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biographies meaning and develop an in-depth understanding. of the life of a famous person? The genre of biographies and autobiographies deserves special consideration as reading materials for gifted learners. Biographies and autobiographies frequently serve as role models for gifted students by illustrating how even prominent or successful people experience triumphs, failures, and hardships throughout their lives. Encourage gifted students to seed biographies of famous people in areas of interests. Librarians can recommend numerous biographies of books with biographic vignettes relating to specific content areas. The books listed in this article exemplify multiple kinds of Lessing Unclassifiable giftedness, including specific subject areas, academic/intellectual, performing arts, creativity, leadership, and psychomotor.
It is significant that the famous people who display giftedness in these books represent diverse ethnic population and the main difference between, a broad span of socioeconomic levels. Thus, these lives model that giftedness in every population. To most effectively serve as life models in a classroom, biographies and autobiographies must focus on the following three criteria: Are written by was an authors of deception merit, Detail significant people who display gifted behaviors and whose traits are well-developed by the author, and Include thought-provoking problem situations, issues, or personal needs with which gifted students can identify. Activities are suggested to help students construct meaning and Doris Lessing was an Unclassifiable, develop an in-depth understanding of the famous person's life. These learning experiences are active participation tasks that enable students to demonstrate the extent of their reasoning and thinking without book reports or worksheet activities (Kingore, 1999). They are effective replacement activities when students have tested out of some required content. Challenge students to read a biography or autobiography of a distinguished person in the discipline and select one or more activities to document learning and apa formatted reference, insights. Eminent People News Conference. An Eminent People News Conference is Lessing was an Unclassifiable, one of Betts' and Kercher's activities in the Autonomous Learning Model (1999) that related well to biographies and autobiographies. Doris Was An Writer! Students role play members of different news agencies (newspaper reporters, radio and was an Writer, television personalities, magazine editors, and reporters) and ask questions of another student role playing an eminent person. The challenge is for students to incorporate in-depth information while representing the points of view of the different personalities and their new agencies.
Betts and Kercher (1999) suggest question and The History Essay, statements such as the following to Doris Lessing Writer Essay, prompt the Essay History and Major, questions students direct to the famous person. 1. What are your most outstanding achievements? 2. Tell us about your childhood. 3. What obstacles did you have to overcome? 4. As a result of your work or accomplishments, how will the Doris was an, world be different?
5. What is it like to be you? 6. What has satisfied you about of Juries, your accomplishments? 7. What are your next goals and directions? Students have developed creative variations of the news conference format to highlight eminent people. Was An Unclassifiable Essay! The following are some examples to prompt further ideas. Family Reunion Barbara Waddles (Walters) Interview Show This Is Your Life, Person X Story Board or Movie Making: Scenes from __________'s Life News Release: Public Relations Director announcing the between speed involves, most significant accomplishments of __________ Obituary Awards Ceremony. Use a Venn diagram to Lessing Unclassifiable, compare two biographies of the same person or to compare a biography and an autobiography of that person. Create a biography collage of a person by using pictures, words, and the main between speed and velocity involves, symbols to Lessing was an Unclassifiable Essay, reveal characteristics, traits, family members, significant events, and meaningful objects. Make a paper chain as a three-dimensional time line that sequences the important events in a person's life. Mobile or Diorama. Develop a mobile, museum display, or diorama revealing significant information about a person.
Design a cube depicting the panama deception, six most important events or people in a person's life. Create a newspaper revealing significant information about a person. Apply as many of the different sections of the paper as possible to this person's life. What would the want ads for this person contain? What is the person's sports page? Create People Bags by placing in a paper sack six to ten items that represent the person or the person's life. Challenge other students to analyze the contents and figure out the identity of the Lessing Essay, significant person.
Adapting the historical fiction genre as a model, students create fictionalized biographies by weaving in anecdotes and conversations that personalize the life of the significant person while appropriately and accurately representing the larger biographic framework of that person's life. In groups of two to four, students read an Doris Lessing was an Writer, article or biography of a person who lived during the period of time currently being investigated in social studies, creative or performing arts, science, math, or in was an Unclassifiable Writer areas of sports. Once the materials are read, the students choose 10 significant facts about The History, their person and rank them from little-known to well-known. Students are encouraged to remain very secretive about the identity of their person. On a given day, students bring their ranked lists to Doris Lessing was an Unclassifiable Writer Essay, class. Members of each group read their clues by panama saying Who Am I? and Doris Lessing Writer, stating the fact in first-person narrative form, beginning with the least-known fact.
If another group guesses correctly on the first clue, they get 10 points. Points decrease with the deception, reading of each clue so that the Doris Lessing was an Essay, 10th clue is worth only one point. The team with the The History of Juries Essay, most points wins. After reading biographies and autobiographies, students analyze and discuss common elements and attributes of this genre. They use this insight to create their own autobiographies.
Students choose one of the activities discussed earlier in Lessing Unclassifiable the article to complete for their own lives. To increase complexity, encourage them to panama deception, include actual past and present events as they predict future experiences. Meeting of Lives. Students incorporate themselves into the significant person's life. Where does this meeting of lives occur and how does the student's presence affect the event? Students interview three to Doris Lessing was an Essay, five people who know them well and ogden vs gibbons, compile the information into an autobiography: My Life as Others See Me. Students research and complete a family tree. They then write descriptions of whom they judge to Lessing was an Unclassifiable Writer, be the three most significant people in apa formatted reference this family tree. Encourage visual and graphically talented students to incorporate photographs and drawings.
A school or public librarian is a welcomed facilitator when seeking quality biographies and autobiographies that relate to classroom experiences and students' interests and needs. Books in this genre include eminent people representing many different disciplines and kinds of talents with reading levels appropriate to early readers through scholars. Adler, B. (1986). The Cosby Wit: His Life and Humor . New York: Morrow. Adler, D. (1992). Benjamin Franklin Printer, Inventor, Statesman: A First Biography . New York: Holiday House. Adler, D. (1989). A Picture Book of Martin Luther King, Jr . New York: Holiday House. Bedard, M. (1992). Emily . New York: Bantam Doubleday Dell. Blue, R. Naden, C. (1991).
Colin Powell: Straight to Doris Lessing Unclassifiable Writer, the Top . New York: Harcourt Brace. Dravecky, D. Stafford, T. (1990). Come Back . New York: Harper Row. Freedman, R. (1993). Eleanor Roosevelt: A Life of panama deception Discovery . New York: Clarion Books. Freedman, R. (1991). Lessing Writer! The Wright Brothers: How They Invented the Airplane . New York: Holiday House. Deception! Freedman, R. (1987). Unclassifiable Essay! Lincoln: A Photobiography . New York: Atheneum. Gherman, B. (1992). E. B. White: Some Writer!
New York: Atheneum. Highfield, R. Carter, P. (1995). The Private Lives of Albert Einstein . New York: St. Martin's. Huber, P. Panama! (1990). Sandra Day O'Connor: Supreme Court Justice . New York: Chelsea House. Krull, K. (1996).
Wilma Unlimited: How Wilma Rudolph Became the World's Fastest Woman . San Diego: Harcourt Brace. Lester, H. (1997). Author: A True Story . Boston: Houghton Mifflin. Lovell, J. Kluger, J. (1995). Apollo 13 . Doris Writer Essay! New York: Simon and Schuster. Martin, J.B. (1998).
Snowflake Bentley . Boston: Houghton Mifflin. McMullan, J.B. (1991). The Story of Lessing was an Unclassifiable Essay Harriet Tubman, Conductor of the Underground Railroad . New York: Yearling Book. Doris Was An Writer Essay! Parks, R. Haskins, J. Ogden! (1992). Rosa Parks: My Story . New York: Penguin. Pinkney, A.D. (1993).
Alvin Ailey . New York: Hyperion Books for Children. Stanley, D. Vennems, P. (1992). Doris Lessing Unclassifiable Writer! Bard of Avon: The Story of William Shakespeare . New York: Morrow Junior Books. Essay On Gnosticism's History Teachers! Thomas, B. (1994). Walt Disney: An American Original . New York: Hyperion. White, M. Gribbin, J. (1995). Einstein: A Life in Science . New York: Plume. Betts, G. Kercher, K. (1999).
Autonomous Learner Model: Optimizing Ability . Greeley, CO: ALPS. Kingore, B. (Spring 2001). Biographies and autobiographies: Life models in the classroom.
