Creative Writing

What does it look like to craft an effective dramatic text,	(M) (NYM)	if "Met," what's the evidence?
·    Did you plan the piece before beginning to write (i.e., characters' motivations, the back-story, the .Iting),	M	I spent several hours on planning the characters of this story, and I wanted to talk about how the honesty of a person can lead him to get success.
·    Did you use elements of form related to dramatic writing (e.g., dialogue/monologue; indicating who is speaking; stage directions; organizing text into scenes)?	NYM
·    Do your characters take action to move the plot forward? Are the characters credible? Can you envision the characters to be real people?	M	The leading character takes most of the moves in the plot forward, but it does not mean the other characters are not realistic.
·    Did you use dialogue to give the reader clues about the characters' personality feelings, motivations,and desires?	NYM
·    Did you provide stage directions which help the actors interpret the scene for the audience (e.g., describe actions, body language, facial expressions, tone of voice of characters; describe the sets, costumes, props, sound effects, and camera angles, shots and lighting effects; identify when a character enters or exits)?	NYM
·    Have you used clear, concise language, figurative language, and literary devices to achieve the purpose of the piece?	Met	I have used a variety of literary devices such as diction, allusion, and imagery to tell the story.

The Story – Honesty of a Little Boy

Once upon a time, a woodcutter lived in a village with his son and wife. The family was very poor, but the woodcutter and his wife raised the child well and tried to provide him as many comforts as possible. When the boy reached his five, the parents decided to send him to the school as they wanted to see him progress. However, it was quite difficult for them to buy books, uniform and other things for their son as they had no money. The woodcutter anyhow arranged some money and paid the admission fee and first month’s fee of his son and began sending him to the school. Over there, the boy used to study with full concentration, and the time passed, he continued his studies and passed the classes with distinction. One day, the boy was returning home from the school when he saw a gold coin on the roadside.

First of all, he thought of bringing it home, but suddenly he realized that it would not be good and that his parents would feel bad. So, he picked up the gold coin and continued his walking toward the house. When he was about to reach home, he saw a little girl running after him and shouting. She came to the boy and told him that the gold coin was her father’s and that he had given her the coin to sell in the market for the sake of money. The boy took no time to hand over her coin to the girl, and this made her happy and satisfied. The same night, an angel came to his dream, praised his honesty and told him that there is another gold coin hidden in the backyard of his house. It was the reward of his sincerity, so the boy woke up instantly and got that gold coin. The next morning, he gave it to his parents and told the entire story. The family sold the coin and were given enough money to build their own house and to start a business.

PERSONAL STATEMENT

I am applying for B.Sc. (HONS) in psychology, and I think that it is the best career choice for me. Psychology has always been a must part of my life, and it is something that has fascinated me in a lot of ways. I love watching the people around me, especially when they interact with each other and are in a happy mood. I want to know what emotional or psychological changes take place within their body and brain during this process. In addition, I have always been interested in knowing more about the health problems of people through counseling sessions. I think that it is the best way to meet new individuals and to communicate with them. Counseling sessions can indeed provide me with plenty of opportunities to strengthen my communication skills. I love knowing how people react to different situations and what behavioral changes take place when they are dragged to uncertain circumstances.

A degree in psychology will prepare me for a bright, prosperous and outstanding tomorrow, which is always a dream of every youngster. I also have an interest in doing social works, and I think that after becoming a psychologist, it would be easy for me to boost my performance and to serve humanity in a better way. Whenever I look around, I find people with various mental problems such as depression, stress, and anxiety, and this makes me feel bad, and I always want to help them. I strongly believe that after completing my degree with distinction, I would be able to assist a large number of people with psychological or mental problems, and I would love to serve more and more people without any extra charges.

When I was in high school, some of the seniors bullied me, and this gave me a lot of pain. With time, I developed the skills of being competitive and sought out the ways to identify and fix my own flaws. I think that it is important for every psychologist to first identify his or her own flaws. Without it, they may never be able to provide best therapies to their patients. I want to assist the people who are in pain, especially the ones who remain stressed and depressed most of the times. I want to help them spiritually, physically, mentally and emotionally, and I believe that the best way is to become a psychologist. My aim is to assist them in a way that they can identify their strengths and weaknesses and can play their vital role in the progress and prosperity of the entire nation.

