Para Me Matahari

awak bangun lah awak

2012-02-28T04:37:00.000+08:00

ala awak , dia bukan kisahkan awak, hati awak sakit awak tanggung sendiri, kalau awak sakit pon siapa peduli awak'semua atas diri awak sendiri , em awak , awak ( mengeleng gelengkan kepala) sedih bila fikirkan awak, kenapa awak masih nak keraskna hati , kenapa awak nak menagis sebab orang yang awak kisah pon tak kisahkan awak , jangan sedih lah awak . jika kata hati awak tak betul dan tak pernah tepat. dah hentikan fikir ynag bukan bukan, awak bukan tak berdaya atau awak tak worth pada dia . em so apa nk di harap bila orang dah kata awak tak worthy pon. so sebenarnya itu kan cabaran , kalau hati awak sedih pon awak ingat dia kisah ke . awak sakit awak ingat dia peduli ke, awak bangun dari mimpi ynag panjang awak. masa dah lama tinggallkan awak. awak dah lambat bangun awak , kenapa mmasih tunggu dia , awak. dia buat hati awak berdarah darah . awak telan semua . awak bangun lah awak. masih bnayk ynag awak perlu buat. awak tak boleh mati selagi tujuan awak belum selesai. awak dengar cakap saya. awak tak boleh tenggelam dalam sedih , awak kena kuatkan langkah awak. awak kena teruskan

Berhenti Menunggu

2011-12-26T20:03:00.004+08:00

Awak Berhenti berharap

Awak sayang dia??

Awak sayang dia sepenuh jiwa..

Awak sayang dia kalah awak sayang nyawa..

Awak sayang dia sebab pada awak dialah segalanya(!)

Awak cinta dia??

Awak cinta dia sampai tahap buang manusia..

Awak cinta dia hingga lupa segala benda termasuk kerja..

Awak cinta dia tanpa gentar halangan termasuk bantahan keluarga(!)

Awak suka dia??

Awak suka dia sangat hingga tidak tidur lena..

Awak suka dia tiada tolok banding kegilaannya..

Awak suka dia walaupun dia mungkin punya perasaan berbeza(!)

Tapi, awak bukan pilihan dia..

Pedih bukan rasa??

Awak, sila berhenti menunggu.(!)

Menanti sesuatu yang membuatkan hidup awak tidak menentu..

Membuatkan awak keras seperti batu..

Ya, menjadikan awak sakit dan berkematu(!)

Awak, dia tidak layak untuk dinanti.

Sekurang-kurangnya bukan oleh awak yang sakit pedih hati..

Awak yang masih setia atas nama persahabatan sejati..

Sudahlah awak, masih banyak benda menanti..

Awak, kerasnya sebuah hati..

Kerasnya kepala awak yang penuh berisi..

Tetapi apakah awak tidak sedar awak sedang disakiti..

Dalam diam awak sebenarnya sedang sendiri..

Tanpa sesiapa pun peduli,

Tanpa sesiapa pun mencari,

Tanpa sesiapa pun simpati,

Tanpa sesiapa pun di dunia ini,

Awak terus mahu menunggu kemunculan dia??

Awak kekal mahu menjadi manusia setia??

Tapi awak tahu awak bukan sesiapa(!)

Bukan manusia yang dia cinta,

Bukan manusia yang dia suka,

Bukan manusia yang dia puja,

Awak, dengar sini..

Awak, baca ini..

Awak, perhatikan dan renungi..

Dia bukan manusia yang awak kena tunggu lagi.(!)

Berhenti..(!)

Awak, dah terlampau banyak beban yang awak galas..

Kenapa tidak pernah rasa malas??

Kenapa enggan rasa culas??

Kenapa tidak mahu lepas??

Awak, berhentilah..

Suatu hari nanti awak akan mengah..

Sudah tiba masa awak mengalah..

Bukan sebagai tanda awak kalah..

Tetapi sudah cukuplah lelah..

Cukuplah...(!)

by Arethick Dak Jahat

Dia bukan di jadikan untuk aku

2011-12-25T17:17:00.001+08:00

Mula mula aku aku rasakan akan hati berkata benar, em memang betullah orang tua tua kata ikut hati mati. memang tidak ada dolak daliknya. aku sedih tapi itu yang terjadi air mata bukan pembasuh luka acap kali hati kecil ini salah menilai antara kaca dan permata. aku benar benar tak tahu kenapa , persoalannya adakah aku sedang di uji dengan ujian ilahi, aku cuba untuk meraih harapan dengan jiwa kental ku harapkan ia akan jadi bintang yang indah bersinar. aku. silap lagi. aku malu pada diri sendiri. aku malu , kenapa aku jatuh hati dengan orang yang tak menghargai aku , jauh sekali inginkan aku. aku sedih terkilan sangat, cara penolakkan yang sedih, alasan yang mengjengkelkan , bila aku katakan aku kan berada jauh , dia mula menjauh. tapi apa sebenarnya, soalannya adakah dia benar benar cinta. pasti dalam hati berani berkata tidak apa yang dia lakukan lakonan semata , dia telah lama melupakan kau, dia tak inginkan kau tak herankan kau, dia hanya akan menambah luka dia hati kau, satu jew soalan , jawapan yang separa ikhlas yang penuh curiga, aku tak faham. hai bodoh betul aku kali ni. hati kecil aku telah membodohkan aku.

dia tak ingin aku hadir di majlisnya,tapi hadir juga. sebab aku rindu. tapi akhirnya aku tahu itu yang terakhir untuk aku terus bodohkan diriku,

cukuplah merayu cinta dia tak cintai mu. dan hanya menambah luka hati mu, abaikan dia

dah tak de apa pon yang kau usahakan cuma memujuk hati kecil yang selalu di kecewakan

mungkin belum masanya untuk bertemu orang yang sebenarnya, apa yang aku cari dalam hidup , teman hidup yang beriman berilaku mulia, apa yang aku inginkan dalam hidup suami yang menyayangi aku sepenuh hatinya. dan menghargai aku bagi pemberian yang indah dari yang maha esa buat teman hidupnya. soalan adakah orang terpuji macam tu ? alor berangan tinggi sgt lah ni. sudahlah encik encik itu semua tak herankan kau sebab mereka fikir mereka boleh cari lagi bagus dari kau, dan sesungguhnya, kau kena terima ni sebagi ujian tuhan dalan hidup kita buat banyak kesilapan, kembali tersedar dari mimpi panjang kau tu woi...,

dah lah mungkin tuhan tak izinkan aku bersama orang yang macam tu, kau sebanrnya jauh terpuji dan jangan fikir nak kembali atau nak rendah diri lagi pada orang macam tu . apa nilai dia untuk kamu. kalau dia singkirkan kau dan tak hargai kau.kedang kadang bukan sebab kita kurang baik tapi tuhan nak tolong jauhkan diri kita dari orang yang berniat jahat.

just lepak hari ni jangan fikir yang bukan bukan sebab dalam keadaan ni memang agak celaru dia tak cintai kau hanya sebenarnya kau yang terhegeh hegehkan dia kenapa mungkin dia fikir dia sangat macho . ar memang dia player, dia tak pernah tulus dan bacul menghadapi masalah. dia tak pernah berani.

banyak perkara yang aku kira menyakitkan hati, ada masa nak text kawan kawan aku tapi tak de masa untuk text aku. tapi aku faham semua ni berlaku sebab satu alasan mudah tuhan tak izinkan cinta sejati dan ini semua bukan untuk dia. aku tahu semua akan jadi komplikated. semua kan jadi sgt susah, semua akan jadi payah, dia bukan untuk aku jadi aku harus terima kenyataan itu, biar hati pedih dan bagi alasan berbagai, tapi satu alasan yang mudah ialah dia bukan dijadikan untuk aku. i just fall into a jerk!...

bersyukurlah tersedar awal, sebenarnya memilih teman ni memang susah, pilihlah yang baik agamanya. baik pula budi bahasanya. jangan jadi macam aku . aku jew baik ... :D terbaik ..

Quotes

2011-12-04T03:26:00.000+08:00

Always remember that you are absolutely unique. Just like everyone else.

It is better to keep your mouth closed and let people think you are a fool than to open it and remove all doubt

Never argue with a fool. People might not know the difference.
Girls have an unfair advantage over men: if they can't get what they want by being smart, they can get it by being dumb.

You see a lot of smart guys with dumb women, but you hardly ever see a smart woman with a dumb guy.

I don't suffer from madness..I enjoy it.

Profesor is the man who is talking while other are sleeping.

An expert is someone who takes a subject you understand and makes it sound confusing.

When we long for life without difficulties, remind us that oaks grow strong in contrary winds and diamonds are made under pressure.

_________________________
Enhanced by http://e.exps.me

Que sera de ti ...

2011-10-29T21:33:00.001+08:00

Qué será de ti?

What will become of you?

Necesito saber hoy de tu vida

I need to know your life today

Alguién que me cuente sobre tus días

Someone tell me about your day

Anocheció y necesito saber

Night fell and I need to know

¿Qué será de ti?

What will become of you?

Cambiaste sin saber toda mi vida

You changed my whole life without knowing

Motivo de una paz que ya se olvida

Reason for peace already forget

No sé si gusto más de mí o más de ti

I do not know if you like best about me or you

Ven, que esa sed de amarte

Come, that thirst for love

Me hace bien It's good

Yo quiero amanecer

I love dawn

Contigo amor

love you

Te necesito para estar feliz

I need you to be happy

Ven, que el tiempo corre

Come, that time is

Y nos separa

And we separated

La vida nos esta dejando atrás,

Life is leaving us behind,

Yo necesito saber

I need to know

¿Qué será de ti?

What will become of you?

¿Qué será de ti?

What will become of you?

Cambiaste sin saber toda mi vida

You changed my whole life without knowing

Motivo de una paz que ya se olvida

Reason for peace already forget

No sé si gusto más de mí o más de ti

I do not know if you like best about me or you

Ven, que esa sed de amarte

Come, that thirst for love

Me hace bien

It's good

Yo quiero amanecer

I love dawn

Contigo amor

love you

Te necesito para estar feliz

I need you to be happy

Ven, que el tiempo corre

Come, that time is

Y nos separa

And we separated

La vida nos esta dejando atrás,

Life is leaving us behind,

Yo necesito saber

I need to know

¿Qué será de ti?

What will become of you?

KIta bukan tahu bila kita akan mati

2011-07-15T13:38:00.001+08:00

Nora habiskan kerja di shift malam, pesakit Nora dengan SLE lupus nephritis kali nie, budyy Nora Noelle malam ni, Noelle memang sporting pada Nora, Ivan pon macam tu juga, Ivan sangat conscious dengan weight , em apa yang menariknya kali ni Nora cerita tentang Oat, cara nak kurangkan berat badan kena tukar nasi yang selalu kita makan dengan mengantikan dengan Oat, melalut pulak Nora dengan kenangan silam, masa mula mula jejakkan kaki ke Tanah Arab ni masih ingat masa Mula sampai masa orientasi, masa Sn 3 tu berlagak macam hebat walhal suboordinate Nora je , bila fikir memang Nora kutuk terbaik . geram tu masih berkesumat dalam hati, Bila terkenang orang kat sekeliling macam lahnat perangai macam mana Nora nak lupa . memang Nora orang baru, Nora tak faham apa , termalogy pun bukan yang biasa sukatan ubat dilution bukan main banyak air lagi , ubat yang selalu bagi guna 10 mls Ns pon jadi 50 mls mengarut tul tapikan dah tempat orangkan nak buat macam mana ,

Masa accidentally triple lumen tercabut macam hampeh je semua orang . menda tu dah lama leaking tapi kan nak buat cam ne dah time Nora pulak nak tercabut em hampeh tul,

Masa tinggalkan pesakit nampak macam okay tapi sesungguhnya ajal maut itu Tuhan yang tentukan pergi rehat tak sampai 15 minit makcik tu mati pulak sedih bukan kepalang terkejut beruk , beruk pun tak terkejut macam tu. kesedihan tahap maksima tak suka lah Nora memang tak boleh nak lupa sikit pun. terkesima terkedu ssemua ada.

