Recovery Room Discharge and Pain Relief

Recovery Room Discharge and Pain Relief Title: Select one aspect of care which you have undertaken in childrens nursing practice in relation to the discharge process and critically analyse and discuss the key components of that care in relation to your experience, discharge planning and the specific research/literature you have reviewed. Introduction The aspect of care to be discussed is pain management for a 4 year old boy after facial surgery, on a Nurse Controlled Analgesic morphine pump, being discharged from the recovery room to the ward The need for discharge planning in optimising patient care has been identified in many recent studies and papers (viz. Mills M M et al. 2006). The basic rationale in all arguments for discharge planning is so that mechanisms to facilitate discharge can be put in place both before interdepartmental discharges and transfers, as well as before the eventual discharge, throughout the period of hospitalisation, so that they do not overwhelm healthcare professionals, the patient or parents at the end of the stay in the facility, department or the hospital. A useful general tool for planning discharge is enunciated by Bruccoliere with identification of tasks and deadlines for transition tasks set shortly after admission and ideally incorporated into daily multidisciplinary ward rounds. This is specifically targeted at total hospital discharge, but has features aimed at departmental discharges or transfers. (Bruccoliere T 2000). This type of approach has been advocated by Halm who has expanded the tool to include a formal review by the responsible nurse (or team leader) for all paediatric patients whose discharge is anticipated within one week, to ensure that the discharge plan includes a projected day of discharge, a check on home equipment and medication, home health needs, home feeding plan, screening needs (e.g. car seat trial; hearing, developmental, or feeding assessment for the very young child), identification of a primary care doctor, and necessary follow-up plans in either primary care or the hospital outpatients. (Halm M A et al. 2003). Such measures may be appropriate for the patient in question at the end of their hospital stay. In this particular case however, one is considering a specific instance of interdepartmental transfer and the discharge planning mechanisms are therefore more specific. This particular examination of departmental discharge will be focussed primarily on pain relief. The key concepts of discharge planning where pain relief is a major feature (in specific consideration of these circumstances) are Assessment of pain Control of pain pharmacological and nonpharmacological Safe storage and use of opiates Individual pain control plans developed with the child and parent (longer term consideration) Appropriate hand over mechanisms for relevant healthcare professionals. (After Pagnamenta R et al. 2008) Outline of the child and family and context (include family involvement in preparation for discharge focusing on the particular aspect of nursing care (pain management). In line with elements of confidentiality outlined in NMC, this essay will refer to the patient concerned as Boy F. (NMC 2004) Boy F. had a delayed extensive facial reconstruction following facial trauma and had been in the recovery room for four hours while his blood pressure and other vital signs stabilised. Pain relief was identified as a major priority in his case. The family comprised of both parents and an older sister who had been present at the hospital throughout the operation and were known to be waiting on the ward for his return. It is known that the family are very questioning and highly involved with the patient’s care and that they would be full of questions relating to the morphine pump when Boy F returns to the ward. The policy of empowerment and education of the patient’s family has been fully embraced in this particular circumstance, (Howe J et al. 2003) and must therefore form a part of the overall discharge plan. Critical analysis of the evidence that supports this aspect of nursing care. Critically analyse and discuss the key components of the care provided in relation to your experience, the discharge process and the research literature reviewed. Break the discharge process into the 4 parts of the Nursing Process: assessment, planning, implementation and evaluation. Assessment (To include; Government recommendations on starting discharge planning on admission and having a discharge coordinator) There are two major elements to the assessment of this case. Planning and pain control. In terms of total hospital discharge, the Government has issued guidance in the form of â€Å"Discharge from hospital : pathway, process and practice (PPP 2003) which, although primarily aimed at hospital discharge, has sections of guidance on organisation of departmental discharges. This was formalised in the context of the NHS Plan (Department of Health 2000), which called for the establishment of a nominated discharge coordinator for each case. In any case of pain control, one of the most important elements of successful control is initial pain assessment. (Treadwell M J et al. 2002). This has the advantage of targeted and appropriate pain relief, but also allows for the retrospective assessment of pain