I have learned a lot from my life; I spent a large portion of my time reading books, helping people through social works, attending seminars on psychology, and developing self-awareness. I think that personal awareness is the key to becoming a successful psychologist, and in this competitive world, I can help people only when I know and understand how they would behave when they are put in a negative situation. Some of them may become negative-minded, while the others will become positive-minded. During this process, a lot of behavioral changes will take place and I want to study these changes in detail as well as want to know how to help them achieve the desired results and to fulfill their dreams.

Dr. Jordan B. Peterson is a professor of psychology at the University of Toronto. He has written a book titled 12 Rules for Life in which he says that we should treat ourselves in a way that we take the responsibility of helping others. I believe that we can all bring positivity to the lives of other people by becoming self-confident. In order to become successful, I should be companionate, understanding, cooperative, good-natured and humble, and I do not think any other discipline can help me become the one. In my life, I love taking charge of everything I do, think and speak, and I want to make my clients understand the same thing through counseling sessions.

Psychology is one of those very few subjects that prepare an individual to help others, and I feel that it should be taught as a foundation subject in all schools. We should all play our role in making this world peaceful, and this is only possible when we identify our core skills and are ready to assist others in the best possible ways. I may assist couples who are about to break their relationships, and for this purpose, I would have to understand their psychology and the way they react to multiple situations. Then I would be able to identify the reason behind their decision of quitting on each other. I think that transformations like this can be brought in society if more and more youngsters study psychology and arrange counseling sessions independently.

It is my dream to gain an understanding of how the human brain functions in uncertain situations that involve stress, depression, and anxiety. The world we live in is full of problems, and I have found every second individual to be suffering from a major or minor mental illness. My decision to study Psychology is absolutely right since it will help me analyze different situations, research and explore the world from a new angle, and help those who are in need of proper guidance and support.

The modules of this degree program will include topics like biological, investigative, social, cognitive, clinical and developmental psychology. I will be taught how to undertake multiple research projects at a time, how to deal with difficult clients, and how to opt for varying research methods to accomplish my tasks. In simple words, it can be said that I will develop transferable skills, problem-solving skills, writing skills, and communication skills during my studies.

In my spare time, I love taking photographs and have published some of them in local newspapers and magazines. Hopefully, this degree will help me face the challenges of professional life and allow me to fulfill my dream of helping people. I am enthusiastic and excited to take the first step toward a bright future.

References

Winnicott, D.W., 2016. A Personal Statement on Child Psychiatry. Oxford Clinical Psychology.

Basu, K., 2016. Notes on Child Labor and Education: A Personal Statement. Children and Sustainable Development, pp.31–35.

Rybarczyk, B., 2014. Sell Yourself: Adding Substance to Your Personal Statement. Science.

EMERGENCY HEALTH CARE PROVIDERS’ PERSPECTIVES ON PROVIDING CARE TO RACIALIZED IMMIGRANT WOMEN EXPERIENCING INTIMATE PARTNER VIOLENCE

Chapter 5

Discussion and Recommendations

In this chapter, I discuss how the findings described in in chapter 4 contribute to existing literature. Specifically, I outline how the themes add, extend and/or indicate new directions for knowledge development within the context of health care provider practice for women seeking IPV care in the ED. Following the discussion of the findings, I will detail recommendations for health care practice, policy, education and research while also outlining the limitations of the study.

The study findings underscore the critical importance of IPV care for women from the perspective of ED health care providers. From the literature, it has been documented that many racialized immigrant women face structural and systematic barriers to access healthcare services;health care providers in this study shared their perspectives about ED care barriers such as the lack of translation services, lack of support and inconsistent services for women, while also discussing their  views that shape IPV care for women in the ED(Cherniak et al. 2005; Lee & Hadeed, 2009; Thandi, 2011). [BH1] 

IPV related resources for ED health care providers.

