in this example, all the to-dos were completed except the â€Å"Start French essay† task, so you would need to move this task to a new date. At this point, your calendar once again holds everything that you need to get done. Now it’s time to figure out your plan for the current day. Go ahead and trash yesterday’s list—it’s served its purpose—and grab a fresh sheet of paper to use as today’s list. Divide it into two columns, as shown in Figure 1, and label them Today’s Schedule and Things to Remember, respectively. Next, look at the calendar entry for the current day. It will probably contain a handful of appointments and todos. Your goal is to figure out how much of this work you can realistically accomplish. You might be tempted to simply copy all of these tasks into your Today’s Schedule column and then treat it as a simple to-do list for the day. Don’t do this! If you want to avoid getting overwhelmed by your work, you need to be smarter about your time. Here is what you should do instead: Try to label each of your to-dos for the day with a specific time period during which you are going to complete it. Be honest. Don’t record that you are going to study for three hours starting at three if you know that you have a meeting at five. And be reasonable about how long things really take—don’t plan to read two hundred pages in one hour. For simplicity, group many little tasks (errands that take less than ten minutes) into one big block (for example: â€Å"10:00 to 10:45—mail letter, return library book, buy new deodorant, fill out transcript request form at registrar†). Leave plenty of time for breaks. Give yourself an hour for meals, not twenty minutes. And, if possible, end your day at an appropriate hour; don’t try to fit in work right up until sleep time because you need to be able to unwind and relax. In general—though it may seem counterintuitive—be pessimistic. The truth is: Things will come up. Don’t assume that every hour that looks free in the morning will stay free throughout the day. Remember, the goal here is not to squeeze everything into one day at all costs, but rather to find out how many of the tasks listed for the day you actually have time to accomplish. If you can’t fit all the to-dos into your schedule for the day, no problem! Simply move the remaining items onto the calendar entries for future dates. You can deal with them later. Your final step is to record the tasks you will have time for into the Today’s Schedule column of your list. As shown in Figure 1, label each task with its time. That’s it. You can now reference your list throughout the day to remind yourself of what you should be doing and when. But here’s the important point: The specific times on your schedule aren’t set in stone—they’re more of a suggestion. As we will discuss shortly, you will be free to move tasks around throughout the day, depending on your energy level and unexpected events that may arise.

Essay --

Introduction A ward handover is a continuous and effective process to circulating essential information about a patient which is necessary to ensure the promotion of safe patient care. Ward handovers require effective communication to ensure correct clinical care delivery to all patients. This takes the form of both verbal and non-verbal communication and requires valuable leadership skills. Following a specific communication model or framework can result in a successful handover and therefore, continuity of care for each individual patient, overall ensuring high quality patient care. Ward handovers are essentially used to improve communication through the sharing of patient information between professionals, improve patient safety by certifying reliable care and improving quality and productivity, this will help reduce inaccuracies in information sharing and the quality of patient care. There is also a growing recognition within ward handovers that enhanced training to ensure effective handover s are crucial in maintaining high standards of clinical care. To ensure that an effective handover takes place all healthcare areas must have a handover policy and compliance to this policy must be ensured. Rfjhskdgnd () said a ward handover†¦ MORE ON WARD HANDOVER SBAR SBAR (Leonard, et al., 2006) is a communication framework which can structure conversations within healthcare settings, particularly those which require immediate action and which may require another member from the multidisciplinary team. (Bomba and Prakash, 2005) revealed that 95% believed that there were no set procedures to assist a ward handover, this is where a communication framework such as SBAR should be brought in to ensure that handovers are produced in... ...e process, using SBAR to prepare the ward handover could help noticeably as it can ensure that the team have based and formatted the handover information correctly. However, information which could be considered relevant should also be used, although this should not overwrite the most essential material which needs to be communicated. Implications for communication in a team Within a team communication can be hindered, this means that within a ward handover communication can be really affected. During a ward handover there is very little time to communicate what information needs to be delivered to each team member, therefore, an understanding and a consensus of this is needed. Conclusion Communication within a ward handover is imperative as this is a designated time to communicate information about patients which could be vital for nurses on the upcoming shift.

