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Research Critique Rubric
Criterion
Description of Criterion
Not Submitted
0%
Not Met
50%
Met
75%
Exceeds
100%
Identification of the research question/problem/hypothesis
10%
This area should cover a review of the introduction of the
article. What do the authors state is the importance of the study
and why is it being conducted? What is the authors’ purpose or
intention for the study? What questions or hypothesis do the
authors aim to answer?
No posts submitted.
The description is not provided.
The description does not address all of the given points, or the
description of any point is not supported by the article.
The description addresses all of the given points, or the
description of any point is not supported by the article.
Identification of topics explored in review of literature
10%
How did the researchers identify a gap in the science? What
literature did the authors review prior to starting the study?
How does the literature review contribute to the research
design? This may or may not have a separate section in the
article itself, but it can be determined by information provided
in the article.
No posts submitted.
The description is not provided.
The description does not address all of the given points, or the
description of any point is not supported by the article.
The description addresses all of the given points, or the
description of any point is not supported by the article.
Identification/definition of research methodology and design
10%
How was the study conducted? Why was this method selected
for the research, and how was the study was conducted. Was
this this most appropriate method for this study?
No posts submitted.
The description is not provided.
The description does not address all of the given points, or the
description of any point is not supported by the article.
The description addresses all of the given points, or the
description of any point is not supported by the article.
Description of subjects/participants in the study
10%
Who were the study participants? Was the group or population
of interest adequately described? Were the setting and sample
described in sufficient detail? Was the best possible method of
sampling used to enhance information richness and address the
needs of the study? Was the sample size adequate?
No posts submitted.
The description is not provided.
The description does not address all of the given points, or the
description of any point is not supported by the article.
The description addresses all of the given points, or the
description of any point is not supported by the article.
Exploration of ethical issues and protection of human subjects
10%
Explain how the protection of human subjects and cultural
considerations were addressed by the researcher, using specific
information from the journal article.
No posts submitted.
The description is not provided.
The description does not address all of the given points, or the
description of any point is not supported by the article.
The description addresses all of the given points, or the
description of any point is not supported by the article.
Data Analysis
10%
How did the researchers analyze the data? What statistical tests
or other methods of interpretation were used to analyze the
data? Was the data analysis strategy compatible with the
research tradition and with the nature and type of data gathered?
Did the analysis yield an appropriate “product” (e.g., a theory,
taxonomy, thematic pattern, etc.)? Did the analytic procedures
suggest the possibility of biases?
No posts submitted.
The description is not provided.
The description does not address all of the given points, or the
description of any point is not supported by the article.
The description addresses all of the given points, or the
description of any point is not supported by the article.
Discussion of findings
10%
How effectively does the researcher answer the posed research
question/problem/hypothesis? What are strengths and
limitations of the study? Do the study findings appear to be
trustworthy—do you have confidence in the truth value of the
results? How might the findings be applied to practice?
No posts submitted.
The description is not provided.
The description does not address all of the given points, or the
description of any point is not supported by the article.
The description addresses all of the given points, or the
description of any point is not supported by the article.
Use of additional sources from nursing journals
10%
At least two sources from nursing journals (or one nursing
journal and one from the text) are used in addition to the article
that was critiqued.
No posts submitted.
No additional journals/text were used and cited, or the journals
used are not nursing journals.
Only one additional source (either nursing journal or text) is
used and cited.
At least two additional nursing journals (or one journal & one
text) are used and cited in the paper.
APA style
10%
Acknowledge sources, using APA-formatted in-text citations
and references, for content that is quoted, paraphrased, or
summarized. A title page, abstract and reference page are
included.
No posts submitted.
The submission does not include in-text citations and references
according to APA style for content that is quoted, paraphrased,
or summarized.
The submission includes in-text citations and references for
content that is quoted, paraphrased, or summarized but does not
demonstrate a consistent application of APA style.
The submission includes in-text citations and references for
content that is quoted, paraphrased, or summarized and
demonstrates a consistent application of APA style.
Grammar and Organization
10%
Demonstrate professional grammar and organization in the
content and presentation of your submission.
No posts submitted.
Content is unstructured, is disjointed, or contains pervasive
errors in mechanics, usage, or grammar.
Content is poorly organized, is difficult to follow, or contains
errors in mechanics, usage, or grammar that cause confusion.
Content reflects attention to detail and is organized. Mechanics,
usage, and grammar promote accurate interpretation and
understanding.
Version 1
NG309 Evidence Based Practice
August 2019
6/17/2019 My Patient Died: A National Study of Nursing
Students' Perceptions After Experiencing a Patient Death -
ProQuest
https://search-proquest-
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9708 1/10
Abstract
Full Text
AIM The purpose of this study was to examine, on a national
level, nursing students' perceptions after
experiencing a patient death. BACKGROUND Death is a highly
stressful experience for nursing students.
Debriefing, which routinely occurs with a patient's demise in
the simulation setting, typically does not happen in
actual death situations. METHOD A mixed-methods design
using quantitative and qualitative questions as part
of an anonymous survey was sent to the membership of the
National Student Nurses' Association. Of
approximately 55,000 members, 2,480 responded to the survey.
RESULTS Experiencing a patient death as a
student occurred for 41 percent of participants in the nationally
representative sample. Of those who
experienced a patient death, 64 percent did not receive any
debriefing. CONCLUSION Most nursing students did
not feel prepared to care for a dying patient and the patient's
family. Students need and want more education on
end-of-life nursing care.
Headnote
Abstract
AIM The purpose of this study was to examine, on a national
level, nursing students' perceptions after
experiencing a patient death.
BACKGROUND Death is a highly stressful experience for
nursing students. Debriefing, which routinely occurs
with a patient's demise in the simulation setting, typically does
not happen in actual death situations.
METHOD A mixed-methods design using quantitative and
qualitative questions as part of an anonymous survey
was sent to the membership of the National Student Nurses'
Association. Of approximately 55,000 members,
2,480 responded to the survey.
RESULTS Experiencing a patient death as a student occurred
for 41 percent of participants in the nationally
representative sample. Of those who experienced a patient
death, 64 percent did not receive any debriefing.
CONCLUSION Most nursing students did not feel prepared to
care for a dying patient and the patient's family.
Students need and want more education on end-of-life nursing
care.
My Patient Died: A National Study of Nursing
Students' Perceptions After Experiencing a Patient
Death
Heise, Barbara A; Wing, Debra K; Hullinger, Amy H R.
Nursing Education Perspectives; New York Vol. 39, Iss. 6,
(Nov/Dec 2018): 355-
359.
DOI:10.1097/01.NEP.0000000000000335
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KEYWORDS Death Education - Debriefing - Nursing Education
- Nursing Students - Death Education - Debriefing
Most nurses experience patient death during the course of their
careers. The nurse is the primary health care
provider involved in caring for patients and their families at the
endof-life (EOL) and throughout the dying
process, including postmortem care (Bryant, 2008). Nurses
promote a "good death" by providing physical,
emotional, and spiritual care while also advocating for the
cultural preferences of dying patients and their
families.
Death is an emotionally charged issue for anyone. For
registered nurses, death is also a high-stress situation
(Leighton & Dubas, 2009; Zheng, Lee, & Bloomer, 2016), with
most experienced nurses able to vividly recall their
first death of a patient (Anderson, Kent, & Owens, 2015; Kent,
Anderson, & Owens, 2012). For nursing students
who are just learning the RN role and responsibilities, the death
of a patient is often a foreign, frightening, and
overwhelming experience that may have long-term effects on
their professional and personal lives (Kent etal.,
2012).
LITERATURE REVIEW
Patient death is a commonly reported source of stress and
anxiety for nursing students (Allchin, 2006; Carson,
2010; Edo-Gual, TomásSábado, Bardallo-Porras, & Monforte-
Royo, 2014; Gallagher et al., 2014; Parry, 2011; Zheng
et al., 2016). Nursing students' reactions to their first patient
death often include negative emotions, such as fear,
sadness, frustration, anxiety, helplessness, and guilt
(Neiderriter, 2009; Parry, 2011; Poultney, Berridge, & Malkin,
2013; Zheng et al., 2016). Although many students experience a
patient death during their education, few feel
adequately prepared to interact with a dying patient and his or
her family in the clinical setting and to cope with
the experience (Gallagher et al., 2014; Zheng et al., 2016).
Current nursing education is generally considered
inadequate to prepare nursing students for EOL care (Cavaye &
Watts, 2012; Gillan, van der Riet, & Jeong, 2014;
Kent et al., 2012; Schlairet, 2009; Wallace et al., 2009). After
their first death experiences, students frequently
state that they were not ready to provide EOL care, expressed
difficulty communicating with the dying patient or
family, and did not receive sufficient support from clinical
instructors and staff. Nursing students reported
increased stress and anxiety due to feelings of inadequacy and
lack of preparation (Cavaye & Watts, 2012; Dos
Santos & Bueno, 2011; Gallagher et al., 2014; Huang, Chang,
Sun, & Ma, 2010; Parry, 2011; Zheng et al., 2016).
Nursing students who had positive first death experiences
indicated that helpful factors included a supportive
clinical instructor or staff member, role modeling, and
postclinical debriefing (Carson, 2010; Gallagher et al.,
2014; Huang et al., 2010). Debriefing is commonly included in
simulated EOL training but often does not occur in
the clinical setting (Thompson, 2005). The opportunity to
discuss the death experience with an instructor may
help nursing students cope with the experience and increase
competence and confidence for future care of dying
patients.
Nursing students must receive adequate preparation and support
to provide quality EOL care in the clinical
setting and be equipped to cope with patient death. Most studies
on nursing students and their experience with
patient death have involved small samples of nursing students.
This survey is the first to examine nursing
students' perceptions of their first experiences with patient
death on a national level. By understanding students'
experiences and the need for suitable preparation, support, and
debriefing, nurse educators may be better able to
guide nursing students through their first experiences with EOL
care and patient death.
THEORETICAL FRAMEWORK
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Benner's (1982) seminal work, From Novice to Expert,
delineates five levels of nursing proficiency. Although
Benner's theory of nursing did not include nursing students, her
delineation provides insight on a prelicensure
nursing student who could be classified at a prenovice level.
Level 1 is the novice RN who has no experience in
clinical situations such as EOL care. At this level, the novice
nurse does not have the discretionary judgment to
determine which parts of the situation are most relevant. The
novice nurse feels most comfortable with objective
tasks, such as taking vital signs, rather than a more advanced
skill of helping the dying patient and family to
cope. Level 2 is the advanced beginner who has marginally
acceptable performance. Nurses at Levels 1 and 2
need mentoring by expert nurses.
At Level 3, the competent nurse has been providing EOL care
for approximately two to three years. Typically, this
nurse provides conscious, deliberate planning to achieve
efficiency and organization, and no mentoring is
needed. However, the competent nurse is still unable to
recognize which parts of the EOL situation are most
important.
At Level 4, the proficient nurse is able to see EOL care for the
dying patient and the family as a whole. This nurse
knows what to typically expect during EOL care and can modify
the plan as needed.
Finally, at Level 5, the nurse is an expert who intuitively hones
in on salient issues. Expert nurses have a deep
understanding of EOL care and the many ways that dying
patients and their families approach death. They offer
many ways to understand, cope, and accept the final phase of
life, which, for most people, is a totally uncharted
passage. Expert nurses in EOL care often stay in this field
because they feel they can coach patients and families
through a very difficult and often not discussed part of life.
Nursing students do not have the experience to perform the
advanced roles of an expert nurse caring for the
dying person and family. Along with competent clinical skills,
expert nursing skills required during EOL care
include advanced communication skills to determine patient
preferences, advocacy for patient and family to
promote dignity, advanced pain management skills,
comprehensive supportive care to the patient and family to
alleviate suffering, constant assessment to ensure interventions
are congruent with patient wishes, and
promoting the dying patient's autonomy and right to self-
determination.
Some nursing students have previously experienced the death of
a family member. However, the death of a
patient is different and may require a level of responsibility that
was not present for the family member. In
addition, caring for someone who is dying, as well as caring for
the dying patient's family, requires advanced
clinical skills that a nursing student does not yet possess.
METHOD
A cross-sectional descriptive survey design was used for this
study. Following approval from the university
institutional review board and National Student Nurses'
Association administration, nursing student members of
National Student Nurses' Association (approximately 55,000
members) were emailed a brief description of the
research project and an invitation to participate with a link to
the online questionnaire. An implied consent form
was available to be viewed by participants before beginning the
survey. Participant responses were collected
using Qualtrics online survey software.
Participants were asked to answer six demographic questions
and 14 survey questions about their experience
regarding a patient death during their time as a nursing student.
Two open-ended questions asked participants
to describe their experience and indicate what they would have
liked to be taught regarding EOL care of a patient.>
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Estimated time commitment for participants was 15 to 20
minutes. This article reports the results of the
quantitative questions in the survey.
After the response period had ended, quantitative data were
downloaded from Qualtrics to SPSS version 22 (IBM
Corp., 2013). Quantitative data were reviewed for missing
values and outliers before further analysis using
appropriate descriptive statistics and plots. Descriptive
statistics for demographic variables and survey
questions were calculated. Chi-square test of association was
used to examine relationships of selected
categorical variables.
RESULTS
Descriptive statistics for demographic characteristics of the
participants are reported in table form in Table 1.