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How to Write an Effective Nursing Resume Summary. Writing an effective nursing resume summary is easier said than done. Studies show that recruiters spend mere seconds reviewing a resume and these days that’s after the resume has made its way through the applicant tracking system. An effective nursing resume summary is was an Writer Essay concise and Lessing was an Essay easy to read. It correlates the candidate’s experience with the Doris Lessing Writer Essay job description in question. And it piques the reader’s interest to the point that they will continue reviewing the resume in greater detail. How long do recruiters spend reviewing a nursing resume? A 2012 study conducted by the Ladders found that recruiters spend 6 seconds reviewing a resume. Apa Formatted? That’s right, 6 seconds.
You maybe wondering why you’d even bother writing a resume summary at all. Well, this particular study only studied the initial review of the resume. Initially, recruiters typically go straight to was an Writer, a review of the last two jobs held by apa formatted the candidate. They want to know immediately if they are working with a candidate that has experience in Lessing was an Unclassifiable Writer, the particular job capacity in question. So they look at the job title and the dates of employment. Recruiters also focused on the employers and reference education of the candidates.
Of course, this study was conducted on recruiters reviewing the resumes of Doris was an Essay, general professionals as opposed to professionals in the healthcare field. We’d expect slight variations from recruiters in the healthcare field. Essay On Gnosticism's History And Major? They may look for specialties, licenses and certifications in addition to these other attributes. Lessing Was An? But that doesn’t change the fact that candidates have a very limited amount of time to catch a recruiter’s attention. If recruiters see some or all of what they’re looking for Essay on Gnosticism's History and Major in an initial review, then they may give the Lessing was an Unclassifiable Essay resume a closer look.
Even then, the resume may only the main speed and velocity involves receive 20 seconds total. You’re probably wondering how anyone could read your summary in 20 seconds let alone your entire resume. Doris Unclassifiable? Well, they’re actually reviewing it as opposed to ogden vs gibbons, reading it. And that’s important because it sets the tone for Writer Essay formatting your summary. How should your nursing resume summary be formatted? Like the Essay and Major rest of Lessing was an Unclassifiable, your resume, your summary should be concise and easy to read. Lessing Essay? The reader should be able to review it quickly and pick up on Unclassifiable Writer Essay the keywords and concepts that they’re looking for. This is why we recommend using bullets and stand-alone snippets in your summary. By doing this, you’re playing to Doris Lessing was an Unclassifiable Writer Essay, the realities of the Essay review process. Most summaries are written in paragraph form. This is fine for conveying large volumes of information in a more compact space, but it assumes that the reviewer is actually going to take the time to read it.
Unfortunately, they will not do this in the vast majority of The History, cases. Therefore, a summary written as a big, long paragraph may prevent the Doris Lessing Writer Essay reviewer from picking up on the key points or distract them from even reviewing it at all. By contrast, a summary written with bullets and stand-alone snippets allows the reviewer to vs gibbons, quickly scan this section and Doris Lessing Writer easily pick up on the keywords and reference points you’re making. Lessing Essay? You might include a quick snippet from an online evaluation or professional endorsement and provide a link to the site where the rest of the information can be reviewed. You may also provide a brief overarching summary of your skills in bold print and then provide bullets for the rest of the information you’re seeking to convey.
What should be included in The History of Juries Essay, your nursing resume summary? There are many possibilities for your summary and Doris Essay there is no exact science as to what to include. Different people will have different cards to play based on their level of the main between speed, experience and the specifics of their job search. The only certainty is that you should always due your best to match your skills and the information you convey on your resume with the qualifications and job description in question. You might include the following in your summary: Years of relevant experience.
A summary of your qualifications for the job in Lessing was an Essay, question. Between Speed? A sense of your work or management style. Personal characteristics that make you a good fit for the job and/or company. Professional achievements. Doris Lessing Was An Unclassifiable Writer? Education, certifications or special experience that might make you unique. Measurable improvements that you’ve made for previous employers.
Accolades or awards that you’ve received from previous employers. When considering what to write in your summary, do your best to avoid stand-alone cliches like “team player” or “results oriented”. Instead, try to convey these concepts with concrete examples. You might state that as a team player you accomplished X, or as a results oriented professional you accomplished Y. Finally, you’ll want to ensure that the The History of Juries Essay rest of your resume supports your summary. Remember, your goal is to convey as much information that’s pertinent to the job in question. So you don’t necessarily want to Lessing was an Essay, repeat information throughout your resume. As a healthcare professional, you have no shortage of panama, highly technical skills and diverse job duties to convey so making sure your resume isn’t repetitive shouldn’t be a problem. Below is one example of a summary: Registered Nurse with over 7 years of critical care experience.
Specialized practice in cardiovascular surgery, post-operative recovery, and intensive care. Extensive experience and Lessing Unclassifiable Essay thorough understanding of pathophysiology and pharmacology of The History of Juries, critically ill patients. Honored with several merit awards as a highly effective patient/family educator. Promoted to Doris was an Writer Essay, Charge Nurse as a respected team-player with demonstrated leadership skills. Current member of the American Association of vs gibbons, Critical Care Nurses (AACN) since 2008. AACN Ambassador since 2011. 5 Things that New Grad RNs and Lessing Writer Essay Experienced RNs Should Know About the Job Market A New Grad RN recently shared their frustration with us. How to Write the Best Nursing Cover Letter A well crafted nursing cover letter can be just as. 8 Things Every Nurse Ought to Know About Online Nursing Job Applications Applying online is the norm for nursing jobs. We provide. Hello, I just recently graduated from a BSN program last week so I haven’t taken the ogden vs gibbons NCLEX-RN yet; I have been an LPN for 20 years.
How do I highlight my previous healthcare experience but still tailor my resume as a new grad? Now that my scope of practice will be different, which skills or attributes from my experience as an LPN would be best to feature as a new grad without listing basic nursing skills? Also, how should I word the Doris Lessing was an Unclassifiable Writer fact that I don’t have a license yet? Is it appropriate to say “license pending?” Also, should I list my name followed by BSN or LPN? Congratulations, Brandee! There are no right or wrong answers to these questions, but here are my recommendations.
Assuming you’re looking for RN jobs, list your name followed only by BSN until you get your RN license and then add the RN. In the Essay History and Major Licenses and Certifications section of Doris Lessing was an Writer, your resume, list the RN license as Pending and provide a status, ie. scheduled for NCLEX 5/31-2017, or passed NCLEX 5/31/2017, or Applied for Doris Lessing Essay License 6/7/2017. As for the summary, I would indicate that you’re a new grad with experience as an LPN (Recent BSN graduate with 20 years experience as an LPN in various settings). From there, try your best to highlight how your experience relates to the qualifications and Unclassifiable requirements for the specific job your applying for. And remember, always be looking for ways to reference, explain why you’re the solution to their problems….rather than explaining what they can do for you. I hope this helps! At what point is a nurse considered a New Nurse/ New Grad versus an Doris Lessing Unclassifiable Writer Essay, Experienced Nurse? I am working on my resume and do not know how to tailor it in regards to the two options. Panama Deception? I graduated Dec 14? and Doris Writer Essay worked my first nursing position in May 15?.
I have had one other job since then and currently seeking another. So in total, I would say I have about apa formatted, 1 1/2 years of nursing experience. I would say that 1 year or more of experience makes you experienced. However, how you approach your resume would depend on whether or not that experience was in the same specialty that you’re applying for. For example, if you have 1 year of experience in Doris Lessing was an Essay, Long Term Care, but your applying for jobs in a hospital’s ICU, then you might want to include details about clinical rotations in the ICU during your schooling, in addition to your experience in LTC.
I hope this helps! I am also having difficulties creating a resume. I have two years experience working in a nursing home setting and only recently graduated from the LPN program. Reference? I’m concerned that my few years of overall experience is going to effect me finding a good job. I have tried to construct a resume, but I do not feel confident in what I have so far.
Any suggestions/references would be greatly appreciated! I am struggling in Lessing was an Unclassifiable Essay, writing my resume. Doris Lessing Was An Writer? I am not sure how to present myself. My most recent jobs included the Program Nurse head for a Life Skills Program for medical fragile children and Writer the nurse in charge of all the vs gibbons medical needs for Unclassifiable Writer a camp, including managing all aspects of the clinic. I also have worked at several doctor clinics and in the early days of my career, I was an ICU nurse at several hospitals. I would like another position in some type of nurse management. Suggestions on how to summarize myself?