Vampire Academy Chapter 17

SEVENTEEN A FEW DAYS LATER, LISSA found me outside the commons and delivered the most astonishing news. â€Å"Uncle Victor's getting Natalie off campus this weekend to go shopping in Missoula. For the dance. They said I could come along.† I didn't say anything. She looked surprised at my silence. â€Å"Isn't that cool?† â€Å"For you, I guess. No malls or dances in my future.† She smiled excitedly. â€Å"He told Natalie she could bring two other people besides me. I convinced her to bring you and Camille.† I threw up my hands. â€Å"Well, thanks, but I'm not even supposed to go to the library after school. No one's going to let me go to Missoula.† â€Å"Uncle Victor thinks he can get Headmistress Kirova to let you go. Dimitri's trying too.† â€Å"Dimitri?† â€Å"Yeah. He has to go with me if I leave campus.† She grinned, taking my interest in Dimitri as interest in the mall. â€Å"They figured out my account finally – I got my allowance back. So we can buy other stuff along with dresses. And you know if they let you go to the mall, they'll have to let you go to the dance.† â€Å"Do we go to dances now?† I said. We never had before. School-sponsored social events? No way. â€Å"Of course not. But you know there'll be all kinds of secret parties. We'll start at the dance and sneak off.† She sighed happily. â€Å"Mia's so jealous she can barely stand it.† She went on about all the stores we'd go to, all the things we'd buy. I admit, I was kind of excited at the thought of getting some new clothes, but I doubted I'd actually get this mythical release. â€Å"Oh hey,† she said excitedly. â€Å"You should see these shoes Camille let me borrow. I never knew we wore the same size. Hang on.† She opened her backpack and began rifling through it. Suddenly, she screamed and threw it down. Books and shoes spilled out. So did a dead dove. It was one of the pale brown mourning doves that sat on wires along the freeway and under trees on campus. It had so much blood on it that I couldn't figure out where the wound was. Who knew something so small even had that much blood? Regardless, the bird was definitely dead. Covering her mouth, Lissa stared wordlessly, eyes wide. â€Å"Son of a bitch,† I swore. Without hesitating, I grabbed a stick and pushed the little feathered body aside. When it was out of the way, I started shoving her stuff back into the backpack, trying not to think about dead-bird germs. â€Å"Why the hell does this keep – Liss!† I leapt over and grabbed her, pulling her away. She had been kneeling on the ground, with her hand outstretched to the dove. I don't think she'd even realized what she was about to do. The instinct in her was so strong, it acted on its own. â€Å"Lissa,† I said, tightening my hand around hers. She was still leaning toward the bird. â€Å"Don't. Don't do it.† â€Å"I can save it.† â€Å"No, you can't. You promised, remember? Some things have to stay dead. Let this one go.† Still feeling her tension, I pleaded. â€Å"Please, Liss. You promised. No more healings. You said you wouldn't. You promised me.† After a few more moments, I felt her hand relax and her body slump against mine. â€Å"I hate this, Rose. I hate all of this.† Natalie walked outside then, oblivious to the gruesome sight awaiting her. â€Å"Hey, do you guys – oh my God!† she squealed, seeing the dove. â€Å"What is that?† I helped Lissa as we rose to our feet. â€Å"Another, um, prank.† â€Å"Is it†¦dead?† She scrunched up her face in disgust. â€Å"Yes,† I said firmly. Natalie, picking up on our tension, looked between the two of us. â€Å"What else is wrong?† â€Å"Nothing.† I handed Lissa her backpack. â€Å"This is just someone's stupid, sick joke, and I'm going to tell Kirova so they can clean this up.† Natalie turned away, looking a little green. â€Å"Why do people keep doing this to you? It's horrible.† Lissa and I exchanged looks. â€Å"I have no idea,† I said. Yet as I walked to Kirova's office, I started to wonder. When we'd found the fox, Lissa had hinted that someone must know about the raven. I hadn't believed that. We'd been alone in the woods that night, and Ms. Karp wouldn't have told anyone. But what if someone actually had seen? What if someone kept doing this not to scare her, but to see if she'd heal again? What had the rabbit note said? I know what you are. I didn't mention any of this to Lissa; I figured there were only so many of my conspiracy theories she could handle. Besides, when I saw her the next day, she'd practically forgotten the dove in light of other news: Kirova had given me permission to go on the trip that weekend. The prospect of shopping can brighten a lot of dark situations – even animal murder – and I put my own worries on hold. Only, when the time came, I discovered my release came with strings attached. â€Å"Headmistress Kirova thinks you've done well since coming back,† Dimitri told me. â€Å"Aside from starting a fight in Mr. Nagy's class?