Semua yang kita buat bila dah sampai ajal tak boleh nak buat apa tuhan Maha kuasa.

bila tengok pesakit terlantar usia muda anak 3 umur baru sebaya Nora, keadaan macam itu harapan apa yang tinggal. tinggal dekat hospital sajalah. bernafas pun guna trachy. harapan apa yang ada , badan sendiri pon dah tak boleh nak jaga . Nora termenung terfikir, Mungkin nora sedih hati Nora murung sebab kekasih hati lupakan Nora, tapi itu tidak terbanding penderitaan pesakit yang sebaya Nora itu yang memang tentu harapan dah tak ada, hidup bergantung dengan ventilator, dylisis 3 kali seminggu nak bergerak pun bukan boleh , harapan apa yang tinggal , Anak tinggal dengan suami untung kalau suami penyayang tiap masa datnag jenguk , isteri yang sakit . nak buka mata pun tak larat

Nora masih beruntung tulang 4 kerat masih ada ., harapan nak hidup masih ada , putus kasih tak apa jangan putus asa dari rahmat Allah, Nora bersyukur masih ada tulang 4 kerat masih boleh cari duit sendiri nak harapkan siapa kalau Nora terlantar macam tu Nora termenung sejenak . kalau dah dugaan tuhan kita mana tahukan . Apa nak di kata , tuhan Maha Kaya dia tahu tahap mana level hambanya. mana lah kita tahu kita hidup sampai bila , kelmarin Nora di kejutkan dengan berita ada nurse yang mati , sebelum ajal dia sempat lah ketuk bilik kawan dalam keadan tercungap cungap sakit dada yng termat, kawan kawan panggilkan ambulan yang kemudian dilarang masuk pula dengan pengawal keselamatan yang tak berapa bijak tu . benak ikan sungguh!, akhirnya nurse tu meninggal dunia, yang Malangnya dah lebih seminggu nurse tu mati. Mayat masih tak tertuntut oleh keluarga , malangkan nak kena hantar balik philiphine .alangkah siksa mayat tu . tuhan saja yang tahu . apa yang Nora boleh buat doakan semoga semua itu berakhir dengan baik. yang mati dah tentu mati yang hidup kena teruskan hidup yang penuh dugaan . ".yang penting biar putus kasih tapi jangan putus asa",Kita bukan tahu bila kita kan mati. Nora tengok orang sakit hari hari berdepan dengan kematian adalah sekali sekala. kalau dah berusia tu Nora tak rasa terkulat kulat sangat tapi bila budak budak muda tu memang Nora rasa ralat sikit . lebih lebih lagi yang jenis kena sawan ketumbuhan otak lepas operation jadi sayur je tinggal di ICU . Sampai tua lah atas katil harapan apa ynag tinggal menunggu mati tak kunjung tiba. Nora rasa ralat hampa kecewa sebab sayangnya muda lagi dah tak de harapan nak hidup nak rasa betapa indahnya dunia ciptaan tuhan nak rasa nak tahu indahnya mencintai dan di cintai nak beramal dan menikmati hidup semua buat Nora rasa beruntung.

Susah nak kata

2011-07-11T03:48:00.000+08:00

Nora ingin marah tapi Nora tak pandai, Nora ingin menjerit sekuat hati tapi bila di ingat Nora rasa eh Gila per ko ni Nora , Relaxlah . nota pendek, sudah lama tak text kan eh pendeknya ! Nora terkejut ini nota pesanan paling ringkas , Yelah memang tiada apa nak di perkatakan sudah . okay . jawapan pon pendek gak lah macam biasa.
Sakitnya jiwa pompuan ku bila baca text pendek jew Weng ! punya berzaman ko tak hantar text berita pendek nak tnay aku hidup lagi ke idak che hampeh!...

Keliru

2011-07-03T17:38:00.000+08:00

Hati berbisik di mana menghilang matahari

adakah dia hilang kerana di balik bulan

gerhanalah matahari

mencari jalan penghidupan yang masih kelam

mencari kebenaran yang terhampar tapi masih buta memilih

keliru atau tak tetap pendirian

lalang atau layang- layang

ku akan tersenyum jika jalan yang di pilih jalan yang lurus

ku akan memandang dengan bersahaja jika jalan mati yang ingin pergi

peta ada ditangan kau sendiri tentukan atau kau perlu GPS navigator.

Tentang Cinta,

2011-04-24T07:34:00.004+08:00

Cinta

Mengapa kita menutup mata ketika kita tidur? ketika kita menangis?

ketika kita membayangkan? ketika kita berciuman? Ini kerana hal

terindah di dunia tak terlihat…

Kita semua agak aneh… dan hidup sendiri juga agak aneh… Dan ketika kita bertemu seseorang yang

persamaannya sejalan dengan kita… maka kita bergabung dengannya dan jatuh ke dalam suatu keanehan

serupa yang dinamakan CINTA.

Mencintai bukan bagaimana kita MELUPAKAN ,

Melainkan bagaimana kita MEMAAFKAN …

Bukanlah bagaimana kita MENDENGARKAN..

Melainkan bagaimana kita MEMAHAMI..

Bukanlah apa yang kita LIHAT..

Melainkan apa yang Kita RASAKAN…

Bukanlah bagaimana kita MELEPASKAN..

Melainkan bagaimana kita BERTAHAN…

Apabila cinta tidak berhasil… BEBASKAN Diri kita…

Biarkan hati kita kembali melebarkan sayapnya dan terbang ke alam bebas

Ingatlah bahawa kita mungkin menemukan cinta dan kehilangannya…

Tapi.. ketika CINTA itu MATI… kamu TIDAK perlu mati bersamanya.

Kadang kala, orang yang kita kasihi adalah orang yang PALING

menyakiti hati dan kadang kala,

Teman yang membawa kita ke dalam pelukannya dan menangis bersama kita adalah

CINTA yang tidak kita

SEDARI

Cinta sebenar

2011-04-24T07:12:00.002+08:00

Adakah tapak tanganmu berkeringat,

hatimu berdebar kencang dan suaramu

tersekat di dadamu?

Itu bukan Cinta, itu SUKA.

Adakah kamu tidak dapat melepaskan

pandangan mata darinya?

Itu bukan Cinta, itu NAFSU.

Adakah kamu menginginkannya kerana

kamu tahu ia ada di sana?

Itu bukan Cinta, itu KESEPIAN.

Adakah kamu mencintainya kerana itulah

yang diinginkan semua orang?

Itu bukan Cinta, itu KESETIAAN

Adakah kamu tetap mengatakan kamu

menyintainya kerana kamu tidak ingin

melukai hatinya?

Itu bukan Cinta, itu BELAS KASIHAN.

Adakah kamu menjadi miliknya kerana

pandangan matanya membuat hatimu

melompat?

Itu bukan Cinta, itu TERGILA-GILA.

Adakah kamu memaafkan kesalahannya

kerana kamu mengambil berat tentangnya?

Itu bukan Cinta, itu PERSAHABATAN.

Adakah kamu mengatakan padanya bahawa

setiap hari hanya dia yang kamu

fikirkan?

Itu bukan Cinta, itu DUSTA.

Adakah kamu rela memberikan semua

perkara yang kamu senangi untuk

kepentingan dirinya?

Itu bukan Cinta, itu KEMURAHAN HATI.

Tetapi

Adakah kamu tetap bertahan kerana

campuran antara kesakitan dan

kegembiraan yang membutakan dan tak

terfahami … menarikmu mendekati dan

tetap bersamanya?

ITULAH CINTA.

Apakah kamu menerima kesalahannya

kerna itu bahagian dirinya dan siapa

dirinya?

Jika demikian, ITULAH CINTA.

Adakah kamu tertarik dengan orang lain

tapi setia dengannya tanpa penyesalan?

Jika demikian, ITULAH CINTA.

Adakah kamu menangis kerana

kesakitannya walaupun saat itu dia

kuat?

ITULAH CINTA.

Adakah hatimu sakit dan hancur ketika

dia bersedih?

ITULAH CINTA.

Adakah hatimu gembira ketika dia

berbahagia?

ITULAH CINTA.

Adakah matanya melihat hatimu dan

menyentuh jiwamu begitu mendalam

sehingga menusuk?

Yang demikian itulah namanya CINTA

Kalau kejahatan berbalas kejahatan itu Dendam

2011-04-18T09:32:00.003+08:00

kalau air mata mampu membasuh segala dosa biarlah ku menangis hingga kabur pandangan mataku. kalau boleh ku luahkan apa yang terbuku dalam hati sanubariku yang menjadi beban hidup ku . ingin ku luahkan segalanya . Namun selalu ku ingatkan sekeping hati ini, dalam dunia yang fana ini, segalanya milik Tuhan dia Maha mengetahui apa yg terkandung dalam hati sanubari.

sayang ketahuilah , apa yang ada padaku hanya sekeping hati , apa yang ku simpanan dalam hatiku hanya sebuah cinta yang ingin ku abadikan untuk si dia yang mencintai.

Kalau pun si dia buat ku sedih , buat hati ku menjauh. buat hati kecil ku terusik sampai bila hidup yang tak kekal lama ini , sampai bila kesenangan dan dunia ini , sampai bila hidup yang sementara ini selagi masih bernafas selagi esok matahari masih menyinar. ku tak pernah membalas kejahatan dengan kejahatan , ku tak pernah ingin membalas apa pun jua, walau maruah terinjak rendah ,ku tak ingin jadi pendendam . walau ku simpan segalanya dalam hati . namun kemaafan dendam terindah. kita manusia biasa , hidup di dunia tak kekal lama. apa gunanya membalas dendam apa gunanya mencipta pembalasan apa guna memuaskan hati yang akhirnya membawa mati.

Penderitaan yang menyakitkan adalah koyaknya kulit pembungkus kesedaran- seperti pecahnya kulit buah supaya intinya terbuka merekah bagi sinar matahari yang tercurah. Kalian memiliki takdir kepastian untuk merasakan penderitaan dan kepedihan. Jika hati kalian masih tergetar oleh rasa takjub menyaksikan keajaiban yang terjadi dalam kehidupan, maka pedihnya penderitaan tidak kalah menakjubkan daripada kesenangan. Banyak di antara yang kalian menderita adalah pilihan kalian sendiri – ubat pahit kehidupan agar manusia sembuh dari luka hati dan penyakit jiwa. Percayalah tabib kehidupan dan teguk habis ramuan pahit itu dengan cekal dan tanpa bicara."

(Kahlil Gibran)

bialah ku nanti sejalur sinar, yang pasti takkan pudar, dalam diri ini ada kepercayaan bahawa Allah tak pernah hampakan ku. selagi ku masih penuh pengharapan.

