Child Labor Essay - 2155 Words

Child Labor The next time when you are out on your shopping trip, chances you may have support a business that exploits children. It is very disturbing and heartbreaking to learn many children are chained to looms for 12 hours a day because families need to have their child bringing home a small amount of moneys. Child labor has always been a difficult subject to address, the topic have become much more complicated and prolific. Child Labor is not an isolated problem. The phenomenon of child labor is an effect of economic discrimination. In different parts of the world, at different stages of histories, laboring of child has been a part of economic life. More than 200 million children worldwide, some are as young as 4 and 5†¦show more content†¦Most of them (57 million) were in Asia. However, over the previous ten years, he found that the absolute number of children working was declining in Asia but rising in the Americas and Africa, sharply in the latter. The problem is enormous, but the trend, fortunately, is heading in the right direction. The overall growth of an economy is by no means the only factor, nor for that matter the most important factor, in the mitigation of child labor. Depending upon many variables, from economic development, to political structure, corruption, and other external factors, some families need to have their child bringing home a small amount of moneys. Therefore , the child labor phenomenon is reasonable. One important which caused child labor is the poverty. The birthrate is so high that create overpopulation and cause poverty and lack of primary education. One way that many families in traditional societies attempt to cope with the pressure of overpopulation and the resulting unemployment is to send children to urban areas to find cash employment. Sending their child out on the labor force is a way to exchange for small loans or to repay the debts of the parents or grandparents. In most Asia countries, they don’t have social security for the elder, so parents often rely on their children for financial support. There were some disturbing cases that children are bought and sold for cash or for the settlement of a debt. SomeShow MoreRelatedThe Nature Of Child Labor1626 Words   |  7 Pagesthat â€Å"Globally there are 168 million child laborers, over half of which, 85 million, are in hazardous work conditions† (ILO). C hild labor is not a new phenomenon by any means; it has been going on for years and has become a social issue. This paper aims to portray the nature of child labor in India. It looks at the definition of child labor, the prevalence, and factors that lead children to work. Definition Often time people assume that the meaning of child labor is clear-cut. However, there is littleRead MoreChild Labor1885 Words   |  8 Pagesâ€Å"Child labor† By Elie Bou Chaaya ENL 110 Section â€Å"D† Miss Zeina Fayyad 18, January, 2008 Outline: Thesis statement: Child labor nowadays is considered to be a social injustice due to its harmful effects on the personal and psychological life of the child where the kinds of work offered to the child increases the amount of these effects regarding the solutions. I. Harmful personal and physical effects of child labor A. Low pay B. Very long work hours C. Forbids childrenRead MoreThe Dilemma Of Childhood And Child Labor837 Words   |  4 PagesChildren in Need The dilemma of childhood and child labor are constantly being argued in overseas and domestic sociological literature. Anthropologists and Sociologists through the time have observed the history and the impact of social institutions on child labor. Professionals researching in the field of sociology of economics and labor by examining the incentive and value orientations of children and teenagers in the labor force, their principles and working conditions, and their outlook towardsRead MoreThe Issue Of Child Labor1196 Words   |  5 PagesThe issue of child labor has drawn significant attention since early 1990s as many labor union and special interest groups advocate banning import of goods produced by the child labor in developing countries and the international consensus in the form of Convention on the Right of the Child (CRC) which is widely ratified in 1989 by countries (Boyden, Ling and Myers, 1998). However, concern regarding child labor is not new and can be dated back to industrial revolution, especially late eighteenthRead MoreChild Labor And The United States2768 Words   |  12 Pages When one hears the term â€Å"Child Labor†, an image of children making low quality clothing in some dingy third world sweatshop inevitably comes to mind. While this imagery is unfortunately founded in fact, the third world is not the only area complicit with this heinous practice. Truthfully, we, as a nation are also guilty of propagating this heinous practice. For over a century, this nation’s youth were subjugated to exploitation and abuse at the hands of captains of industry in the hopes of extractingRead MoreChild Labor Industrialization Essay1537 Words   |  7 Pagesthat they should be protected. However, those people believed in a child s capacity to change the world in the future. While people in the