† â€Å"She doesn't blame you for that. Not entirely. I convinced her you needed a break†¦and that you could use this as a training exercise.† â€Å"Training exercise?† He gave me a brief explanation as we walked out to meet the others going with us. Victor Dashkov, as sickly as ever, was there with his guardians, and Natalie practically barreled into him. He smiled and gave her a careful hug, one that ended when a coughing fit took over. Natalie's eyes went wide with concern as she waited for it to pass. He claimed he was fine to accompany us, and while I admired his resolve, I thought he'd be putting himself through a lot just to shop with a bunch of teenage girls. We rode out the two-hour trip to Missoula in a large school van, leaving just after sunrise. Many Moroi lived separately from humans, but many also lived among them, and when shopping at their malls, you had to go during their hours. The back windows of the van had tinted glass to filter the light and keep the worst of it away from the vampires. We had nine people in our group: Lissa, Victor, Natalie, Camille, Dimitri, me, and three other guardians. Two of the guardians, Ben and Spiridon, always traveled with Victor. The third was one of the school's guardians: Stan, the jerk who'd humiliated me on my first day back. â€Å"Camille and Natalie don't have personal guardians yet,† Dimitri explained to me. â€Å"They're both under the protection of their families' guardians. Since they are Academy students leaving campus, a school guardian accompanies them – Stan. I go because I'm Lissa's assigned guardian. Most girls her age wouldn't have a personal guardian yet, but circumstances make her unusual.† I sat in the back of the van with him and Spiridon, so they could dispense guardian wisdom to me as part of the â€Å"training exercise.† Ben and Stan sat up front, while the others sat in the middle. Lissa and Victor talked to each other a lot, catching up on news. Camille, raised to be polite among older royals, smiled and nodded along. Natalie, on the other hand, looked left out and kept trying to shift her father's attention from Lissa. It didn't work. He'd apparently learned to tune out her chatter. I turned back to Dimitri. â€Å"She's supposed to have two guardians. Princes and princesses always do.† Spiridon was Dimitri's age, with spiky blond hair and a more casual attitude. Despite his Greek name, he had a Southern drawl. â€Å"Don't worry, she'll have plenty when the time comes. Dimitri's already one of them. Odds are you'll be one too. And that's why you're here today.† â€Å"The training part,† I guessed. â€Å"Yup. You're going to be Dimitri's partner.† A moment of funny silence fell, probably not noticeable to anyone except Dimitri and me. Our eyes met. â€Å"Guarding partner,† Dimitri clarified unnecessarily, like maybe he too had been thinking of other kinds of partners. â€Å"Yup,† agreed Spiridon. Oblivious to the tension around him, he went on to explain how guardian pairs worked. It was standard stuff, straight from my textbooks, but it meant more now that I'd be doing it in the real world. Guardians were assigned to Moroi based on importance. Two was a common grouping, one I'd probably work in a lot with Lissa. One guardian stayed close to the target; the other stood back and kept an eye on the surroundings. Boringly, those holding these positions were called near and far guards. â€Å"You'll probably always be near guard,† Dimitri told me. â€Å"You're female and the same age as the princess. You can stay close to her without attracting any attention.† â€Å"And I can't ever take my eyes off her,† I noted. â€Å"Or you.† Spiridon laughed again and elbowed Dimitri. â€Å"You've got a star student there. Did you give her a stake?† â€Å"No. She's not ready.