Sample
A total of 2,804 individuals responded to the invitation to
participate and started the survey. A total of 2,480 (88.4
percent) completed the survey. Most respondents (80 percent)
were female, half were under age 27, and the
majority were white (67.6 percent). A majority of the
respondents (60.7 percent) reported being single, and about
a quarter (26.8 percent) reported being married. Most (57.6
percent) of the students said they were in bachelor's
programs; about a quarter (25.9 percent) reported being in
associates programs. Participants came from every
state in the United States as well as the District of Columbia
with more populous states (e.g., CA, FL, NY, PA, and
TX) proportionally represented in the sample.
Descriptive statistics for questionnaire items are reported in
Table 2. A majority (65.8 percent) of respondents
reported being present at a death outside of their nursing
experience; almost 41 percent reported being present
at a death as a nursing student. The majority of those who
experienced a patient death (62 percent) experienced
that death early in their nursing programs.
Responses for Students Who Experienced a Death
The remaining questions were directed specifically toward those
who reported experiencing a patient death as a
student (n = 1,148). Slightly more than a quarter of those
respondents (26.8 percent) said they needed help
coping. Only one third of these students received debriefing.
A chi-square test of association was used to examine the
relationship between reporting the need for help
coping with a patient death and receiving debriefing. Of the
1,148 students respondents, 33 (2.6 percent) had
missing data and were excluded from the test. The test was not
significant, x2(df = 1, n = 1,115) = 1.19, p = .275,
indicating that there did not seem to be an association between
needing help coping and receiving debriefing
after experiencing a patient death as a student. A majority
(194/306, 63.4 percent) of those who reported
needing help coping did not receive debriefing.
Participants were asked to rate their level of preparation on a
scale of 1 to 4 (1 = prepared, 2 = somewhat
prepared, 3 = prepared, 4 = very prepared) in several areas
related to death and dying: process of death and dying,
EOL care, and ways to cope with the death of a patient.
* Thirty-six percent of nursing students asked if they felt
prepared with the process of death and dying reported
they were less than prepared (not prepared or somewhat
prepared). >
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* Perceptions of being prepared to provide EOL care resulted in
45 percent feeling less than prepared (not
prepared or somewhat prepared) and 47 percent felt prepared or
very prepared.
* Asked if they felt prepared to cope with the death of a patient,
most nursing students (45 percent vs. 35
percent) felt less than prepared (unprepared or somewhat
prepared).
Only 24 percent of the nursing students reported that their
nursing curriculum (what they learned in class)
prepared them in general EOL care. Only 17 percent felt that
the curriculum prepared them to cope with the death
of a patient. Participants were asked who helped them prepare
to deal with issues surrounding patient death
(process of death and dying, EOL care, and ways to cope with
death of a patient); options for each category were
as follows: no one, clinical instructor, clinical staff, other
nursing students, friend or family member, and learned
in nursing class. Learned in nursing class and clinical instructor
were among the top-ranked answers in most
categories. The top answer to who prepared respondents to cope
with the death of a patient was "no one."
Clinical instructors were referred to as preparation resources for
EOL care (19 percent), process of death and
dying (17 percent), and coping (17 percent) in these areas.
Participants were asked to rate their level of preparation on a
scale of 1 to 4 (1 = unprepared, 2 = somewhat
prepared, 3 = prepared, 4 = very prepared) in several areas
related to communication: communication with dying
patient, communication with patient's family, and
communication with members of the health care team. The
majority (57 percent) of nursing students felt less than prepared
(unprepared or somewhat prepared) to
communicate with a dying patient; only 23 percent reported
feeling prepared or very prepared. Again, the majority
(64 percent) of participants felt unprepared or somewhat
prepared to communicate with the dying patient's
family. However, participants felt more prepared to
communicate with members of the health care team (45
percent vs. 35 percent).
Participants were asked who helped them prepare to deal with
issues surrounding communication
(communication with dying patient, communication with
patient's family, and communication with members of
health care team); options for each category were as follows: no
one, clinical instructor, clinical staff, other
nursing students, friend or family member, and learned in
nursing class. The top answer to who prepared
respondents for all the communication questions was "no one."
Students responded that their curriculum
prepared them to communicate only 18 percent of the time when
communicating with the dying patient, 20
percent of the time when communicating with the family of a
dying patient, and 18 percent of the time when
communicating with the health care team. Clinical instructors
helped prepare students to communicate with the
dying patient (15 percent), the family of the dying patient (14
percent), and the health care team (18 percent) of
the time.
Nursing students were asked specifically about what they would
like to be taught about EOL care. The number
one answer from students was more education on how to
communicate with the dying patient and family.
Students wanted more education on EOL care in general,
including the actively dying process and supportive
resources for the family and the patient. Students also wanted
education on postmortem care of the patient.
Students requested debriefing and education on how to cope
with a patient death. They suggested more
education on EOL care earlier in the nursing curriculum with
more educational activities involving death and
dying through simulation scenarios, faculty experiences, and
even a hospice clinical.
DISCUSSION
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It is significant to note that the sample was fairly representative
of nurses in the United States, both in terms of
geography and in terms of race. Participants came from every
state and the District of Columbia. Nearly one third
(31.9 percent) identified with racial groups other than
Caucasian.
Nationally, nursing students (41 percent) reported being present
at a patient death. This high percentage of
individuals who experience a patient death as a student
highlights the importance of death education. Despite
the sensitive nature of the topic of death itself, nurses need to
be prepared for the almost inevitable death
experiences they will encounter. Current recommendations
strongly encourage nursing schools to educate
students about EOL care (Ferrell, Malloy, Mazanec, & Virani,
2016). Death education may be integrated into
nursing curricula, particularly for concept-based nursing
programs.
More work needs to be done to help students cope with patient
death. Asked who helped them cope with the
death of a patient, the top answer was "no one." Clinical
instructors were reported to play a leading role in the
training of nursing students in all areas regarding death and
dying. Given that clinical instructors are frequently
adjunct faculty who receive lower levels of professional
development than regular faculty in the academic
setting, it is possible that many clinical instructors are
insufficiently prepared to guide students in matters of
death and dying, communication with family and medical staff,
and debriefing. Clinical instructors spend more
one-on-one time with students than almost any other instructor
in nursing school. They are also uniquely
positioned to observe student interactions with patients and
patients' families.
The Institute of Medicine (2015) publication Dying in America
specifically identifies a lack of communication
skills, interprofessional education, and curricula focused on
palliative and EOL care in nursing education. The
American Association of Colleges of Nursing (2016)
recommends competencies and curricular guidelines
regarding EOL issues, including communication with dying
patients and families and assisting the patient, family,
colleagues, and one's self to cope with the dying process, grief,
and bereavement. Role modeling, simulation, and
debriefing may be the most efficacious ways to prepare students
to deal with the challenges associated with
patient death (Keene, Hutton, Hall, & Rushton, 2010). In
addition, introducing students to critical reflective
practice early in their academic endeavors may increase their
resilience while creating cultural meaning for the
dying process (Hodges, Keely, & Grier, 2005). As Benner
(1982) noted, novice nurses (and we would add prenovice
nurses) need mentoring, particularly in the advanced skills
needed for EOL care.
LIMITATIONS
It may be noted that a sizeable proportion (11.6 percent) of
those who began the survey did not complete it. It
may also be noted that many of the questions directed to those
who experienced a patient death as a student (n
= 1,148) had high rates of missing data (around 20 percent).
Patterns of missing data for those questions were
examined. Most individuals completed all of the questions (n =
902, 78.6 percent). It was found that a large
majority of missing answers were attributed to a consistent set
of individuals (n = 224, 19.5 percent), who, it
seems, simply did not complete most of the questions. A small
percentage of individuals (n = 22, 1.9 percent)
chose not to answer between one and six questions but
completed the others.
Although it is not possible to determine specific reasons for
noncompletion, it may be possible to speculate. The
topic of experiencing a patient death during schooling has the
potential to be emotionally difficult to think about
and discuss. It may be that the emotionally difficult nature of
the topic led some individuals to not complete the
questions. This survey also asked several open-ended questions
in the format of typed responses. It may be that
additional time required to think about and formulate responses
led some individuals to give up rather than
complete the entire survey.
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IMPLICATIONS FOR NURSING EDUCATION
Students need and want more education on EOL nursing care as
well as how to communicate with dying patients
and their families and postmortem care. Most nurses, at some
point in their careers, will encounter a patient who
is dying. Although death is often not discussed in many
societies, it is a conversation that needs to be held in
order to ensure that the dying patient's wishes are known.
The Conversation Project (http://theconversationproject.org),
which is dedicated to helping individuals talk
about their EOL issues, gives individuals the words to say to
family members and to health care providers to start
the conversation on what they would like at EOL. Nurses
provide the majority of care and are uniquely positioned
to help start the conversation of patient preferences and assist
the patient and family through the dying process.
Dying is a deeply personal experience. For nursing students, the
death of a patient, at the very beginning of their
career path, is often a stressful and overwhelming experience.
Although debriefing and mentoring take place
routinely in simulation, they do not happen most of the time in
real life. It is a double-edged sword to tell novice
nurses to care about their patients while asking those same
nursing students to turn off caring when the patient
is dying or has died. Experienced nurses do a disservice to
novice nurses when they tell them to "toughen up,"
rather than discuss their views of the dying experience. This
lack of discussion and acknowledgement of salient
issues during the dying process may lead to nurse burnout and
compassion fatigue.
In the clinical setting, nurse educators, particularly adjunct
clinical faculty, need to be trained in debriefing
techniques, critical reflection, and mentoring nursing students
as they provide care for those in the last phase of
life. Students need to be exposed to the dying experience, but
with expert nurse mentors to role model and guide
them through an often challenging situation (Österlind et al.,
2016).
For nursing students, as suggested by the respondents to this
study, more simulation experiences with patient
demise and debriefing need to be part of the nursing curriculum.
Allen (2018) points out that, even in an EOL
simulation setting, nursing students caring for dying patients
experience increased stress. In our study, students
requested more EOL experiences through simulation and
through clinical experiences, such as hospice and
palliative care with mentoring from their nursing faculty.
Sidebar
The authors have declared no conflict of interest.
Copyright © 2018 National League for Nursing
doi: 10.1097/01.NEP.0000000000000335
References
REFERENCES
Allchin, L. (2006). Caring for the dying: Nursing student
perspectives. Journal of Hospice & Palliative Nursing, 8,
112-117.
Allen, M. (2018). Examining nursing students' stress in an end-
of-life care simulation. Clinical Simulation in
Nursing, 14, 21-28.
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American Association of Colleges of Nursing. (2016). Peaceful
death: Recommended competencies and
curricular guidelines for end of life nursing care. Retrieved
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Anderson, N., Kent, B., & Owens, R. (2015). Experiencing
patient death in clinical practice: Nurses' recollections of
their earliest memorable patient death. International Journal of
Nursing Studies, 52(3), 695-704.
Benner, P. (1982). From novice to expert. American Journal of
Nursing, 82(3), 402-407.
Bryant, H. (2008). Maintaining patient dignity and offering
support after miscarriage. Emergency Nurse, 15(9), 26-
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Carson, S. (2010). Do student nurses within an undergraduate
child health programme feel that the curriculum
prepares them to deal with the death of a child? Journal of Child
Health Care: For Professionals Working With
Children in the Hospital and Community, 14, 367.
Cavaye, J., & Watts, J. (2012). End-of-life education in the pre-
registration nursing curriculum: Patient, carer, nurse
and student perspectives. Journal of Research in Nursing, 17(4),
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Dos Santos, J. L., & Bueno, S. M. (2011). Death education for
nursing professors and students: A document
review of the scientific literature. Revista da Escola de
Enfermagem da USP, 45(1), 272-276.
Edo-Gual, M., Tomás-Sábado, J., Bardallo-Porras, D., &
Monforte-Royo, C. (2014). The impact of death and dying
on nursing students: An explanatory model. Journal of Clinical
Nursing, 23(23-24), 3501-3512. Retrieved from
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Ferrell, B., Malloy, P., Mazanec, P., & Virani, R. (2016).
CARES: AACN's new competencies and recommendations
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palliative care. JournalofProfessionalNursing, 32(5),
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Gallagher, O., Saunders, R., Tambree, K., Alliex, S.,
Monterosso, L., & Naglazas, Y. (2014). Nursing student
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Professional resilience, practice longevity, and Parse's theory
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Huang, X. Y., Chang, J. Y., Sun, F. K., & Ma, W. F. (2010).
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1
Second Treatise on Government by John Locke(1690)
Chapter I:
§.3. POLITICAL POWER, then, I take to be a RIGHT of making
laws with penalties of
death, and consequently all less penalties, for the regulating and
preserving of property,
and of employing the force of the community, in the execution
of such laws, and in the
defence of the common-wealth from foreign injury; and all this
only for the public good.
Chapter II: Of the State Of Nature
§.4. To understand political power aright, and derive it from its
original, we must
consider what estate all men are naturally in, and that is, a state
of perfect freedom to
order their actions, and dispose of their possessions and persons
as they think fit, within
the bounds of the law of Nature, without asking leave or
depending upon the will of any
other man.