levels to ensure that current dosage of medication is likely to be adequate. (Morton N J 2007) With problems inherent in effective communication with the younger child, a number of different rating scales have been developed and validated and these include the Postoperative pain score (PPS) for infants up to about 12 months, (Barrier G et al. 1999), the CHEOPS pain scale for children between 1 and 3 yrs old, (Taddio S E et al. 1994, the Faces scale for children back pain 3 and 6 yrs. (Champion G et al. 1998). Children older than this can often use a VAS (visual analogue scale) with reproducible accuracy. (Champion G et al. 1998). In the case of Boy F, the faces scale was used. The child is asked to indicate which, of a series of nine faces, best reflects the pain that they are feeling at the time. This tool is validated to produce a good repeatability and inter-rater compliance. This mechanism allowed for an assessment of the degree of pain perceived by the patient and appropriate adjustment of the Nurse Controlled morphine pump to minimise the pain experience for the patient. Planning (To include; justification of why planning is appropriate to discharge process with evidence) Post operative pain relief is likely to be a feature of Boy F’s case for at least the next few days. It is planned to keep the morphine pump in place for at least the next two days. It cannot be assumed that the nurse taking over the care will be completely familiar with the device, and therefore part of the planning process must be to make provision for the recovery room nurse to both demonstrate and satisfy herself that the receiving nurse fully understands the use of the device prior to the handover. (Yura H et al. 1998) Other aspects to be considered in the planning stage, are to ensure that the appropriate paper chain is competed relating to the controlled drugs. It is important also to establish that the receiving ward has the appropriate drugs (in the appropriate form) in stock and readily available after transfer. Other aspects of pain relief must be considered and would include the psychological aspects of pain relief. These are particularly important in the young child. (Suresh S et al. 2002). In the context of this particular situation one must consider empowerment and education of the patient even at this comparatively young age. To explain to Boy F what is happening, to give him the knowledge that he is surrounded by sympathetic people who will help him and to allow him to have confidence the he is surrounded by faces that he knows in otherwise strange and hostile situations, are all measures that will help to minimise the overall pain experience associated with the operation. (Carr A J et al. 2001). For this reason it would be helpful if the handover (discharge procedure) could be to a nurse from the ward who was already known to Boy F. if this was not possible, then the new nurse should allow sufficient time prior to handover to allow a period of familiarisation with Boy F. (Walker L S et al. 2002) Clearly there must be an element of planning to allow for this to happen. In the light of the potential of questioning by the family, appropriate measures should be anticipated, planned for and then instigated so that the ward nurse who effects the transfer would be fully aware of all aspects of the pain relief strategy. This would help to instil confidence into the family during an obviously stressful time. Implementing (what happened, how you implemented the chosen aspect of care e.g. notified the pain team back up with evidence) Implementation of the discharge plan was facilitated by requesting the receiving nurse to attend the recovery room allowing 30 mins. to be briefed on the use of the morphine pump. Prior to handover, the Faces (pain assessment tool) assessment was repeated to ensure that the patient was sufficiently comfortable. Written details of the analgesic regime were both explained and handed over prior to discharge. The Pain team in the hospital was notified of the discharge and requested to assess the patient on the ward. The receiving nurse was also able to utilise the time to allow Boy F to get to know and trust her. This proved to be particularly important later when the dressings had to be changed and Boy F was only happy if this nurse could do it for him. Evaluating (Reflective, evaluate the whole process, support with evidence) A reflective evaluation would suggest that this experience could be construed by taxonomies such as the experimental learning proposed by Steinaker and Bell, as providing a situation where a student could reflect and learn from considering not only the actual situation that arose, but also by investigating the background literature which forms the evidence base of the clinical situation. (Steinaker and Bell 1979). In essence, they suggested that an adult learns best by the provision of circumstances that are new experiences which could be evaluated and then used as a basis for further learning. I felt that this particular discharge form the recovery suite had been handled particularly well. Prior assessment and planning had allowed a smooth handover which proved to be beneficial for the patient as well as for the family, and was therefore professionally satisfying. Demonstrate knowledge and understanding of key aspects of discharge process