Selagi ada cinta ku Ku di sini

2011-04-02T05:33:00.001+08:00

Termenung lagi. buka mata dan apa yang terlintas di fikiran nora cuma sidia.
Kak faridah nak berangkat pulang balik ke Malaysia, aku masih melayan jiwa yang kacau entah sampai bila. berdiskusi tentang apa baiknay tinggal di sini. sush nak buat keputusan . kalau aku fikirkan aku memang nak balik. tapi balik pon bukan ada apa. mak abah memang ada. masalah pon masih banyak.. tapukkan hutang masih tinggi lagi tak habis habis, tukaran wang makin rendah, adik masih tak faham . abang masih tak bekerja. mak abah masih susah nak balik buat apa. hidup masih terhimpit. memang aku boleh balik kalau aku pentingkan diri. aku nak hirup udara segar bayu pantai. aku rindu highway malaysia, aku rindu budi bahasa orang kita aku rindu masyarakat ku yang bertoleransi aku rindu pada kelembutan dan kemesraan , rasa hormat menghormati yang ada dalam masyarakat ku.

tapi aku pilu dengan kesunyian , aku pilu dengan kenangan silam aku hiba dengan semua yang pernah menghuris hati ku. aku hiba dengan pengalaman pahit semalam yang pernah menghiris menjadikan diri makin tegal untuk terus berada di sini.

suka duka dan cabaran di mana jua akan an ada . tapi bila ada cinta hidup lebih bermakna. dalam hati pernah ada cinta yang subur, hingga satu hari mati teracun kerana bisa lidahnya hebat perilakunya. dalam hati pernah ada rasa cinta yang ikhlas tpi mati jua akhirnya.
pernah di suarakan kesepian , pernah di perkatakan kesunyian , silap ynag berlaku dia maafkan tapi masih jua berulangan. dalam doa ku menangis air mata sepi ku tak pernah henti. pilu hati Tuhan jua yang tahu. betapa yang menanggung sangat pilu.
ku masih tegal disini selagi masih ada cinta yang suci dan ikhlas.

autonomi. atau maid. angel or devil.percutian

2011-03-30T22:07:00.001+08:00

minggu yna meletihkan . aku rasa sangat penat. letih giler ar. kekadang aku ras hospital ni cam tempat long term care jew. tiap kali kerja malam ada jew RRT call code green lah penat penat penat
nurses week pon satu sebab yang meletihkan kena gi layan buat booth tu , gi sekolah meeting lah. em menyesal lak pergi datang pon hanya untuk dengar profession ni menerima tuduhan dan profession antara yang terbanyak undiannya menerima tuduhan bersalah aaaaarrrrrrrrrr.!. kekadang tu aku terfikir juga . cakap bunyi macam indah hakikatnya kerja ni tak ubah macam maid jew bukan ada autonomy. em !frustrated

aku kesian pon ada nak gelak badak pon ada aku kerja tengok makcik nie rambutnia dah kena perdajal dengan sapa tah, cam kena gam jew toncit dan gam . mula mula ingatkan styling gel ha ha ha rupa rupanya kena gam . hu hu hu. aku tak tau nak cakap macam mana macam rambut bob ,marley pon ada. anak dia sikit punya marah . em klau aku pon aku rasa ralat gak kalau orang buat mak aku macam tu kan . itu tak bertanggung jawab tu . em ! sapa lah devil yang banut macam tu. kan buat tercalar image nurse saja. dah buat rambut dia tegak macam pokok kelapa tsunami pon tak boleh tumbangkannya., :) mungkin!
puas dok selidik. kajian mendapati makcik dah lama tak cuci rambut. dah macam org sakit mental rambut pon dah kusut bukan sikit sikit . em nasib lah makche.

percutian dah konfirm cuma bad delaykan untuk ke spain sebab alasan visa dia tak past lagi em minta aku sambungkan cuti ke 19 hb april . masalah roster boss dah keluarkan . dah nak cari orang gantikna aku kerja malam tu yang susah sikit. akhirnya dapat juga che cari hu hu hu...

cuti kerja malam badan aku panas. hidung berair. em macam nak demam rasanya. aku betul betul rasa tak sihat.em letih sangat kot. rjumah aku macam kapal pecah tak terkemas . kucing aku mengurus. makan pon sama tak lalu macam aku. aku nak mandi letih giler . lah hari nie.

Dah le huduh perangai beruk.ishk ishk ishk

2011-03-23T13:10:00.001+08:00

HUh! rasa nak fuck off jew org kat sini. sangat menjengkelkan. sepetang bersiar siar dengan abg Bad dan bestfriend dia. em aku suka suka ambik gambar kat sekitar jamjoom. bukan apa pon cuma ambik gambar bunga bunga ada kereta lalu try try lah zoom cacth . apa pakcik pakcik nie bangsat betul.
di pendekkan cerita pak arab ni kononnya hanginlah ingat aku snap gamabr dia cari pasal lak dengan abg bad ku ni. ni yang tak puas hati ni. ingat dia tu glamour lah . gemuk cam badak air ada hati . siot betul. eleh! hoi si gemuk. dah le gemok macam badak air. cari pasal pulak . dah le rupa hudoh perangai pon hudoh! memang penyakit lah orang kat sini cepat perasan. suka cari pasal. nak kena maki jew jew kerja dia . siot tul!..
kalau kamu tu cantik sangat aku kisah lah . boleh le bayar royalti kew apa kew. ini dah le rupa huduh aku ambik no plat kereta jew pon jadi isu. sangat menjengkelkan ....

jadi isu lak, nak cari gaduh cian aku ! nak backing aku ni! dia pon rasa frustrated.Piss off! em hampeh tul! sangat haprak mereka nie.

dah le tak de sivik! buang sampah merata rata , pengotor siot jew. merokok merata rata bukan ikut rule.! mak bapak macam beruk anak macam kera lah.bukan ada rasa hormat pada orang lain nama jew muslim. buat malu agama jew. sial betul lah!...

Kanan ke kiri, lutut ke siku?

2011-03-21T14:36:00.000+08:00

Ah malasnya nak bangun pagi. nak kerja pagi ni. Malas pun ken kerja juga perut kena isi kan ini namanya bekerja nak isi perut kan nak hidup mesti kena kerja nak tampung periuk nasi kenalah kerja huar.! ambik bas lewat ha ha ha !.. selesai solat subuh aku bersiap ke sekolah eh bukan tempat kerja.
em awal pagi !:D setiba di ward em bagus dah tak de CVVHDF lagi bila tamat ni Wah macam ada improvement. em! jangkaan yang meleset.
wah memang ada improvement pakcik nie. oxigenation dah kurang em peep dah kurang asidsis lagi em kronik COPD.
sorry beb! Arterial line dah kong semalam! ar tp masih depent dengan inotrope lagi failed weaning. okay see how!
Paco2/Fio2: <200 : aku mengariskan masalah jew; inotrope tak leh nak weaning. arterial line kena insert , oxigenation improve slowly. blood sugar pon tak control tak de lak pulak nak bagi pakcik ni continous infusion cheh! overload lak! huh lambatnya para tabib nie. breathing above vent lak ! em kesian betul.ek tabib dah datang nie! aku pon mengatur bicara mengariskan permasalahan ku dengan pesakit aku ni. em he.sedation dah off withdrawal lak : ek tabib nie konfius lak line kat kanan , kiri lak di belek belek . MAaf encik tabib kanan sebelah sana .. ni kiri sana kanan... hu hu hu .. awal pagi konfius lak . ni buat aku nak gelak masa exam dulu pun kawan aku bengong macam tu biaslah kan exam > suruh balut siku kiri dia pi balut lutut kanan he he he :D kiri kanan siku ke lutut .

Sedangkan pantai pun terhakis inikan pula sekeping hati

2011-03-18T17:05:00.004+08:00

Seharian berkurung dalam bilik . Bila teringat tentang dia, air mata menitik mengalir perlahan suara hati ingin ku jerit sekuat hati namun masih tak berdaya suara pun tak mampu keluar huh!~kesal mendalam menghiris jiwa. Bila kesudahannya. kesunyian menghiris setiap detik waktu. bencinya aku dengan mu .

masuk 2 gelas kopi pagi ni. anak kucing ku mengiau ngiau dah ku bagi makan . hujan rintik rintik lagi di luar. musim tak menentu,

Email tak berbalas. sukarnya jika dalam hati jika ada dendam, sukarnya jika dalam hati cinta tak pernah lurus, sukarnya dalam hati kalau dalam hati tak ikhlas. bukan aku tak pernah ingat masa- masa bahagia, tapi setiap peristiwa sedih yang berlaku buat hati makin menjauh dari dia. makin ingin melupakan dia. apa harga seorang isteri pada dia . kalau kehadiran menyusahkan kenapa tidak di singkirkan. kalau kehadiran membebankan kenapa masih inginkan ku dan sakiti hati ku . sangat menjengkelkan . Masih ku bertahan buat sekian lama . masih ku cuba menafikan buat sekian lama . Tapi sampai bila Sedangkan pantai pun terhakis. inikan pula sekeping hati yang retak kau biarkan lukanya kering sendiri.

Mudah membaca coretan insan lain. Menghadapi dugaan hidup di dunia yang berdebu derita. membicarakan insaniah , rohaniah dan jasmaniah, keintelektualan, pahitnya memujuk hati. pahitnya menerima dengan redha pahitnya menerima kenyataan tapi itukan kenyataan. esok , selagi masih bernafas hidup perlu di teruskan .

Apa terjadi kita perlu hadapi, susah , senang kita harus hadapi sepenuh hati , separuh hati tak berhati pun kita kena jalani. bila membaca tentang memotivasikan diri. bunyinya macam mudah tapi sebenarnya tidak.Sebenarnya suka atau tidak, kita harus hadapi. esok tetap akan ada cuma tak tahu apa akan berlaku, masa depan masih kabur kecewakah, deritakah, bahagia kah. Bila ku fikir Tuhan takkan mengubah nasib sesuatu kaum jika kaum itu tidak mengubahnya. jadi apa harus ku lakukan . esok dan hari berlalu menuntut masa yang terlalu panjang buntu aku fikirkan.

Aku ingin pulang dan selesaikan semua jika aku berkemampuan, tapi sangat rindu pada Jeddah. satu tempat yang ku rasakan aman dan tenteram jauh dari kekalutan hidup ku di sana.

tapi dia menyiksa hidupku tak ingin kan ku bahagia.aku burung yang terbang tapi kakiku masih terikat .Dia tahu, ku tak ingin bersamanya lagi, dia tahu ku sangat benci padanya dia tahu . tapi dia mahu aku derita , derita itu dendam dia .Dia tak kan ingin melihat ku bahagia kerana dia lebih mencintai dirinya sendiri.

Tuhan bagi dugaan untuk kita , kerana dia nak naikkan darjat kita.

2011-03-13T06:40:00.001+08:00

Dalam hidup kita seharian memang banyak masalah dan dugaan melanda. memang tak dapat di nafikan . kalau dalam sebuah keluarga adik beradik kita ipar duai dan sebagainya suami kita semua ada di sekeliling kita. kita sanggup korbankan apa saja utuk membantu mereka . tapi sedihnya bila tiba giliran kita nak minta tolong sikit punya susah kena maki lagi,

Kita susah orang tak tahu, waktu kita dilanda masalah kita usahakn sendiri apa pun cara kita ikhtiar untuk atasi masalah, kalau tak di pecahkan ruyung manakan dapat sagunya , kalau tak berusah mana nak dapt hasilnya. ingatlah Tuhan bagi dugaan untuk kita , kerana dia nak naikkan darjat kita.Tuhan tak kan mengubah nasib seseorang jika dia tidak mengubahnya. dan janganlah kita menjadi orang yang meminta minta.Minta lah pada Tuhan yang Maha kaya. minta petunjuk minta di bimbing, Tuhan dan berikan panduan jalan yang lurus yang membengkoknya kita juga .
Sediakan diri utuk hadapi dugaan Maha hebat. kerana bukan kesukaran itu dugaan , kesenangan juga satu dugaan dalam apa juga waktu jangan lupa itu dugaan menguji kita , adakah kita orang yang beringat dan janganlah kita menjadi orang yang melampaui batas.