† â€Å"I would be if someone would show me how to use one,† I argued. I knew every guardian in the van had a stake and a gun concealed on him. â€Å"More to it than just using the stake,† said Dimitri in his old-and-wise way. â€Å"You've still got to subdue them. And you've got to bring yourself to kill them.† â€Å"Why wouldn't I kill them?† â€Å"Most Strigoi used to be Moroi who purposely turned. Sometimes they're Moroi or dhampirs turned by force. It doesn't matter. There's a strong chance you might know one of them. Could you kill someone you used to know?† This trip was getting less fun by the minute. â€Å"I guess so. I'd have to, right? If it's them or Lissa†¦Ã¢â‚¬  â€Å"You might still hesitate,† said Dimitri. â€Å"And that hesitation could kill you. And her.† â€Å"Then how do you make sure you don't hesitate?† â€Å"You have to keep telling yourself that they aren't the same people you knew. They've become something dark and twisted. Something unnatural. You have to let go of attachments and do what's right. If they have any grain of their former selves left, they'll probably be grateful.† â€Å"Grateful for me killing them?† â€Å"If someone turned you into a Strigoi, what would you want?† he asked. I didn't know how to answer that, so I said nothing. Never taking his eyes off me, he kept pushing. â€Å"What would you want if you knew you were going to be converted into a Strigoi against your will? If you knew you would lose all sense of your old morals and understanding of what's right and wrong? If you knew you'd live the rest of your life – your immortal life – killing innocent people? What would you want?† The van had grown uncomfortably silent. Staring at Dimitri, burdened by all those questions, I suddenly understood why he and I had this weird attraction, good looks aside. I'd never met anyone else who took being a guardian so seriously, who understand all the life-and-death consequences. Certainly no one my age did yet; Mason hadn't been able to understand why I couldn't relax and drink at the party. Dimitri had said I grasped my duty better than many older guardians, and I didn't get why – especially when they would have seen so much more death and danger. But I knew in that moment that he was right, that I had some weird sense of how life and death and good and evil worked with each other. So did he. We might get lonely sometimes. We might have to put our â€Å"fun† on hold. We might not be able to live the lives we wanted for ourselves. But that was the way it had to be. We understood each other, understood that we had others to protect. Our lives would never be easy. And making decisions like this one was part of that. â€Å"If I became Strigoi†¦I'd want someone to kill me.† â€Å"So would I,† he said quietly. I could tell that he'd had the same flash of realization I'd just had, that same sense of connection between us. â€Å"It reminds me of Mikhail hunting Sonya,† murmured Victor thoughtfully. â€Å"Who are Mikhail and Sonya?† asked Lissa. Victor looked surprised. â€Å"Why, I thought you knew. Sonya Karp.† â€Å"Sonya Kar†¦you mean, Ms. Karp? What about her?† She looked back and forth between me and her uncle. â€Å"She†¦became Strigoi,† I said, not meeting Lissa's eyes. â€Å"By choice.† I'd known Lissa would find out some day. It was the final piece of Ms. Karp's saga, a secret I'd kept to myself. A secret that worried me constantly. Lissa's face and bond registered complete and utter shock, growing in intensity when she realized I'd known and never told. â€Å"But I don't know who Mikhail is,† I added. â€Å"Mikhail Tanner,† said Spiridon. â€Å"Oh. Guardian Tanner. He was here before we left.† I frowned. â€Å"Why is he chasing Ms. Karp?† â€Å"To kill her,† said Dimitri flatly. â€Å"They were lovers.† The entire Strigoi thing shifted into new focus for me. Running into a Strigoi I knew during the heat of battle was one thing. Purposely hunting down someone†¦someone I'd loved. Well, I didn't know if I could do that, even if it was technically the right thing. â€Å"Perhaps it is time to talk about something else,† said Victor gently. â€Å"Today isn't a day to dwell on depressing topics.