Health care providers in this study emphasized how thelack of resources for women experiencing IPV was a significant factor shaping their care for women in the ED. In addition, the participants highlighted that even when resources were present, there was a lack ofawareness among HCPs and particularly for those that may have relevance for racialized immigrant women. Within the study site,for example, there is a large population of Punjabi-Sikh immigrants and many may not be able to communicate fluently in English (Statistics Canada, 2014). The findings from this study support other studies wherein language barriers and the lack of education and awareness about services and resources provided act as to impedecare for racialized immigrant women(Ahmad et al. 2009[BH2] ).

In this study HCPs described the lack of awareness of resources, services, training and referral opportunities resources and services for women. Similarly, Al-Natour et al. (2014) found that HCPs experienced challenges when trying to refer women due to the lack of awareness about accessing appropriate resources or navigating the healthcare system[BH3] . Enhancing the availability of resources to women impacted by IPV was a key theme in this study, along with the importance of tailoring care to the needs of racialized immigrant women. As one ER participant mentioned, resources are sometimes not available in other languages; thus, specific populations of women experiencing IPV may have difficulties understanding and knowing where to go for IPV care and how to  obtain more information about IPV. HCPs in this study, as in other studies (cite some?) indicated that they were unaware of resources and where to refer these women.

In addressing IPV among racialized immigrant women, resources are always a necessary consideration both at the ED level and for women seeking care themselves.e. Resources include sufficient HCPs[BH4] , sufficient personnel at the ED, and sufficiently trained HCPs on caring for women impacted byIPV[BH5] . According to participant three and five, the major discussion within the ED with women impacted by IPV is whether they have available resources to seek help and potentially leave their partners. These findings align with the findings from a study by Kaplan and Komurcu (2017) who found out that HCPs felt ill-equipped when dealing with IPV experiencing women due tolack of resources and knowledge.

Racialized[BH6]  immigrant women face many barriers that exacerbate other health care barriers when living with IPV, such as poverty and education[BH7] . The findings from participant one and participant three indicated inadequate information and education on the part of HCPs in offering care to women experiencing IPV. The absence of the required resources meant thatHCPsin this study feltthey were unable to provide the required assistance to women in the ED[BH8] .

Language as a barrier.

In this study, it was evident that language acts as amajor hindrance accessing health services, especially amongst racialized immigrant women. The available pamphlets at SMH are only in English. This reduces the effectiveness of using pamphlets and other literally materials among racialized immigrant women. These findings also point to the difficulty of HCPs communicating with thesewomen as they need an interpreter to assist in the conversation. This creates a barrier for history taking and a comprehensive assessment that is necessary for effective IPV care and can also influence the necessary privacy and confidentialitywomen need in the ED. The findings revealed that language acts as a barrier to care forracialized immigrant populations and the populations described by HCPs in this study wereSyrian immigrants and the Indo-Canadian population. Similarly, studies by Ahmad et al. (2009) and Du Mont and Forte (2012)confirmed language as a primary barrier for racialized women impacted by IPV when seeking help.

The findings further indicated that some HCPs[BH9] experienced difficulties speaking to their clients as some of these women were not fluent in English, especially the Syrian immigrants who spoke certain Arabic dialects where finding appropriate translators was challengingEven when translation services are available, translators can fail to understand and translate accurately hence adversely affecting the quality of services provided to women experiencing IPV and impacting the quality of care HCPs can provide to women impacted by IPV (Lipsky et al. 2006; Setia et al. 2011).

Unawareness of forensic services.

Another important aspect that was revealed in this study was the lack of awareness of the forensic team at SMH, especially from ER nurses, RCMP, and other community members. While the forensic team is located in the ER,many staffare unaware of the type of services provided by the forensics team and the services they are able to provide to women affected by IPV. Research has indicated that many women impacted by IPV do present themselves in the ER,thus this lack of awareness acts as a significant barrier to effective and timely care(Lipsky et al. 2006; Sormanti & Shibusawa, 2008). The findings revealed that thislack of awareness about available forensic services at SMH is also a considerable barrier to care for women. The findings not only indicated the lack of awareness about services but also lack of knowledge about caring for racialized immigrant populations as shared by HCP participants one, three and four respectively. While providing services to women experiencing IPV, awarenessabout racialized immigrant populations is of great importance. Awareness about racialized immigrant populations would enable health professionals to offer tailored services to women experiencing IPV. The findings suggested that knowledge about racialized immigrant populationswould empower nurses to be more confident when interacting with racialized immigrant women impacted by IPV whichmay facilitate better care for women experiencing IPV by creating the relational space for effective care and safety planning.