Low Life or High Life

2011-03-08T06:29:00.001+08:00

Sepetang tekak rasa sangat haus nak minuman yang sejuk . ternyata hari ni Teayana jadi pilihan.

em lemon mint dan mango mana yang sedap ni . che nak dua dua boleh he boleh boleh boleh.

he tamak ....

ambik ubat! minum sampai kembung hu hu hu...
tapi apa yang nak Nora katakan ialah hidup Low Life dengan High Life memang jauh berbeza. kalau minum petang pun sampai habis beratus untuk sandwich dan mango smoothies dan lemon mint,
high life dengan barang berjenama pentingkan standard dan quality lah kononnya . tapi bagi Nora
memang jauh berbeza hidup dulu yang Nora rasa simple dan murah,
memang costzy dan semakin besar periuk besar pula keraknya,
teringat masa masa indah minum teh tarik makan roti canai mamak tepi longkang pon longkanglah, nyamuk gigit pon apew de kisah.. tapi tu sama lagi sekarang tepi longkang tak de dah kat jeddah nie nyamuk ada juga ,
kedai mamak dan restoran 5 bintang memang jauh beza .low life simple dan seadanya, high life masih nora tak faham apa objectivenya walau apapun nora masih nora orang kampung jenjarom, anak encik samsuri, tukang kebun yang buat kerja sendiri, jangan ubah diriku untuk fit high life mu...

ku simpan rindu untuk mu

2011-03-08T05:46:00.005+08:00

Mak telefon suruh balik " baliklah sana kan perang nanti macam mana dengan Z bila nak balik sini jumpa dia kenapa nak kerja jauh jauh baliklah. " kata mak lagi, sayup sayup suara mak dalam telefon ku.
Petang tadi berita tentang demontrasi di negara C masih bersiaran lansung dari semua stesen TV dan aku menonton secara percuma dari bilik kawan ku. aku bertanya dengan kawan ku " kalaulah kita ni tengah perang kan Moi, tengah tengah aku telefon mak aku buat report kan ada pulak bom jatuh , mau tak cuak morang tua tu kan , mau done done tu dia suruh aku balik kan , Mak mana tak sayang kan anak kan" Hahaha , pecah ketawa kawan aku . " kau nak menyorok kat mana. bawa katil: sampuk kawan ku. Aku menyambung "manalah tahu masa kita buat kerja kerja suka rela ni tiba tiba pulak berlaku mahu tak cuak : : his tragik tu moi, macam cerita Bukit kepong pulak" kata ku aku ketawa kecil "Bukit kepong " sebuah cerita tragik perjuangan mempertahankan kehormatan dari dari cabul komunis hingga ke titisan darah terakhir.

Aku sampai di rumah lewat senja dan angkat gagang telepon dengan malas menghubungi sahabat ku. " honey kau dah makan. " soalku .. Eh tak pelah aku dah makan kau makan lah seorang " " kata honey. Okay ringkas jawab ku. sambil menyanyi kecil aku aku menyanyi lagu' Yang lebih kau cinta' yang pernah popular satu ketika dulu. Em .. keluh ku masa bercinta semua indah belaka , akan ku petik bintang menci menci menci kesal aku ! tapi hati kecil masih membisik kata cinta andainya kau tahu biar mak kata balik namun aku tak ingin balik biarlah ku simpan rindu di hati kecil ku, biarlah ku simpan segalanya menyesakkan dada namun tak ingin ku kembali .

Hujan rintik rintik serintik hatiku

2011-01-04T03:27:00.000+08:00

Tahun baru. hujan rintik rintik sepanjang hari. mendung kelabu menyisih mega di hujung senja. termanggu seketika melihat bumi dan rumput di basahi hujan sedang sepanjnag tahun panas dan hangatnya membakar. Kaki terus melangkah ah ! mungkinkah Nora akan balik . kaki terus melangkah meneruskan tujuan selagi tidak bertemu tak mungkin berhenti.selagi fikiran masih kacau jiwa tak kan tenang.Nora tahu kekasih tak lagi inginkan ku, Nora tahu rintik hujan dan mendung semendung hatiku, semua yang ada pasti akan pergi. silih berganti datang dan pergi.Tapi Nora ingin tahu sampai bila perlu simpan pedih hati Nora ingin tahu, apa yang si dia fikirkan Nora ingin tahu kenapa susah benar menzahirkan rasa hormat dan sayang yang kian menghilang, kenapa susah benar si dia untuk di tafsirkan. kalau cinta ada apa buktinya. kalau sayang masih bertugu kenapa derita.Andai berjauhan lebih menenangkan ..
Oh! hujan, Oh! awan mendung semendung hatiku ,
Dia kekasih tak lagi inginkan ku, diam membisu, menbatu mungkin itu yang terbaik, adakah masih berserpih lagi rindu Hanya Tuhan lebih tahu. apa yangtersimpan di sanubari mu.

lost peal in the mud of survivor

2010-11-01T22:57:00.005+08:00

I looked down. : I'm almost reach on my blessed land of Malaysia " I reached in the airport then I drop by to the duty free and I wonder to buy my mom a new fragrance of Escada " Absolutely me" after some time I finally bought it. and I switch on my phone, and call my husband and his answered" honey i'm working right now" okay i speak slowly" I will ask my brother to fetch me'. huh! i know it seem that we been missed each other but yet we lose the moment that so treasures, aren't u remember when thing so fiery everything was fine 'I will be where ever you be'..when we meet each other things goes so quiet, why thing goes so different I wonder why... every moment was so quiet and you easily tempered to me... i don't mine if you are so dam busy. i don't mine settle down my thing my own. I don't mine being alone every time but don't you realize in this relationship there's something missing something more valuable then money. ..and when I looked at your eyes I don't see your words synchronized with what you said.where is the sincerity...
I wish we can holding hand like before and there is no words will hurt each other. I wish thing can last more longer. as memories still linger . I wish you will treat me as someone you love like before not somebody stranger that you don't know. The wind blow so cold and i realized tear drop on my cheek. I realized I could not find the lost pearl anymore....

I could not predict

2010-08-26T10:31:00.000+08:00

It is hard week that I went through I'm in depressed and shocked because of recent thing happen so sudden and i could not determine what is sudden and i could not accept sudden but everything was so sudden but it all about bound between sympathetic nurse with her patient and it about feeling sad ,wish and hope.

I become so upset till i cried the whole day and night. but i could not change thing has happened and i could not do anything.even though i can share how i felt for my patient with my friends but yet i could not forget how shock I'm. event it not the first time i saw people dying tragically but it really left me trauma when some one can say thank you and left u ,then the heart stop beating and not breathing.sometime looked so fine after defib can open eyes and smile and say thank u but at the moment u walk away she go with u. nothing can bring her back.

How could I accept every time I nurse her i will pray for her may god bless her , may god not prolonging her suffer. and on that day I recite quran quietly and really she looked so fine only become more pale and then more cold. I cold not determined how i felt the temperature was fine blood pressure was good, but because she so pale i took blood investigation to determine why. I left her for 30 minute break when i came back she gone. How can I accept it so sudden. Why my eyes so blind why i could not see i swear with the name of God . the way she go left me with trauma. and then another patient of mine before asystole when i just came back from morgue , how could i accept it so sudden like some one up there is listening to what i pray.oh God please bless them i have done my part .

Malaysia Ku Bumi bertuah

2010-05-07T21:37:00.004+08:00

Tanah Pusaka

Sungguh gemilang negeriku
Yang kupuja oh tanah ku
Di merata dunia harum semerbak
namamu oh Malaysia

Aman makmur kaya-raya
Selama-lama hidup maju jaya
Oh tanah pusaka
Negaraku yang berdaulat dan merdeka

c/o Tanah pusaka bertuah
   Berbagai bangsa didalamnya
   Hidup aman dan berjaga
   Bertekun kerja dan berjasa

Musuh melanggarku gempur
Sungguh rela ku gugur kerana
Kau tanah pusaka
Biar putih tulang jangan putih mata

Lirik Lagu Tanah Pusaka
rindunya pada Malaysia, rindu hijau suasana , riang ria . hu hu seronoknya seronoknya , I love Malaysia

Kota Mekah Satu Anugerah

2010-05-01T22:52:00.004+08:00

Seharusnya seperti kawan kawan lain bila tiba cuti lepas kerja kita akan terus ke lapangan terbang untuk

menuju pulang untuk bertemu dengan orang yang di cintai, keluarga yang di tinggalkan. namun tidak bagi Cik

Nora , Sukar benar untuk Cik Nora tinggalkan bumi Saudi Arabia ni.kerana hati sangat tenang di sini

dengan langkah perlahan Cik Nora memulakan langkah untuk menyahut panggilannya...........

hanya bebekal niat dan keinginan Cik Nora pergi bersendirian Kerana Cik Nora yakin Allah sentiasa ada

bersama ku dimana jua Macam iklan Digi I will Follow U!...

Sampai di sana , semua tempat penginapan dah penuh, maklumlah Cik Nora gamble jew... Oh nasib baik..

Cik Nora Dapat bilik Akhirnya ,walau dalam hati dah berkata kata ," apa lagi tidur masjid lah"

Syukur pada Allah Cik Nora dapat tempat penginapan dan

pemandangan ni dari bilik Cik Nora, seketika terpukau dengan kebesaran Ilahi. sesungguhnya Dia sangat

pengasih.

Semasa Cik Nora tenang membaca rangkaian ayat ayat suci si kecil ni sibuk duduk di sejadah Cik Nora,

membalikkan Al-Quran ku,Memang kau nakal tapi kau buat aku gembira hai si kecil............

keesokkan hari, Cik Nora menunaikan umrah dan selapai selesai tawaf wida, Cik Nora melangkah pulang,

dengan hati berat untuk meninggalkan , kerinduan yang memanggil, bukan kota itu, tapi dalam jiwa yang

akan rasa tenang yang Yakin Dia sentiasa Ada bersama Mu..........

Masjidil Haram monument yang melambangkan kebesaran tempat Suci Kita umat Islam.Manisnya rindu

Pada Nya sukar untuk ku definasikan .................

It Must Have Been Love trial 1.wmv

2010-04-25T19:26:00.000+08:00

It must have been love, but its over now

Lay a whisper on my pillow,

leave a winter on the ground

I wake up lonely, there's air of silence

in the bedroom and all around

Touch me now, I close my eyes and dream away

It must have been love, but its over now

It must have been good, but I lost it somehow

It must have been love but its over now

from the moment we touched till the time had run out

Make believing, we're together

that I'm sheltered by hour heart

But in and outside I've turned to water

like a teardrop in your palm

And its hard, winter's day, I dream away

It must have been love, but its over now

It was all I wanted, now I'm living without

It must have been love but its over now

Its where the water flows, its where the wind blows...........

Nursing in mental Illness treatment and Prevention

2010-03-29T16:45:00.009+08:00

Major objectives that serve as guidelines toward achieving a good mental health

1. Promoting of mental health

2. Prevention of mental health

3. Treatment of client with mental disorders

4. Restoration of health

1. Promoting good mental health it is nurse responsibility to promote good mental health that contributes to the social, human and economic capital of society. Mental ill health can drastically reduce the quality of life of affected individuals and their families, in promoting mental health nurse does promoting campaign healthy life style, taking regular exercise, balance diet, good hygiene habit and good stress management and life pressure. Example nurse does a campaign to school and industry to give our society an awareness of stress sign and symptom.

2. Prevention of mental illness is whereby a nurse does identify and advice Public who had or experiences the symptom will come and seek treatment and counseling to consult their problem. Nurse does prevent by advising the patient to continue the medication to prevent relapse cases and follow the physician advise when to discontinue their medication or how to overcome burn out from stressful life and does community visit to see examined ex-patient will mental illness from relapse

Level of prevention consist of 3 level

1. Primary prevention-focus on reducing occurrence and incidence of mental disorder e.g. Meet the senior citizen to discuss strategies for linking with community resources, staying socially and intellectually active.

2. Secondary prevention- focus on reducing the prevalence of mental disorder. trough early identification of symptom

E.g. treats patient with after making diagnoses of mental disorder, such as mental clinic, day treatment, home and school. Then referring patient to family therapy as additional treatment.

3. Tertiary prevention-focus on reducing residual effect of disorder and providing rehabilitation and restoration.

E.g.; continue to meet the family who has a member with mental disorder assist and reinforce willingness to care for the member and help identify symptom that occur. And conduct seminar and workshop to teach patient job skill and match potential employer with potential patient employees,

3. Treatment of client with mental disorders. Usually treatment will be eletroculvalsive ECT and therapy Medication using psychotic drug. That reduce psychosis symptom.