past saw children as a way to change the world while they were children. In the late seventeenth century, industrialization arose in Englan d ushering in a new era of industry in our world. More industry means more workers, including children. With the rise of industrialization in a nation, child laborers are viciously abused due to their niche roles in productionRead MoreThe Effects Of Child Slavery And Child Labor On Chocolate Plantation1617 Words   |  7 PagesChild slavery and child labor on chocolate plantations is one of the world’s greatest concerns at the moment. Chocolate plantations are specifically mentioned because chocolate is such a large industry and many kids, particularly in tropical African countries, are affected by child labor. In Cà ´te d’Ivoire alone, around 15,000 children are slaves working on chocolate, or cacao, plantations. (american.edu) This problem is concerning because not only is it unethical, but child labor and, thereforeRead MoreChild Labor766 Words   |  4 PagesThe History of Child Labor In AmericaTopic: The History Of Child LaborQuestion: In what ways was child l abor cruel to children?Thesis: Child labor in America has been very cruel and unfair to children as their jobs were not paid a decent amount of money, were working under terrible conditions, and they led to diseases. Starting in about the 1700s, hand labor was replaced by power driven machines to make jobs easier.1 The industrial revolution had begun, and families needed a job and money to be ableRead MoreChinas High Dependence On Child Labor1677 Words   |  7 PagesChild labor is a commonplace in China. Most of the children in China, families work income is dependent on their family’s survival. Child labor is a major issue throughout the global economy, especially in developing countries like China. Although, China has anti-child labor laws, many children in China are forced to work against their will. China is the home of many poor families and some of these families force their children to work because of their struggle with poverty and their lack of incomeRead MoreTakin g a Look at Child Labor1957 Words   |  8 PagesThe term ‘child labor is used for employment below a certain age, which is considered illegal by law and customs. Children are the greatest gift to humanity and Childhood is an important and impressionable stage of human development as it holds the potential to the future development of any society. A young child has yet to develop a substantial set of life experiences to allow for mature choices and decisions. Children depend on the support of adults to get them through life to ensure an adequate

Plato s Philosophy And Philosophy - 1070 Words

Plato, a Greek philosopher, was born around 423 to 428 BC, and died around 347 or 348 BC, at the age of eighty. He was a great philosopher, taught by Socrates. His dialogues have been used to teach many subjects, consisting of logic, ethics, rhetoric, religion, and mathematics, as well as philosophy. Plato was born between 429 and 423 BC, in either Athens or Aegina. At some point during his childhood, his father died, but the date is unknown. He was named Aristocles after his grandfather, but his wrestling coach named him Platon, meaning â€Å"broad,† because of his robust figure. As a child, his father, Ariston, wanted him to have a good education, so it is likely he was taught in grammar, music, gymnastics and philosophy by some of the most†¦show more content†¦Plato has possibly traveled in Italy, Sicily, Egypt, and Cyrene, Libya. Upon his return to Athens at the age of forty, he founded one of the earliest known organized schools in Academus. The Academy operated until Lucius Cornelius Sulla ordered its destruction in 84 BC. It was revived in the early 5th century by Neoplatonists, and operated until AD 529. Of the many intellectuals trained in the Academy, Aristotle was the most distinguished. Plato became intertwined with politics in the city of Syracuse all through his later life. The time of which Dionysius was ruling over Syracuse was when he visited. During this time, he almost died, but was instead sold into slavery, until finally, his freedom was bought by Anniceris. Plato was requested by Dion to return to Syracuse after Dionysius’ death to train Dionysius II to become a philosopher king. Dionysius II later became suspicious of his uncle, Dion, and banished him from Syracuse while keeping Plato against his will. Plato eventually left Syracuse, and Dionysius II was later overthrown by Dion. In many of Plato’s dialogues, Socrates communicates that knowledge is an event of recollection, not learning, observation, or study . Socrates has also argued that knowledge comes from divine insight, and is not empirical. Plato recommends a faith in the immortality of the soul in dialogues, including the Phaedo, Republic, and Phaedrus. Several of his dialogues are concluded with long

Richard The Lion Hearted Essay Paper Example For Students