in relation to child, family and aspect of nursing care The anaesthetist had made a good decision to allow nurse controlled morphine pump. Other anaesthetists could have simply prescribed stat doses of analgesia which may not have controlled the overall pain experience for Boy F in a satisfactory fashion. It is clearly important to consider all aspects of the discharge in terms of one’s own responsibility to the patient, and to facilitate a smooth transfer of responsibility to another healthcare professional. The key aspects of the discharge process have been set out above, and include anticipation of potential problems, risk assessment of these problems, formulation of measures to combat potential problems and their successful implementation. (Fawcett J 2005) Evidence of integrated theory and practice The concept of the multidisciplinary treatment team is important in this type of situation. The receiving nurse should be regarded as the nominated member of the ward team who takes responsibility of transferring information from the recovery ward to the ward team. The presence of a pain management team must not be overlooked. Nursing theory is clearly an excellent basis for practice, but there is an element of professional and clinical knowledge that is required to translate that theory into practice. Areas such as the establishment of professional empathy between nurse and patient are theoretical concepts (Mason T et al. 2003) but it requires considerable time and effort to translate the theoretical concept into reality. This is particularly true when dealing with younger children. (Hogston, R et al. 2002) Identifies implications for clinical practice (reflect upon your findings and outline implications for future practice) The findings from the investigation for this essay revolve around the clear need for assessment and planning of any discharge, whether it is from a department (as in this case) or from the hospital at the end of a course of treatment. This essay has identified various areas such as the knowledge of the receiving nurse relating to a morphine pump and the need to build an empathetic environment for the child to minimise his total pain experience as being crucial elements in the discharge process as well as more formal needs such as the need to leave a clear paper trail for controlled medication. Conclusion Summary of essay no new points here. (provide clear and concise conclusion) This essay has considered the case of Boy F and his discharge from the recovery room. It has assessed his needs, considered his imminent discharge from the department, considered the potential problems that might be encountered, formulated a plan of action to address these problems and presented some of the evidence base behind the theoretical issues, References Barrier G Attia J, Mayer M N, Amiel-Tison C Shnider S M : (1999) Measurement of a post operative pain scale and narcotic administration in infants using a new clinical scoring system : Intensive Care Med. 1999; 15 : S 37 S 39 Bruccoliere T. (2000) How to make patient teaching stick. RN. 2000;63 : 34 – 38 Carr A J, Higginson I J. (2001) Are quality of life measures patient centred? BMJ Vol 18 Issue 42 2001 Champion G Goodenough B, von Bayer C, Thomas W : (1998) Measurement of pain by self report, in Finley G, McGrath P, (eds) Measurement of pain in infants and children. Seattle, WA IASP Press 1998; 123 160 Department of Health (2004). The NHS Plan. A plan for investment. A plan for reform. Cm 4818. HMSO : London 2004 Fawcett J (2005) Contemporary Nursing Knowledge: Analysis and Evaluation of Nursing Models and Theories, 2nd Edition. Boston: Davis Co 2005 ISBN : 0 8036 1194 3 Halm M A, Gagner S, Goering M, Sabo J, Smith M, Zaccagnini M : (2003) Interdisciplinary rounds. Clin Nurse Spec. 2003; 17 : 133 – 142 Hogston, R. Simpson, P. M. (2002) Foundations in nursing practice 2nd Edition, London: Palgrave Macmillian. 2002 Howe and Anderson (2003) Involving patients in medical education. BMJ, Aug 2003 ; 327 : 326 328. Mason T and Whitehead E (2003) Thinking Nursing. Open University. Maidenhead. 2003 Mills M M, Sims D C, Jacob J. (2006) Implementation and Case-Study Results of Potentially Better Practices to Improve the Discharge Process in the Neonatal Intensive Care Unit. Paediatrics Vol. 118 Supplement November 2006, pp. S 124 S 133 Morton N J (2007) Management of postoperative pain in children : Archives of Disease in Childhood Education and Practice 2007 ; 92 : ep14 ep19; NMC (2004) Nurse Midwifery Council: Code of professional conduct: Standards for conduct, performance and Ethics (2004) London : Chatto Windus 2004 Pagnamenta R, Benger J R. (2008) Factors influencing parent satisfaction in a children’s emergency department: prospective questionnaire-based study. Emergency Medicine Journal 2008; 25 : 417 419 ; PPP (2003) Discharge from hospital: pathway, process and practice : HMSO : London 2003 Steinaker, N. and Bell, R. (1979) ‘The experiential taxonomy: a new approach to teaching and learning’, Academic Press: London. 1979 Suresh S, Barcelona S L, Young N M, Seligman I, Heffner C L, Cotà © C J (2002) Postoperative Pain Relief in Children Undergoing Tympanomastoid Surgery: Is a Regional Block Better than Opioids? Anesth Analg 2002; 94 : 859 862 Taddio S E, Nulman I, Goldbach M, Ipp M: (1994) Use of Lidocaine / Prilocaine cream for vaccination pain in infants : J Paediatr 1994; 124 : 273 280 Treadwell M J,. Frank L S, Vichinsky E. (2002) Using quality improvement strategies to enhance pediatric pain assessment. International Journal for Quality in Health Care 14 : 39 47 (2002) Walker L S, Lewis Claar R, Garber J (2002) Social Consequences of Childrens Pain: When Do They Encourage Symptom Maintenance? Journal of Pediatric Psychology, Vol. 27, No. 8, 2002, pp. 689 698 Yura H, Walsh M. (1998) The nursing process. Assessing, planning, implementing, evaluating. 5th edition. Norwalk, CT: Appleton Lange, 1998. ############################################################## 12.9.08 Word count 2,834 PDG