Cultural context.

The findings also indicated that women’s cultural context is relevant for how women seek care and the degree to which women may engage in discussions that disclose violence; however, HCPs need to be critical of tendency to locate violence within “culture” or align with ethnicity to explain women’s help seeking behaviours decisions to seek care. Creating safe spaces, contexts and relationship is far more important for providing care for women than HCPs efforts to better know “culture” as it relates to women’s needs.The findings of this study concur with those of Boursnell & Prosser(2010) amdEfe & Taskin, (2012)who  emphasize that ER nurses must have knowledge about barriers for care affecting women impacted by IPV; barriers to care that are relational and structural need to be tackled for the creation of safe relationships as the basis for IPV care in the ED.

Wait times, privacy and confidentiality and HCPs bias.

The study further revealed a number of other barriers such as long waiting times in the ER, lack of privacy and confidentiality, and biases by HCPs. It was evident thatERs may have long waiting times which, in turn, can make things worse and difficult for women experiencing IPV, especially for women living with trauma and violence and who lack supportive spaces and relationships while seeking care[BH10] . The study revealed that IPV cases may make individuals [BH11] impatient when waiting in the queue to see a doctor unlike other forms of illnesses. The findings indicate that most of the women experiencing IPV that seek help at the ED are at times just in need of someone to talk to. This expectation is at times hard to meet since emergency cases are always given priority in theED. The findings indicated that waiting times can be reduced by assigning specific HCPs the role of attending to women impacted by IPV in a given healthcare centre.  Nevertheless, Al-Natour et al. (2014) argued that HCPs lack time to attend to women experiencing IPV. This acts as a barrier towards responding to women experiencing IPV. [BH12] 

The lack of privacy and confidentiality was also descrived by HCPs[BH13]  are impacting how and when  women who have experienced IPV seek care. Right now, forensic nurses are on-call at SMH. However, if there is twenty-four hourscoverage, waiting times for these women could  decrease., Cherniak et al. (2005)affirmed that women who lack necessary privacy may feel uncomfortable and unsafe to disclose IPV.

The study further revealed that women experiencing IPV are at times met with bias from HCPs. It was evident that women are likely to experience discrimination when seeking help from HCPs. As such, women are not likely to receive care related with IPV and may as well fail to receive suitable referrals. Similarly, personal biases among HCPs towards women experiencing IPV were also reported by Cherniak et al. (2005), DeBoer et al. (2013), and Leppakoski et al. (2010).

Presenceof children in the ER[BH14] .

The findings of the study revealed that offering support to children and young adults accompanying women seeking assistance following IPV constitute a challengeto quality services. The delivery of quality services in the presence of children to the patient demands for extra resources for keeping them busy as they wait for their mothers. As a result, EDs often seek  help from S.M.A.R.T workers to keep the children busy during consultations. The findings revealed that the main challenge is when the child is unwilling to let go of the mother and the ER nurse has no option than to offer services in the child’s presence. Moreover, the findings indicated that theER is not that well equipped to accommodate children. Such an environment brings forth privacy concerns, especially if the child is old enough to discern what is going on. HCPs[BH15]  views on the challenges faced by racialized women.

The findings emphasized HCPs view that racialized immigrant women are the least likely to visit ER for IPV; the participants identified several factors such as language barriers and the lack of awarenessof the ER is a point of care. HCPs also described their views that racialized immigrant women often face resistance from their family members in seeking medical care, citing “culture” as a potential barrier to care. For example,HCPs pointed to how racialized immigrant women are often are often accompanied by family members probably to ensure non-disclosure of IPV. Spencer et al. (2014) found that women experiencing IPV may seek assistance from family members only to be discouraged not to disclose IPV[BH16] . While the HCPs perspectives reflect their experiences, the analysis undertaken in this study was based on a more critical notion of culture to shifts attention to the culture of ED care that manifests in structural and interpersonal barriers – such as bias – to IPV care for all women.