4. Restoration of health. After patient under go their treatment and being trained in mental hospital they will be trained to do they activity daily living by themselves so that they will not depend on family and will be able to organize and manage they own life so that they serve in community and work as normal person after under go treatment and job skill.. Example: Treatment And Job Skill In Occupational therapy and speech therapy.

2. The principle of nurse :patient relationship

· 1.The relationship is therapeutic rather than social

A therapeutic relationship is formed to help patient to solve problem, make decision, achieve growth, learn coping strategies, let go unwanted behaviors, reinforce self worth and examine relationship example. Teach the patient what to do and method of solving problem such as how to work and get money to survive

· 2. The focus remains on the patient’s need and problem rather than the nurses or other issues.

Client focus patient redirect the focus away from self by changing the subject the nurse confront the diversion in matter of fact way and refocus the topic example nurse control the conversation by asking patient what their problem. Because patient maybe fear or anxiety.

· 3. The relationship is purposeful and goal directed

Goal direction the primary purpose of a therapeutic relationship is helping clients to meet adaptive goal. Nurse and patient together determining problem and issues and collaboratively decide what the client needs and able to achieve, the nurse and patient agree to work toward those goal and put intention into action modifying strategies until they goal achieve. Example Patient taught to do his own activity daily living such bathing and self hygiene and planning patient into occupational therapy so that patient learn to work.

· 4.The relationship is objective rather than subjective in quality

Nurse remain therapeutic when they remain objective mean remain free from bias, prejudice and personal identification in interaction with patient and able to process information based on facts. and subjective mean nurse should emphasis own feeling , attitude, and opinion when interacting with the patient. Example : nurse who encounter a patient who depressed and grieving in the recent death of her mother. The nurse should seek supervision or therapy for the patient so that the patient will recover. Nurse do not enmeshed by sharing her experience.

· 5. The relationship is time limited rather than open ended

Nurse should set a time for her to see patient on specific time, and nurse should know when to end the time while meeting patient. Nurse should know when patient become irritable and she should discontinue them conversation. Example nurse should determine when to meet patient and do not continue asking patient to identify the patient problem because patient can be aggressive.

The factors that can influence and hinder the effectiveness of therapeutic Communication.

Communication consists of several structural components the stimulus, the sender, the massage, the medium, the receiver, and feed back.

Sender/receiver, perception,value, culture, environment, relationship, content, contex, socioeconomic, knowledge, life/family experiance

Communication is learned process influence by several factors, including the environment, the relationship between the sender and the receiver, the content of the massage and the context in which the massage takes place other factor include attitude, values, ethic background, socioeconomic status, family dynamic, life experience, knowledge level and the ability to relate to others experience, knowledge level and the ability to relate to other.

Therapeutic communication is foundation of psychiatric nursing and the psychiatric nurse’s single most importance tool. It is an interactive process that occurs between the nurse and the patient.

The art of interacting therapeutically is a learned skill involving non verbal and verbal communication. The purpose of therapeutic communication is to enhance patient growth and intervention to promoting health to patient.

The effectiveness of therapeutic communication can be influence by trait of genuineness, positive regard or respect, empathy, trustworthiness, clarity, responsibility and assertiveness. They incorporate verbal and nonverbal behavior as well attitudes, beliefs and feeling behind the communication all of this necessary for therapeutic communication to take place.

1.Genuineness. Is being consistent with both verbal and non verbal behavior. Consistent verbal and non verbal behavior shows that we are open, honest and sincere. Genuineness is importance to patient to develop trust in nurse.

2.Positive regard or respect and acceptance. Nurses should shows that they view their client as worthy. For example sitting and listening to patient expressing concern about event affecting the patient and validating the patient feeling nurse also should shows positive regard by being nonjudgmental. Avoid harsh judgment of patient behavior and feelings both are real and cannot be argued with, discounted or criticize.

3. Empathy is the foundation of all therapeutic nurse client relationship and essential trait for nurses to have in order to meet their patient needs. It is difficult for client to trust their nurse if they do not believe the nurse has empathetic appreciation of them as individuals (McCabe, 2004: Reynolds,2000)

Therefore, empathy or understanding is the nurse ability to see thing from patient view point and to communicate the ability to be sensitive and communicate understanding to the patient the ability to be sensitive to and communicate understanding of the patient feeling(May and Alligood,2000) Empathy begins with awareness of another person's feelings. It would be easier to be aware of other people's emotions if they would simply tell us how they felt. But since most people do not, we must resort to asking questions, reading between the lines, guessing, and trying to interpret non-verbal cues. Emotionally expressive people are easiest to read because their eyes and faces are constantly letting us know how they are feeling.

Once we have figured out how another person feels, we show empathy by acknowledging the emotion. We may say, for example,

- I can see you are really uncomfortable about this.
- I can understand why you would be upset.

We can also show empathy through a simple sign of affection such as hug or a tender touch. Though empathy is usually used in reference to sensing someone else's painful feelings, it can also apply to someone's positive feelings of success, accomplishment, pride, achievement etc. In this case a "high five" would also be a sign of empathy.

Empathy poses 2 stages if patient an importance and uncomfortable emotions first be receptive to understand the patient by putting your self in the patient place. Then be able to communicate understanding.

4. Trustworthy

Trustworthy is another essential characteristic of an effective nurse being trustworthy nurse keep commitment and promise and consistent their approach and respond to patient the trustworthy nurse respect the patient privacy, dignity and need for confidentiality.

5. Clarity

Nurses need to communicated clearly to the patient who often have difficulty processing information or thinking clearly as a result as their mental disorder.

Problem will happen if instruction and information are given in highly technical manner. patient are embarrass to ask for clarification. Therefore nurse should make an effort to speak at the patient

Hinder of effectiveness of therapeutic communication is resistance, transference, counters transference and boundary violations are obstacle to therapeutic communication.

1. Resistance, occur when patient who consciously or unconsciously maintain a lack of awareness of their problem in order to avoid anxiety. The nurse should assure the patient to overcome the patient fear.

2. Transference,

Is when patient unconsciously associates the nurse with someone significant in his life, the patient transfer they feeling and attitude about the other person to the nurse. Transference is a simple appearing idea that has to do with the way people understand one another and form relationships with one another. As its name suggests, it involves the idea of transferring something from one place to another.. example a patient sees a nurse as some she don’t like then she resist, nurse should listen to the patient and u used therapeutic communication technique ,clarifying and reflecting to recognize the reason for resistance.

3. Counter transference

In the nurse emotional response to specific client. The response to a specific patient the response is irrational, inappropriate, highly charge counter transference occur when the feeling are intense either positive or negative.

When patient displaying aggressive and resistive behavior, is the nurse still angry with the patient as the result of these behavior, the nurse will lose the objectivity needed to promote healthy change.

To deal with counter transference, nurse should conduct an honest self appraisal throughout the course of the therapeutic relationship while gaining a good understanding of patient background.

4. Boundary violations

Occur when the nurse go beyond the establishing therapeutic relationship. Standard and enter into social or personal relationship with the client. For example the nurse discloses to much personal information to the client in order to benefit the nurse.

4. The role of common neurotransmitters in the functioning of the central nervous system.

Neurotransmitters are chemicals located and released in the brain to allow an impulse from one nerve cell to pass to another nerve cell. Neurotransmitters can excite or inhibit neurons (nerve cells). Some common neurotransmitters are acetylcholine, norepinephrine, dopamine, serotonin and gamma aminobutyric acid (GABA). Acetylcholine and norepinephrine are excitatory neurotransmitters while dopamine, serotonin, and GABA are inhibitory. Each neurotransmitter can directly or indirectly influence neurons in a specific portion of the brain, thereby affecting behavior.

A nerve impulse travels through a nerve in a long, slender cellular structure called an axon, and it eventually reaches a structure called the presynaptic membrane, which contains neurotransmitters to be released in a free space called the synaptic cleft. Freely flowing neurotransmitter molecules are picked up by receptors.

Neurotransmitters are chemicals that transmit messages from one nerve cell (neuron) to another. The nerve impulse travels from the first nerve cell through the axon. A single smooth body arising from the nerve cell to the axon terminal and the synaptic knobs. Each synaptic knob communicates with a dendrite or cell body of another neuron, and the synaptic knobs contain neurovesicles that store and release neurotransmitters. The synapse lies between the synaptic knob and the next cell. For the impulse to continue traveling across the synapse to reach the next cell, the synaptic knobs release the neurotransmitter into that space, and the next nerve cell is stimulated to pick up the impulse and continue it.

In a structure called the postsynaptic membrane of another nearby neuron. Once the neurotransmitter is picked up by receptors in the postsynaptic membrane, the molecule is internalized in the neuron and the impulse continues. This process of nerve cell communication is extremely rapid.

Once the neurotransmitter is released from the neurotransmitter vesicles of the presynaptic membrane, the normal movement of molecules should be directed to receptor sites located on the postsynaptic membrane. However, in certain disease states, the flow of the neurotransmitter is defective. For example, in depression, the flow of the inhibitory neurotransmitter serotonin is defective, and molecules flow back to their originating site (the presynaptic membrane) instead of to receptors on the postsynaptic membrane that will transmit the impulse to a nearby neuron.

The mechanism of action and localization of neurotransmitters in the brain has provided valuable information concerning the cause of many mental disorders, including clinical depression and chemical dependency, and in researching medications that allow normal flow and movement of neurotransmitter molecules.

Excitatory neurotransmitters are excitatory transmitters regulate many of the body’s most basic functions including: thought processes, the body’s fight or flight response, motor movement and higher thinking. Physiologically, the excitatory transmitters act as the body's natural stimulants, generally serving to promote alertness, energy, and activity. Without a functioning inhibitory system to put on the brakes, things can get out of control.

Inhibitory neurotransmitters Excitation in the brain must be balanced with inhibition. Too much excitation can lead to restlessness, irritability, insomnia, and even seizures. The inhibitory system slows things down. Physiologically, the inhibitory transmitters act as the body's natural tranquilizers, generally serving to induce sleep, promote calmness and decrease aggression.

Excitatory neurotransmitters

· Dopamine

· Histamine

· Norepinephrine

· Epinephrine

· Glutamate

· Acetylcholine

Inhibitory neurotransmitters

· GABA

· Dopamine

· Serotonin

· Acetylcholine

Acetylcholine helps with memory and learning. Dopamine is primarily responsible for, mood, alertness, and movement. Norepinephrine and epinephrine influence alertness, arousal, and mood. Serotonin is involved in mood, appetite control, emotional balance, and impulse control. GABA helps with relaxation and sedation.

Acetylcholine neurotransmitter

Acetylcholine release can be excitatory or inhibitory depending on the type of tissue and the nature of the receptor with which it interacts. Acetylcholine plays numerous roles in the nervous system. Its primary action is to stimulate the skeletal muscular system. It is the neurotransmitter used to cause voluntary muscle contraction or relaxation in the muscles. But particularly high concentrations occur in the basal nuclei and motor cortex of the brain. It often called cholinergic

In the brain, acetylcholine is involved in learning and memory. Acetylcholine is a small molecule transmitter that is also found in the hippocampus and prefrontal cortex. The hippocampus is responsible for memory and memory retrieval. Alzheimer’s disease is associated with a lack of acetylcholine in certain regions of the brain.

Dopamine

Dopamine is a hormone and neurotransmitter occurring in a wide variety of animals, including both vertebrates and invertebrates. In the brain, this phenethylamine functions as a neurotransmitter, activating the five types of dopamine receptors D1, D2, D3, D4 and D5, and their variants. Dopamine is produced in several areas of the brain, including the substantia nigra and the ventraltegmental area. Dopamine is also a neuro hormone released by the hypothalamus. Its main function as a hormone is to inhibit the release of prolactin from the anterior lobe of the pituitary.