A state also of equality, wherein all the power and jurisdiction
is reciprocal, no one
having more than another, there being nothing more evident
than that creatures of the
same species and rank, promiscuously born to all the same
advantages of Nature, and the
use of the same faculties, should also be equal one amongst
another, without
subordination or subjection, unless the lord and master of them
all should, by any
manifest declaration of his will, set one above another, and
confer on him, by an evident
and clear appointment, an undoubted right to dominion and
sovereignty…
§.6. But though this be a state of liberty, yet it is not a state of
licence; though man in that
state have an uncontrollable liberty to dispose of his person or
possessions, yet he has not
liberty to destroy himself, or so much as any creature in his
possession, but where some
nobler use than its bare preservation calls for it. The state of
Nature has a law of Nature
to govern it, which obliges every one, and reason, which is that
law, teaches all mankind
who will but consult it, that being all equal and independent, no
one ought to harm
another in his life, health, liberty or possessions; for men being
all the workmanship of
one omnipotent and infinitely wise Maker; all the servants of
one sovereign Master, sent
into the world by His order and about His business; they are His
property, whose
workmanship they are made to last during His, not one another's
pleasure. And, being
furnished with like faculties, sharing all in one community of
Nature, there cannot be
supposed any such subordination among us that may authorise
us to destroy one another,
as if we were made for one another's uses, as the inferior ranks
of creatures are for ours.
Every one as he is bound to preserve himself, and not to quit his
station wilfully, so by
the like reason, when his own preservation comes not in
competition, ought he as much
as he can to preserve the rest of mankind, and not unless it be to
do justice on an
2
offender, take away or impair the life, or what tends to the
preservation of the life, the
liberty, health, limb, or goods of another.
CHAP. IX: Of the Ends of Political Society and Government.
§. 123. IF man in the state of nature be so free, as has been said;
if he be absolute lord of
his own person and possessions, equal to the greatest, and
subject to no body, why will he
part with his freedom? why will he give up this empire, and
subject himself to the
dominion and controul of any other power? To which it is
obvious to answer, that though
in the state of nature he hath such a right, yet the enjoyment of
it is very uncertain, and
constantly exposed to the invasion of others: for all being kings
as much as he, every man
his equal, and the greater part no strict observers of equity and
justice, the enjoyment of
the property he has in this state is very unsafe, very unsecure.
This makes him willing to
quit a condition, which, however free, is full of fears and
continual dangers: and it is not
without reason, that he seeks out, and is willing to join in
society with others, who are
already united, or have a mind to unite, for the mutual
preservation of their lives, liberties
and estates, which I call by the general name, property.
§. 124. The great and chief end, therefore, of men’s uniting into
common-wealths, and
putting themselves under government, is the preservation of
their property. To which in
the state of nature there are many things wanting.
First, There wants an established, settled, known law, received
and allowed by common
consent to be the standard of right and wrong, and the common
measure to decide all
controversies between them: for though the law of nature be
plain and intelligible to all
rational creatures; yet men being biassed by their interest, as
well as ignorant for want of
study of it, are not apt to allow of it as a law binding to them in
the application of it to
their particular cases.
§. 125. Secondly, In the state of nature there wants a known and
indifferent judge, with
authority to determine all differences according to the
established law: for every one in
that state being both judge and executioner of the law of nature,
men being partial to
themselves, passion and revenge is very apt to carry them too
far, and with too much
heat, in their own cases; as well as negligence, and
unconcernedness, to make them too
remiss in other men’s.
§. 126. Thirdly, In the state of nature there often wants power to
back and support the
sentence when right, and to give it due execution. They who by
any injustice offended,
will seldom fail, where they are able, by force to make good
their injustice; such
resistance many times makes the punishment dangerous, and
frequently destructive, to
those who attempt it.
3
§. 127. Thus mankind, notwithstanding all the privileges of the
state of nature, being but
in an ill condition, while they remain in it, are quickly driven
into society. Hence it comes
to pass, that we seldom find any number of men live any time
together in this state. The
inconveniencies that they are therein exposed to, by the
irregular and uncertain exercise
of the power every man has of punishing the transgressions of
others, make them take
sanctuary under the established laws of government, and therein
seek the preservation of
their property. It is this makes them so willingly give up every
one his single power of
punishing, to be exercised by such alone, as shall be appointed
to it amongst them; and by
such rules as the community, or those authorized by them to
that purpose, shall agree on.
And in this we have the original right and rise of both the
legislative and executive
power, as well as of the governments and societies themselves.
§. 128. For in the state of nature, to omit the liberty he has of
innocent delights, a man has
two powers.
The first is to do whatsoever he thinks fit for the preservation of
himself, and others
within the permission of the law of nature: by which law,
common to them all, he and all
the rest of mankind are one community, make up one society,
distinct from all other
creatures. And were it not for the corruption and vitiousness of
degenerate men, there
would be no need of any other; no necessity that men should
separate from this great and
natural community, and by positive agreements combine into
smaller and divided
associations.
The other power a man has in the state of nature, is the power to
punish the crimes
committed against that law. Both these he gives up, when he
joins in a private, if I may so
call it, or particular politic society, and incorporates into any
common-wealth, separate
from the rest of mankind.
§. 129. The first power, viz. of doing whatsoever be thought for
the preservation of
himself, and the rest of mankind, he gives up to be regulated by
laws made by the society,
so far forth as the preservation of himself, and the rest of that
society shall require; which
laws of the society in many things confine the liberty he had by
the law of nature.
§. 130. Secondly, The power of punishing he wholly gives up,
and engages his natural
force, (which he might before employ in the execution of the
law of nature, by his own
single authority, as he thought fit) to assist the executive power
of the society, as the law
thereof shall require: for being now in a new state, wherein he
is to enjoy many
conveniencies, from the labour, assistance, and society of others
in the same community,
as well as protection from its whole strength; he is to part also
with as much of his natural
liberty, in providing for himself, as the good, prosperity, and
safety of the society shall
require; which is not only necessary, but just, since the other
members of the society do
the like.
4
§. 131. But though men, when they enter into society, give up
the equality, liberty, and
executive power they had in the state of nature, into the hands
of the society, to be so far
disposed of by the legislative, as the good of the society shall
require; yet it being only
with an intention in every one the better to preserve himself, his
liberty and property; (for
no rational creature can be supposed to change his condition
with an intention to be
worse) the power of the society, or legislative constituted by
them, can never be supposed
to extend farther, than the common good; but is obliged to
secure every one’s property,
by providing against those three defects above mentioned, that
made the state of nature so
unsafe and uneasy. And so whoever has the legislative or
supreme power of any
common-wealth, is bound to govern by established standing
laws, promulgated and
known to the people, and not by extemporary decrees; by
indifferent and upright judges,
who are to decide controversies by those laws; and to employ
the force of the community
at home, only in the execution of such laws, or abroad to
prevent or redress foreign
injuries, and secure the community from inroads and invasion.
And all this to be directed
to no other end, but the peace, safety, and public good of the
people.
CHAP. XI: Of the Extent of the Legislative Power.
§. 134. THE great end of men’s entering into society, being the
enjoyment of their
properties in peace and safety, and the great instrument and
means of that being the laws
established in that society; the first and fundamental positive
law of all common-wealths
is the establishing of the legislative power; as the first and
fundamental naturallaw, which
is to govern even the legislative itself, is the preservation of the
society, and (as far as
will consist with the public good) of every person in it. This
legislative is not only the
supreme power of the common-wealth, but sacred and
unalterable in the hands where the
community have once placed it; nor can any edict of any body
else, in what form soever
conceived, or by what power soever backed, have the force and
obligation of a law,
which has not its sanction from that legislative which the public
has chosen and
appointed: for without this the law could not have that, which is
absolutely necessary to
its being a law,*the consent of the society, over whom no body
can have a power to make
laws, but by their own consent, and by authority received from
them; and therefore all the
obedience, which by the most solemn ties any one can be
obliged to pay, ultimately
terminates in this supreme power, and is directed by those laws
which it enacts: nor can
any oaths to any foreign power whatsoever, or any domestic
subordinate power,
discharge any member of the society from his obedience to the
legislative, acting
pursuant to their trust; nor oblige him to any obedience contrary
to the laws so enacted, or
farther than they do allow; it being ridiculous to imagine one
can be tied ultimately to
obey any power in the society, which is not the supreme.
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§. 135. Though the legislative, whether placed in one or more,
whether it be always in
being, or only by intervals, though it be the supreme power in
every common-wealth; yet,
First, It is not, nor can possibly be absolutely arbitrary over the
lives and fortunes of the
people: for it being but the joint power of every member of the
society given up to that
person, or assembly, which is legislator; it can be no more than
those persons had in a
state of nature before they entered into society, and gave up to
the community: for no
body can transfer to another more power than he has in himself;
and no body has an
absolute arbitrary power over himself, or over any other, to
destroy his own life, or take
away the life or property of another. A man, as has been proved,
cannot subject himself
to the arbitrary power of another; and having in the state of
nature no arbitrary power
over the life, liberty, or possession of another, but only so much
as the law of nature gave
him for the preservation of himself, and the rest of mankind;
this is all he doth, or can
give up to the common-wealth, and by it to the legislative
power, so that the legislative
can have no more than this. Their power, in the utmost bounds
of it, is limited to the
public good of the society. It is a power, that hath no other end
but preservation, and
therefore can never* have a right to destroy, enslave, or
designedly to impoverish the
subjects. The obligations of the law of nature cease not in
society, but only in many cases
are drawn closer, and have by human laws known penalties
annexed to them, to inforce
their observation. Thus the law of nature stands as an eternal
rule to all men, legislators as
well as others. The rules that they make for other men’s actions,
must, as well as their
own and other men’s actions, be conformable to the law of
nature, i. e. to the will of God,
of which that is a declaration, and the fundamental law of
nature being the preservation of
mankind, no human sanction can be good, or valid against it.
§. 136. Secondly,* The legislative, or supreme authority, cannot
assume to its self a
power to rule by extemporary arbitrary decrees, but is bound to
dispense justice, and
decide the rights of the subject by promulgated standing laws,
and known authorized
judges: for the law of nature being unwritten, and so no where
to be found but in the
minds of men, they who through passion or interest shall
miscite, or misapply it, cannot
so easily be convinced of their mistake where there is no
established judge: and so it
serves not, as it ought, to determine the rights, and fence the
properties of those that live
under it, especially where every one is judge, interpreter, and
executioner of it too, and
that in his own case: and he that has right on his side, having
ordinarily but his own
single strength, hath not force enough to defend himself from
injuries, or to punish
delinquents. To avoid these inconveniencies, which disorder
men’s properties in the state
of nature, men unite into societies, that they may have the
united strength of the whole
society to secure and defend their properties, and may have
standing rules to bound it, by
which every one may know what is his. To this end it is that
men give up all their natural
power to the society which they enter into, and the community
put the legislative power
into such hands as they think fit, with this trust, that they shall
be governed by declared
laws, or else their peace, quiet, and property will still be at the
same uncertainty, as it was
in the state of nature.
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§. 137. Absolute arbitrary power, or governing without settled
standing laws, can neither
of them consist with the ends of society and government, which
men would not quit the
freedom of the state of nature for, and tie themselves up under,
were it not to preserve
their lives, liberties and fortunes, and by stated rules of right
and property to secure their
peace and quiet. It cannot be supposed that they should intend,
had they a power so to do,
to give to any one, or more, an absolute arbitrary power over
their persons and estates,
and put a force into the magistrate’s hand to execute his
unlimited will arbitrarily upon
them. This were to put themselves into a worse condition than
the state of nature, wherein
they had a liberty to defend their right against the injuries of
others, and were upon equal
terms of force to maintain it, whether invaded by a single man,
or many in combination.
Whereas by supposing they have given up themselves to the
absolute arbitrary power and
will of a legislator, they have disarmed themselves, and armed
him, to make a prey of
them when he pleases; he being in a much worse condition, who
is exposed to the
arbitrary power of one man, who has the command of 100,000,
than he that is exposed to
the arbitrary power of 100,000 single men; no body being
secure, that his will, who has
such a command, is better than that of other men, though his
force be 100,000 times
stronger. And therefore, whatever form the commonwealth is
under, the ruling power
ought to govern by declared and received laws, and nor by
extemporary dictates and
undetermined resolutions: for then mankind will be in a far
worse condition than in the
state of nature, if they shall have armed one, or a few men with
the joint power of a
multitude, to force them to obey at pleasure the exorbitant and
unlimited decrees of their
sudden thoughts, or unrestrained, and till that moment unknown
wills, without having
any measures set down which may guide and justify their
actions: for all the power the
government has, being only for the good of the society, as it
ought not to be arbitrary and
at pleasure, so it ought to be exercised by established and
promulgated laws; that both the
people may know their duty, and be safe and secure within the
limits of the law; and the
rulers too kept within their bounds, and not be tempted, by the
power they have in their
hands, to employ it to such purposes, and by such measures, as
they would not have
known, and own not willingly.
§. 138. Thirdly, The supreme power cannot take from any man
any part of his property
without his own consent: for the preservation of property being
the end of government,
and that for which men enter into society, it necessarily
supposes and requires, that the
people should have property, without which they must be
supposed to lose that, by
entering into society, which was the end for which they entered
into it; too gross an
absurdity for any man to own. Men therefore in society having
property, they have such a
right to the goods, which by the law of the community are
their’s, that no body hath a
right to take their substance or any part of it from them, without
their own consent:
without this they have no property at all; for I have truly no
property in that, which
another can by right take from me, when he pleases, against my
consent. Hence it is a
mistake to think, that the supreme or legislative power of any
common-wealth, can do
what it will, and dispose of the estates of the subject arbitrarily,
or take any part of them
at pleasure. This is not much to be feared in governments where
the legislative consists,
7
wholly or in part, in assemblies which are variable, whose
members, upon the dissolution
of the assembly, are subjects under the common laws of their
country, equally with the
rest. But in governments, where the legislative is in one lasting
assembly always in being,
or in one man, as in absolute monarchies, there is danger still,
that they will think
themselves to have a distinct interest from the rest of the
community; and so will be apt
to increase their own riches and power, by taking what they
think fit from the people: for
a man’s property is not at all secure, tho’ there be good and
equitable laws to set the
bounds of it between him and his fellow subjects, if he who
commands those subjects
have power to take from any private man, what part he pleases
of his property, and use
and dispose of it as he thinks good.