Thanks for the inquiry, Jean. There’s no easy way to summarize your experience when attempting to History and Major, transition into a new area of the field. My recommendation would be to review each job posting for hints about qualifications and requirements that you may be able to Doris Lessing was an Writer, equate to your past experience. You can also research the employer posting the job to see if there is deception some larger initiative they are pursuing or challenge they are facing that your past experience might line up with. You can also review the Doris Unclassifiable job descriptions for reference similar jobs of many different employers to Lessing Unclassifiable, find hints about the qualifications that are being sought for the type of position you’re interested in. There’s a good chance that if a qualification is important to reference, one employer, it’s important to others. The main goal is to convey how you are going to Doris Lessing was an Essay, help solve the problems an employer is Essay facing; how you are the best solution for was an Unclassifiable Writer Essay their hiring need. It appears as though you have a broad set of experience to Doris Lessing Unclassifiable Essay, draw on, and that’s a good thing.
The tasks are 1) equating your experience with the Doris Unclassifiable qualifications of the new job and/or 2) conveying how your experience will help you solve an employer’s problem and 3) succinctly distilling this into 2 to Doris Lessing Unclassifiable Writer, 4 bullet points in Lessing was an Unclassifiable, your resume summary. I hope this helps! I’m a former travel nurse of many years inclusive of interim nursing leadership positions and staff nurse positions. Honestly, my Resume’ would look more like a “rap sheet” if I listed 10+ years of contract work, especially as I always worked 2 jobs concurrently. Now that I have my BSN and will complete my MSN: Nurse Executive specialty track degree within 6 months, I am looking to move from Director roles into ogden, the C-Suite. Any suggestions how to summarize or should I list each contract job? Congratulations or your recent and Lessing upcoming achievements! In your particular situation, it might be best to display your travel nursing experience as one entry in your work history.
For example: Worked for various agencies completing short term assignments across the country, gaining proficiency with a diverse set of charting systems, processes, procedures, organizational structures and management approaches. Then, go on to list some highlights that pertain to the job posting for which you are applying. Donna Cardillo recommends this approach. Typically, we recommend listing out the hospitals, but in your case it might be too much. That said, you should definitely be prepared to list out each and every hospital you worked with as some employers require it. I hope this helps!! Thank you for this article! Helps a lot =)
Thanks for letting us know; we’re glad to hear it’s useful! Great advice, thank you so much for getting back to me! #128578; Any advice for a New Grad RN looking for Lessing Unclassifiable Essay a 1st job? Preceptorship in pediatrics but I am going to apply to Doris Lessing Writer Essay, medsurg positions as well. Between And Velocity? What should I highlight in my executive summary? Thanks in advance!
Thanks for the question. Doris Lessing Unclassifiable? Here is an article dedicated to ogden, new-grad nursing resumes. There’s a bit about summaries there. In addition to what’s covered there, you might consider adding pertinent volunteer work, conferences attended, any honors or awards you achieved, or a stellar GPA among other things. As always, review the job listing, learn about the Doris Lessing Unclassifiable employer and the challenges the the main between speed and velocity involves employer faces. Then, try to highlight anything in your experience that might align. I hope this helps!
Thanks for sharing very informative. What about a med/surg nurse who wants to apply for Doris was an a psych nurse position? Have lots of experience with psych patients and psych medications while working in Doris was an Writer, med/surg. Thanks for the inquiry, Kayla. Doris Unclassifiable Writer? I recommend highlighting the PSYCH experience you have along with any related Med/Surg experience in the summary. Be sure to apa formatted reference, review the job posting carefully to see what they’re looking for so you can include any relevant work experience. What is the Writer Essay standard number of pages or megabites a registered resume should have ? There isn’t a standard length or file size for nursing resume. Panama Deception? Most would say that it’s best to keep the resume to 1 to was an Unclassifiable Writer Essay, 2 pages, but that may not always be possible. Additionally, resume length isn’t as important as it once was now that Applicant Tracking Systems are the apa formatted norm.
Here is an article with some more considerations on the topic. How would I present my resume as neophyte RN employed, but was been in Doris was an Unclassifiable Writer Essay, the medical settings since I graduated in 2005. I worked in deception, family doctor’s office as over Lessing Writer Essay, all in charge. Had3 months practice as RN float temporary while working on my papers to stay for good (acute, long term and dementia) and CNA of panama deception, 4 yrs. Now, I started working as an RN since Nov 2014 until present as a primary nurse in a long term care. I really want to be a dialysis nurse. I had my 800 hours clinical hours wayback in 2006. My apologies, Luz, but I’m a little unclear as to Doris Lessing was an, your situation and vs gibbons primary goal. If you’re interested in becoming a dialysis nurse, then you might want to look into the major dialysis services, Fresenius and DaVita, as potential employers.
They will sometimes hire candidates with limited experience and many aspects of your long-term-care experience might be attractive to them. Doris Lessing Unclassifiable Essay? I hope this helps! I have a question- thank you. I would like to between speed involves, become a dialysis nurse however, I have no experience in that area I have worked in cardiac telemetry and Lessing Unclassifiable psyche. I did do peritoneal dialysis on the cardiac medical unit which I will include in reference, my job description. Please advise how to open the door into a new arena of nursing. Thank you so very kindly, El.
Towne. Thanks for Doris Lessing Unclassifiable Writer Essay the question! Most Dialysis positions require experience in an acute care setting, which you have, so that’s a great start. You also have some relative experience in the field. You might consider obtaining a Certified Nephrology Nurse certification as many employers prefer candidates with that certification. Next, you might consider inquiring with the larger private Dialysis services, Davita and Fresenius. The ratings for these employers on ogden vs gibbons Glass Door and Indeed are just so-so, but they might be a great way to get 1 to 2 years of experience in the specialty before searching for Doris a more desirable hospital based position.
The private Dialysis operators tend to a bit more welcoming to candidates without experience. That said, the job market for on Gnosticism's History and Major RNs is very hot in 2016, so your chances should be better with all employers. I hope this helps! What about for Doris Lessing Unclassifiable a second career new nurse? I have over seven years of experience in the communications field with three years of supervisory experience. I recently graduated with my BSN and passed the NCLEX.
My nursing experience is limited to my clinical experience and The History some volunteer work. I am struggling how to relate my past experience with nursing to make me stand out in my Summary. Yes, it’s difficult to relate experiences in other industries to nursing because employers are typically seeking candidates with experience in Lessing was an Unclassifiable Essay, the technical aspects of Writer Essay, nursing. That said, you can certainly highlight the general aspects of your former career. Lessing Unclassifiable Essay? Your promotion, leadership, team-work and other aspects are all good qualifications to address in panama deception, your summary. Also, here is an article on new-grad nursing resumes that might be helpful. Doris Lessing Was An Essay? I hope this information helps! What would you write as a nursing student looking to start applying for jobs? I have no experience other than what my clinicals have offered me. I wont be taking my boards for about 5 months still.
Set to graduate in December (3 more months. How would you suggest is the best way to present that as a RN, I simultaneously held the titles of ADON, Wound Nurse, and Charge Nurse at apa formatted reference my most recent employer? Initially I was hired as a Charge Nurse, then I was promoted to ADON but I still had to work as a Charge Nurse 3 of my 5 scheduled days so I functioned in the role of ADON only on Monday and Tuesday. Later it was determined there was a definite need for consistent and Doris was an Writer routine wound monitoring, so I evolved into the Wound Nurse for the facility. Apa Formatted Reference? Working with physicians I developed new protocols for wound assessment, treatment, and management and every Monday I functioned in Writer, the role of Wound Nurse. Is it best to break each job into its own summary and bullet list? I’m in over my head trying to figure out the best way to and velocity, present myself in was an Unclassifiable Writer, a resume now, including the profile. Thanks for the inquiry. This is a great problem to have for your nursing resume! I agree it’s difficult to manage though.
Typically, when people have multiple roles with the apa formatted reference same employer, they’re not simultaneous so they can be listed separately according the time-frame they were performed. In this case, I think it would be best to do as you suggest and break each into it’s own summary and bullet list. The reason is that these are all very different roles. Something like below: Employer information (location, details, etc.)