Dopamine can act as both an excitatory or inhibitory neurotransmitter Dopamine’s functions are diverse, affecting memory, motor control, and pleasure. It allows us to be alert and motivated and to feel satisfied. Dopamine is associated with positive stress states such as being in love, exercising, listening to music. Once produced, dopamine can convert into the brain chemicals norepinephrine and epinephrine.

High levels

Increased level of dopamine in the frontal lobe of the brain contributes to the incoherent and disrupted thought processes that are characteristic of schizophrenia. Excessive levels of dopamine cause our thinking to become excited, energized, then suspicious and paranoid as we are hyper stimulated by our environment. With low levels of dopamine we lose the ability to focus. When dopamine levels are too high our focus becomes narrowed and intense. High dopamine levels have been observed in patients with poor gastrointestinal function, autism, mood swings, aggression, psychosis, anxiety, hyperactivity, and children with attention disorders.

Low levels

Low level of dopamine in the motor areas of the brain is responsible for Parkinson's disease, which involves uncontrollable muscle tremors. A decline in dopamine levels in the thinking areas of the brain is linked to cognitive problems (learning and memory deficits), poor concentration, difficulty initiating or completing tasks, impaired ability to “lock onto” tasks, activities, or conversations, lack of energy, lack of motivation, inability to “feel alive”, addictions, cravings, compulsions, a loss of satisfaction in activities which previously pleased you, and slowed motor movements.

Epinephrine

Epinephrine, also known as adrenaline, is an excitatory neurotransmitter. It is derived from norepinephrine and is secreted along with norepinephrine in response to fear or anger. This reaction, referred to as the “fight or flight” response, prepares the body for strenuous activity. Epinephrine regulates attentiveness, arousal, cognition, sexual arousal, and mental focus. It is also responsible for regulating the metabolism. Epinephrine is used medicinally as a stimulant in cardiac arrest, as a vasoconstrictor in shock, as a bronchodilator and antispasmodic in bronchial asthma, and anaphylaxis.

High levels

Epinephrine levels which are too high can result in restlessness, anxiety, sleep problems, acute stress, and ADHD. Excess amounts of epinephrine can also raise the blood pressure, increase the heart rate, cause irritability and insomnia.

Low levels

Low levels of epinephrine can also contribute to weight gain, fatigue, lack of focus, decreased sexual arousal, and poor concentration. Stress tends to deplete our store of adrenalin (epinephrine), while exercise tends to increase it.

GABA

GABA is the abbreviation for Gamma-aminobutyric acid. GABA is the major inhibitory neurotransmitter in the central nervous system and plays a major role in regulating anxiety and reducing stress. GABA has a calming effect on the brain and helps the brain filter out “background noise”. It improves mental focus while calming the nerves. GABA acts like a brake to the excitatory neurotransmitters which can cause anxiety if the system is over stimulated. It regulates norepinephrine, adrenaline, dopamine, and serotonin and is a significant mood modulator. The primary function of GABA is to prevent over stimulation.

High levels

Excessive GABA levels result in excessive relaxation and sedation

Low levels

Insufficient GABA results in the brain being over stimulated. People with too little GABA tend to suffer from anxiety disorders and may have a predisposition to alcoholism. Low levels of GABA are associated with bipolar disorder, mania, poor impulse control, epilepsy, and seizure disorders. Since proper GABA functioning is required to induce relaxation, analgesia, and sleep, dysfunction of the GABA system is implicated in the pathophysiology of several neuropsychiatric disorders, including anxiety and depression.

Glutamate

Glutamate is a major excitatory neurotransmitter that is associated with learning and memory. It is also thought to be associated with Alzheimer’s disease. Glutamate has been implicated in epileptic seizures and is a key molecule in cellular metabolism. It is also one of the major food components that provides flavor. Glutamate is found in all protein-containing foods such as cheese, milk, mushrooms, meat, fish, and many vegetables. Monosodium glutamate is a sodium salt of glutamate.

High levels

Excessive levels of glutamate are toxic to neurons and have been implicated in the development of neurological disorders such as amyotrophic lateral sclerosis and Huntington's chorea, peripheral neuropathies, chronic pain, schizophrenia, stroke, and Parkinson's disease.

Low levels

Insufficient levels of glutamate may play a role in impaired memory and learning.

Histamine

Histamine is most commonly known for its role in allergic reactions but it is also involved in neurotransmission and can affect your emotions and behavior as well. Histamine helps control the sleep-wake cycle and promotes the release of epinephrine and norepinephrine.

High levels

High histamine levels have been linked to obsessive compulsive tendencies, depression, and headaches.

Low levels

Low histamine levels can contribute to paranoia, low libido, fatigue, and medication sensitivities.

Monoamines This is a class of neurotransmitters which includes serotonin, norepinephrine, GABA, glutamate, and dopamine. The monoamine hypothesis holds that mood disorders are caused by depletion in the levels of one or more of these neurotransmitters.

Norepinephrine

Norepinephrine is an excitatory neurotransmitter that is important for attention and focus. Norepinephrine is synthesized from dopamine and is strongly associated with bringing our nervous systems into the “fight or flight” state. Norepinephrine triggers the release of hormones from the limbic section of the brain that signal other stress hormones to act in a crisis. It can raise blood pressure and increase heart rate. It can elevate the metabolic rate, body temperature and stimulate the smooth bronchial muscles to assist breathing. It is also important for forming memories.

High levels

Elevated norepinephrine activity seems to be a contributor to anxiety. Also, brain norepinephrine turnover is increased in conditions of stress. Increased levels of norepinephrine will lead to alertness and mood elevation and increased sexual interest. However, high amounts raise blood pressure, increase heart rate, and cause anxiety, fear, panic, stress, hyperactivity, an overwhelming sense of dread, irritability, and insomnia.

Low levels

Low levels of norepinephrine are linked to lack of energy, focus, and motivation. Insufficient norepinephrine levels also contribute to depression, loss of alertness, and poor memory.

Serotonin

Serotonin is an inhibitory neurotransmitter involved in the regulation of mood, anxiety, libido, compulsivity, headaches, aggression, body temperature, eating disorders, social anxiety, phobias, sleep, appetite, memory and learning, cardiovascular function, muscle contraction, and endocrine regulation. Other brain neurotransmitters, such as dopamine and norepinephrine, also influence mood and arousal. However, serotonin generally has different effects. Serotonin plays a major role in sleep and mood regulation. Proper amounts of circulating serotonin promote relaxation. Stress reduces our serotonin levels as our body uses up serotonin in an attempt to calm itself.

Low levels

Low levels of serotonin can result in depressed mood, anxiety, panic attacks, low energy, migraines, sleeping problems, obsessions or compulsions, feeling tense and irritable, craving sweets or loss of appetite, impaired memory and concentration, angry or aggressive behavior, slowed muscle movement, slowed speech, altered sleep patterns, and having a reduced interest in sex.

High levels

Excess amounts of serotonin cause sedation, a decrease in sexual drive, a sense of well being, bliss, and of being one with the universe if serotonin levels become too high they can result in Serotonin Syndrome. Extremely high levels combining different agents known to increase levels of Serotonin, such as an SSRI and an MAOI, can result in violent trembling, profuse sweating, insomnia, nausea, teeth chattering, chilling, shivering, aggressiveness, over-confidence, agitation, and malignant hyperthermia.

5. The relationship of neurotransmitters’ dysfunction to mental disorder

Serotonin and its close chemical relatives dopamine and norephenephrine , are the neurotransmitters and most widely involved in various form of depression. there appears to be abnormal excess or inhibition of signals that control mood, thoughts, pain, and other sensations. Depression is treated with antidepressants that affect norepinephrine and serotonin in the brain. The 2 major classes of antidepressant tricyclic and selective serotonin reuptake inhibitor (SSRI)

The antidepressants help correct the abnormal neurotransmitter activity. A newer drug, fluvoxamine @Luvox, is a selective serotonin reuptake inhibitor (SSRI) that appears to establish the level of serotonin required to function at a normal level. As the name implies, the drug inhibits the re-uptake of serotonin neurotransmitter from synaptic gaps, thus increasing neurotransmitter action. In the brain, then, the increased serotonin activity alleviates depressive symptoms.

Other anti depressant is monoamine Oxidase Inhibitor (MAOI) and an enzyme that typically deactivates serotonin and dopamine .deactivating this enzyme leaves the system unable to run off the effect of these transmitter substance. MAOI reduces the transmission between the two neuron. Catechole 0 methyl tranferase (COMT) an enzyme normally responsible for deactivating norepenephrine to much of this enzyme prevent adrenergic neuron from effectively communicating with one and other. Anti depressant that reduce level of Catechole 0 methyl tranferase restore neuronal communication ability because norephineprine is importance in regulating heart rate activities eg. Blood pressure and heart rate.

Impairment of dopamine which is containing neurons in the brain is implicated in schizophrenia, a mental disease marked by disturbances in thinking and emotional reactions. Medications that block dopamine receptors in the brain, such as chlorpromazine and clozapine, have been used to alleviate the symptoms and help patients return to a normal social setting.

Parkinsonism is cause by dopamine deficiency in basal nuclei involved in motor coordinator . patient who suffering in Parkinson’s disease display tremors, a shuffling gait, is characterized by memory loss and the eventual inability for self-care. The disease seems to be caused by a loss of cells that secrete acetylcholine in the basal forebrain region of brain that is the control center for sensory and associative information processing and motor activities). Some medications to alleviate the symptoms have been developed, but presently there is no known treatment for the disease.

Generalized anxiety disorder

People with generalized anxiety disorder (GAD) experience excessive worry that causes problems at work and in the maintenance of daily responsibilities. Evidence suggests that GAD involves several neurotransmitter systems in the brain, including norepinephrine and serotonin.

Attention-deficit/hyperactivity disorder

People affected by attention-deficit/hyperactivity disorder (ADHD) experience difficulties in the areas of attention, over activity, impulse control, and distractibility. Research shows that dopamine and norepinephrine imbalances are strongly implicated in causing ADHD.

Drug addictions

Cocaine and crack cocaine are psycho stimulants that affect neurons containing dopamine in the areas of the brain known as the limbic and frontal cortex. When cocaine is used, it generates a feeling of confidence and power. However, when large amounts are taken, people "crash" and suffer from physical and emotional exhaustion as well as depression.

Opiates, such as heroin and morphine, appear to mimic naturally occurring peptide substances in the brain that act as neurotransmitters with opiate activity called endorphins. Natural endorphins of the brain act to kill pain, cause sensations of pleasure, and cause sleepiness. Endorphins released with extensive aerobic exercise, for example, are responsible for the "rush" that long-distance runners experience. It is believed that morphine and heroin combine with the endorphin receptors in the brain, resulting in reduced natural endorphin production. As a result, the drugs are needed to replace the naturally produced endorphins and addiction occurs. Attempts to counteract the effects of the drugs involve using medications that mimic them, such as nalorphine, naloxone, and naltrexone.Alcohol is one of the depressant drugs in widest use, and is believed to cause its effects by interacting with the GABA receptor. Initially anxiety is controlled, but greater amounts reduce muscle control and delay reaction time due to impaired thinking.

PART B

The Components Of Assessment By Using Mental Status And Psychosocial Criteria In Order To Provide A Quality Psychiatric-Mental Health Care.

The components of assessment by using mental status and psychosocial are:-

MENTAL STATUS EXAMINATION

1. Appearance

· Dress, grooming, hygiene, cosmetic, age posture, facial expression

2. Behaviour and activity

· hypo activity or hyperactivity, rigid, relaxed, agitated motor movement, gait(way of walking) and coordination facial grimacing, gesture or abnormal movement.

3. Attitude

· interactions with the interviewer, : cooperative , resistive, friendly.

4. Speech

· Quantity: Poverty of speech, poverty of content or voluminous( too many word).,

· Quality: articulate (well spoken),Congruent (make sense) monotone. Talkative repetitious.circumlocutary.Circular, confabulation superficial fragmented broken speech.