† I think all of us felt relieved to get to the mall. Shifting into my bodyguard role, I stuck by Lissa's side as we wandered from store to store, looking at all the new styles that were out there. It was nice to be in public again and to do something with her that was just fun and didn't involve any of the dark, twisted politics of the Academy. It was almost like old times. I'd missed just hanging out. I'd missed my best friend. Although it was only just past mid-November, the mall already had glittering holiday decorations up. I decided I had the best job ever. Admittedly, I did feel a little put out when I realized the older guardians got to stay in contact through cool little communication devices. When I protested my lack of one, Dimitri told me I'd learn better without one. If I could handle protecting Lissa the old-fashioned way, I could handle anything. Victor and Spiridon stayed with us while Dimitri and Ben fanned out, somehow managing not to look like creepy stalker guys watching teenage girls. â€Å"This is so you,† said Lissa in Macy's, handing me a low-cut tank top embellished with lace. â€Å"I'll buy it for you.† I regarded it longingly, already picturing myself in it. Then, making my regular eye contact with Dimitri, I shook my head and handed it back. â€Å"Winter's coming. I'd get cold.† â€Å"Never stopped you before.† Shrugging, she hung it back up. She and Camille tried on a nonstop string of clothes, their massive allowances ensuring that price posed no problem. Lissa offered to buy me anything I wanted. We'd been generous with each other our whole lives, and I didn't hesitate to take her up on it. My choices surprised her. â€Å"You've got three thermal shirts and a hoodie,† she informed me, flipping through a stack of BCBG jeans. â€Å"You've gone all boring on me.† â€Å"Hey, I don't see you buying slutty tops.† â€Å"I'm not the one who wears them.† â€Å"Thanks a lot.† â€Å"You know what I mean. You're even wearing your hair up.† It was true. I'd taken Dimitri's advice and wrapped my hair up in a high bun, earning a smile when he'd seen me. If I'd had molnija marks, they would have shown. Glancing around, she made sure none of the others could hear us. The feelings in the bond shifted to something more troubled. â€Å"You knew about Ms. Karp.† â€Å"Yeah. I heard about it a month or so after she left.† Lissa tossed a pair of embroidered jeans over her arm, not looking at me. â€Å"Why didn't you tell me?† â€Å"You didn't need to know.† â€Å"You didn't think I could handle it?† I kept my face perfectly blank. As I stared at her, my mind was back in time, back to two years ago. I'd been on day two of my suspension for allegedly destroying Wade's room when a royal party visited the school. I'd been allowed to attend that reception too but had been under heavy guard to make sure I didn't â€Å"try anything.† Two guardians escorted me to the commons and talked quietly with each other along the way. â€Å"She killed the doctor attending her and nearly took out half the patients and nurses on her way out.† â€Å"Do they have any idea where she went?† â€Å"No, they're tracking her†¦but, well, you know how it is.† â€Å"I never expected her to do this. She never seemed like the type.† â€Å"Yeah, well, Sonya was crazy. Did you see how violent she was getting near the end? She was capable of anything.† I'd been trudging along miserably and jerked my head up. â€Å"Sonya? You mean Ms. Karp?† I asked. â€Å"She killed somebody?† The two guardians exchanged looks. Finally, one said gravely, â€Å"She became a Strigoi, Rose.† I stopped walking and stared. â€Å"Ms. Karp? No†¦she wouldn't have†¦Ã¢â‚¬  â€Å"I'm afraid so,† the other one replied. â€Å"But†¦you should keep that to yourself. It's a tragedy. Don't make it school gossip.† I went through the rest of the night in a daze. Ms. Karp. Crazy Karp. She'd killed someone to become Strigoi. I couldn't believe it. When the reception ended, I'd managed to sneak off from my guardians and steal a few precious moments with Lissa. The bond had grown strong by now, and I hadn't needed to see her face to know how miserable she was. â€Å"What's wrong?† I asked her. We were in a corner of the hallway, just outside the commons. Her eyes were blank. I could feel how she had a headache; its pain transferred to me. â€Å"I†¦I don't know. I just feel weird. I feel like I'm being followed, like I have to be careful, you know?† I didn't know what to say. I didn't think she was being followed, but Ms. Karp used to say the same thing. Always paranoid. â€Å"It's probably nothing,† I said lightly. â€Å"Probably,† she agreed. Her eyes suddenly narrowed. â€Å"But Wade isn't. He won't shut up about what happened. You can't believe the things he's saying about you.