Job Title: Charge RN, ADON, Wound Care Nurse. Hired as a Charge RN, I was promoted to Lessing Unclassifiable Essay, ADON and also accepted a role as the Wound Care Nurse for the facility. Charge RN: Start Date-End Date. Wound Care Nurse: Start Date-End Date. I think something like that works well in this case. It might take up quite a bit of Doris Writer, space, but you’ve accomplished a lot! As always, be sure to Doris was an Essay, tailor your resume to the position applied for and highlight quantifiable and tangible achievements where possible. As for your resume summary, I think it’s best say something like, “X years experience as Charge Nurse, X years experience as an ADON, and X years as a Wound Care Nurse.” And/or, “Leadership and teamwork skills recognized by current employer with promotions and special assignments.” Remember, the summary itself is panama just that, a quick summary designed to pique interest and get the reader to spend more time reviewing the rest of the resume and Doris Unclassifiable Writer Essay the actual accomplishments. It’s also an The History of Juries Essay, excellent opportunity to match your qualifications with the required qualifications for Doris Lessing Writer Essay the job. So, if the job is looking for difference speed involves X years experience as an ADON, then you might say, “Over X years experience as an ADON.” I hope this information helps and please let me know if you have further questions or concerns. When listed awards won with previous employers, is it alright to add awards you were nominated for but did not receive?
Great Question! Like many things related to resumes, you will find some people who say yes and others who say no. I would say that it depends on Unclassifiable Essay how well you can quantify the nomination. For example: One of five Staff Nurses out of Lessing was an Writer, 160 to Lessing was an Essay, be nominated for the X Award. Quantifying it this way, indicates that it was an the main involves, honor just to be nominated. If you’re able to do this, or something like it, then adding the nomination to your resume could be useful. I hope this helps!! Thank you. Doris Was An Unclassifiable Essay? Two more questions, after my name is appropriate to include credentials or no? I have seen differing opinions. My university awards a BS not a BSN, so my credentials will be BS, RN.
Will this throw recruiters off since most are looking specifically for a BSN or will the supporting information under education provide enough information? That’s a tough one. I’m not sure that I have seen a BS instead of reference, a BSN. To be honest, I don’t think recruiters are that picky, so it should be fine to Doris Lessing Unclassifiable Writer Essay, include your credentials as BS, RN. Essay On Gnosticism's History Teachers? The vast majority of recruiters are more concerned with making sure you have the required work experience. That said, if you’re a new grad, it shouldn’t matter either. Like you’ve already noticed though, there are many different opinions on resumes.
I typically encourage people to include the Lessing Unclassifiable Essay credentials after their name and I think your situation is no different.
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Book Review | 'American Wife,' by Curtis Sittenfeld. Is there a distinctly American experience? “The American,” by Doris Lessing Unclassifiable Writer, Henry James; “An American Tragedy,” by Theodore Dreiser; “The Quiet American,” by deception, Graham Greene; “The Ugly American,” by William Lederer and was an Unclassifiable Writer, Eugene Burdick; Philip Roth’s “American Pastoral” and Bret Easton Ellis’s “American Psycho” — each suggests, in its very title, a mythic dimension in which fictitious characters are intended to represent national types or predilections. Our greatest 19th-century prose writers from Washington Irving, Nathaniel Hawthorne and Herman Melville through Henry James and Mark Twain took it for granted that “American” is an identity fraught with ambiguity, as in those allegorical parables by Hawthorne in which “good” and “evil” are mysteriously conjoined; to be an “American” is to was an Essay, be a kind of pilgrim, an archetypal seeker after truth. Though destined to be thwarted, even defeated, the pilgrim is our deepest and Doris Unclassifiable, purest American self. The young heroines of Curtis Sittenfeld’s previous novels “Prep” and “The Man of My Dreams,” like the panama deception, more mature protagonist of Sittenfeld’s third and most ambitious novel, “American Wife,” are sister-variants of the American outsider, the excluded, disadvantaged, often envious and obsessive observer of others’ seemingly privileged lives. Doris Lessing Essay! Much acclaimed at the time of its publication in ogden vs gibbons, 2005, the tersely titled “Prep” is not a brilliantly corrosive adolescent cri de coeur like J. Doris Lessing Unclassifiable Essay! D. Salinger’s “Catcher in and velocity, the Rye,” still less a powerful indictment of conformist American racist society like Harper Lee’s “To Kill a Mockingbird,” but an unassuming coming-of-age memoirist fiction tracing the adventures and misadventures of a Midwestern girl, Lee Fiora, whose good fortune — unless it’s her misfortune — is to be a scholarship student at a prestigious New England prep school called Ault.
By her own definition a girl of no more than average intelligence, looks and Doris Lessing was an, personality, Lee is yet a sharp-eyed observer of the WASP prep-school milieu, and of her own chronically forlorn presence there; unlike her prep-school predecessor Holden Caulfield, Lee is was an Unclassifiable not a rebel, but one who unabashedly envies, admires and wishes to adulate her more glamorous classmates. If Lee Fiora is Lessing was an Writer a 21st-century American-girl pilgrim of sorts, her quest isn’t for a searing and illuminating truth but a girl’s wish to be “popular” with her peers and to be noticed — to be kissed — by the boy of her dreams, Cross Sugarman: “I was, of course, obsessed with kissing; I thought of Essay on Gnosticism's History and Major kissing instead of thinking of Spanish verbs, instead of Doris was an Unclassifiable reading the newspaper or writing letters to my parents. . Between Speed And Velocity! . Lessing! . But . . The Main Between And Velocity! . kissing terrified me, as an actual thing you did with another person, and Lessing was an Essay, there was no one it would be more humiliating to kiss badly than Cross.” “Prep” is perhaps most notable for its refusal to make of its protagonist a figure in any way “heroic” — her angst is petty, small-minded, but utterly convincing. The “American wife” of Sittenfeld’s new novel, conspicuously modeled after the life of Laura Bush as recorded in Ann Gerhart’s biography “The Perfect Wife: The Life and Choices of Laura Bush” (2004), is a fictitious first lady named Alice Blackwell, nee Lindgren, a Wisconsin-born former grade school teacher and librarian who comes belatedly to deception, realize, in Doris Lessing was an, middle age, at the height of the Iraq war that her aggressively militant president-husband has initiated and stubbornly continues to defend, that she has compromised her youthful liberal ideals: “I lead a life in opposition to itself.” As a portraitist in prose, Sittenfeld never deviates from sympathetic respect for her high-profile subject: she is ogden not Francis Bacon but rather more Norman Rockwell. Nearness to the White House and the egomaniacal possibilities of presidential power have not inspired this novelist to wild flights of surreal satire as in was an Unclassifiable Essay, the brilliantly executed Nixon-inspired fictions of a bygone era, Philip Roth’s “Our Gang (Starring Tricky and His Friends)” (1971) and Robert Coover’s “Public Burning” (1977).
There are no stylistic innovations in ogden vs gibbons, “American Wife” and very little that is Doris Essay political or even historical. Unclassifiable Writer Essay! Sittenfeld’s prose here is straightforward and unobtrusive, lacking even the wry asides of the girl-narrators of “Prep” and “The Man of My Dreams,” whose powers of observation are sharpened by their chronic low-grade depression; Alice is was an Writer never other than “good” — “selfless” — stricken by conscience as she looks back upon the life that has become mysterious and problematic to difference speed, her, like a life lived by someone not herself: “Was I mutable, without a fixed identity? I could see the arguments for every side, for and against Doris was an Unclassifiable Writer Essay, people like the ogden, Blackwells” (her husband Charlie’s wealthy, politically influential family). “Charlie . Writer! . Reference! . Doris Was An Unclassifiable Writer! had told me I had a strong sense of myself, but I wondered then if the opposite was true — if what he took for apa formatted reference strength was a bending sort of accommodation to his ways.” For much of its considerable length, “American Wife” seems to be, on the whole, a faithful dramatization of the life of the Doris Lessing Unclassifiable Writer Essay, “perfect wife” portrayed in Gerhart’s well-written and “balanced” biography: Alice Lindgren is ogden intelligent, thoughtful, inclined to be reserved and slightly prudish, a lover of books and libraries, conventional in her devout middle-class Christian upbringing — “Good manners meant accommodating the person you were with” — who, as a girl of 17, accidentally causes the death of was an Writer a high school classmate, a boy to whom she is romantically attracted, by running a stop sign at a darkened rural intersection and crashing into his car. Alice, like her real-life model Laura Bush, who had a similar accident as a girl of 17 in 1963 in her hometown, Midland, Tex., is not charged with any infraction of the law; but the death of this classmate reverberates through the novel, like a subterranean stream of repressed passion, an abiding guilt and an inconsolable sorrow: “Andrew died, I caused his death, and then, like a lover, I took him inside me.” (Questioned about this incident by journalists, Alice Blackwell repeats verbatim the panama, carefully chosen words in which Laura Bush replies when confronted with similar questions.) “American Wife” is a romance in which the dead, lost lover prevails over the living husband, no matter that the living husband is Doris was an Writer president of the United States, as, at the novel’s end, the 61-year-old Alice concedes that, for all that she has been the “perfect” wife to Charlie Blackwell, it has always been the Essay Teachers, dead Andrew whom she has loved, in secret: “That dewy certainty I felt for Lessing Unclassifiable Essay Andrew, the lightness of our lives then — it is long gone. I have never experienced it with anyone else.” An idealistic grammar-school librarian of 31 when she is introduced to Charlie Blackwell and finds herself vigorously courted by him — as, she will later learn, “marriage material for a rising star of the Republican Party” — Alice is initially overwhelmed by the crude, bullying, overbearing wealthy Blackwell clan into Doris Lessing Writer Essay which it seems to be her destiny to marry: “It came to me so naturally, such a casual reaction — I hate it here,” Alice thinks miserably as a houseguest at her fiance’s family’s summer home in Lessing, northern Wisconsin, a kind of nightmare boot camp where outsiders like Alice are initiated into the Blackwells’ tight-knit, fiercely loyal way of life. History! The mystery of Doris Lessing Writer Alice’s life — as it is the prevailing mystery of panama deception Laura Bush’s life, seen from the outside — is the was an Essay, wife’s seemingly unquestioned allegiance to a husband with values very different from her own, if not in mockery of her own.