India shine

As the first reports started to trickle in, the apprehensions of the party workers at 7 RCA and Congress WHQL began to crystallize to gloom. The early trends seemed to be daunting and slowly yet steadily the buildup towards the ultimate result was emerging. Beyond doubt the flow was In favor of Brutally Kanata Party (BGP), the major opposition party. By the end of the day†¦ The Congress was truly humbled with an abysmally low tally†¦ 44 seats, the lowest ever in the electoral history since independence. For the first time in two decades BGP emerged on its own as the arrest single party.Backdrop & Introspection The result had its impact, at the Congress Parliamentary Board Meeting, the next day. Party President Mrs.. Sonic Gandhi and the Vice President Mr.. Rural Gandhi offered to resign. In an expected twist to the tale, their resignations were not accepted and the party decided to take collective responsibility. There were many issues to focus and It was quite unclear as t o how the grand old party would seek to address these. For two successive terms, the party governed at centre along with Its coalition partners. 2004 elections sprang a definite surprise.The BGP government was on an upswing, the campaign was highly Innovative, the economy In good nick with growth rate around 9. 5% and the image of Its leader Mr.. ABA Payees was most respected. The party perceived itself to be in the driving seat and its campaign â€Å"India Shining† was expected to hit off well with the electorate. In spite of strong economic indicators, fairly good record of governance, general sense of well being and all the predictions of re-election, the BGP were stunned. The congress campaign negated the best of Bops claims thus enabling them to take the lead in forming the government.An intrepid and a politically innovative advertisement blitz failed to impress. The most unexpected happened and Congress secured its victory. The first five years I. E. 2004-2009, were con servative yet relatively non controversial. The symptoms of decline began to emerge. The economy was showing signs of recession, growth rate was on the slump, global economic conditions started to show challenging signs yet the congress managed to pull off In 2009 to get re-elected to form a coalition government again. Things began to change†¦ Emboldened by its re-election and the arty started to influence policies and decisions resulting in an indifferent state of governance, conflicts, dilution of control, ineffective monitoring. Ministries began to exert themselves and more or less operated with impunity and became non responsive to PM; abundance of corrupt practices and scandals broke out, economy began to decline with high inflation, price rise, unemployment, dropping investments, growing incidents of violence against women, Look pal agitation etc which put a great deal of pressure.The PM to large extent restricted his operations to his domain and as not seen exerting hims elf to bring the administration under his control. Coupled with this was the most Ineffective approach towards media and interaction on media which left the party scuttling for cover on many occasions. There emerged a general sense of strolls and stagnant state of affairs which was becoming a common overlook a large number of them. For the elections 2014, the focus of the party remained on personality I. E.BGP preliminaries candidate and the issue of secularism. The emergence of PAP and its impact was sidelined and many issues relevant to the runner context of elections were not taken into cognizance. The approach was quite ambivalent and ambiguous. The net result was a mixed message to the electorate looking for answers to questions which remained unanswered. Campaign Challenges : BGP By 2011, the BGP apparently began its preparations to target the 2014 elections. The party began its preparation with a focus on identifying the correct strategy.Having faced the double defeat in 2004 and 2009, it realized that success is possible if the party is able to project its image and be identified as a national alternative. In order to do so, it had to set itself on important issues namely Personality, Platform, Plank, Diversity, Demography and Development. By default, the PUP lead government seemed to pave way for crystallization of BGP campaign strategy by series of actions and inactions. As a first step, the BGP began the exercise of identifying a candidate suitable for spearheading the campaign.After a series of up's and town's, the party was able to narrow down to the CM of Gujarat, Mr.. Neared Mood. The choice was fraught with controversy as many including leading