Richard The Lion Hearted Essay Paper Greek Mythology played a very key role in the lives of the Greeks. Through the many legends about the gods, the Greeks were able to find reasons for all the laws of nature in a supernatural form. These legends were passed down from generation to generation until the spread of Christianity. On top of giving the Greeks reasons for natures action, their religion also gave them a faith that thing were going to be okay, which is something that all humans crave. The Greeks had 13 major gods. They often used these gods in their myths and prayed to them for particular needs. The head of the gods was Zeus who was also the god of the sky. Whenever Zeus spoke, he was listened to and his word was always final. Zeus had two brothers, Poseidon and Hades. The three brothers drew straws to decide who would control the skies, who would control the seas, and who would control the underworld. Zeus gained control over the skies and became king of the gods. Zeus used his mighty thunderbolts to punish all those who disobeyed him. Zeus married Hera, making her the queen of the gods. The sky god was extremely unfaithful to his wife and slept with women from queens all the way down to peasants. Since Zeus was king of the gods Hera could rarely force Zeus to do any penance, so she took out her wrath on the women Zeus slept with. Zeuss symbols were thunderbolts and eagles. When the three brothers drew straws to determine what area they would control Poseidon got the sea. His wife was Amphritrite who was a Nereid. Like Zeus, Poseidon was not very faithful to his spouse and had many affairs with the nymphs. Poseidon fathered several children who were extremely cruel and wild. Among his children were Orion the giant and the Polyphemus Cyclops. In art, Poseidon is generally featured holding a trident and accompanied by a dolphin. Also, Poseidon was said to have created many animals. He accidentally created such animals as the zebras while perfecting the horse. Hades was the god of the dead. When he and his three brothers divided up the universe, he ended up with the underworld. Hades rarely came out of the underworld to Mount Olympus, the place where the gods resided, because he was not welcome there. Persephone, whom Hades had abducted in order to get her to the underworld, was Hades queen. Hades was a pitiless god who never paid attention to prayer or sacrifice. But Hades was not an evil god. He was often referred to as the Lord of the riches because his kingdom was believed to be the reason for precious metals and crops. Hades wore a helmet and a cape that made him invisible. Hera was the queen of the gods. She was both the wife and sister of Zeus. Hera was a jealous goddess who never forgot an injury and always remembered to retaliate at the source of the injury with vengeance. She was the mother of Ares, Hebe, and Hephaestus. Hera was extremely displeased at the way that Zeus often treated children. Hera was the protector of marriage, married women, and children. Many people think that Hera was an ugly god that had no life outside of harassing here husband about his other relationships, because she was always after Zeuss mortal partners, but this is not true for she was thought to be one of the most beautiful gods, and many god were attracted to her. Demeter was the goddess of harvest. When her daughter, Persephone, was abducted to the underworld, Demeter became depressed. As a result Demeter produced no harvest and caused a famine. Zeus had to step in to correct the situation. Zeus ordered Hades to allow Persephone to be released. Hades obeyed his brother but before he let Persephone go, he forced her to eat pomegranate seeds that would cause her to come back to him for four months each year. So during the months Demeter was with her daughter she produced great crops; during the months Hades was with Persephone there was only death among the crops. Hestia was the goddess of the hearth and everyday life. She was also Zeuss sister. Most Greek people prayed to Hestia each day. In most homes there was a hearth that was not ever allowed to be put out because the fire was devoted to Hestia. These fires that burned in everyones home created a unity between the people. Ares was the son of Zeus through Hera and was perhaps the only son they had together. Both Zeus and Hera hated their son. Ares was the combat part of war. Ares is often looked on as an inspiration for people fighting for their life with odds heavily against them. The vulture and dog were the two animals associated with Ares. Both describe his character extremely well. Athena or Athene was the goddess of wisdom and the other god of war. Role as a war god was to give strategies guidance and wisdom to the warriors. She was Zeuss daughter and had no mother because Zeus had created her from the earth. Athena is often called gray-eyed because of her deep colored eyes. She was by far the favorite child of. Zeus even let her carry his aegis and use his thunderbolts. Sh e created the olive tree, which became known as her tree. The owl was her bird because they both were thought to have great wisdom. Cecrops was the king of Attica and had plans to build a magnificent city. The gods saw the plans for the building of this city and were greatly interested. The gods foresaw that this city would become a great city, so they had a dispute over which god should be the citys patron. After a many long arguments, it became obvious that