§. 139. But government, into whatsoever hands it is put, being,
as I have before shewed,
intrusted with this condition, and for this end, that men might
have and secure their
properties; the prince, or senate, however it may have power to
make laws, for the
regulating of property between the subjects one amongst
another, yet can never have a
power to take to themselves the whole, or any part of the
subjects property, without their
own consent: for this would be in effect to leave them no
property at all. And to let us
see, that even absolute power, where it is necessary, is not
arbitrary by being absolute,
but is still limited by that reason, and confined to those ends,
which required it in some
cases to be absolute, we need look no farther than the common
practice of martial
discipline: for the preservation of the army, and in it of the
whole common-wealth,
requires an absolute obedience to the command of every
superior officer, and it is justly
death to disobey or dispute the most dangerous or unreasonable
of them; but yet we see,
that neither the serjeant, that could command a soldier to march
up to the mouth of a
cannon, or stand in a breach, where he is almost sure to perish,
can command that soldier
to give him one penny of his money; nor the general, that can
condemn him to death for
deserting his post, or for not obeying the most desperate orders,
can yet, with all his
absolute power of life and death, dispose of one farthing of that
soldier’s estate, or seize
one jot of his goods; whom yet he can command any thing, and
hang for the least
disobedience; because such a blind obedience is necessary to
that end, for which the
commander has his power, viz. the preservation of the rest; but
the disposing of his goods
has nothing to do with it.
§. 140. It is true, governments cannot be supported without
great charge, and it is fit
every one who enjoys his share of the protection, should pay out
of his estate his
proportion for the maintenance of it. But still it must be with
his own consent, i. e. the
consent of the majority, giving it either by themselves, or their
representatives chosen by
them: for if any one shall claim a power to lay and levy taxes on
the people, by his own
authority, and without such consent of the people, he thereby
invades the fundamental
law of property, and subverts the end of government: for what
property have I in that,
which another may by right take, when he pleases, to himself?
8
§. 141.Fourthly, The legislative cannot transfer the power of
making laws to any other
hands: for it being but a delegated power from the people, they
who have it cannot pass it
over to others. The people alone can appoint the form of the
common-wealth, which is by
constituting the legislative, and appointing in whose hands that
shall be. And when the
people have said, We will submit to rules, and be governed by
laws made by such men,
and in such forms, no body else can say other men shall make
laws for them; nor can the
people be bound by any laws, but such as are enacted by those
whom they have chosen,
and authorized to make laws for them. The power of the
legislative, being derived from
the people by a positive voluntary grant and institution, can be
no other than what that
positive grant conveyed, which being only to make laws, and
not to make legislators, the
legislative can have no power to transfer their authority of
making laws, and place it in
other hands.
§. 142. These are the bounds which the trust, that is put in them
by the society, and the
law of God and nature, have set to the legislative power of
every common-wealth, in all
forms of government.
First, They are to govern by promulgated established laws, not
to be varied in particular
cases, but to have one rule for rich and poor, for the favourite at
court, and the country
man at plough.
Secondly, These laws also ought to be designed for no other end
ultimately, but the good
of the people.
Thirdly, They must not raise taxes on the property of the
people, without the consent of
the people, given by themselves, or their deputies. And this
properly concerns only such
governments where the legislative is always in being, or at least
where the people have
not reserved any part of the legislative to deputies, to be from
time to time chosen by
themselves.
Fourthly, The legislative neither must nor can transfer the
power of making laws to any
body else, or place it any where, but where the people have.
CHAP. XII.: Of the Legislative, Executive, and Federative
Power of the Common-
wealth.
§. 143. THE legislative power is that, which has a right to direct
how the force of the
common-wealth shall be employed for preserving the
community and the members of it.
But because those laws which are constantly to be executed, and
whose force is always to
continue, may be made in a little time; therefore there is no
need, that the legislative
should be always in being, not having always business to do.
And because it may be too
great a temptation to human frailty, apt to grasp at power, for
the same persons, who have
the power of making laws, to have also in their hands the power
to execute them,
9
whereby they may exempt themselves from obedience to the
laws they make, and suit the
law, both in its making, and execution, to their own private
advantage, and thereby come
to have a distinct interest from the rest of the community,
contrary to the end of society
and government: therefore in well-ordered common-wealths,
where the good of the
whole is so considered, as it ought, the legislative power is put
into the hands of divers
persons, who duly assembled, have by themselves, or jointly
with others, a power to
make laws, which when they have done, being separated again,
they are themselves
subject to the laws they have made; which is a new and near tie
upon them, to take care,
that they make them for the public good…
CHAP. XVIII.: Of TYRANNY.
§. 199. AS usurpation is the exercise of power, which another
hath a right to; so tyranny
is the exercise of power beyond right, which no body can have a
right to. And this is
making use of the power any one has in his hands, not for the
good of those who are
under it, but for his own private separate advantage. When the
governor, however
intitled, makes not the law, but his will, the rule; and his
commands and actions are not
directed to the preservation of the properties of his people, but
the satisfaction of his own
ambition, revenge, covetousness, or any other irregular
passion…
In Congress, July 4, 1776
The Unanimous Declaration of the Thirteen United States of
America
When in the Course of human events, it becomes necessary for
one people to
dissolve the political bands which have connected them with
another, and to assume
among the Powers of the earth, the separate and equal station to
which the Laws of
Nature and of Nature's God entitle them, a decent respect to the
opinions of mankind
requires that they should declare the causes which impel them
to the separation.
We hold these truths to be self-evident, that all men are created
equal, that they
are endowed by their Creator with certain unalienable Rights,
that among these are
Life, Liberty and the pursuit of Happiness. That to secure these
rights, Governments
are instituted among Men, deriving their just powers from the
consent of the
governed, That whenever any Form of Government becomes
destructive of these
ends, it is the Right of the People to alter or to abolish it, and to
institute new
Government, laying its foundation on such principles and
organizing its powers in
such form, as to them shall seem most likely to effect their
Safety and Happiness.
Prudence, indeed, will dictate that Governments long
established should not be
changed for light and transient causes; and accordingly all
experience hath shown,
that mankind are more disposed to suffer, while evils are
sufferable, than to right
themselves by abolishing the forms to which they are
accustomed. But when a long
train of abuses and usurpations, pursuing invariably the same
Object evinces a design
to reduce them under absolute Despotism, it is their right, it is
their duty, to throw off
such Government, and to provide new Guards for their future
security. -- Such has
been the patient sufferance of these Colonies; and such is now
the necessity which
constrains them to alter their former Systems of Government.
The history of the
present King of Great Britain is a history of repeated injuries
and usurpations, all
having in direct object the establishment of an absolute Tyranny
over these States.
To prove this, let Facts be submitted to a candid world.
He has refused his Assent to Laws, the most wholesome and
necessary for the
public good.
He has forbidden his Governors to pass Laws of immediate and
pressing
importance, unless suspended in their operation till his Assent
should be obtained;
and when so suspended, he has utterly neglected to attend to
them.
He has refused to pass other Laws for the accommodation of
large districts of
people, unless those people would relinquish the right of
Representation in the
Legislature, a right inestimable to them and formidable to
tyrants only.
He has called together legislative bodies at places unusual,
uncomfortable, and
distant from the depository or their public Records, for the sole
purpose of fatiguing
them into compliance with his measures.
He has dissolved Representative Houses repeatedly, for
opposing with manly
firmness his invasions on the rights of the people.
He has refused for a long time, after such dissolutions, to cause
others to be
elected; whereby the Legislative powers, incapable of
Annihilation, have returned to
the People at large for their exercise; the State remaining in the
mean time exposed to
all the dangers of invasion from without, and convulsions
within.
He has endeavoured to prevent the population of these States;
for that purpose
obstructing the Laws for Naturalization of Foreigners; refusing
to pass others to
encourage their migration hither, and raising the conditions of
new Appropriations of
Lands.
He has obstructed the Administration of Justice, by refusing his
Assent to Laws
for establishing Judiciary powers.
He has made Judges dependent on his Will alone, for the tenure
of their offices,
and the amount and payment of their salaries.
He has erected a multitude of New Offices, and sent hither
swarms of Officers to
harrass our people, and eat out their substance.
He has kept among us, in times of peace, Standing Armies,
without the Consent
of our legislatures.
He has affected to render the Military independent of and
superior to the Civil
power.
He has combined with others to subject us to a jurisdiction
foreign to our
constitution, and unacknowledged by our laws; giving his
Assent to their Acts of
pretended Legislation:
For quartering large bodies of armed troops among us:
For protecting them, by a mock Trial, from Punishment for any
Murders which
they should commit on the Inhabitants of these States:
For cutting off our Trade with all parts of the world:
For imposing Taxes on us without our Consent:
For depriving us in many cases, of the benefits of Trial by
Jury:
For transporting us beyond Seas to be tried for pretended
offenses:
For abolishing the free System of English Laws in a
neighboring Province,
establishing therein an Arbitrary government, and enlarging its
Boundaries so as to
render it at once an example and fit instrument for introducing
the same absolute rule
into these Colonies:
For taking away our Charters, abolishing our most valuable
Laws, and altering
fundamentally the Forms of our Governments:
For suspending our own Legislatures, and declaring themselves
invested with
power to legislate for us in all cases whatsoever.
He has abdicated Government here, by declaring us out of his
Protection and
waging War against us.
He has plundered our seas, ravaged our Coasts, burnt our
towns, and destroyed
the lives of our people.
He is at this time transporting large Armies of foreign
Mercenaries to compleat
the works of death, desolation and tyranny, already begun with
circumstances of
Cruelty & perfidy scarcely paralleled in the most barbarous
ages, and totally
unworthy the Head of a civilized nation.
He has constrained our fellow Citizens taken Captive on the
high Seas to bear
Arms against their Country, to become the executioners of their
friends and Brethren,
or to fall themselves by their Hands.
He has excited domestic insurrections amongst us, and has
endeavoured to bring
on the inhabitants of our frontiers, the merciless Indian
Savages, whose known rule of
warfare, is an undistinguished destruction of all ages, sexes and
conditions.
In every state of these Oppressions We have Petitioned for
Redress in the most
humble terms: Our repeated Petitions have been answered only
by repeated injury.
A Prince, whose character is thus marked by every act which
may define a Tyrant, is
unfit to be the ruler of a free people.
Nor have We been wanting in attentions to our Brittish
brethren. We have
warned them from time to time of attempts by their legislature
to extend an
unwarrantable jurisdiction over us. We have reminded them of
the circumstances of
our emigration and settlement here. We have appealed to their
native justice and
magnanimity, and we have conjured them by the ties of our
common kindred to
disavow these usurpations, which, would inevitably interrupt
our connections and
correspondence. They too have been deaf to the voice of justice
and of
consanguinity. We must, therefore, acquiesce in the necessity,
which denounces our
Separation, and hold them, as we hold the rest of mankind,
Enemies in War, in Peace
Friends.
We, Therefore, the Representatives of the United States of
America, in General
Congress, Assembled, appealing to the Supreme Judge of the
world for the rectitude
of our intentions, do, in the Name, and by Authority of the good
People of these
Colonies, solemnly publish and declare, That these United
Colonies are, and of Right
ought to be Free and Independent States; that they are Absolved
from all Allegiance
to the British Crown, and that all political connection between
them and the State of
Great Britain, is and ought to be totally disolved; and that as
Free and Independent
States, they have full Power to levy War, conclude Peace,
contract Alliances,
establish Commerce, and to do all other Acts and Things which
Independent States
may of right do. And for the support of this Declaration, with a
firm reliance on the
protection of Divine Providence, we mutually pledge to each
other our Lives, our
Fortunes and our sacred Honor.
Brainstorm
Research Question
· You get to frame the extent of the research question
· What is included?
· What is left out?
· How you frame your question can radically change the results
you find
· Do not begin with the thesis/claim
· What biases or assumptions (good or bad) am I bringing into
the question?
Development
· What have other scholars said about the subject?
· What have they left out?
· What have they overlooked?
· What can I add?
· Anticipate counterarguments and other claims
Essay
· Introduction
· Introduce topic
· Be specific and contextual
· Avoid sweeping generalizations
· Introduce claim (thesis)
· Thesis should be narrowly focused and specific
· Do not try to cover too much or claim more than you can
prove
· Thesis should be direct and clear
· Thesis should be debatable
· Otherwise you are not making a claim but stating the facts
· Organization
· Each body paragraph should have specific evidence
· Historical data
· Legal research
· Textual analysis
· Engage with the existing scholarship
· Give credit where credit is due
· Introduce a contrary view
· There should be a logical flow to arrangement of your essay as
a whole
· Build up your argument
· Conclusion
· Don’t just repeat your thesis
· Explain the significance of your topic
· End memorably
· Link your argument to current events
· Provide a salient quotation or recount an anecdote
· Editing
· Be concise; edit ruthlessly
· Eliminate repetition
· Combine sentences and vary syntactical patterns
· Be as PRECISE as possible in your diction or word choice
· Use active verbs when possible
· Check for spelling errors or faulty comma use
Prompts
1) According to John Locke, what is political power and where
does it come from? What are the just limits of the use of
legislative power? How did this understanding influence the
Constitution?