political analysts felt that this old endanger the Bops chances. Even within the party there was a dissent from senior leaders like ELK Divan, Cushman Swarms etc. The other national parties seemed to rejoice as they felt it was a trap BGP had set for itself and the choice would undo their chances. By 201 3, the official declaration took place and Mood was anointed the PM candidate, the face of BGP for the 2014 elections.While the choice of Mood was becoming a controversy, the approach towards elections was to be aligned. The reach out was tremendous, the political alliances were challenging, the geographical ileitis were imposing, the regional heavy weights were difficult to rope in, Mood as a choice was also alienating some erstwhile partners like JDK(U). The party had to identify themes and means to reach out to the target population and make a convincing pitch. The environment had undergone an extensive technology makeover since 2004.The decade has brought in changes in perception as regards elections, greater apolitical pro activity and dependence on reliable and fast communications. The demography too has undergone a rapid change; there was a growing sense of discontent on account of various factors effecting the society, economy and evildoer. Moreover, issues like unrest due t o nationalism, cross border tensions, reactive neighborhood etc also tended to make the Job of convincing electorate that much more difficult. Though the national situation on multiple fronts was grim, the fact that such a situation was a hidden opportunity or not was truly debatable.There were challenges in abundance and the choices were limited by time. The objective was to conceive and present a campaign which appeals to all sections simultaneously and converts the message to conviction and thereafter to action in terms of vote. Starting a campaign too early would be self defeating (2004 stands testimony for that) and too late would be ineffective or defensive (2009 a possible example). The question of when, where, how and who? For an effective campaign message and medium were to be identified and reinforced convincingly as a national alternative.Bops approach towards 2014 was characterized by structured planning and focused execution. It SE about the Job in a clinical manner wit h pre defined objectives to achieve. The campaign activity was set in motion by basic reorganization of the party dare, revamp & election of national executive, short listing prospective Prime Ministerial candidate, identifying issues relevant for campaign, projecting party agenda through articulate spokespersons, adopting multiple media options to leverage reach & communicate were part of numerous hurdles that needed to be considered.The national demography has undergone a substantial change and the increased awareness would also need specific attention. The climate across the country appears to have undergone a change with people across the cross section of society evincing a new found interest in elections. The youth and the educated middle and the upper middle class known for its disregard towards participation in elections appeared reengineering. A conservative estimate put the number of youth vote bank across the country was at 100 million.A substantial chunk of this needed to be harnessed and it was also essential for the party to enhance its vote share across the country. The party needed to correctly identify the challenges of multiple segments divided by diverse parameters such as culture, language, education, age, economic status, religion. Large number of local issues were taking precedence over sectional issues which diluted the party's influence visa–visa the regional players.The campaign called for deliberate action plan with defined objectives and with red flags across the time span to accelerate/ decelerate the campaign. The party decided to go all out leveraging the best of technical brains. A multi-tiered campaign was to be conducted with the objective of targeting and winning over the circumspect population in its favor.. The impact was like a corporate entity trying to rebind itself with a new product launch. There was branding, there was product development, here was segment specific media strategy and there was people to people co ntact.As the stage was set, the BGP was in top gear with the assemble results in northern states showing a thundering favor towards BGP. The time of opportune but the choices were different and difficult. Any misalignment would prove costly. The Aftermath The campaign was highly intense. Both the national parties pitched in all the resources. It was a no holds bar election with reputations at stake. The results were historic. An outright majority for BGP and an irrevocable domination of the Look Saba long with its allies.The congress and the PUP stood decimated. The results were a surprise & beyond all the expectations of all political parties, experts and election surveys. What went right for BGP and why? What factors in this election are lessons for use of effective advertising and media promotion? How did Congress â€Å"Fail to sense the pulse†? What went wrong with experts and pollsters who could not identify the mood? Did â€Å"Personality, Platform, Plank, Diversity, D emography and Development† influence the advertising and media choices and if so how?