either Athena or Poseidon would be the citys patron. A contest was held to end the dispute in which both Athena and Poseidon would give a gift to the city. Whoevers gift was greater would become the patron of the city. Poseidon created a four-mile salt spring that extended to the city and promised a might navy and great trading vessels. Then gray-eyed Athena planted a small bush that was laughed at by many. She said that it was the olive bush and poor men could flavor their bread and milk, and rich men could feast on oil create d from these olives bushes. Many gifts of this oil would be used as a sacrifice to the gods. The judges were so pleased with the olive that they declared the city Athens and built a huge temple in honor of the citys new patron Athena. Apollo was the son of Zeus through Leto. Many of the gods loved Apollo because he displayed his great musical talents before them. He was the god of healing and archery. It was said that when a mortal got sick it was because Apollo had shot him with one of his arrows. When a mortal healed it was credited to Apollo because he had first taught man how to heal. Apollo was also the god of light (not sun) and truth since he never told a lie. The animals sacred to him were the crow and dolphin. Artemis was the twin sister of Apollo and daughter of Zeus. She was like an untamed animal that loved to hunt. Artemis was the goddess of wild women, the moon, and untamed animals. Artemis was the protector (along with Hera) and the hunter of the gods. She seemed to a lmost have a split personality because at times she could be the most gentle and loving of the gods, usually when she was around children, and at other times she was the most ferocious and angry of all the gods, often when someone killed an animal on her sacred grounds. The deer was the animal most loved by Artemis. It is unsure whether Aphrodite is another daughter of Zeus or born from the sea. Most stories state that she was born from the sea. Aphrodite was the goddess of beauty and love because she was by far the most beautiful of all the gods. She was in the love triangle between her lame husband Hephaestus and Ares the god of war. The swan and dove were two of the birds sacred to her. Maia was the son of Atlas and a nymph. The son of Zeus and Maia was Hermes. Hermes was the messenger god and ended up in most all tales of mythology. Hermes ran messages for all the gods, but mainly for Zeus. Hermes was the god of trade and commerce. He was also a master thief and protector of tra ders. Hermes stole Apollos herds when he was a day old, but earned his forgiveness by giving Apollo the lyre he had just made. During Hermes last message he was led to the underworld by Hades where he had to stay for eternity much to most of the gods displeasure. Through these gods and the legends surrounding the gods, the Greeks found reasons for everything they did. They were also always able to find a god to motivate them to continue through the day and to use as inspiration. Even though the gods would eventually be nearly forgotten after the spread of Christianity, they would be studied for generations to follow. .u3dee00afa9827b958fe936b3831cb1ac , .u3dee00afa9827b958fe936b3831cb1ac .postImageUrl , .u3dee00afa9827b958fe936b3831cb1ac .centered-text-area { min-height: 80px; position: relative; } .u3dee00afa9827b958fe936b3831cb1ac , .u3dee00afa9827b958fe936b3831cb1ac:hover , .u3dee00afa9827b958fe936b3831cb1ac:visited , .u3dee00afa9827b958fe936b3831cb1ac:active { border:0!important; } .u3dee00afa9827b958fe936b3831cb1ac .clearfix:after { content: ""; display: table; clear: both; } .u3dee00afa9827b958fe936b3831cb1ac { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u3dee00afa9827b958fe936b3831cb1ac:active , .u3dee00afa9827b958fe936b3831cb1ac:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u3dee00afa9827b958fe936b3831cb1ac .centered-text-area { width: 100%; position: relative ; } .u3dee00afa9827b958fe936b3831cb1ac .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u3dee00afa9827b958fe936b3831cb1ac .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u3dee00afa9827b958fe936b3831cb1ac .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u3dee00afa9827b958fe936b3831cb1ac:hover .ctaButton { background-color: #34495E!important; } .u3dee00afa9827b958fe936b3831cb1ac .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u3dee00afa9827b958fe936b3831cb1ac .u3dee00afa9827b958fe936b3831cb1ac-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u3dee00afa9827b958fe936b3831cb1ac:after { content: ""; display: block; clear: both; } READ: Most Beautiful Girl in the World Essay End NotesHistory Essays

Neighbourhood Nursing Essay Example