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Research Critique RubricCriterionDescription of CriterionN.docx

  • 1. Research Critique Rubric Criterion Description of Criterion Not Submitted 0% Not Met 50% Met 75% Exceeds 100% Identification of the research question/problem/hypothesis 10% This area should cover a review of the introduction of the article. What do the authors state is the importance of the study and why is it being conducted? What is the authors’ purpose or intention for the study? What questions or hypothesis do the authors aim to answer? No posts submitted. The description is not provided. The description does not address all of the given points, or the description of any point is not supported by the article. The description addresses all of the given points, or the description of any point is not supported by the article. Identification of topics explored in review of literature 10% How did the researchers identify a gap in the science? What literature did the authors review prior to starting the study? How does the literature review contribute to the research
  • 2. design? This may or may not have a separate section in the article itself, but it can be determined by information provided in the article. No posts submitted. The description is not provided. The description does not address all of the given points, or the description of any point is not supported by the article. The description addresses all of the given points, or the description of any point is not supported by the article. Identification/definition of research methodology and design 10% How was the study conducted? Why was this method selected for the research, and how was the study was conducted. Was this this most appropriate method for this study? No posts submitted. The description is not provided. The description does not address all of the given points, or the description of any point is not supported by the article. The description addresses all of the given points, or the description of any point is not supported by the article. Description of subjects/participants in the study 10% Who were the study participants? Was the group or population of interest adequately described? Were the setting and sample described in sufficient detail? Was the best possible method of sampling used to enhance information richness and address the needs of the study? Was the sample size adequate? No posts submitted. The description is not provided.
  • 3. The description does not address all of the given points, or the description of any point is not supported by the article. The description addresses all of the given points, or the description of any point is not supported by the article. Exploration of ethical issues and protection of human subjects 10% Explain how the protection of human subjects and cultural considerations were addressed by the researcher, using specific information from the journal article. No posts submitted. The description is not provided. The description does not address all of the given points, or the description of any point is not supported by the article. The description addresses all of the given points, or the description of any point is not supported by the article. Data Analysis 10% How did the researchers analyze the data? What statistical tests or other methods of interpretation were used to analyze the data? Was the data analysis strategy compatible with the research tradition and with the nature and type of data gathered? Did the analysis yield an appropriate “product” (e.g., a theory, taxonomy, thematic pattern, etc.)? Did the analytic procedures suggest the possibility of biases? No posts submitted. The description is not provided. The description does not address all of the given points, or the description of any point is not supported by the article.
  • 4. The description addresses all of the given points, or the description of any point is not supported by the article. Discussion of findings 10% How effectively does the researcher answer the posed research question/problem/hypothesis? What are strengths and limitations of the study? Do the study findings appear to be trustworthy—do you have confidence in the truth value of the results? How might the findings be applied to practice? No posts submitted. The description is not provided. The description does not address all of the given points, or the description of any point is not supported by the article. The description addresses all of the given points, or the description of any point is not supported by the article. Use of additional sources from nursing journals 10% At least two sources from nursing journals (or one nursing journal and one from the text) are used in addition to the article that was critiqued. No posts submitted. No additional journals/text were used and cited, or the journals used are not nursing journals. Only one additional source (either nursing journal or text) is used and cited. At least two additional nursing journals (or one journal & one text) are used and cited in the paper. APA style 10%
  • 5. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized. A title page, abstract and reference page are included. No posts submitted. The submission does not include in-text citations and references according to APA style for content that is quoted, paraphrased, or summarized. The submission includes in-text citations and references for content that is quoted, paraphrased, or summarized but does not demonstrate a consistent application of APA style. The submission includes in-text citations and references for content that is quoted, paraphrased, or summarized and demonstrates a consistent application of APA style. Grammar and Organization 10% Demonstrate professional grammar and organization in the content and presentation of your submission. No posts submitted. Content is unstructured, is disjointed, or contains pervasive errors in mechanics, usage, or grammar. Content is poorly organized, is difficult to follow, or contains errors in mechanics, usage, or grammar that cause confusion. Content reflects attention to detail and is organized. Mechanics, usage, and grammar promote accurate interpretation and understanding. Version 1 NG309 Evidence Based Practice August 2019
  • 6. 6/17/2019 My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death - ProQuest https://search-proquest- com.ezproxy.brenau.edu:2040/docview/2132190303?accountid= 9708 1/10 Abstract Full Text AIM The purpose of this study was to examine, on a national level, nursing students' perceptions after experiencing a patient death. BACKGROUND Death is a highly stressful experience for nursing students. Debriefing, which routinely occurs with a patient's demise in the simulation setting, typically does not happen in actual death situations. METHOD A mixed-methods design using quantitative and qualitative questions as part of an anonymous survey was sent to the membership of the National Student Nurses' Association. Of approximately 55,000 members, 2,480 responded to the survey. RESULTS Experiencing a patient death as a student occurred for 41 percent of participants in the nationally representative sample. Of those who
  • 7. experienced a patient death, 64 percent did not receive any debriefing. CONCLUSION Most nursing students did not feel prepared to care for a dying patient and the patient's family. Students need and want more education on end-of-life nursing care. Headnote Abstract AIM The purpose of this study was to examine, on a national level, nursing students' perceptions after experiencing a patient death. BACKGROUND Death is a highly stressful experience for nursing students. Debriefing, which routinely occurs with a patient's demise in the simulation setting, typically does not happen in actual death situations. METHOD A mixed-methods design using quantitative and qualitative questions as part of an anonymous survey was sent to the membership of the National Student Nurses' Association. Of approximately 55,000 members, 2,480 responded to the survey. RESULTS Experiencing a patient death as a student occurred for 41 percent of participants in the nationally representative sample. Of those who experienced a patient
  • 8. death, 64 percent did not receive any debriefing. CONCLUSION Most nursing students did not feel prepared to care for a dying patient and the patient's family. Students need and want more education on end-of-life nursing care. My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death Heise, Barbara A; Wing, Debra K; Hullinger, Amy H R. Nursing Education Perspectives; New York Vol. 39, Iss. 6, (Nov/Dec 2018): 355- 359. DOI:10.1097/01.NEP.0000000000000335 > https://search-proquest- com.ezproxy.brenau.edu:2040/indexinglinkhandler/sng/au/Heise ,+Barbara+A/$N?accountid=9708 https://search-proquest- com.ezproxy.brenau.edu:2040/indexinglinkhandler/sng/au/Wing ,+Debra+K/$N?accountid=9708 https://search-proquest- com.ezproxy.brenau.edu:2040/indexinglinkhandler/sng/au/Hulli nger,+Amy+H+R/$N?accountid=9708 https://search-proquest- com.ezproxy.brenau.edu:2040/pubidlinkhandler/sng/pubtitle/Nu rsing+Education+Perspectives/$N/25605/DocView/2132190303/ fulltext/A05AE6FD9348451BPQ/1?accountid=9708 https://search-proquest-
  • 9. com.ezproxy.brenau.edu:2040/indexingvolumeissuelinkhandler/ 25605/Nursing+Education+Perspectives/02018Y11Y01$23Nov$ 2fDec+2018$3b++Vol.+39+$286$29/39/6?accountid=9708 6/17/2019 My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death - ProQuest https://search-proquest- com.ezproxy.brenau.edu:2040/docview/2132190303?accountid= 9708 2/10 KEYWORDS Death Education - Debriefing - Nursing Education - Nursing Students - Death Education - Debriefing Most nurses experience patient death during the course of their careers. The nurse is the primary health care provider involved in caring for patients and their families at the endof-life (EOL) and throughout the dying process, including postmortem care (Bryant, 2008). Nurses promote a "good death" by providing physical, emotional, and spiritual care while also advocating for the cultural preferences of dying patients and their families. Death is an emotionally charged issue for anyone. For registered nurses, death is also a high-stress situation (Leighton & Dubas, 2009; Zheng, Lee, & Bloomer, 2016), with most experienced nurses able to vividly recall their
  • 10. first death of a patient (Anderson, Kent, & Owens, 2015; Kent, Anderson, & Owens, 2012). For nursing students who are just learning the RN role and responsibilities, the death of a patient is often a foreign, frightening, and overwhelming experience that may have long-term effects on their professional and personal lives (Kent etal., 2012). LITERATURE REVIEW Patient death is a commonly reported source of stress and anxiety for nursing students (Allchin, 2006; Carson, 2010; Edo-Gual, TomásSábado, Bardallo-Porras, & Monforte- Royo, 2014; Gallagher et al., 2014; Parry, 2011; Zheng et al., 2016). Nursing students' reactions to their first patient death often include negative emotions, such as fear, sadness, frustration, anxiety, helplessness, and guilt (Neiderriter, 2009; Parry, 2011; Poultney, Berridge, & Malkin, 2013; Zheng et al., 2016). Although many students experience a patient death during their education, few feel adequately prepared to interact with a dying patient and his or her family in the clinical setting and to cope with the experience (Gallagher et al., 2014; Zheng et al., 2016). Current nursing education is generally considered inadequate to prepare nursing students for EOL care (Cavaye & Watts, 2012; Gillan, van der Riet, & Jeong, 2014;
  • 11. Kent et al., 2012; Schlairet, 2009; Wallace et al., 2009). After their first death experiences, students frequently state that they were not ready to provide EOL care, expressed difficulty communicating with the dying patient or family, and did not receive sufficient support from clinical instructors and staff. Nursing students reported increased stress and anxiety due to feelings of inadequacy and lack of preparation (Cavaye & Watts, 2012; Dos Santos & Bueno, 2011; Gallagher et al., 2014; Huang, Chang, Sun, & Ma, 2010; Parry, 2011; Zheng et al., 2016). Nursing students who had positive first death experiences indicated that helpful factors included a supportive clinical instructor or staff member, role modeling, and postclinical debriefing (Carson, 2010; Gallagher et al., 2014; Huang et al., 2010). Debriefing is commonly included in simulated EOL training but often does not occur in the clinical setting (Thompson, 2005). The opportunity to discuss the death experience with an instructor may help nursing students cope with the experience and increase competence and confidence for future care of dying patients. Nursing students must receive adequate preparation and support to provide quality EOL care in the clinical
  • 12. setting and be equipped to cope with patient death. Most studies on nursing students and their experience with patient death have involved small samples of nursing students. This survey is the first to examine nursing students' perceptions of their first experiences with patient death on a national level. By understanding students' experiences and the need for suitable preparation, support, and debriefing, nurse educators may be better able to guide nursing students through their first experiences with EOL care and patient death. THEORETICAL FRAMEWORK > 6/17/2019 My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death - ProQuest https://search-proquest- com.ezproxy.brenau.edu:2040/docview/2132190303?accountid= 9708 3/10 Benner's (1982) seminal work, From Novice to Expert, delineates five levels of nursing proficiency. Although Benner's theory of nursing did not include nursing students, her delineation provides insight on a prelicensure nursing student who could be classified at a prenovice level. Level 1 is the novice RN who has no experience in
  • 13. clinical situations such as EOL care. At this level, the novice nurse does not have the discretionary judgment to determine which parts of the situation are most relevant. The novice nurse feels most comfortable with objective tasks, such as taking vital signs, rather than a more advanced skill of helping the dying patient and family to cope. Level 2 is the advanced beginner who has marginally acceptable performance. Nurses at Levels 1 and 2 need mentoring by expert nurses. At Level 3, the competent nurse has been providing EOL care for approximately two to three years. Typically, this nurse provides conscious, deliberate planning to achieve efficiency and organization, and no mentoring is needed. However, the competent nurse is still unable to recognize which parts of the EOL situation are most important. At Level 4, the proficient nurse is able to see EOL care for the dying patient and the family as a whole. This nurse knows what to typically expect during EOL care and can modify the plan as needed. Finally, at Level 5, the nurse is an expert who intuitively hones in on salient issues. Expert nurses have a deep understanding of EOL care and the many ways that dying
  • 14. patients and their families approach death. They offer many ways to understand, cope, and accept the final phase of life, which, for most people, is a totally uncharted passage. Expert nurses in EOL care often stay in this field because they feel they can coach patients and families through a very difficult and often not discussed part of life. Nursing students do not have the experience to perform the advanced roles of an expert nurse caring for the dying person and family. Along with competent clinical skills, expert nursing skills required during EOL care include advanced communication skills to determine patient preferences, advocacy for patient and family to promote dignity, advanced pain management skills, comprehensive supportive care to the patient and family to alleviate suffering, constant assessment to ensure interventions are congruent with patient wishes, and promoting the dying patient's autonomy and right to self- determination. Some nursing students have previously experienced the death of a family member. However, the death of a patient is different and may require a level of responsibility that was not present for the family member. In addition, caring for someone who is dying, as well as caring for the dying patient's family, requires advanced
  • 15. clinical skills that a nursing student does not yet possess. METHOD A cross-sectional descriptive survey design was used for this study. Following approval from the university institutional review board and National Student Nurses' Association administration, nursing student members of National Student Nurses' Association (approximately 55,000 members) were emailed a brief description of the research project and an invitation to participate with a link to the online questionnaire. An implied consent form was available to be viewed by participants before beginning the survey. Participant responses were collected using Qualtrics online survey software. Participants were asked to answer six demographic questions and 14 survey questions about their experience regarding a patient death during their time as a nursing student. Two open-ended questions asked participants to describe their experience and indicate what they would have liked to be taught regarding EOL care of a patient.> 6/17/2019 My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death - ProQuest
  • 16. https://search-proquest- com.ezproxy.brenau.edu:2040/docview/2132190303?accountid= 9708 4/10 Estimated time commitment for participants was 15 to 20 minutes. This article reports the results of the quantitative questions in the survey. After the response period had ended, quantitative data were downloaded from Qualtrics to SPSS version 22 (IBM Corp., 2013). Quantitative data were reviewed for missing values and outliers before further analysis using appropriate descriptive statistics and plots. Descriptive statistics for demographic variables and survey questions were calculated. Chi-square test of association was used to examine relationships of selected categorical variables. RESULTS Descriptive statistics for demographic characteristics of the participants are reported in table form in Table 1. Sample A total of 2,804 individuals responded to the invitation to participate and started the survey. A total of 2,480 (88.4 percent) completed the survey. Most respondents (80 percent) were female, half were under age 27, and the
  • 17. majority were white (67.6 percent). A majority of the respondents (60.7 percent) reported being single, and about a quarter (26.8 percent) reported being married. Most (57.6 percent) of the students said they were in bachelor's programs; about a quarter (25.9 percent) reported being in associates programs. Participants came from every state in the United States as well as the District of Columbia with more populous states (e.g., CA, FL, NY, PA, and TX) proportionally represented in the sample. Descriptive statistics for questionnaire items are reported in Table 2. A majority (65.8 percent) of respondents reported being present at a death outside of their nursing experience; almost 41 percent reported being present at a death as a nursing student. The majority of those who experienced a patient death (62 percent) experienced that death early in their nursing programs. Responses for Students Who Experienced a Death The remaining questions were directed specifically toward those who reported experiencing a patient death as a student (n = 1,148). Slightly more than a quarter of those respondents (26.8 percent) said they needed help coping. Only one third of these students received debriefing.