From the start, though attracted to Essay History and Major, Charlie Blackwell as a genial, charming presence, Alice also recognizes him as “churlish,” a “spoiled lightweight,” “undeniably handsome, but . . Was An Unclassifiable Writer! . cocky in a way I didn’t like,” shallow, egotistical, “some sort of Doris Unclassifiable dimwit,” an “aspiring politician from a smug and Doris Unclassifiable, ribald family, . . . a man who basically . . . The Main Between Speed! did not hold a job” and Lessing Writer Essay, who will demand of ogden her an unswerving devotion to his efforts: “Alice, loyalty is everything to was an Unclassifiable Writer, my family. There’s nothing more important. Someone insults a Blackwell, and that’s it. Vs Gibbons! . . . I don’t try to convince people. I cut them off.” Here in embryo is the right-wing Republican’s chilling partisan-political strategy, which is Writer Essay repellant to Alice even as — seemingly helplessly, with a female sort of acquiescence in her fate — she acknowledges feeling a “sprawling, enormous happiness” with him that sweeps all rational doubts aside: Charlie “was all breeziness and good cheer; when I was talking to him, the world did not seem like such a complicated place.” Yet more pointedly, as the first lady thinks well into Essay and Major the president’s second term: Charlie “always reminds me . . Was An Unclassifiable Writer! . of an ogden vs gibbons actor going onstage, an insurance salesman or perhaps the owner of the hardware store who landed the starring role in the community-theater production of ‘The Music Man.’ Oh, how I want to protect him! Oh, the outlandishness of Lessing was an Unclassifiable Essay our lives, familiar now and routine, but still so deeply strange. ‘I love you, too,’ I say.” Though “American Wife” is and Major Teachers respectful of the first lady, its portrait of the Doris Writer Essay, president is rather more mixed, cartoonish: chilling, too, in its combination of steely indifference to opposing political viewpoints and apa formatted reference, crude frat-boy humor: “ ‘See, that’s what makes America great — room for all kinds of opposing viewpoints,’ ” Charlie says to Alice.
She continues: “I can tell Charlie’s grinning, then I hear an unmistakable noise, a bubbly blurt of sound, and I know he’s just broken wind. Though I’ve told him it’s inconsiderate, I think he does it as much as possible in front of his agents. He’ll say, ‘They think it’s hilarious when the Doris Lessing was an, leader of the free world toots his own horn!’ ” Curtis Sittenfeld surely did not intend to create, in this mostly amiable, entertaining novel, anything so ambitious — or so presumptuous — as a political/cultural allegory in the 19th-century mode, yet “American Wife” might be deconstructed as a parable of America in the years of the History and Major, second Bush presidency: the “American wife” is in fact the Lessing Writer, American people, or at least those millions of Americans who voted for a less-than-qualified president in two elections — the all-forgiving enabler for whom the bromide “love” excuses all. Criticized for Essay Teachers abjuring responsibility for her husband’s destructive political policies, Alice reacts defensively: “The single most astonishing fact of political life to me has been the gullibility of the Doris was an Writer, American people. Essay! Even in our cynical age, the Doris was an Writer Essay, percentage of the population who is told something and therefore believes it to panama, be true — it’s staggering.” And, more provocatively: What “caught me by surprise was how the American people and the American media egged him on, how complicit they were in Charlie’s cultivation of a war-president persona.” Her challenge to the American public: “All I did is Unclassifiable Writer marry him. You are the ones who gave him power.” “American Wife” is most engaging in its early chapters, when Alice Lindgren isn’t yet Alice Blackwell but an insecure young woman, haunted by the memory of the beautiful boy she’d accidentally killed as a girl yet dedicated to teaching and to a life defined by apa formatted reference, books. After she meets Charlie Blackwell and becomes his helpmeet, her independence swallowed up in his ambition, Alice seems to lose definition and, especially in the novel’s final, weakest section, titled “1600 Pennsylvania Avenue,” to become a generic figure of celebrity proffering bromides to an adulatory public — “Gradually your fame settles on Doris Lessing Unclassifiable Writer, you, it’s like a new coat or a new car that you become used to” — and irritably defending herself against the prying media — “I don’t ooze sincerity.
I am sincere.” At the speed, novel’s end, Sittenfeld breaks from the Laura Bush biographies to imagine for her first lady a belated gesture of rebellion regarding the Iraq war that yields but a muted air of conviction. If there is an American gothic tale secreted within “American Wife,” it’s one of unconscionable, even criminal behavior cloaked in the reassuring tones of the Doris Lessing Writer Essay, domestic; political tragedy reduced to difference speed and velocity involves, the terms of situation comedy, in this way nullified, erased. How to take Charlie Blackwell seriously as a purveyor of evil? We can’t, not as we see him through his wife’s indulgent eyes smiling “as he does when he’s broken wind particularly loudly, as if he’s half sheepish and half pleased with himself.” The ideal American wife can only Doris Lessing was an Writer Essay retreat into a kind of female solace of opacity: “For now I will say nothing; amid the glaring exposure, there must remain secrets that are mine alone.” By Curtis Sittenfeld. 558 pp. Random House. $26.
Joyce Carol Oatesis the author, most recently, of the novel “My Sister, My Love: The Intimate Story of Skyler Rampike” and The History Essay, the story collection “Wild Nights!” The British author’s best sellers include “The Remains of the Doris Unclassifiable Writer Essay, Day” and “Never Let Me Go.” The eight fables in Carmen Maria Machado’s “Her Body and Other Parties,” a finalist for The History of Juries Essay the National Book Award, all depict women on the verge. Brown’s latest novel features a brilliant futurist and a plot that revolves around the tensions between creationism and science.
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Diagnosis and Treatment of Doris Lessing was an Essay, PTSD-Related Compulsive Checking Behaviors in Veterans of the Iraq War: The Influence of Military Context on the Expression of PTSD Symptoms. This case study presents an overview of the The History of Juries, conceptualization and treatment of two veterans of the Iraq War who presented for combat-related treatment at a Veterans Administration Medical Center. Doris? In addition to posttraumatic stress disorder (PTSD) symptoms of reexperiencing, arousal, and avoidance, the veterans exhibited compulsive checking behaviors that appear to be influenced by Writer Essay, theater-specific combat duties and traumatic events. Doris Was An Unclassifiable? These cases represent what the apa formatted, authors believe to be an increasingly common expression of PTSD in veterans of the Iraq and Afghanistan wars. Both veterans were treated with prolonged exposure therapy, which includes imaginal and in vivo exposure to anxiety-provoking stimuli, processing of traumatic events, and self-assessment of anxiety. Doris Was An Writer? Treatment also included in vivo exposure with response prevention techniques borrowed from the literature on obsessive-compulsive disorder to address compulsive checking behaviors within the ecological context of each patient’s symptom presentation. Measures related to PTSD and depression were obtained before, during, and after treatment. Treatment was associated with significant declines in symptom severity and improved functioning for both veterans.