† I could, actually but I didn't care. â€Å"Forget about him. He's nothing.† â€Å"I hate him,† she said. Her voice was uncharacteristically sharp. â€Å"I'm on the committee with him for that fund-raiser, and I hate hearing him run his fat mouth every day and seeing him flirt with anything female that walks by. You shouldn't be punished for what he did. He needs to pay.† My mouth went dry. â€Å"It's okay†¦I don't care. Calm down, Liss.† â€Å"I care,† she snapped, turning her anger on me. â€Å"I wish there was a way I could get back at him. Some way to hurt him like he hurt you.† She put her hands behind her back and paced back and forth furiously, her steps hard and purposeful. The hatred and anger boiled within her. I could feel it in the bond. It felt like a storm, and it scared the hell out of me. Wrapped around it all was an uncertainty, an instability that said Lissa didn't know what to do but that she wanted desperately to do something. Anything. My mind flashed to the night with the baseball bat. And then I thought about Ms. Karp. She became a Strigoi, Rose. It was the scariest moment of my life. Scarier than seeing her in Wade's room. Scarier than seeing her heal that raven. Scarier than my capture by the guardians would be. Because just then, I didn't know my best friend. I didn't know what she was capable of. A year earlier, I would have laughed at anyone who said she'd want to go Strigoi. But a year earlier, I also would have laughed at anyone who said she'd want to cut her wrists or make someone â€Å"pay.† In that moment, I suddenly believed she might do the impossible. And I had to make sure she didn't. Save her. Save her from herself. â€Å"We're leaving,† I said, taking her arm and steering her down the hall. â€Å"Right now.† Confusion momentarily replaced her anger. â€Å"What do you mean? You want to go to the woods or something?† I didn't answer. Something in my attitude or words must have startled her, because she didn't question me as I led us out of the commons, cutting across campus toward the parking lot where visitors came. It was filled with cars belonging to tonight's guests. One of them was a large Lincoln Town Car, and I watched as its chauffeur started it up. â€Å"Someone's leaving early,† I said, peering at him from around a cluster of bushes. I glanced behind us and saw nothing. â€Å"They'll probably be here any minute.† Lissa caught on. â€Å"When you said, ? ®We're leaving,' you meant†¦no. Rose, we can't leave the Academy. We'd never get through the wards and checkpoints.† â€Å"We don't have to,† I said firmly. â€Å"He does.† â€Å"But how does that help us?† I took a deep breath, regretting what I had to say but seeing it as the lesser of evils. â€Å"You know how you made Wade do those things?† She flinched but nodded. â€Å"I need you to do the same thing. Go up to that guy and tell him to hide us in his trunk.† Shock and fear poured out of her. She didn't understand, and she was scared. Extremely scared. She'd been scared for weeks now, ever since the healing and the moods and Wade. She was fragile and on the edge of something neither of us understood. But through all of that, she trusted me. She believed I would keep her safe. â€Å"Okay,† she said. She took a few steps toward him, then looked back at me. â€Å"Why? Why are we doing this?† I thought about Lissa's anger, her desire to do anything to get back at Wade. And I thought about Ms. Karp – pretty, unstable Ms. Karp – going Strigoi. â€Å"I'm taking care of you,† I said. â€Å"You don't need to know anything else.† At the mall in Missoula, standing between racks of designer clothes, Lissa asked again, â€Å"Why didn't you tell me?† â€Å"You didn't need to know,† I repeated. She headed toward the dressing room, still whispering with me. â€Å"You're worried I'm going to lose it. Are you worried I'll go Strigoi too?† â€Å"No. No way. That was all her. You'd never do that.† â€Å"Even if I was crazy?† â€Å"No,† I said, trying to make a joke. â€Å"You'd just shave your head and live with thirty cats.† Lissa's feelings grew darker, but she didn't say anything else. Stopping just outside the dressing room, she pulled a black dress off the rack. She brightened a little. â€Å"This is the dress you were born for. I don't care how practical you are now.