  • 18. A chi-square test of association was used to examine the relationship between reporting the need for help coping with a patient death and receiving debriefing. Of the 1,148 students respondents, 33 (2.6 percent) had missing data and were excluded from the test. The test was not significant, x2(df = 1, n = 1,115) = 1.19, p = .275, indicating that there did not seem to be an association between needing help coping and receiving debriefing after experiencing a patient death as a student. A majority (194/306, 63.4 percent) of those who reported needing help coping did not receive debriefing. Participants were asked to rate their level of preparation on a scale of 1 to 4 (1 = prepared, 2 = somewhat prepared, 3 = prepared, 4 = very prepared) in several areas related to death and dying: process of death and dying, EOL care, and ways to cope with the death of a patient. * Thirty-six percent of nursing students asked if they felt prepared with the process of death and dying reported they were less than prepared (not prepared or somewhat prepared). > 6/17/2019 My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death - ProQuest
  • 19. https://search-proquest- com.ezproxy.brenau.edu:2040/docview/2132190303?accountid= 9708 5/10 * Perceptions of being prepared to provide EOL care resulted in 45 percent feeling less than prepared (not prepared or somewhat prepared) and 47 percent felt prepared or very prepared. * Asked if they felt prepared to cope with the death of a patient, most nursing students (45 percent vs. 35 percent) felt less than prepared (unprepared or somewhat prepared). Only 24 percent of the nursing students reported that their nursing curriculum (what they learned in class) prepared them in general EOL care. Only 17 percent felt that the curriculum prepared them to cope with the death of a patient. Participants were asked who helped them prepare to deal with issues surrounding patient death (process of death and dying, EOL care, and ways to cope with death of a patient); options for each category were as follows: no one, clinical instructor, clinical staff, other nursing students, friend or family member, and learned in nursing class. Learned in nursing class and clinical instructor were among the top-ranked answers in most categories. The top answer to who prepared respondents to cope
  • 20. with the death of a patient was "no one." Clinical instructors were referred to as preparation resources for EOL care (19 percent), process of death and dying (17 percent), and coping (17 percent) in these areas. Participants were asked to rate their level of preparation on a scale of 1 to 4 (1 = unprepared, 2 = somewhat prepared, 3 = prepared, 4 = very prepared) in several areas related to communication: communication with dying patient, communication with patient's family, and communication with members of the health care team. The majority (57 percent) of nursing students felt less than prepared (unprepared or somewhat prepared) to communicate with a dying patient; only 23 percent reported feeling prepared or very prepared. Again, the majority (64 percent) of participants felt unprepared or somewhat prepared to communicate with the dying patient's family. However, participants felt more prepared to communicate with members of the health care team (45 percent vs. 35 percent). Participants were asked who helped them prepare to deal with issues surrounding communication (communication with dying patient, communication with patient's family, and communication with members of
  • 21. health care team); options for each category were as follows: no one, clinical instructor, clinical staff, other nursing students, friend or family member, and learned in nursing class. The top answer to who prepared respondents for all the communication questions was "no one." Students responded that their curriculum prepared them to communicate only 18 percent of the time when communicating with the dying patient, 20 percent of the time when communicating with the family of a dying patient, and 18 percent of the time when communicating with the health care team. Clinical instructors helped prepare students to communicate with the dying patient (15 percent), the family of the dying patient (14 percent), and the health care team (18 percent) of the time. Nursing students were asked specifically about what they would like to be taught about EOL care. The number one answer from students was more education on how to communicate with the dying patient and family. Students wanted more education on EOL care in general, including the actively dying process and supportive resources for the family and the patient. Students also wanted education on postmortem care of the patient. Students requested debriefing and education on how to cope
  • 22. with a patient death. They suggested more education on EOL care earlier in the nursing curriculum with more educational activities involving death and dying through simulation scenarios, faculty experiences, and even a hospice clinical. DISCUSSION > 6/17/2019 My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death - ProQuest https://search-proquest- com.ezproxy.brenau.edu:2040/docview/2132190303?accountid= 9708 6/10 It is significant to note that the sample was fairly representative of nurses in the United States, both in terms of geography and in terms of race. Participants came from every state and the District of Columbia. Nearly one third (31.9 percent) identified with racial groups other than Caucasian. Nationally, nursing students (41 percent) reported being present at a patient death. This high percentage of individuals who experience a patient death as a student highlights the importance of death education. Despite
  • 23. the sensitive nature of the topic of death itself, nurses need to be prepared for the almost inevitable death experiences they will encounter. Current recommendations strongly encourage nursing schools to educate students about EOL care (Ferrell, Malloy, Mazanec, & Virani, 2016). Death education may be integrated into nursing curricula, particularly for concept-based nursing programs. More work needs to be done to help students cope with patient death. Asked who helped them cope with the death of a patient, the top answer was "no one." Clinical instructors were reported to play a leading role in the training of nursing students in all areas regarding death and dying. Given that clinical instructors are frequently adjunct faculty who receive lower levels of professional development than regular faculty in the academic setting, it is possible that many clinical instructors are insufficiently prepared to guide students in matters of death and dying, communication with family and medical staff, and debriefing. Clinical instructors spend more one-on-one time with students than almost any other instructor in nursing school. They are also uniquely positioned to observe student interactions with patients and patients' families.
  • 24. The Institute of Medicine (2015) publication Dying in America specifically identifies a lack of communication skills, interprofessional education, and curricula focused on palliative and EOL care in nursing education. The American Association of Colleges of Nursing (2016) recommends competencies and curricular guidelines regarding EOL issues, including communication with dying patients and families and assisting the patient, family, colleagues, and one's self to cope with the dying process, grief, and bereavement. Role modeling, simulation, and debriefing may be the most efficacious ways to prepare students to deal with the challenges associated with patient death (Keene, Hutton, Hall, & Rushton, 2010). In addition, introducing students to critical reflective practice early in their academic endeavors may increase their resilience while creating cultural meaning for the dying process (Hodges, Keely, & Grier, 2005). As Benner (1982) noted, novice nurses (and we would add prenovice nurses) need mentoring, particularly in the advanced skills needed for EOL care. LIMITATIONS It may be noted that a sizeable proportion (11.6 percent) of those who began the survey did not complete it. It may also be noted that many of the questions directed to those
  • 25. who experienced a patient death as a student (n = 1,148) had high rates of missing data (around 20 percent). Patterns of missing data for those questions were examined. Most individuals completed all of the questions (n = 902, 78.6 percent). It was found that a large majority of missing answers were attributed to a consistent set of individuals (n = 224, 19.5 percent), who, it seems, simply did not complete most of the questions. A small percentage of individuals (n = 22, 1.9 percent) chose not to answer between one and six questions but completed the others. Although it is not possible to determine specific reasons for noncompletion, it may be possible to speculate. The topic of experiencing a patient death during schooling has the potential to be emotionally difficult to think about and discuss. It may be that the emotionally difficult nature of the topic led some individuals to not complete the questions. This survey also asked several open-ended questions in the format of typed responses. It may be that additional time required to think about and formulate responses led some individuals to give up rather than complete the entire survey. >
  • 26. 6/17/2019 My Patient Died: A National Study of Nursing Students' Perceptions After Experiencing a Patient Death - ProQuest https://search-proquest- com.ezproxy.brenau.edu:2040/docview/2132190303?accountid= 9708 7/10 IMPLICATIONS FOR NURSING EDUCATION Students need and want more education on EOL nursing care as well as how to communicate with dying patients and their families and postmortem care. Most nurses, at some point in their careers, will encounter a patient who is dying. Although death is often not discussed in many societies, it is a conversation that needs to be held in order to ensure that the dying patient's wishes are known. The Conversation Project (http://theconversationproject.org), which is dedicated to helping individuals talk about their EOL issues, gives individuals the words to say to family members and to health care providers to start the conversation on what they would like at EOL. Nurses provide the majority of care and are uniquely positioned to help start the conversation of patient preferences and assist the patient and family through the dying process. Dying is a deeply personal experience. For nursing students, the death of a patient, at the very beginning of their
  • 27. career path, is often a stressful and overwhelming experience. Although debriefing and mentoring take place routinely in simulation, they do not happen most of the time in real life. It is a double-edged sword to tell novice nurses to care about their patients while asking those same nursing students to turn off caring when the patient is dying or has died. Experienced nurses do a disservice to novice nurses when they tell them to "toughen up," rather than discuss their views of the dying experience. This lack of discussion and acknowledgement of salient issues during the dying process may lead to nurse burnout and compassion fatigue. In the clinical setting, nurse educators, particularly adjunct clinical faculty, need to be trained in debriefing techniques, critical reflection, and mentoring nursing students as they provide care for those in the last phase of life. Students need to be exposed to the dying experience, but with expert nurse mentors to role model and guide them through an often challenging situation (Österlind et al., 2016). For nursing students, as suggested by the respondents to this study, more simulation experiences with patient demise and debriefing need to be part of the nursing curriculum. Allen (2018) points out that, even in an EOL
  • 28. simulation setting, nursing students caring for dying patients experience increased stress. In our study, students requested more EOL experiences through simulation and through clinical experiences, such as hospice and palliative care with mentoring from their nursing faculty. Sidebar The authors have declared no conflict of interest. Copyright © 2018 National League for Nursing doi: 10.1097/01.NEP.0000000000000335 References REFERENCES Allchin, L. (2006). Caring for the dying: Nursing student perspectives. Journal of Hospice & Palliative Nursing, 8, 112-117. Allen, M. (2018). Examining nursing students' stress in an end- of-life care simulation. Clinical Simulation in Nursing, 14, 21-28. > 6/17/2019 My Patient Died: A National Study of Nursing
  • 29. Students' Perceptions After Experiencing a Patient Death - ProQuest https://search-proquest- com.ezproxy.brenau.edu:2040/docview/2132190303?accountid= 9708 8/10 American Association of Colleges of Nursing. (2016). Peaceful death: Recommended competencies and curricular guidelines for end of life nursing care. Retrieved from www.aacn.nche.edu/elnec/publications/peaceful-death Anderson, N., Kent, B., & Owens, R. (2015). Experiencing patient death in clinical practice: Nurses' recollections of their earliest memorable patient death. International Journal of Nursing Studies, 52(3), 695-704. Benner, P. (1982). From novice to expert. American Journal of Nursing, 82(3), 402-407. Bryant, H. (2008). Maintaining patient dignity and offering support after miscarriage. Emergency Nurse, 15(9), 26- 29. Carson, S. (2010). Do student nurses within an undergraduate child health programme feel that the curriculum prepares them to deal with the death of a child? Journal of Child Health Care: For Professionals Working With Children in the Hospital and Community, 14, 367.