Neighbourhood Nursing Essay The ethos of a report by Cumberledge, Neighbourhood Nursing A Focus for Care (DOH, 1986), was to introduce nurse prescribing from a limited formulary to improve the care of patients in their own homes, and it identified that district nurses wasted valuable time requesting prescriptions from general practitioners (GPs) when they had seen and assessed the patient themselves with no medical involvement (Baird, 2003). Nurses as prescribers need to be aware of the influences on prescribing and the need for bias to be controlled in the information sources that they use, as patients receiving prescriptions from nurse prescribers will assume the product prescribed is safe and appropriate for them (Parker, 2000). In order to demonstrate the principles of safe, effective, appropriate and cost-efficient prescribing, the author will analyse the critical incident described in Appendix 1, and using the prescribing pyramid (NPC, 1999) to assist decision-making, explore the most appropriate course of action in terms of treatment. Consider the Patient Before prescribing, a thorough assessment of the patients medical and social history should be taken (NPC, 1999). We will write a custom essay sample on Neighbourhood Nursing specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Neighbourhood Nursing specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Neighbourhood Nursing specifically for you FOR ONLY $16.38 $13.9/page Hire Writer A leg ulcer has been defined as the loss of skin below the knee, which takes more than six weeks to heal (Dale et al, 1983). Mr X had injured his leg six weeks prior to his referral to the DNs, therefore a leg ulcer assessment was conducted that incorporated a Doppler ultrasound, assessment of previous medical history and assessment of the limb and wound to determine the underlying cause of the ulcer and any associated diseases. This assessment will influence decisions about prognosis, referral, investigation and management (RCN, 1998). Lack of appropriate clinical assessment of patients with limb ulceration has often led to long periods of ineffective or inappropriate treatment (Stevens et al, 1997). The Doppler ultrasound revealed an ankle-brachial pressure index (ABPI) of 1.1 and 1.0 in the left. This gave an indication that Mr X had a vascular problem rather than arterial. The wound bed was sloughy, with slight inflammation around the edge, indicating a localised infection, which could delay healing; the wound was also malodorous again indicating infection was present. Chronic venous insufficiency of the lower extremities is a complicated disorder, affecting the productivity and wellbeing of millions of people worldwide (Donaldson, 2000; de Araujo et al, 2003). It is also a major cause of morbidity among patients in hospital and community settings (Nelson, 2001) Venous disease is the most common cause of leg ulcers. Identification of the risks of venous ulceration is important, as is optimal therapy, which requires control of abnormal venous physiology combined with adjunctive treatments to correct secondary skin ulceration, infection and lymphoedema (Donaldson, 2000). Which Strategy? Having established that the reason the ulcer was not showing signs of healing was due to venous insufficiency to the affected limbs and a localised infection to the wounds, the options for treatment needed to be considered. Liaison with his GP was essential to discuss pain management strategies with Mr X to control any pain he was suffering along with any anti-biotic therapy regarding the localized infection. However, the role of bacteria in chronic ulcers is a matter of debate and many authors have contradictory views regarding the use of antibiotic therapy (Tammelin et al, 1998). Within the local trust, guidelines suggest that if the patient is not showing signs of clinical infection such as pyrexia, friable, bleeding granulation tissue or cellulitis, antibiotics are not indicated. Furthermore, routine swabbing is not recommended as this is thought to be neither helpful nor cost-effective (Gilchrist, 2002). All chronic wounds contain bacteria and often represent either secondary colonisation or merely contamination, therefore not actually causing clinical infection (Morison et al, 1999). Consider the Choice of Product Short-stretch compression bandaging has been shown to be equally efficacious when compared to other compression systems in healing venous ulcers independent of associated factors (Scriven et al, 1998; Nelson, 1996; Vowden, 1998). This has directed a trend towards the use of short-stretch bandaging as a cost-effective and proven method of reversing venous hypertension and enhancing the wound repair process in some patients (Charles, 1998). Short-stretch compression bandages are fairly inelastic because the weave allows for minimal stretch and recoil (Charles, 1998). When applied to a leg at 90-100% stretch with a 50% overlap the inelastic nature of the bandage allows it to form a firm tube. When the muscle of the calf contracts, it reflects or rebounds from the wall of the tube, which increases the action of the calf muscle pump, thereby promoting venous return to the heart. It also has an effect on the microcirculation with an overall improvement in the function of the skin (Klyscz et al, 1997; Coleridge-Smith, 1997). The combination of increased calf muscle pump activity and an improved microcirculation as a result of short-stretch compression therapy therefore has the potential to correct venous incompetence and promote healing in venous disease. Non-compliance is a recognised problem in the use of compression therapy (Mayberry et al, 1991; Taylor, 1992). There are a number of reasons why this is the