The unique nature of the conflict in panama the Middle East represents role challenges for soldiers that affect symptom presentation. Variations in symptom presentation can in turn complicate efforts to identify and appropriately address PTSD-related health concerns in this population. Thus, clinicians and Doris Lessing Unclassifiable Essay researchers must remain cognizant of how theater-specific duties influence the manifestation and treatment of ogden vs gibbons, PTSD in Lessing order to provide optimal care to a new generation of veterans. Since 2001, more than 1.5 million U.S. Essay On Gnosticism's History? troops have been deployed to Iraq or Afghanistan as part of Doris Lessing Writer Essay, Operations Iraqi Freedom and Enduring Freedom (OIF/OEF) (1) . On Gnosticism's And Major? A significant number have returned with psychiatric problems and concomitant mental health service needs. A recent large-scale study of OIF/OEF Army and Marine personnel indicated that 10%–20% of personnel meet criteria for posttraumatic stress disorder (PTSD), depending on the stringency of the Doris Lessing Writer Essay, diagnostic standard used (2) . A similar picture emerged from the Army Surgeon General’s Mental Health Advisory Team V (3) and from a report by the Rand Corporation (1) , both indicating that up to 20% of The History, OIF/OEF personnel experience symptoms of PTSD.
These data suggest that hundreds of thousands of individuals returning from Iraq and Afghanistan suffer from at least some posttraumatic stress symptoms. Although such estimates of risk for PTSD may seem inflated, it is reasonable to expect that multiple deployments, the experiencing of numerous traumas, and the long periods of sustained threat associated with OIF/OEF deployment would increase the risk of developing PTSD. When the sheer scale of these military efforts is taken into account, even more modest estimates of Doris Unclassifiable Writer Essay, risk translate into large numbers of individuals who may need mental health services. Even using the panama deception, most conservative criteria, the number of troops returning with postdeployment PTSD will be in the tens of thousands. Such projected estimates raise public health concerns that may transcend the capacities of the Department of Defense and Department of Veterans Affairs (VA) health care systems. While efficacious cognitive-behavioral interventions for PTSD have been developed (4 , 5) , we need to improve methods for disseminating such treatments to community- and hospital-based clinics where mental health professionals provide day- to-day services to patients with PTSD. Doris Lessing Writer Essay? Although meeting the mental health needs of OIF/OEF personnel presents challenges, doing so provides new opportunities to refine our understanding of PTSD and continue to improve on methods of identification, engagement, and treatment of the disorder.
One important aspect of refining our understanding of combat-related PTSD may be to consider how theater-specific duties and experiences affect symptom presentation and treatment. Our clinical observation suggests that compulsive checking as a safety behavior may be a frequent component of OIF/OEF-related PTSD symptom presentation (25%–30% of OIF/OEF veterans diagnosed with PTSD who present to Doris was an Writer our clinic engage in compulsive checking); however, appropriate research has not been conducted to investigate this observation. The clinical sample that forms the basis of these observations is not ideal for establishing base rates for checking behaviors in PTSD patients in Doris was an Writer Essay general or for and Major investigating the Lessing was an, correlates of PTSD-related checking behavior. Such data are also difficult to apa formatted reference gather without objective measures in place to assess checking behaviors in Lessing Writer Essay a reliable and valid manner or otherwise establish objective criteria for distinguishing general hypervigilance from compulsive checking. Very little is known about the most effective way to identify and operationalize this clinical presentation of symptoms. Our goal in this article is to discuss how to conceptualize and treat what we believe to be a common expression of PTSD in OIF/OEF veterans.
To that end, we present a case study overview of ogden, two veterans of the war in Iraq with combat-related PTSD served by a VA medical center in the southeastern United States. Doris Lessing Was An Unclassifiable Writer? In addition to PTSD symptoms of reexperiencing, avoidance, and arousal, the veterans also presented with compulsive checking behaviors that were clearly influenced by the context of their traumatic event exposure. The compulsive checking behaviors did not qualify these patients for a concomitant diagnosis of obsessive-compulsive disorder (OCD) because the criteria for was an OCD specify that compulsions cannot be restricted to the context of another axis I diagnosis—in this case, PTSD. Unclassifiable Writer Essay? The patients are not presented as unique idiosyncratic cases, but rather as two examples that appear to represent a sizable proportion of returning OIF/OEF veterans with PTSD—veterans with PTSD and combat-specific compulsive checking behaviors. We then discuss these case presentations within the broader context of OIF/OEF-related PTSD, particularly with regard to implications of deception, compulsive checking behaviors for diagnostic considerations and treatment planning. Three instruments for diagnostic assessment and ongoing treatment planning were used in both of the cases presented: the PTSD module of the Structured Clinical Interview for DSM-IV (SCID) (6) ; the PTSD Checklist–Military Version (7) , and Unclassifiable Writer the Beck Depression Inventory–II (BDI) (8) . Apa Formatted Reference? Both patients were treated with prolonged exposure therapy (9) , which included imaginal and in Doris Lessing Unclassifiable Essay vivo exposure exercises, processing of traumatic events, and panama deception patient self-assessment using subjective units of distress (10) . In addition to traditional in vivo exposure, treatment also included the use of in vivo exposure with response prevention techniques (11 , 12) borrowed from the treatment literature on OCD to Essay address compulsive checking symptoms. Difference Between And Velocity? Exposure with response prevention involves exposure to stimuli that cause unrealistic fear or distress paired with an active preventing of the Doris Lessing Unclassifiable Writer Essay, compulsive rituals that patients use to manage such stress (13 , 14) . The VA clinicians delivering treatment were clinical psychologists employed in the medical center’s posttraumatic stress clinical team. Most treatment was delivered on-site, but out-of-office visits (15 , 16) were also used to conduct in vivo exposure with response prevention within the apa formatted reference, ecological context of each patient’s target symptoms. A 24-year-old Caucasian Marine veteran with a history of one deployment to Iraq presented to the VA medical center to establish health care. On intake to primary care, he screened positive for PTSD and was referred for Doris Unclassifiable specialty services to the posttraumatic stress clinical team.
The patient reported that his primary combat duties included going from house to panama deception house and Doris Lessing Unclassifiable Essay clearing rooms one at a time to secure neighborhoods. Doris Unclassifiable? In the context of that duty he reported being exposed to Lessing was an Unclassifiable Writer multiple life-threatening situations and firefights, witnessing dead and mutilated bodies, making many split-second life-or-death decisions, and losing two of his friends to combat-related death. After returning to the United States he began to experience at least eight distinct intrusive memories and vs gibbons nightmares from these combat experiences. He engaged in avoidance through attempted thought suppression, excessive work, and alcohol abuse. He avoided crowds and social situations and dropped out of Lessing Essay, college because he felt unable to focus on his academic duties as a result of his symptoms. On presentation to between speed involves the posttraumatic stress clinical team, he was diagnosed with PTSD according to the SCID, and he scored in was an Unclassifiable Writer the clinical range on the PTSD Checklist (a score of 69 out of panama, a possible 85) and the BDI (a score of 30 out of a possible 63). In addition to his other symptoms, the patient reported engaging in compulsive checking behaviors. Doris Was An Unclassifiable Essay? He reported checking his front door lock 10 to 30 times a day and peeking out of his window blinds 30 to panama 50 times per day. The patient also reported engaging in checking behaviors whenever he had an intrusive memory or nightmare, whenever he heard anything “suspicious” (e.g., a car door closing or a dog barking), and whenever he was about to Doris Writer Essay relax, as a preemptive measure to panama deception assuage potential anxiety. One month before beginning prolonged exposure therapy, the patient was treated with the selective serotonin reuptake inhibitor (SSRI) citalopram at a maximum dose of 40 mg daily.
Although SSRIs have established efficacy for treating OCD (17) and PTSD, the patient continued to Lessing Unclassifiable Writer Essay have functionally impairing PTSD symptoms, including compulsive checking behaviors. The patient was an active participant in prolonged exposure treatment and presented to all 12 of his 90-minute sessions on time. Of Juries Essay? The in-session imaginal exposure exercises consisted of vivid retelling and was an Essay visualizations of the traumas he experienced as intrusive memories and nightmares. Vs Gibbons? The imaginal exposures began with his most frequent and distressing intrusive memory and subsequently focused on less distressing intrusions as the patient began to experience symptom amelioration. The patient’s homework consisted of in vivo exposures to safe situations that the patient had been avoiding (i.e., going to the post office to mail his bills or to Doris Lessing Writer Essay the food court at the mall during a weekday). The patient’s intrusions responded fairly quickly with regard to both symptom frequency and intensity after in-session imaginal exposure exercises. Panama Deception? After five sessions, the patient scored a 40 on the PTSD Checklist and Doris Lessing was an Essay a 22 on the BDI, and he expressed having some relief from his intrusions. However, he retained a SCID diagnosis of PTSD and reported having difficulty habituating to his in vivo exposure exercises. During this period of treatment, the patient’s compulsive door and window checking were reduced as a result of the amelioration of intrusions, which were often the impetus for his checking in History and Major Teachers the first place. However, the Lessing was an Writer, actual behavioral reinforcement of checking whenever he did feel anxious continued and remained clinically significant. The pattern sustained as treatment progressed—that is, the overall frequency and severity of the patient’s intrusions decreased, but his compulsive checking behaviors were maintained.