· Rate: slow . rapid or normal.

5. Mood and affect

· Mood _ (intensity, depth , duration,) sad, fearful , depressed, angry, anxious, ambivalent, (opposing feeling,)Happy ,ecstatic, grandiose( Feeling of greatness)

· Affect intensity depth, duration);appropriate, sad, apathy(indifferent),constricted(narrowed) blunted, flat no expression. Labile, euphoric(exaggerated, happiness), Bizarre( add, abnormal

6. Perception

· Hallucination ,( can be auditory , visual, tactile, olfactory,)illusion (misinterprets reality can be auditory, visual, tactile, olfactory, depersonalization,(detachment)dereaization disconnects from reality, distortions, (view object out of proportion)

7. Thoughts

· Form and content: logical and illogical loose associations(fragmented) flight of ideas rapid, Thought ,autistic(internally stimulated thoughts),bloking broadcasting, neologism, New word. Word salad(mixed up word) obsession(persistence thought)rumination , rethinking, same thought, delusions(Fixed believe)abstract(conceptual) or concrete(literal)

8. Sensorium and cognition

· Level of consciousness: orientation (aware of person, Place , time and situation.) , Attention span, recent and remote memory (can recall current and past event.)Concentration. Ability to comprehend and process information; intelligence, fund of knowledge(sufficient amount of knowledge),judgement(makes rational decision),insight(aware of situation such as own illness and reason for hospitalization),ability to abstract and use proverbs(understands meanings of common sayings and expressions).

9. Judgement

· Ability to asses and evaluate situations, make rational decisions, understand consequences of behaviour, and take responsibility for actions.

10. Insight

· Ability to perceive and understand the cause and nature of own and others’ situation; aware of his or her mental illness and effects or symptoms.

11. Reliability

· Interviewer’s impression that individual reported information accurately and completely.

PSYCHOSOCIAL CRITERIA

1. Stressors

· Internal: Psychiatric or medical illness, including pain, perceived loss, such as loss of self concept/self esteem.

· External: Actual loss(e.g. death of loved one,divorce,lack of support system, job or financial loss, retirement, dysfunctional family system)

2. Coping skills

· Adaptation to internal and external stressors; use of functional, adaptive coping mechanisms and techniques; management of activities of daily living; ability to solve problems associated with daily life.

3. Relationships

· Attainment and maintenance of satisfying, interpersonal relationships congruent with developmental stage; includes sexual relationship as appropriate for age and status.

4. Cultural

· Ability to adapt and conform to prescribed norms, rules, ethics, and mores of an identified group.

5. Spiritual (value belief)

· Presence of a self satisfying value belief system that the individuals regard as right, desirable, worthwhile and comforting.

6. Occupational

· Engagement is useful, rewarding activity, congruent with developmental stage and societal standards (work, school, recreation).

2. The Rights Of Mental Health Clients And Its Application In Practice.

1. Rights of clients

When patient enter a mental health facilities. There are basic rights such as to send and receive unopened mail; to wear owns clothes, to receive visitors, to keep and use personal possessions and to access to telephone.

Patient has a right to be informed regarding potential risk, benefit and reasonable alternative before giving consent for any specific therapy, surgery or treatment, including, medication, and nurse need to disclose side effect that will be uncomfortable or reversible to patient.

2. Right to treatment

A Movement bean in Alabama, 1980 for the right to treatment for people with mental illness. With financial limitation within the mental health system, employee at Bryce Hospital were laid off because of budget shortfall as a result of this situation, a class action suit on behalf of the employees and patient was field, alleging that fewer employees the patient could not receive the proper treatment. And settle by consent at 1986, and then many jurisdictions continue follow some of the standard and guidelines specified, including the right to privacy, and dignity. The right to the least restrictive treatment and individual treatment plan.

3. Right to refuse treatment

The right of a patient to refuse treatment is based upon five constitutional protections:

· the 8^th amendment’s protection against cruel and unusual punishment

· the 1^st amendment’s protection of free speech (freedom of thought / ideas)

· the 1^st amendment’s protection of freedom of religion

· the more broadly interpreted right to privacy

· the 14^th amendment’s protection of liberty (the right to be free from unjustified intrusions on personal security)

In fact, these protections constitute a competent individual’s right to accept or refuse an intervention, based upon the principles of patient autonomy and informed consent. Within psychiatry, however, these guarantees have been variably interpreted and restrained. First, the state has been permitted a range of activities under its police authority, in which the rights of the public have super ceded the rights of the mentally ill Second, the state has been permitted a range of activities under the doctrine of parens patriae --the 14^th century theory which established the legitimacy of the state to act as guardian for those unable to care for themselves (http://psychrights.org/Articles/rightorefuse.htm)

4. Application to practice

Nurses practicing in mental health facilities need to be aware of the state and case laws and policies and procedures for that jurisdiction regarding the administration of medication to voluntary and involuntary competent patient.

Frequent nursing assessment for side effect and careful documentation of patient for patient complaint to side effect for adjustment or discontinuance of medication.

References

M.F.Katherine (2008): Psychiatric mental health nursing (4^th edition) Canada: Mosby

http://www.wellesley.edu/Chemistry/Chem101/mental/mental.html

http://en.wikipedia.org/wiki/Neurotransmitter

http://psychrights.org/Articles/rightorefuse.htm

http://allpsych.com/disorders

http://www.mentalhelp.net/poc/view_doc.php

I'm not in planet earth

2010-03-23T21:37:00.002+08:00

Just imagine.. we are in another planet he he he.... people around us look alike but very different, look like we are the same but very different, we have same colour of blood but dam we still done understand each other coz we are communicating using ET language. ha ha ha... we may think that we already done as best what we can do , but yet we can not satisfied them, no matter you do good or how polite the language is still we are the wrong ones and we are he guilty ones. have you ever come into my situation. to tell the true is the most difficult but it is true nothing only the true ha ha ha ..............just tell the true and be frank with what we do......... at the end of the day just let the thing goes by the wind ....... using this ET language every times people around will misunderstand you. just imagine how to communicated with Alien. say peace to the earth!...................

Break After Stressing Grey matter of my brain

2010-02-26T01:14:00.002+08:00

Recently I was so busy and in i have been joining my friends playing badminton and learn to play tennis, but I still to dam slow... unskillful and i missed blogging, i take some picture around the area where I play, it just for fun and exercise to kept healthy how ever deep inside my heart I miss Malaysia so much, After playing Badminton my friend introduce me with this Indian food.

this is the palace, located in azziyah street, jeddah know as Indian town also.

I'm not use to eat but really nice, but they come in big portion ohw I can't finished, what a waste...

they give some rice and roti canai as well ,

Next, day I went for tennis games, and I play for a while but the rest I spent to take picture of the are Hotel of Bilad, the beach is near by but i don't go.

i just spend my time learning taking picture for close up,

and I try several time, it look like blurred , sometime, but really interesting.

this a break after stressing my brain with ACLS( Advance Cardio Life support) exam.

when we need mouth to mouth breath huh.........

Yesterday is my bad day.

2010-02-04T15:14:00.000+08:00

I don't like to talk so much about my work in my blog. dam. I hate It.........but i really need to talk so we can think.
yesterday, i been called by my head of nursing for the infection purpose, my name been listed for the infection related. is because of my practice ... i feel so ridiculous, and this all about paper base ...everything about paper...... but i don't mind very much because i know what i,m doing, who involved in handling the illness and how it is happened. for me it part of the disease it self, and are they really realize that the P stay in ICU to long, and recently the P coming with very ill condition and multiple complication, To correct the practice and at the same time i feel that some people a really just fill the paper as they like. what ever. i know them, no matter how. no matter what, every health worker should alert that, hand washing is always mandatory, gloving, and gowning always compulsory,and icu always full of infection. and we a struggling to control the infection......... i realized that very much...espeacially, BSI, UTI, VAP and this actually the most importance infection and required serious intervention ,

it make me angry some times, when i need to fill so many paper, when i want to clean my cubicle and the items is dangling everywhere,and the set up up my ICU is not move_able, it fixed and for me it look they just do it as long they had and they put it. some time i think like they don,t think and they don,t discuss to each other. some IPP also not practical , this obstacle sometime make me down and make me feel bad i don't archive satisfactory in my job. i hate it so much. and people talk more than doing they job..
since i came, my task always required me heavy intervention. my colleague always said " TOXIC" I,m so toxic, but it is ICU is .........hemodynamically always not stable and dynamically changes.
Then, communication is the other problem here, sometime i really don,t understand what they want. but good sometimes, no hurt feeling.,OVR occurance of variance. some times it good but many time it written by not a thinking person, just to cover them self. than pointing fault to other.and good thing , is sometime, used to cover up from legal aspect.

Anuar Zain Tinggalkan Aku

2010-01-25T11:43:00.001+08:00

ignorance is bliss...............

Sunset view in Corniche

2010-01-25T07:37:00.000+08:00

Sunset view in Corniche

2010-01-25T07:31:00.000+08:00

Let picture tell everything, silence evening but meaningful, I really enjoy taking picture with fresh ocean breeze... heaven...

Silver sand Beach

2009-12-24T04:43:00.007+08:00

Kali ni Nora, habiskan masa pergi Beach Silver Sand kat Jeddah ni, ni lepas hujan , kat Jeddah kalau hujan banjir , sebab tak de longkang ahak.... takung airlah jawabnya.

Private beach ni, kalau nak masuk kena bayar 100 riyal, hanya orang luar, bukan warganegara saudi di benarkan masuk. Untung kita, Kat Mesia tak kena bayar nak gi Pantai.........

jadi sehari lah menghabiskan masa kat pantai ni untuk memuaskan hati, mata dan sebagainya ...

walau bagaimana pun tempat ni cantik cuma terhad untuk berenang renang, kalau nak snokling, kena pergi pantai lagi satu. Itu, nanti dulu.. Tunggu!....

kalau rasa rasa nak main perahu layar sila sila ...

Apa yang paling menarik, Ketam bunga nie, kat Mesia mmg kita tak kan jumpa ketam bunga besar dan segar , gemuk macam nie. credit kat ketam bunga.

pemalu sungguh sampai tergolek golek , tunggu sikit punya lama nak ambik gambar ketam ni saja,sebab sensitif dengan bunyi, dan manusia macam aku ni............ but finally dapat jugak!!!!!..........

Gadis dan Bunga

2009-12-10T16:11:00.010+08:00

Gadis dan bunga ,

Si gadis cik adik manis tersenyum bila bunga menjadi luahan cinta,kalau dia tak suka tak de jiwa lah si dier tu,

alahai, senyum 72 jam, tidur pun senyum ......

gadis dan bunga, si gadis ibarat bunga...

yang cantik kembangnya, manis rupanya

gadis dan bunga,

kalaulah benar ibarat bunga di petik layu apa yang akan kekal?

layu si bunga sebelum berkembang

cam ne nak kira?

Si gadis manis di ibarat bunga kerana kecantikan si Bunga menjadi idaman

si gadis ibarat bunga kerana keayuan dan kesantunan, keindahan budinya.

yang tak kan hilang hingga ke akhir hayat.

jika layu sebelum berkembang, ada kesilapan harus diperbetulkan

kurek kendi si merah saga.yang cantik budi yang indah bahasa.

kalau bunga di jaga di sembur racun serangga,

dibaja dengan baik , pasti hasilnya bunga cantik kelopak tak carik.

Gadis dan bunga

kalau gadis tu jual bunga .....

tapi kalau cik abang yang jual bunga ?

ahak abang dan bunga ahak .....

"adik manis mari beli bunga ahak....."

Kalau tak de kerja kita pergi makan yer....

2009-12-10T06:20:00.005+08:00

Merayau isi masa lapang , window shopping, makan dan makan adalah xtvt Nora di masa cuti cuti hujung minggu di saudi(Khamis dan Jumaat) kali ni destinasi Nora red sea Mall dengan kawan Nora Cik Rose.