case, including factors such as forgetting instructions, difficulty managing the bandages and discomfort caused by the bandages for example, finding them too hot (Samson and Showalter, 1996). Mr X had experienced leg ulcer in the past and had not felt happy with four layer bandaging as he had complained of them making his legs too hot and also they felt bulky. Negotiate a Contract To ensure concordance it is important that the patient plays a central role in the decision-making process (NPC, 1999). If the patient is not consulted and does not understand the rationale for dressing choice, compliance with the treatment may be affected (Cole, 2004). A nurse prescriber has to balance dressing cost with nursing time, together with patient acceptability and concordance (Edwards, 2000). Mr X had experience of other wound care products used on his leg in the past, and had strong opinions about which ones he was willing to accept the use of. It is important to be aware of influences that may affect the way treatments are prescribed however, such as patient pressure or drug companies promotional advertising (Brew, 1994). Autonomy is grounded in respect for patients ability to choose, decide and take responsibility for their own lives (Randers and Mattiasson, 2004), but had his decisions been inappropriate, unsafe or not based on best evidence, agreeing to prescribe them could be deemed maleficent (Pridmore, 1998). Providing information on the benefits of the treatment proposed, in addition to the drawbacks enabled him to make an informed choice. Ultimately, negotiation ensures that the patient receives the most appropriate evidence-based care, which is safe, and which he agrees on. Review the Patient Twice weekly visits were agreed with Mr X to monitor the effectiveness of the bandaging and ensure that it was not causing a reaction, was helping to debride the slough, reduce the localised infection and absorb the exudate. Mr X was informed of the signs of an adverse reaction to the dressing, such as itching, increased localised pain and irritation at the site of the dressing, and advised to ring the DN if at all concerned. If the dressing used caused a reaction to Mr Xs leg and it was not picked up soon enough and the dressing removed, the effects could be deemed maleficent (Pridmore, 1998). Ongoing evaluation of the prescribed treatment should always be undertaken, as modifications may need to be made if conditions change (Morison et al, 1999). Once the primary objective has been achieved, the assessment process needs to be repeated in order to identify the next treatment objective until the wound has healed (Collier, 2002). After one week the inflammation surrounding the ulcer had gone and there was evidence that the slough was beginning to lift. Mr X had not reported any discomfort or irritation to the ulcer or surrounding tissue, which suggests that the dressing prescribed, was suitable for him. Record Keeping As a registered nurse one has both a professional and legal duty of care, therefore all nurses have a responsibility to keep accurate and up-to-date records that should be an accurate account of treatment, care planning and delivery that provides clear evidence of the decisions made (NMC, 2002a). This form of communication ensures that all members of the healthcare team involved in the care of the patient are fully informed, and ensures changes in the patients condition are detected at an early stage (NMC, 2000b). Details of the prescribed treatment were entered into Mr Xs assessment notes with a clear rationale for the choice of treatment. The trust has a specific form to complete that informs the GP of the treatment prescribed, which was completed and handed to Mr Xs doctor. Reflection Utilising a structured model of reflection by Driscoll (2000) has provided a useful means of reflecting on the incident described and analysing the decisions made. Although Mr X had expressed strong opinions about the choice of treatment he was willing to accept on his ulcer, negotiation had enabled a decision to be made that was safe, appropriate and cost-effective, in addition to being acceptable by him, thus ensuring concordance. Using the prescribing pyramid (NPC, 1999) provided a systematic, structured method of decision-making in relation to the choice of treatment, therefore ensuring that all essential aspects that needed to be considered were included. Conclusion Many district nurses have expertise in the different causes and manifestations of leg ulceration and wound care, thus most GPs tend not to interfere in the treatment, preferring to take advice from the experts in this field. So it makes sense that district nurses should be able to prescribe the most appropriate choice of dressing themselves. A good knowledge of wound healing mechanisms in relation to venous ulcers, in addition to a knowledge of treatment choices that reflect local policy, their suitability, contradictions and adverse reactions based on evidence not influence, ensured that Mr X received a dressing that proved successful in reducing the bacterial load, healing of the ulcer and comfort. The dressing did not cause any reaction or deterioration, therefore was safe and effective.