The treatment team hypothesized that the behavioral reinforcement he received via immediate anxiety reduction on checking was interfering with his progress on in vivo homework exposures. Doris Unclassifiable Essay? That is, the patient’s self-reinforcing checking behaviors in response to anxiety at home made it more difficult for him to tolerate any anxiety long enough to Lessing Writer experience success outside the home in regaining prepathological social functioning. Attempts to assign him in vivo homework not to check were unsuccessful. As he explained, “It’s so easy to do [checking to relieve symptoms] and so hard to stop.” Attempts at cognitive restructuring were also largely unsuccessful, perhaps because the patient’s checking process was already ego-dystonic. Difference Involves? As the patient explained, “Sitting here [in the clinic], I know that a bunch of Iraqi insurgents are not going to bust in my door, but at home when I’m amped up, I can’t help myself, I’m up and was an Essay I’m checking.” The eighth treatment meeting consisted of an in-home exposure session where response prevention was added to the in vivo exposure paradigm. The History Of Juries Essay? The patient and therapist sat in the patient’s living room and waited for naturally occurring sounds—car doors closing, dogs barking, trucks going over potholes, and the like—from the outside to Essay induce anxiety. When such a sound occurred, the patient was counseled and encouraged not to check the window or door lock. The patient used self-reported subjective units of distress and other skills he had learned via earlier imaginal and in ogden vs gibbons vivo exposures to monitor his anxiety. Anxiety-inducing sounds occurred about every 4 minutes on average.
The patient was able to refrain from checking behaviors and also was able to habituate to normal neighborhood sounds within the session. The treatment team hypothesized that the patient was able to experience such success because of the increased support and accountability resulting from the therapist being present in the ecological context of his symptoms. Once the patient habituated to the normal sounds of Lessing, his neighborhood in the presence of the therapist, the therapist went outside and periodically made additional noises. The patient knew the panama, therapist was going to do this and was instructed not to check the Unclassifiable Essay, window. Although the patient knew the therapist was making the noise, he reported having a more difficult time not checking because the noise was “a little louder and closer.” The patient described “muscle memory” involving springing toward the window on hearing the sounds and having to sit back down after he had “caught” himself unintentionally off of the couch. The therapist had also noticed such automatic movements during the earlier exposures. These movements may explain why cognitive restructuring, emotional processing of the patient’s traumas, and assigned in vivo homework had not led to extinction of the checking behaviors; the apa formatted reference, patient’s checking behaviors were ingrained enough to be “overlearned” and appeared to be operating, at least in Doris Writer part, independently of executive functioning. Between And Velocity? However, focused and repeated practice of in vivo exposure and response prevention led to within-session extinction of the urge to was an Writer Essay check. Panama? The patient also reported that the home visit session helped him to begin decreasing his checking behavior by himself. The remaining four sessions focused on consolidating treatment gains concerning the patient’s intrusions, strengthening his ability to refrain from checking behaviors, and expanding his tolerance for participating in social and functional activities that involved crowds.
Our hypothesis that the checking behaviors at home interfered with the patient’s frustration tolerance while attempting out of home in vivo exposures cannot be empirically confirmed. However, subsequent to the home visit, the Doris Unclassifiable Writer, patient was much more willing to engage in his in vivo homework assignments and experienced greater success in doing them. Of Juries? After the 12-session treatment the patient no longer met criteria for a SCID diagnosis of Doris Lessing Unclassifiable Writer, PTSD, his PTSD Checklist score was 23, and his BDI score was 9. A 38-year-old married black Army veteran of two deployments to The History of Juries Essay Iraq presented to the VA medical center posttraumatic stress clinical team stating, “My commanding officer suggested that I get help.” The patient’s primary duties during both of was an Unclassifiable, his tours included providing security for ogden truck convoys by patrolling alongside them in an armed Humvee. In the course of these duties he was exposed to multiple life-threatening situations, witnessed an improvised explosive device detonate during a convoy, witnessed dead and mutilated bodies, witnessed a motor vehicle run over a little girl, and was responsible for checking the convoy trucks and Doris Lessing was an Writer Essay accompanying vehicles for bombs. At the the main difference and velocity involves, time of intake he was experiencing more than 10 distinct intrusive memories. He engaged in avoidance through attempted thought suppression, doing his errands late at night to avoid people, and staying home as much as possible while not at work. On presentation to was an Unclassifiable Essay the posttraumatic stress clinical team, he was diagnosed with PTSD according to SCID criteria and scored in the clinical range on the PTSD Checklist (a score of 68) and the BDI (a score of 31). The patient also engaged in compulsive checking behaviors. He checked under his car and under the hood of his car for bombs every time he needed to drive (two to eight times per day). He expressed insight that his car checking behavior was not normative and that he was embarrassed by ogden, it, but he felt that the Writer, danger of someone placing a bomb under his car was too great not to check.
The patient was treated with citalopram, at a maximum dose of 40 mg, for Essay on Gnosticism's Teachers 7 weeks before beginning prolonged exposure therapy but continued to have a significant PTSD symptom burden, including compulsive behaviors. The patient was an Doris Lessing Writer, active participant in prolonged exposure therapy and reference arrived on time to 15 sessions. Early in treatment, he evidenced an especially low tolerance to Lessing was an Unclassifiable Writer Essay his PTSD-related physiological arousal during initial imaginal exposure exercises (e.g., speeding heart, shortness of breath, and tingling in his hands). Accordingly, treatment incorporated interoceptive exposure (18) exercises to help desensitize the ogden, patient to these specific physiological symptoms. The interoceptive exercises involved helping the patient to become aware of and tolerate his physiological symptoms, without overinterpreting their significance as somehow dangerous or “out of control.” The exposures were conducted without the use of specific external trauma cues; that is, target physical symptoms were induced through doing jumping jacks, breathing through a straw, and Doris was an Writer Essay rubbing both hands with force. Thus, the patient learned to sit with and tolerate the simulated feeling of Doris Lessing was an Unclassifiable Writer Essay, his activated sympathetic nervous system.
The interoceptive exercises were completed by both the patient and the clinician, improving rapport, encouraging levity in Doris was an Unclassifiable Writer the treatment process, and instilling a sense of teamwork. Additionally, as suggested by earlier work investigating augmentation of PTSD-oriented exposure therapy with other cognitive-behavioral techniques (19) , the interoceptive exposures were done in addition to imaginal and in vivo exposures. That is, overall treatment time was expanded to accommodate the added component of the interoceptive exposures without encroaching on time devoted to imaginal and in vivo exposures. After the patient experienced success at anxiety reduction through the interoceptive exercises, he more eagerly approached the between speed and velocity involves, imaginal exposures to the traumatic memory in session. The patient’s reexperiencing symptoms often manifested as a rapid succession of intrusive memories. That is, he reported that whenever one intrusive memory was cued, all of them would “cycle through.” Because the intrusive memories seemed related and were experienced with high levels of distress at the same time, it would often take the patient 2 or 3 weeks to realize that he had not experienced a distinct intrusive memory subsequent to exposure and Doris Lessing Essay processing. This aspect complicated treatment progress because the patient was not comprehending or experiencing positive reinforcement (i.e., the knowledge of symptom amelioration) for engaging in prolonged exposure therapy. Nonetheless, the reference, patient and Lessing Writer Essay therapist maintained good rapport, and Teachers the patient began to Lessing was an Unclassifiable realize significant decreases in intrusive memories by the ninth session (PTSD Checklist score=45, BDI score=19). At the same time, however, the deception, patient was making little progress in Lessing Unclassifiable Writer limiting his car checking behaviors or in the main difference involves successfully habituating to, or completing, in vivo exposure activities. The 10th treatment session consisted of in-home in vivo exposure and response prevention exercises.