My finger

Almost lost a finger When I was about 12 years old I loved to ride my Hard BMW bike around my neighborhood a lot with my friend nick. Nick and I used to fix our own bikes and learn how to do it all ourselves. We would work on our bikes all day every day and take them apart and put them back together, we got so good at riding and fixing our bikes we fixed are bikes anywhere at any time or at least I thought so. One day during the summer of freshman year nick and I went for a ride to the park down the street from y house to play soccer.After we played soccer at the park for a while we decided to go to nicks house to play video games and get something to drink. So as were riding back to nicks house my chin felt a little loose so I thought it was a good idea to try and fix it while I was riding. I put my in on my chain while riding the bike and my hand got stuck in the chain and I couldn't get it out and the only way to get my finger out was to peddle and get it out of the chain but once I peddled I felt this very sharp pain in my finger but didn't look till I got to my friend's house.Once I had finally looked at it, it took me a second to really realize my finger was Just barely hanging on by a small piece of skin. Nicks mom then did all she could and called my mom and said â€Å"you need to take Andrew to the emergency room†. My mom rushed over to nicks house and we went to the emergency room. After the x rays were taken of my finger they were able to stitch It back together and make sure I could still have feeling in my finger and that the bone healed well. My finger By Vanessa they were able to stitch it back together and make sure I could still have feeling in my

Wide Sargasso Sea and The Color Purple Essay - 864 Words

nbsp;nbsp;nbsp;nbsp;nbsp;Problems, along with misery, become apart of life whether you’re willing to accept it or not. For those who have accepted such troubles, have also learned to cope with it one way or another. Antoinette’s character in â€Å"Wide Sargasso Sea† and Celie’s character in â€Å"The Color Purple† have both experienced problems with depression, loneliness, violence, inferiority, racism, and self-identity. It is important for such characters as Antoinette and Celie to express their emotions and have a method of working out there issues. nbsp;nbsp;nbsp;nbsp;nbsp;In the novel â€Å"Wide Sargasso Sea† by Jean Rhys, the character Antoinette is left mainly to her own free will as a child with no friends and relied on herself to†¦show more content†¦Without a mothers love Antoinette becomes increasingly lost in thought and isolated, showing the early signs of her inherited emotional fragility. As an adult, insulting refrains would resurface in her mind as she becomes increasingly paranoid. Antoinette’s arranged marriage begins to distresses her, as she is married to a controlling white Englishman who feels alienated were she feels at home. Indeed, their marriage is a mismatch of culture and custom. Anoinette and her husband, Mr. Rochester, fail to relate to one another or comfort each other when Antoinette needs it the most. His unsympathetic feelings intensify her condition and even push her to fits of violence. An exile within her own family, a quot;white cockroachquot; to her disdainful servants, and an oddity in the eyes of her own husband, Antoinette cannot find a peaceful place for herself. Now she seeks refuge of the cruel world by surrounding herself in nature’s fold. Antoinette is fascinated with nature, which becomes a central character, and perhaps her only friend. Similarly, in the novel â€Å"The Color Purple† by Alice Walker, the character Celie also has a rough childhood. As a young girl, Celie is constantly subjected to abuse, rape, and told she is poor and ugly. Celie begins to write to God for guidance because she dose not understand what’s happening to her. At only fourteen, Celie is already pregnant with her second child as a result of rape from her father. He threatens her toShow MoreRelatedJane Eyre vs Wide Sargasso Sea Essay example1635 Words   |  7 Pagesï » ¿Tyler Perimenis Professor Mathews English 2301W 21 October 2014 Symbolism through Theme Of Jane Eyre and Wide Sargasso Sea â€Å"To produce a mighty book, you must choose a mighty theme. No great and enduring volume can ever be written on the flea, though many there be that have tried it,† stated Herman Melville. As implied, without theme, no novel can be considered â€Å"mighty† or have any depth. Theme is essential in any work of art. Jane Eyre is a novel by Charlotte Brontà « that takes the readerRead MoreWide Sargasso Se The Intersection Of English And British Colonial Cultures Through The Union Of Rochester And Antoinette1502 Words   |  7 PagesJean Rhys’s novel Wide Sargasso Sea centers on the intersection of English and British colonial cultures through the union of Rochester and Antoinette Cosway. Rochester represents patriarchal and imperialist Victorian values, which Mary Lou Emery suggests thrive in part on â€Å"distinctions between...legitimate and illegitimate sexuality, madness and reason, primitive and civilized behavior, [and] fiction and fact† (428). Antoinette threatens these supposedly objective distinctions in her emotional (â€Å"‘AfraidRead MoreThe Interpretation of â€Å"Let Them Call It Jazz† by Jean Rhys.1440 Words   |  6 PagesThe interpretation of â€Å"Let Them Call It Jazz† by Jean Rhys. Jean Rhys is famous for her â€Å"prequel† to Charlotte Brontà «s â€Å"Jane Eyre† called â€Å"Wide Sargasso Sea†, however, it should be said that she was writing mainly novels. Her work are characteristic for using topics concerning the immigrants’ position in the West culture. The fact that she was born in West Indies influences deeply on her later publications in which she frequently presents her reflection on the problems that the strangers have to