Applebees makan makan dan makan...

Makan lagi makan..

bersama kawan kita Sean.............. hu makan sampai kenyang dan jalan jalan, bila dah penat

singgah lagi minum, oleh kerana penat menjamu mata dan perut tekak rasa haus pulak

singgah lagi minum habis 2 cawan jus dan teh

akhirnya ......

Soal Hati

2009-12-09T22:02:00.005+08:00

Soal Hati, pernah kita terfikir soal hati, hati yang punya angkara, hati punya pasal dan semuanya soal hati,sedih hati , suka hati, luka hati, hati hati ,pedih hati jatuh hati, semua angkara hati.

Dari perspektif kehidupan seharian,

Ikut hati mati, (peribahasa) Saat bercinta kita sangat suka hati,berbunga bunga hati, bersinar sinar mata, senyum dengan wajah berseri seri, dan bila sedih, hati jugaklah punya pasal sebab kawan tu tak de hati + perut, soal hati, tahukah kita pentingnya punya hati.......... hati nurani yang baik ,hati yang ikhlas, hati jujur dan suci murni penurasan dua kali.

Dari sudut demensi perubatan , hati adalah organ penting yang mendetoxificasikan sebarang racun yan kita makan. bila hati rosak (liver cirrosis) ia adalah penghujung kehidupan maka berkumpulah racun dalam badan merosakkan setiap inci darah daging. hingga otak tak boleh berfikir dengan betul muka pucat kuning sebab tak mampu menangung banyaknya toksin dan berakhirnya sebuah kehidupan.

Jadi di simpulkan, teramat penting kita menjaga hati , sekeping hati yang baik menentukan kehidupan tuannya jadi baik dan masyarakatnya di segani, bangsanya di sanjungi, kerana sekeping hati yang rosak akan membunuh tuannya, dan meracuni bangsa dan meruntuhkan masyarakatnya segalanya kerana hati.

Oleh itu Kita kita kena jaga hati, berhati hati, jangan hasad dan dengki sesama kita, jangan busuk hati, jangan tak berhati + perut,hati hati lah kita dalam melalui kehidupan.

Malicycllin & Malaysia

2009-12-08T02:53:00.008+08:00

huh rasa nak pergi lagi , jalan jalan dengan minum air jus yang manis dengan si manis nelly. dan setiap kali pergi berjalan jalan Mall tutup sebab. buka petang- petang jew, dan dengan tak malunya aku buat cam aku dah sewa untuk ku sorang......... melayan kegilaan ahak malicycllin..
buat cam rumah sendiri ahak , he he tak malu tul ... mall kat saudi buka petang jew.. so seharian kat sana malicycllin jew ar,... tengok pintu yang tutup jew ahak..............

bila balik Malaysia, percutian yang seminggu mana cukup nak jalan satu Klang nak ziarah kenkawan...

orang pertama yang mesti di ziarahi mestilah bestfriend, girlfriend ni maka habis sehari suntuk bersama die menghabiskan masa mengenyangkan mata dan perut yang makin gendut ........alor nak diet angan- angan......... tak pe boleh consider hek hek,
tengok kasut, opppppp beli kasut..........

Kenapa rindu Ha!

2009-12-08T02:25:00.003+08:00

Kenapa dengan Nora ni, Kenapa rindu bertandang tanpa di jemput, Kenapa persoalan tak terjawab menci menci menci, siang tadi ada deringan telepon Nora tak jawab, ku tamatkan dengan " call back I busy nie..." em............tak call back pun hu hu hu, yang sibuk aminah nie,....

aduh apa dah jadi nie.... rasa bersalah lak berlandang dalam hati, uwek.... nape leh jadi mental nie....

rasa malas berlumba lumba datang menerjah , nak kuar dengan Nelly, em kerja pulak, nanti bila korang balik Mesia , em kena sawan lah Nora kat sini, sawan siang, sawan segala sawan menyawan tulang temulang nie, em napa kena balik , kenapa mesti balik,........ oh jangan tingal daku, kesunyian lah nora nanti kesepian lah Nora nanti, bertambahlah ketagihan Nora nanti,Nelly jangan balik lama lama............em Kak Ana, Kak Lin Jangan balik lama lama, siapa nak masak untuk Nora, siapa nak manjakan budak nakal nie.............. hu hu hu.

kalau tak balik,

Kesian Mak, kesian abah, termenung merenung nasib si Nora budak nakal, dah jangan mak abah jengkelkan, Nora tau lah jaga diri, Abah jangan lah pura pura nyorok lagi, jangan sembunyikan airmata saatku nak pergi, Nora tau Nora faham, pokok beri berbuah manis, abah simpan rambutan dan bela bambam dengan Cycik yang suka makan wiskish, Abah pakai baju yang Nora beli sampai 2-3 hari, nora tau, di sebalik senyuman tu ada kegusaran hati yang sukar di katakan atau di suratkan.........

Nora tau, semua yang tersembunyi, dalam hati................ berat nak lepas Nora pergi... jauh sampai kat sini,

sakit tulang tulang dengan saraf otak fikirkan, nanti putus lak,sykpe dengan ym kan ada suruh along on kan. suruh Aim.Alan ke Adik on kan nanti leh kita berbualpanjang.

rindukan Ixora pun ixora tak ada masa nak online, em rindukan saat bahagia bersama mereka,

rindukan gelak tawa Nelly yang sesungguh hati, rindukan ngeow manja cycik dan bam bam......... bila lagi boleh makan durian dengan cycik.. dan makan biskut dengan bambam.... ah rindu menjenguk kalau hati tak terisi dengan busy.................

maka biarlah blog bersawang, dan ku isi masa lapangku klik klik nufnang.............

Mengejar Pelangi

2009-10-19T23:27:00.007+08:00

Pelangi oh pelangi kau sangat indah
kau buat mataku terpana dan terdiam terpersona
kerana memandangmu bisa buatku tersenyum

wahai pelangi tahukah kau Jiwaku kacau, jiwa ini meronta ronta
rasa ingin ku campakkan beban yang ku galas
namun itu tak mungkin....... kerana ia tanggungjawab

Hatiku di ketuk dengan seribu satu persoalan yang tak ku temui jawapannya
aku hanya berspekulasi dengan diri sendiri
hanya mengejarmu pelangi di saat ku menyisih mega kelabu.
apakah mungkin ku jawab persoalan jiwa
yang menghantui dan membelenggu ku kini
hatiku tertusuk duri .duri yang tersisip dari sinar mata ini

Wahai pelangi kau hadir membawa senyum dan tawa
tapi kini tinggalkan diriku dengan seribu kekesalan
aku termanggu dan bertanya mengapa semua ini berlaku
pelangiku hilang tiba tiba
aku terkesima dan terdiam membisu
apakah dia kan kembali pada ku atau sirna tanpa jejak

Fikiran ku bercelaru. hati di ketuk sejuta persoalan
ingin ku hulur tangan mengapaimu tapi tak sampai
dalam hati cinta padamu tak pernah pudar
hanya keadaan membuatku gusar
kerana esok masa depan yang tak ku ketahui
dan amat menakutkan .
duri yang merintang jalan tak tau di mana menjerat kaki,
air mata telah lama kering dan hati tak ingin berdarah lagi
mengapa semua ini berlaku disaat hati bertaut padamu.
sejalur sinar bersama pelangi buat hati tertusuk duri.

SISHA OR SIESHA ?

2009-10-06T20:18:00.005+08:00

Hujung minggu, kat Saudi kira hari Khamis ngn jumaat cam kat negara kita hari sabtu ngn ahad kan nora ngn kwn baik ni gilah kat tepi pantai corniche

pemandangan dari Movenpick.. |Bandar Cornice yang boleh dilihat dari tempat menjamu selera.

Tersenyum girang Zahidah bila akhirnya kami tiba di perkarangan Al Waada ,

Macam biasa bergambar untuk kenangan bersama dan catatan internet ku

ni lah siesha .. kawan ni kata die nak hisap siesha ni.. layan jew lah... hek hek.. cam kelakar lak .. kiri kanan sume orang mencandu.. tak retilah nak hisap he he.. rasa kat mesia nampak gak benda nie kan..

nora makan nie jew ...

Kuih Raya dan Rendang Bujang Cik Nora

2009-09-28T08:31:00.007+08:00

Masih lagi dalam mood raya. Nora semakin weng rindukan Si dier yang buat rasa nak menitis air mata bila teringat ah! buat jiwa makin kacau... dan ini Terapi minda Nora untuk melupakan kesunyian yang menghimpit... Kali ni Nora kongsikan bersama resepi nora untuk membuat biskut paling mudah best dan sedap di makan begitu saja.. Jeng jeng jeng ...

HONEY CORNFLAKES

Bahan bahannya:
-C0rnflakes 1 kotak (500gram)
-kacang tanah di kisar kasar atau bijan ke kismis suka hati(optional)
-1/2 cawan gula perang
-1/2 buku butter(mentega)
- 3 sudu madu

cara caranya:
cairkan mentega dgn gula perang dengan madu lebih senang kalau gunakan microwave , kalau tak de atas api pun boleh. pastu gaulkan dengan cornflakes kemudian susun dalam cake cup dan bakar dalam oven 10 minit jangan lama -lama nanti hangus....dan Tara!....
dah siap dan boleh di makan... kalau nak tabur coklat urai ke sebarang hiasan itu ikut suka hati.

oleh kerana rindu nak makan rendang tak de orang nak masak kan kenalah masak sendiri. em ni rendang bujang Cik Nora

bahan bahannya:

-ayam 500 gram
-1/2 cawan santan pekat

bahan kisar
- 2-3 ulas bawang merah
- 2-3 ulas bawang putih
- 2 batang serai
-3 inchi halia
-3 inchi kunyit
-3 inchi lengkuas
-1/2 camca jintan manis
-1/2 camca ketumbar
-7 biji cili padi

cara caranya
mula mula kisar jew sume bahan untuk kisar , ayam boleh di goreng lebih dahulu kalau suka kalau tak rajin masukkan begitu saja pun boleh
panaskan minyak dan tumis bahan kisat tadi, masukkan ayam, gaulkan rata dan masukkan santan. tutup dan masak dengan api sederhana , kacau sekali sekala bagi jangan berkerak nanti hangus he he... masaklah sampai naik minyak. masukkan garam dan gula serta penambah perisa sesuka hati ... kalau nak bagi bau yang wangi boleh guna daun kunyit atau daun limau purut... sebagai final touch... senang jewkan ..

Raya oh Raya Saya Suka Hari Hari Raya...

2009-09-26T14:31:00.012+08:00

Mula mula Nora sangka hari raya akan hambar dan tidak bermaya...Namun ada berita yang buat hati kembali berbunga bunga riang kerana limpah kurnia dari yang Esa . Yg di pertuan Agong kita telah hadir di Jeddah untuk bersama sama menyambut hari raya dengan rakyat Di Jeddah...yang berlangsung di Hotel Hilton, Jeddah Maaflah Kalau gambar tak clear.. sebab Nora duduk paling hujung . maklumlah saya Pemalu...... hu hu hu.....
pemandangan sewaktu Nora sampai , tempat duduk masih kosong lagi , suasana aman damai dan gilang gemilang..

dan inilah kawan kawan yang berkesempatan untuk ikut bersama merayakan hari raya Goh dan Teoh . selain kak Lyn dan kak Ana.Ini pulak menu yang disajikan untuk kita , tapi walaubagaimana pun masakan malaysia juga yang paling sedap dan sedap di makan di Malaysia hu hu...
dan menjunjung kasih Tuanku kerana mengkurniakan biskut raya untuk patik yang memang rindu nak makan biskut raya ni he he he...
sebenarnya ada 4 kotak satu dah makan habis baru ingat nak ambik gambar hek hek......apa apajelah ,Selamat Hari raya buat semua ....