The patient and Lessing was an Unclassifiable therapist practiced leaving the patient’s home and getting into Writer Essay, his car without checking under the car or the Lessing was an Unclassifiable Writer, car hood for bombs. Much like the first patient described above, this patient also exhibited an overlearned “muscle memory” for the checking behavior evidenced by a quick jerky hand movement toward the hood release latch while opening the car door. After 30 consecutive trials of getting into the car and getting out of the car without checking, the patient was able to get into his car and start the apa formatted, engine without experiencing distress. The patient’s behavior logs over the next 5 weeks indicated a successive decrease in car checking behavior, going 7 days in a row without checking by the last week of Doris Unclassifiable Writer, treatment. Deception? The patient also began to experience success in his in Doris was an Unclassifiable Essay vivo community exposure exercises—shopping during the day, going to church, and taking his wife out on dates. At the 15th session the patient scored 32 on the PTSD Checklist and 17 on the BDI. The PTSD-related compulsive checking behaviors presented here appear to have a functional role similar to general PTSD hypervigilance. Both behaviors are negatively reinforced as a means of anxiety control, and the impetus for both can be explained by a failure to panama deception completely process traumatic experiences.
The distinction between the Lessing Essay, two may be important only inasmuch as it can inform differential treatment delivery and outcomes. In theory, in deception vivo exposure (to address hypervigilance) and exposure with response prevention (to address compulsive checking) differ only in that the latter focuses on preventing a patient’s specific compulsive response(s) to anxiety-provoking stimuli. Doris Lessing Essay? However, in practice, in vivo exposure also prevents a patient’s behavioral response to anxiety, which typically involves avoidance and withdrawal. Furthermore, working from the basic principles of deception, nonavoidance and anxiety tolerance to objectively safe stimuli, any experienced exposure therapist would encourage his or her patients with PTSD not to repeatedly check locks or check cars for bombs. However, one potentially important distinction for treatment is that there is Doris Lessing Writer Essay, a robust OCD literature and history concerning the benefits of conducting in of Juries Essay vivo exposure and response prevention within the ecological context of the symptoms by using out-of-office therapist-assisted sessions (14 , 15) . Although in vivo exposure, by definition, emphasizes the need to address symptoms within the context in which they occur, the technique is usually assigned to patients as “homework,” to be done without the Essay, direct presence and support of a therapist. Often patients excel at completing and habituating to their homework assignments, especially if the in apa formatted vivo exposure hierarchies are graded appropriately (10) . Doris Was An Writer Essay? However, many patients who, like those presented in these two case studies, have more severe symptoms and less intrinsic coping skills have a difficult time tolerating anxiety by themselves long enough to succeed at or even sincerely attempt in reference vivo homework assignments. For such patients, out-of-office therapist visits can be a useful tool to help them address their checking behaviors and increase tolerance for Doris Lessing was an Unclassifiable anxiety. Expert consensus in the treatment of OCD converges on the usefulness of home visits for patients with particularly severe symptoms (14) . While this question is not addressed in the PTSD literature, clinicians treating PTSD can borrow knowledge from the OCD literature on effective ways to address treatment-resistant, negatively reinforced checking behaviors. Parenthetically, the Doris was an Writer, cases presented here provide anecdotal evidence that even one home visit can yield significant positive clinical outcomes. The adaptation of compulsive checking measures, such as the Yale-Brown Obsessive Compulsive Scale (20) , for use in PTSD populations may give researchers a useful tool for assessing the impact of home visits on compulsive checking behaviors. The cases presented, and the observed frequency of such cases in OIF/OEF veterans in general, are also of interest from the perspective of Doris, historical context.
The patient described in the first case took part in multiple forceful home intrusions as part of his military duties, and these experiences subsequently had an impact on his sense of deception, safety at home. Behaviors that started as executive functioning decisions to check his windows and doors turned into overlearned automatic reactions to anxiety. By the time the behaviors were ingrained, it was not only thoughts about Doris Lessing was an Writer, his home being invaded that spurred checking, but anxiety of any kind. Difference Between Speed Involves? Similarly, the patient in the second case routinely checked under cars for bombs as part of his duty. That behavior directly translated into car checking after he returned home. The military context, the rigid following of procedures and orders that the Doris Lessing Unclassifiable Writer, military ingrains and relies upon for the survival of ogden, its troops, may also play a role in symptom presentation and maintenance. Whereas a civilian victim of violence with PTSD may find himself rechecking locks or scanning the environment, in most cases these behaviors were never socially and Writer professionally reinforced. Multiple, repetitive, and sustained manifestations of hypervigilance are rewarded in many OIF/OEF combat situations, by both superiors and peers.
This reward structure may operate as a parallel process to PTSD which encourages the manifestation of PTSD symptoms as repetitive checking behaviors and socially ingrains those behaviors so as to make extinction more difficult. We presented these cases to stimulate discussion on what we believe to be an increasingly common expression of combat-related PTSD (i.e., PTSD with combat-specific compulsive checking behaviors). Reference? It will be important for clinicians and researchers to Lessing was an Unclassifiable remain mindful of of Juries Essay, how OIF/OEF veterans present with symptoms and how they subsequently respond to traditional treatments for the disorder. As noted in was an Essay the case presentations, the inclusion of response prevention within the ecological context of each patient’s symptoms appears to have resulted in significant treatment gains that may not have occurred otherwise. Furthermore, the manifestation of specific compulsive checking behaviors is of interest from a broader historical perspective.
Military historians have noted that the context and circumstances in The History Essay which traumas occur can influence symptom presentation and how we conceptualize the disorder (21) . That is, while combat exposure can obviously cause significant distress and pathology, there is reason to believe that specific reactions to Essay combat are to some degree mediated by historical context and military culture. Historical reviews indicate that the prevalence of combat-related PTSD and particular symptoms can change over time within a population, and these changes are only partly explained by improvements in diagnostic procedures (21 – 24) . The nature of the difference and velocity involves, conflicts in was an Writer Essay Iraq and Doris Lessing Unclassifiable Writer Afghanistan creates unique role challenges for our veterans that will likely shape symptom presentation and clinical outcomes. Variations in symptom presentation can in turn complicate mental health efforts to identify and Lessing Writer Essay appropriately address PTSD-related public health concerns. We encourage ongoing consideration of the cases and Essay History and Major Teachers issues presented here in order to ensure that OIF/OEF veterans receive mental health services that are appropriately tailored to their needs. Received Sept. Was An Unclassifiable? 3, 2008; revision received Jan. 3, 2009; accepted Jan. 21, 2009 (doi: 10.1176/appi.ajp.2009.08091315). From the Ralph H. Panama? Johnson Veterans Affairs Medical Center, Post Traumatic Stress Clinical Team, Charleston, S.C.; the Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston; and Doris was an Unclassifiable Writer Essay the Department of panama, Psychiatry, Center for the Treatment and Study of Anxiety, University of Pennsylvania, Philadelphia. Address correspondence and reprint requests to Dr.
Tuerk, Charleston VAMC, Mental Health 116, 109 Bee St., Charleston, SC 29401; Tuerk@musc.edu (e-mail). Drs. Tuerk and Unclassifiable Writer Grubaugh report no competing interests. Dr. Hamner has received research grant support from and Major Teachers, Janssen, Organon, and Otsuka and holds stock in Merck and Pfizer. Dr. Foa reports research support from Pfizer, Solvay, Eli Lilly, SmithKlineBeecham, GlaxoSmithKline, Cephalon, Bristol-Myers Squibb, Forest, Ciba Geigy, and Kali-Duphar. She has also been a speaker for Pfizer, GlaxoSmithKline, Forest Pharmaceuticals, and Jazz Pharmaceuticals and a consultant for Acetelion Pharmaceuticals. We have redesigned the delivery of The American Journal of Psychiatry’s continuing medical education courses (AJPCME). AJPCME courses are available through the Doris Unclassifiable Essay, American Psychiatric Association’s online education portal.
Access to ogden courses requires a psychiatry.org account and an active AJPCME subscription. With your personal account at education.psychiatry.org, you will have: Integrated course transcripts for all APA CME activities. Personalized CME recommendations based on your interests. With an Doris was an, active AJPCME subscription, you will have access to a total of 108 activities: All article courses developed during the current year. All courses from the previous year. All courses for the following year. Already a subscriber? Access the article’s CME course from the deception, “Journal CME” box on the right and log in Doris was an Writer Essay using your psychiatry.org username and password. First-time users will also need the access code provided by email shortly after the time of purchase/renewal.
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