  • 30. Cavaye, J., & Watts, J. (2012). End-of-life education in the pre- registration nursing curriculum: Patient, carer, nurse and student perspectives. Journal of Research in Nursing, 17(4), 317-326. Dos Santos, J. L., & Bueno, S. M. (2011). Death education for nursing professors and students: A document review of the scientific literature. Revista da Escola de Enfermagem da USP, 45(1), 272-276. Edo-Gual, M., Tomás-Sábado, J., Bardallo-Porras, D., & Monforte-Royo, C. (2014). The impact of death and dying on nursing students: An explanatory model. Journal of Clinical Nursing, 23(23-24), 3501-3512. Retrieved from http:// onlinelibrary.wiley.com.erl.lib.byu.edu/doi/10.1111/jocn.12660 2/abstract Ferrell, B., Malloy, P., Mazanec, P., & Virani, R. (2016). CARES: AACN's new competencies and recommendations for educating undergraduate nursing students to improve palliative care. JournalofProfessionalNursing, 32(5), 327-333. Gallagher, O., Saunders, R., Tambree, K., Alliex, S., Monterosso, L., & Naglazas, Y. (2014). Nursing student experiences of death and dying during a palliative care clinical placement: Teaching and learning implications. In
  • 31. In Transformative, Innovative and Engaging: Proceedings of the 23rd Annual Teaching Learning Forum, 30-31 January 2014. Perth, Australia: University of Western Australia. Gillan, P., van der Riet, P., & Jeong, S. (2014). End of life care education past and present: A review of the literature. Nurse Education Today, 34,331 -342. Hodges, H. F., Keeley, A. C., & Grier, E. C. (2005). Professional resilience, practice longevity, and Parse's theory for baccalaureate education. Journal of Nursing Education, 44(12), 548-554. Huang, X. Y., Chang, J. Y., Sun, F. K., & Ma, W. F. (2010). Nursing students' experiences of their first encounter with death during clinical practice in Taiwan. Journal of Clinical … 1 Second Treatise on Government by John Locke(1690) Chapter I: §.3. POLITICAL POWER, then, I take to be a RIGHT of making laws with penalties of death, and consequently all less penalties, for the regulating and
  • 32. preserving of property, and of employing the force of the community, in the execution of such laws, and in the defence of the common-wealth from foreign injury; and all this only for the public good. Chapter II: Of the State Of Nature §.4. To understand political power aright, and derive it from its original, we must consider what estate all men are naturally in, and that is, a state of perfect freedom to order their actions, and dispose of their possessions and persons as they think fit, within the bounds of the law of Nature, without asking leave or depending upon the will of any other man. A state also of equality, wherein all the power and jurisdiction is reciprocal, no one having more than another, there being nothing more evident than that creatures of the same species and rank, promiscuously born to all the same advantages of Nature, and the use of the same faculties, should also be equal one amongst another, without
  • 33. subordination or subjection, unless the lord and master of them all should, by any manifest declaration of his will, set one above another, and confer on him, by an evident and clear appointment, an undoubted right to dominion and sovereignty… §.6. But though this be a state of liberty, yet it is not a state of licence; though man in that state have an uncontrollable liberty to dispose of his person or possessions, yet he has not liberty to destroy himself, or so much as any creature in his possession, but where some nobler use than its bare preservation calls for it. The state of Nature has a law of Nature to govern it, which obliges every one, and reason, which is that law, teaches all mankind who will but consult it, that being all equal and independent, no one ought to harm another in his life, health, liberty or possessions; for men being all the workmanship of one omnipotent and infinitely wise Maker; all the servants of one sovereign Master, sent into the world by His order and about His business; they are His property, whose
  • 34. workmanship they are made to last during His, not one another's pleasure. And, being furnished with like faculties, sharing all in one community of Nature, there cannot be supposed any such subordination among us that may authorise us to destroy one another, as if we were made for one another's uses, as the inferior ranks of creatures are for ours. Every one as he is bound to preserve himself, and not to quit his station wilfully, so by the like reason, when his own preservation comes not in competition, ought he as much as he can to preserve the rest of mankind, and not unless it be to do justice on an 2 offender, take away or impair the life, or what tends to the preservation of the life, the liberty, health, limb, or goods of another. CHAP. IX: Of the Ends of Political Society and Government. §. 123. IF man in the state of nature be so free, as has been said; if he be absolute lord of
  • 35. his own person and possessions, equal to the greatest, and subject to no body, why will he part with his freedom? why will he give up this empire, and subject himself to the dominion and controul of any other power? To which it is obvious to answer, that though in the state of nature he hath such a right, yet the enjoyment of it is very uncertain, and constantly exposed to the invasion of others: for all being kings as much as he, every man his equal, and the greater part no strict observers of equity and justice, the enjoyment of the property he has in this state is very unsafe, very unsecure. This makes him willing to quit a condition, which, however free, is full of fears and continual dangers: and it is not without reason, that he seeks out, and is willing to join in society with others, who are already united, or have a mind to unite, for the mutual preservation of their lives, liberties and estates, which I call by the general name, property. §. 124. The great and chief end, therefore, of men’s uniting into common-wealths, and putting themselves under government, is the preservation of
  • 36. their property. To which in the state of nature there are many things wanting. First, There wants an established, settled, known law, received and allowed by common consent to be the standard of right and wrong, and the common measure to decide all controversies between them: for though the law of nature be plain and intelligible to all rational creatures; yet men being biassed by their interest, as well as ignorant for want of study of it, are not apt to allow of it as a law binding to them in the application of it to their particular cases. §. 125. Secondly, In the state of nature there wants a known and indifferent judge, with authority to determine all differences according to the established law: for every one in that state being both judge and executioner of the law of nature, men being partial to themselves, passion and revenge is very apt to carry them too far, and with too much heat, in their own cases; as well as negligence, and unconcernedness, to make them too
  • 37. remiss in other men’s. §. 126. Thirdly, In the state of nature there often wants power to back and support the sentence when right, and to give it due execution. They who by any injustice offended, will seldom fail, where they are able, by force to make good their injustice; such resistance many times makes the punishment dangerous, and frequently destructive, to those who attempt it. 3 §. 127. Thus mankind, notwithstanding all the privileges of the state of nature, being but in an ill condition, while they remain in it, are quickly driven into society. Hence it comes to pass, that we seldom find any number of men live any time together in this state. The inconveniencies that they are therein exposed to, by the irregular and uncertain exercise of the power every man has of punishing the transgressions of others, make them take
  • 38. sanctuary under the established laws of government, and therein seek the preservation of their property. It is this makes them so willingly give up every one his single power of punishing, to be exercised by such alone, as shall be appointed to it amongst them; and by such rules as the community, or those authorized by them to that purpose, shall agree on. And in this we have the original right and rise of both the legislative and executive power, as well as of the governments and societies themselves. §. 128. For in the state of nature, to omit the liberty he has of innocent delights, a man has two powers. The first is to do whatsoever he thinks fit for the preservation of himself, and others within the permission of the law of nature: by which law, common to them all, he and all the rest of mankind are one community, make up one society, distinct from all other creatures. And were it not for the corruption and vitiousness of degenerate men, there would be no need of any other; no necessity that men should separate from this great and
  • 39. natural community, and by positive agreements combine into smaller and divided associations. The other power a man has in the state of nature, is the power to punish the crimes committed against that law. Both these he gives up, when he joins in a private, if I may so call it, or particular politic society, and incorporates into any common-wealth, separate from the rest of mankind. §. 129. The first power, viz. of doing whatsoever be thought for the preservation of himself, and the rest of mankind, he gives up to be regulated by laws made by the society, so far forth as the preservation of himself, and the rest of that society shall require; which laws of the society in many things confine the liberty he had by the law of nature. §. 130. Secondly, The power of punishing he wholly gives up, and engages his natural force, (which he might before employ in the execution of the law of nature, by his own single authority, as he thought fit) to assist the executive power
  • 40. of the society, as the law thereof shall require: for being now in a new state, wherein he is to enjoy many conveniencies, from the labour, assistance, and society of others in the same community, as well as protection from its whole strength; he is to part also with as much of his natural liberty, in providing for himself, as the good, prosperity, and safety of the society shall require; which is not only necessary, but just, since the other members of the society do the like. 4 §. 131. But though men, when they enter into society, give up the equality, liberty, and executive power they had in the state of nature, into the hands of the society, to be so far disposed of by the legislative, as the good of the society shall require; yet it being only with an intention in every one the better to preserve himself, his liberty and property; (for
  • 41. no rational creature can be supposed to change his condition with an intention to be worse) the power of the society, or legislative constituted by them, can never be supposed to extend farther, than the common good; but is obliged to secure every one’s property, by providing against those three defects above mentioned, that made the state of nature so unsafe and uneasy. And so whoever has the legislative or supreme power of any common-wealth, is bound to govern by established standing laws, promulgated and known to the people, and not by extemporary decrees; by indifferent and upright judges, who are to decide controversies by those laws; and to employ the force of the community at home, only in the execution of such laws, or abroad to prevent or redress foreign injuries, and secure the community from inroads and invasion. And all this to be directed to no other end, but the peace, safety, and public good of the people. CHAP. XI: Of the Extent of the Legislative Power.
  • 42. §. 134. THE great end of men’s entering into society, being the enjoyment of their properties in peace and safety, and the great instrument and means of that being the laws established in that society; the first and fundamental positive law of all common-wealths is the establishing of the legislative power; as the first and fundamental naturallaw, which is to govern even the legislative itself, is the preservation of the society, and (as far as will consist with the public good) of every person in it. This legislative is not only the supreme power of the common-wealth, but sacred and unalterable in the hands where the community have once placed it; nor can any edict of any body else, in what form soever conceived, or by what power soever backed, have the force and obligation of a law, which has not its sanction from that legislative which the public has chosen and appointed: for without this the law could not have that, which is absolutely necessary to its being a law,*the consent of the society, over whom no body can have a power to make
  • 43. laws, but by their own consent, and by authority received from them; and therefore all the obedience, which by the most solemn ties any one can be obliged to pay, ultimately terminates in this supreme power, and is directed by those laws which it enacts: nor can any oaths to any foreign power whatsoever, or any domestic subordinate power, discharge any member of the society from his obedience to the legislative, acting pursuant to their trust; nor oblige him to any obedience contrary to the laws so enacted, or farther than they do allow; it being ridiculous to imagine one can be tied ultimately to obey any power in the society, which is not the supreme. http://oll.libertyfund.org/?option=com_staticxt&staticfile=show. php%3Ftitle=222&chapter=16384&layout=html&Itemid=27#lf0 057_footnote_nt008 5 §. 135. Though the legislative, whether placed in one or more, whether it be always in being, or only by intervals, though it be the supreme power in every common-wealth; yet,
  • 44. First, It is not, nor can possibly be absolutely arbitrary over the lives and fortunes of the people: for it being but the joint power of every member of the society given up to that person, or assembly, which is legislator; it can be no more than those persons had in a state of nature before they entered into society, and gave up to the community: for no body can transfer to another more power than he has in himself; and no body has an absolute arbitrary power over himself, or over any other, to destroy his own life, or take away the life or property of another. A man, as has been proved, cannot subject himself to the arbitrary power of another; and having in the state of nature no arbitrary power over the life, liberty, or possession of another, but only so much as the law of nature gave him for the preservation of himself, and the rest of mankind; this is all he doth, or can give up to the common-wealth, and by it to the legislative power, so that the legislative can have no more than this. Their power, in the utmost bounds of it, is limited to the
  • 45. public good of the society. It is a power, that hath no other end but preservation, and therefore can never* have a right to destroy, enslave, or designedly to impoverish the subjects. The obligations of the law of nature cease not in society, but only in many cases are drawn closer, and have by human laws known penalties annexed to them, to inforce their observation. Thus the law of nature stands as an eternal rule to all men, legislators as well as others. The rules that they make for other men’s actions, must, as well as their own and other men’s actions, be conformable to the law of nature, i. e. to the will of God, of which that is a declaration, and the fundamental law of nature being the preservation of mankind, no human sanction can be good, or valid against it. §. 136. Secondly,* The legislative, or supreme authority, cannot assume to its self a power to rule by extemporary arbitrary decrees, but is bound to dispense justice, and decide the rights of the subject by promulgated standing laws, and known authorized
  • 46. judges: for the law of nature being unwritten, and so no where to be found but in the minds of men, they who through passion or interest shall miscite, or misapply it, cannot so easily be convinced of their mistake where there is no established judge: and so it serves not, as it ought, to determine the rights, and fence the properties of those that live under it, especially where every one is judge, interpreter, and executioner of it too, and that in his own case: and he that has right on his side, having ordinarily but his own single strength, hath not force enough to defend himself from injuries, or to punish delinquents. To avoid these inconveniencies, which disorder men’s properties in the state of nature, men unite into societies, that they may have the united strength of the whole society to secure and defend their properties, and may have standing rules to bound it, by which every one may know what is his. To this end it is that men give up all their natural power to the society which they enter into, and the community put the legislative power
  • 47. into such hands as they think fit, with this trust, that they shall be governed by declared laws, or else their peace, quiet, and property will still be at the same uncertainty, as it was in the state of nature. http://oll.libertyfund.org/?option=com_staticxt&staticfile=show. php%3Ftitle=222&chapter=16384&layout=html&Itemid=27#lf0 057_footnote_nt009 http://oll.libertyfund.org/?option=com_staticxt&staticfile=show. php%3Ftitle=222&chapter=16384&layout=html&Itemid=27#lf0 057_footnote_nt010 6 §. 137. Absolute arbitrary power, or governing without settled standing laws, can neither of them consist with the ends of society and government, which men would not quit the freedom of the state of nature for, and tie themselves up under, were it not to preserve their lives, liberties and fortunes, and by stated rules of right and property to secure their peace and quiet. It cannot be supposed that they should intend, had they a power so to do, to give to any one, or more, an absolute arbitrary power over their persons and estates,
  • 48. and put a force into the magistrate’s hand to execute his unlimited will arbitrarily upon them. This were to put themselves into a worse condition than the state of nature, wherein they had a liberty to defend their right against the injuries of others, and were upon equal terms of force to maintain it, whether invaded by a single man, or many in combination. Whereas by supposing they have given up themselves to the absolute arbitrary power and will of a legislator, they have disarmed themselves, and armed him, to make a prey of them when he pleases; he being in a much worse condition, who is exposed to the arbitrary power of one man, who has the command of 100,000, than he that is exposed to the arbitrary power of 100,000 single men; no body being secure, that his will, who has such a command, is better than that of other men, though his force be 100,000 times stronger. And therefore, whatever form the commonwealth is under, the ruling power ought to govern by declared and received laws, and nor by extemporary dictates and