† Made of silky black material, the dress was strapless and sleek, falling about to the knees. Although it had a slight flair at the hemline, the rest looked like it would definitely manage some serious clinging action. Super sexy. Maybe even challenge-the-school-dress-code sexy. â€Å"That is my dress,† I admitted. I kept staring at it, wanting it so badly that it ached in my chest. This was the kind of dress that changed the world. The kind of dress that started religions. Lissa pulled out my size. â€Å"Try it on.† I shook my head and started to put it back. â€Å"I can't. It would compromise you. One dress isn't worth your grisly death.† â€Å"Then we'll just get it without you trying it on.† She bought the dress. The afternoon continued, and I found myself growing tired. Always watching and being on guard suddenly became a lot less fun. When we hit our last stop, a jewelry store, I felt kind of glad. â€Å"Here you go,† said Lissa, pointing at one of the cases. â€Å"The necklace made to go with your dress.† I looked. A thin gold chain with a gold-and-diamond rose pendant. Emphasis on the diamond part. â€Å"I hate rose stuff.† Lissa had always loved getting me rose things – just to see my reaction, I think. When she saw the necklace's price, her smile fell away. â€Å"Oh, look at that. Even you have limits,† I teased. â€Å"Your crazy spending is stopped at last.† We waited for Victor and Natalie to finish up. He was apparently buying her something, and she looked like she might grow wings and fly away with happiness. I was glad. She'd been dying for his attention. Hopefully he was buying her something extra-expensive to make up for it. We rode home in tired silence, our sleep schedules all messed up by the daylight trip. Sitting next to Dimitri, I leaned back against the seat and yawned, very aware that our arms were touching. That feeling of closeness and connection burned between us. â€Å"So, I can't ever try on clothes again?† I asked quietly not wanting to wake up the others. Victor and the guardians were awake, but the girls had fallen asleep. â€Å"When you aren't on duty, you can. You can do it during your time off.† â€Å"I don't ever want time off. I want to always take care of Lissa.† I yawned again. â€Å"Did you see that dress?† â€Å"I saw the dress.† â€Å"Did you like it?† He didn't answer. I took that as a yes. â€Å"Am I going to endanger my reputation if I wear it to the dance?† When he spoke, I could barely hear him. â€Å"You'll endanger the school.† I smiled and fell asleep. When I woke up, my head rested against his shoulder. That long coat of his-the duster-covered me like a blanket. The van had stopped; we were back at school. I pulled the duster off and climbed out after him, suddenly feeling wide awake and happy. Too bad my freedom was about to end. â€Å"Back to prison,† I sighed, walking beside Lissa toward the commons. â€Å"Maybe if you fake a heart attack, I can make a break for it.† â€Å"Without your clothes?† She handed me a bag, and I swung it around happily. â€Å"I can't wait to see the dress.† â€Å"Me either. If they let me go. Kirova's still deciding if I've been good enough.† â€Å"Show her those boring shirts you bought. She'll go into a coma. I'm about ready to.† I laughed and hopped up onto one of the wooden benches, pacing her as I walked along it. I jumped back down when I reached the end. â€Å"They aren't that boring.† â€Å"I don't know what to think of this new, responsible Rose.† I hopped up onto another bench. â€Å"I'm not that responsible.† â€Å"Hey,† called Spiridon. He and the rest of the group trailed behind us. â€Å"You're still on duty. No fun allowed up there.† â€Å"No fun here,† I called back, hearing the laughter in his voice. â€Å"I swear – shit.† I was up on a third bench, near the end of it. My muscles tensed, ready to jump back down. Only when I tried to, my foot didn't go with me. The wood, at one moment seemingly hard and solid, gave way beneath me, almost as though made of paper. It disintegrated. My foot went through, my ankle getting caught in the hole while the rest of my body tried to go in another direction. The bench held me, swinging my body to the ground while still seizing my foot. My ankle bent in an unnatural direction. I crashed down. I heard a cracking sound that wasn't the wood. The worst pain of my life shot through my body. And then I blacked out.

Starbucks Organizational Culture - 2278 Words

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