While on the recurrence of IPV among racialized immigrant women indicated that women are less likely to seek help due to the lack of awareness of their rights and their inability to open up to HCPs, the findings here turn attention to health care culture – and the ED environment for barriers to care for women that impact help-seeking and disclosure[BH17] . WhileSpencer et al. (2014) confirmed that racialized women experiencing IPV are likely not to be aware of where to seek assistance on IPV related care, the findings of this study counter this individualizing orientation to ‘help seeking’. More often than not, lack of awareness is not an individual’s problem or shortcoming, but a complex interplay of structural and interpersonal factors that impact HCP practice. In this study, not accessing or seeking out available services was primarily understood by HCPs as related to language barriers and the lack of trust and rapport with HCPs based on their societal norms and past history. Cherniak et al. (2005) confirmed that language acts as a significant barrier towards disclosing IPV related experiences.In addition, and importantly, racialized immigrant women also face challenges of trusting ER nurses. The needs of IPV patientsvary from one patient to the next. For instance, the study also revealed that racialized immigrant women may also prefer female HCPs who are not of their ethnic background and the possible language barriers only end up limiting the amount of disclosure as mentioned by participants four and five (Hyman et al. 2009; Lipsky et al. 2006; Setia et al. 2011).

Recommendations

Practice.

Having strong and competent translators and supporting them in their roles is important when communicating with women experiencing IPV, especially for racialized immigrant women who disproportionately face barriers to care.Additionally, having translators available that speak a wide array of languages is critical to meet the needs ofnew immigrant arrive in BC. There should also be a creation of a private area for women impacted by IPV who come to ER for treatment. This has the potential of benefiting these women and help increase privacy and discretion. The provision of forensic nursing services in the ER is not only essential but vital for comprehensive care. It is thus important to meet the medical and legal needs of women impacted by IPV as well as ensure they receive compassionate and quality care.

Anti-discrimination training and more critical orientations to the culture of health care as it impacts racialized immigrant womenare necessary to address biases, along with the capacity to analyze the structural barriers to accessing IPV care for all women in the ED. Hiring nurses who speak multiple languages or hiring of translators may adequately solve issues involving language barriers. In addition, there should be efforts to inform health care professionals who are likely to come into contact with women experiencing IPV concerning the services offered in the ER department. This would ensure that health care professionals are able to offer the much-needed support and resources to women impacted by IPV in a timely manner. Furthermore, the presence of adequately trained forensic nurses to handle these cases will greatly help women impacted by IPV. Moreover, any ED ought to have space or resources to accommodate children while their mothers seek care in the ED.

Policy and education.

HCPs need to be properly trained and educated about resources and services available for women impacted by IPV. Furthermore, it is pertinent to have resources that are specifically tailored to serve racialized immigrant women. The resources should take account of how structural and institutional racism acts ate barriers to seeking help and care within the context of IPV. In addition, te importance of non-judgemental and compassionate care to all women impacted by IPV is critical, with knowledge of how discrimination and bias affects access to and quality of IPV care.

The results indicated that ER nurses and HCPs were unaware of the type of services forensics nurses provide and RCMP and women themselves were unaware that they can come to ER for support. As such, there needs to be more education, awareness, and support such as doing online courses, in-services, and reaching out to the RCMP and ER HCPs. Education and raising awareness may help sensitize that ER is a critical point of care for women experiencingIPV.There is need to educate the nurses about available resources that can be used to offer services to racialized immigrant women experiencing IPV.

 IPV related care requires specialized skills on how to meet the needs of  racialized women and as such, training nurses will  offer more effective  and informed care to their patients.Some of the specialized skills that the nurses can acquire includethe capability to identify inconsistencies with stories that may not match injuries such as those related to IPV[BH18] [BH19] . [BH20] 

Further research.