  • 49. undetermined resolutions: for then mankind will be in a far worse condition than in the state of nature, if they shall have armed one, or a few men with the joint power of a multitude, to force them to obey at pleasure the exorbitant and unlimited decrees of their sudden thoughts, or unrestrained, and till that moment unknown wills, without having any measures set down which may guide and justify their actions: for all the power the government has, being only for the good of the society, as it ought not to be arbitrary and at pleasure, so it ought to be exercised by established and promulgated laws; that both the people may know their duty, and be safe and secure within the limits of the law; and the rulers too kept within their bounds, and not be tempted, by the power they have in their hands, to employ it to such purposes, and by such measures, as they would not have known, and own not willingly. §. 138. Thirdly, The supreme power cannot take from any man any part of his property
  • 50. without his own consent: for the preservation of property being the end of government, and that for which men enter into society, it necessarily supposes and requires, that the people should have property, without which they must be supposed to lose that, by entering into society, which was the end for which they entered into it; too gross an absurdity for any man to own. Men therefore in society having property, they have such a right to the goods, which by the law of the community are their’s, that no body hath a right to take their substance or any part of it from them, without their own consent: without this they have no property at all; for I have truly no property in that, which another can by right take from me, when he pleases, against my consent. Hence it is a mistake to think, that the supreme or legislative power of any common-wealth, can do what it will, and dispose of the estates of the subject arbitrarily, or take any part of them at pleasure. This is not much to be feared in governments where the legislative consists,
  • 51. 7 wholly or in part, in assemblies which are variable, whose members, upon the dissolution of the assembly, are subjects under the common laws of their country, equally with the rest. But in governments, where the legislative is in one lasting assembly always in being, or in one man, as in absolute monarchies, there is danger still, that they will think themselves to have a distinct interest from the rest of the community; and so will be apt to increase their own riches and power, by taking what they think fit from the people: for a man’s property is not at all secure, tho’ there be good and equitable laws to set the bounds of it between him and his fellow subjects, if he who commands those subjects have power to take from any private man, what part he pleases of his property, and use and dispose of it as he thinks good. §. 139. But government, into whatsoever hands it is put, being, as I have before shewed,
  • 52. intrusted with this condition, and for this end, that men might have and secure their properties; the prince, or senate, however it may have power to make laws, for the regulating of property between the subjects one amongst another, yet can never have a power to take to themselves the whole, or any part of the subjects property, without their own consent: for this would be in effect to leave them no property at all. And to let us see, that even absolute power, where it is necessary, is not arbitrary by being absolute, but is still limited by that reason, and confined to those ends, which required it in some cases to be absolute, we need look no farther than the common practice of martial discipline: for the preservation of the army, and in it of the whole common-wealth, requires an absolute obedience to the command of every superior officer, and it is justly death to disobey or dispute the most dangerous or unreasonable of them; but yet we see, that neither the serjeant, that could command a soldier to march up to the mouth of a
  • 53. cannon, or stand in a breach, where he is almost sure to perish, can command that soldier to give him one penny of his money; nor the general, that can condemn him to death for deserting his post, or for not obeying the most desperate orders, can yet, with all his absolute power of life and death, dispose of one farthing of that soldier’s estate, or seize one jot of his goods; whom yet he can command any thing, and hang for the least disobedience; because such a blind obedience is necessary to that end, for which the commander has his power, viz. the preservation of the rest; but the disposing of his goods has nothing to do with it. §. 140. It is true, governments cannot be supported without great charge, and it is fit every one who enjoys his share of the protection, should pay out of his estate his proportion for the maintenance of it. But still it must be with his own consent, i. e. the consent of the majority, giving it either by themselves, or their representatives chosen by
  • 54. them: for if any one shall claim a power to lay and levy taxes on the people, by his own authority, and without such consent of the people, he thereby invades the fundamental law of property, and subverts the end of government: for what property have I in that, which another may by right take, when he pleases, to himself? 8 §. 141.Fourthly, The legislative cannot transfer the power of making laws to any other hands: for it being but a delegated power from the people, they who have it cannot pass it over to others. The people alone can appoint the form of the common-wealth, which is by constituting the legislative, and appointing in whose hands that shall be. And when the people have said, We will submit to rules, and be governed by laws made by such men, and in such forms, no body else can say other men shall make laws for them; nor can the people be bound by any laws, but such as are enacted by those whom they have chosen,
  • 55. and authorized to make laws for them. The power of the legislative, being derived from the people by a positive voluntary grant and institution, can be no other than what that positive grant conveyed, which being only to make laws, and not to make legislators, the legislative can have no power to transfer their authority of making laws, and place it in other hands. §. 142. These are the bounds which the trust, that is put in them by the society, and the law of God and nature, have set to the legislative power of every common-wealth, in all forms of government. First, They are to govern by promulgated established laws, not to be varied in particular cases, but to have one rule for rich and poor, for the favourite at court, and the country man at plough. Secondly, These laws also ought to be designed for no other end ultimately, but the good of the people.
  • 56. Thirdly, They must not raise taxes on the property of the people, without the consent of the people, given by themselves, or their deputies. And this properly concerns only such governments where the legislative is always in being, or at least where the people have not reserved any part of the legislative to deputies, to be from time to time chosen by themselves. Fourthly, The legislative neither must nor can transfer the power of making laws to any body else, or place it any where, but where the people have. CHAP. XII.: Of the Legislative, Executive, and Federative Power of the Common- wealth. §. 143. THE legislative power is that, which has a right to direct how the force of the common-wealth shall be employed for preserving the community and the members of it. But because those laws which are constantly to be executed, and whose force is always to continue, may be made in a little time; therefore there is no need, that the legislative
  • 57. should be always in being, not having always business to do. And because it may be too great a temptation to human frailty, apt to grasp at power, for the same persons, who have the power of making laws, to have also in their hands the power to execute them, 9 whereby they may exempt themselves from obedience to the laws they make, and suit the law, both in its making, and execution, to their own private advantage, and thereby come to have a distinct interest from the rest of the community, contrary to the end of society and government: therefore in well-ordered common-wealths, where the good of the whole is so considered, as it ought, the legislative power is put into the hands of divers persons, who duly assembled, have by themselves, or jointly with others, a power to make laws, which when they have done, being separated again, they are themselves subject to the laws they have made; which is a new and near tie
  • 58. upon them, to take care, that they make them for the public good… CHAP. XVIII.: Of TYRANNY. §. 199. AS usurpation is the exercise of power, which another hath a right to; so tyranny is the exercise of power beyond right, which no body can have a right to. And this is making use of the power any one has in his hands, not for the good of those who are under it, but for his own private separate advantage. When the governor, however intitled, makes not the law, but his will, the rule; and his commands and actions are not directed to the preservation of the properties of his people, but the satisfaction of his own ambition, revenge, covetousness, or any other irregular passion… In Congress, July 4, 1776
  • 59. The Unanimous Declaration of the Thirteen United States of America When in the Course of human events, it becomes necessary for one people to dissolve the political bands which have connected them with another, and to assume among the Powers of the earth, the separate and equal station to which the Laws of Nature and of Nature's God entitle them, a decent respect to the opinions of mankind requires that they should declare the causes which impel them to the separation. We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness. That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to
  • 60. institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness. Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shown, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security. -- Such has been the patient sufferance of these Colonies; and such is now the necessity which constrains them to alter their former Systems of Government. The history of the present King of Great Britain is a history of repeated injuries
  • 61. and usurpations, all having in direct object the establishment of an absolute Tyranny over these States. To prove this, let Facts be submitted to a candid world. He has refused his Assent to Laws, the most wholesome and necessary for the public good. He has forbidden his Governors to pass Laws of immediate and pressing importance, unless suspended in their operation till his Assent should be obtained; and when so suspended, he has utterly neglected to attend to them. He has refused to pass other Laws for the accommodation of large districts of people, unless those people would relinquish the right of Representation in the Legislature, a right inestimable to them and formidable to tyrants only. He has called together legislative bodies at places unusual, uncomfortable, and distant from the depository or their public Records, for the sole purpose of fatiguing
  • 62. them into compliance with his measures. He has dissolved Representative Houses repeatedly, for opposing with manly firmness his invasions on the rights of the people. He has refused for a long time, after such dissolutions, to cause others to be elected; whereby the Legislative powers, incapable of Annihilation, have returned to the People at large for their exercise; the State remaining in the mean time exposed to all the dangers of invasion from without, and convulsions within. He has endeavoured to prevent the population of these States; for that purpose obstructing the Laws for Naturalization of Foreigners; refusing to pass others to encourage their migration hither, and raising the conditions of new Appropriations of Lands. He has obstructed the Administration of Justice, by refusing his Assent to Laws for establishing Judiciary powers.
  • 63. He has made Judges dependent on his Will alone, for the tenure of their offices, and the amount and payment of their salaries. He has erected a multitude of New Offices, and sent hither swarms of Officers to harrass our people, and eat out their substance. He has kept among us, in times of peace, Standing Armies, without the Consent of our legislatures. He has affected to render the Military independent of and superior to the Civil power. He has combined with others to subject us to a jurisdiction foreign to our constitution, and unacknowledged by our laws; giving his Assent to their Acts of pretended Legislation: For quartering large bodies of armed troops among us: For protecting them, by a mock Trial, from Punishment for any Murders which they should commit on the Inhabitants of these States:
  • 64. For cutting off our Trade with all parts of the world: For imposing Taxes on us without our Consent: For depriving us in many cases, of the benefits of Trial by Jury: For transporting us beyond Seas to be tried for pretended offenses: For abolishing the free System of English Laws in a neighboring Province, establishing therein an Arbitrary government, and enlarging its Boundaries so as to render it at once an example and fit instrument for introducing the same absolute rule into these Colonies: For taking away our Charters, abolishing our most valuable Laws, and altering fundamentally the Forms of our Governments: For suspending our own Legislatures, and declaring themselves invested with power to legislate for us in all cases whatsoever. He has abdicated Government here, by declaring us out of his Protection and waging War against us.
  • 65. He has plundered our seas, ravaged our Coasts, burnt our towns, and destroyed the lives of our people. He is at this time transporting large Armies of foreign Mercenaries to compleat the works of death, desolation and tyranny, already begun with circumstances of Cruelty & perfidy scarcely paralleled in the most barbarous ages, and totally unworthy the Head of a civilized nation. He has constrained our fellow Citizens taken Captive on the high Seas to bear Arms against their Country, to become the executioners of their friends and Brethren, or to fall themselves by their Hands. He has excited domestic insurrections amongst us, and has endeavoured to bring on the inhabitants of our frontiers, the merciless Indian Savages, whose known rule of warfare, is an undistinguished destruction of all ages, sexes and conditions.
  • 66. In every state of these Oppressions We have Petitioned for Redress in the most humble terms: Our repeated Petitions have been answered only by repeated injury. A Prince, whose character is thus marked by every act which may define a Tyrant, is unfit to be the ruler of a free people. Nor have We been wanting in attentions to our Brittish brethren. We have warned them from time to time of attempts by their legislature to extend an unwarrantable jurisdiction over us. We have reminded them of the circumstances of our emigration and settlement here. We have appealed to their native justice and magnanimity, and we have conjured them by the ties of our common kindred to disavow these usurpations, which, would inevitably interrupt our connections and correspondence. They too have been deaf to the voice of justice and of consanguinity. We must, therefore, acquiesce in the necessity, which denounces our
  • 67. Separation, and hold them, as we hold the rest of mankind, Enemies in War, in Peace Friends. We, Therefore, the Representatives of the United States of America, in General Congress, Assembled, appealing to the Supreme Judge of the world for the rectitude of our intentions, do, in the Name, and by Authority of the good People of these Colonies, solemnly publish and declare, That these United Colonies are, and of Right ought to be Free and Independent States; that they are Absolved from all Allegiance to the British Crown, and that all political connection between them and the State of Great Britain, is and ought to be totally disolved; and that as Free and Independent States, they have full Power to levy War, conclude Peace, contract Alliances, establish Commerce, and to do all other Acts and Things which Independent States may of right do. And for the support of this Declaration, with a firm reliance on the protection of Divine Providence, we mutually pledge to each
  • 68. other our Lives, our Fortunes and our sacred Honor. Brainstorm Research Question · You get to frame the extent of the research question · What is included? · What is left out? · How you frame your question can radically change the results you find · Do not begin with the thesis/claim · What biases or assumptions (good or bad) am I bringing into the question? Development · What have other scholars said about the subject? · What have they left out? · What have they overlooked? · What can I add? · Anticipate counterarguments and other claims Essay · Introduction · Introduce topic · Be specific and contextual · Avoid sweeping generalizations · Introduce claim (thesis) · Thesis should be narrowly focused and specific · Do not try to cover too much or claim more than you can prove · Thesis should be direct and clear · Thesis should be debatable · Otherwise you are not making a claim but stating the facts
  • 69. · Organization · Each body paragraph should have specific evidence · Historical data · Legal research · Textual analysis · Engage with the existing scholarship · Give credit where credit is due · Introduce a contrary view · There should be a logical flow to arrangement of your essay as a whole · Build up your argument · Conclusion · Don’t just repeat your thesis · Explain the significance of your topic · End memorably · Link your argument to current events · Provide a salient quotation or recount an anecdote · Editing · Be concise; edit ruthlessly · Eliminate repetition · Combine sentences and vary syntactical patterns · Be as PRECISE as possible in your diction or word choice · Use active verbs when possible · Check for spelling errors or faulty comma use Prompts 1) According to John Locke, what is political power and where does it come from? What are the just limits of the use of legislative power? How did this understanding influence the Constitution?