The HCPs emphasized the significance of offering women experiencing IPV with relevant resources. Nevertheless, HCPs indicated that there is lack of resources and inability to access information within the ER setting. Therefore, it would be important for future researchers to consider how accessibility of information among HCPs can be improved. Specifically, they need to focus on how resources for racialized women within the ER setting can be enhanced, and one way of achieving, among others, that could be by educating HCPsEvidence informed practices through research could improve the quality of services offered to racialized immigrant women experiencing IPV.

Limitations.

The sample size of the study was small and consisted of mostly forensic nurses, one ER nurse, and one social worker and no ER physicians. The smaller sample size was a limitationwhen attempting to make inferences and generalization of the findings[BH21] . Additionally, the small sample size was a limitationwith regard the breadth, depth, and variability of the data; As a novice researcher, the researcher may have held strong assumptions [BH22] about the topic under study (violence is cultural) based on the ethnicity. Additionally, the research questions did not allow for deeper probing, so the analysis lacked more critical breadth and depth. [BH23] 

In addition, the researcher is of South Asian and Canadian descent and may have unknowingly influenced results. The researcher might  made efforts to consider their own thoughts (reflexivity) when undertaking the study but the degree of influence likely was still operating, as evidence by the continual need to have assumptions challenged by the supervisory committee. . As such, the researcher may have unknowingly influenced the results of the interviews. This could have influenced the credibility of research outcomes. [BH24] 

Summary

            Chapter five presented a discussion of findings in relation to the perspectives as well as experiences of health care providers when caring for women experiencing IPV. The chapter also presented recommendations and limitations of the study. The discussion of the findings revealed that HCPs experience barriers including the lack of translation services, the lack of support, and inconsistent services for women. The perspectives and views of HCPs were shown to shape IPV care for women in the ED. The discussion revealed that HCPs lack adequate resources to attend to these women. Additionally, HCPs emerged to be unaware about available resources in the ER department especially pertaining to forensic services. Language was also identified as a key challenged faced by HCPs when offering health care services to these women. Offering support to children and young adults accompanying women seeking assistance following IPV was also revealed to be a key challenge to quality services.

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 [BH1]There ought not to be a reference here, this is about your study so remove these and use later when you discuss the findings in relation to what these studies show.

 [BH2]Any others you can add here?

 [BH3]Good!

 [BH4]? sufficient how?

 [BH5]Is this your study or others?

 [BH6]New topic, new para

 [BH7]Reference this claim!

 [BH8]Can you show what this adds, looking back at the studies you cite in the lit review?

 [BH9]You don’t need this detail here

 [BH10]Can you cite similar studies to emphasize this importance?

 [BH11]?? make who impatient, HCPs?

 [BH12]This para is not clear, please edit for clarity

 [BH13]You didn’t interview women so you can write this as if they said these things, it is all through the lens of the HCPs so do check for that throughout.

 [BH14]I see you are only discussing some of your findings here. At the start of the chapter, state how you are drawing from your findings to structure this discussion so your reader can follow your logic about what you are discussing; for example, there is no mention of motivation to provide care yet that was a subtheme; provide your discussion rationale so its clear, otherwise the reader wonders about the findings not discussed.

 [BH15]And how does any of this related to literature? Is there any? If not say this is under investigated area that needs more research!

 [BH16]How is this study relevant for your findings about racialized women?

 [BH17]Good!

 [BH18]This is not in your data – say how it is about safe spaces so woman feel safe to seek care!

 [BH19]It was not said that nurses should police consistency in stories and injuries, but create safety for disclosure, but so much more.

 [BH20]You have already said this several times – it cannot be the sole answer

 [BH21]This is not a limitation, qualitative findings are never intended to  be generalizable.

It is reasonable to say the small sample limited depth of the data only.

 [BH22]This is not about being novice, it is about being an ER nurse; and living in the world as a immigrant women potentially? Lived experience creates assumptions, and so becoming critically conscious was challenging; unpacking violence is cultural was your biggest challenge

 [BH23]This is not accurate, your RQs did but your lack of experience with research may have limited the depth reached.

 [BH24]This is not accurate – its about knowingly becoming aware and you are a novice at that, so say that!