Transforming Care at the Bedside free essay sample

This paper explores several published articles following the national program, Transforming care at the Bedside (TCAB), developed by the Robert Wood Johnson Foundation (RWJF) and the Institute for Healthcare Improvement (IHI); and how it supports the ethical principles of patient autonomy, beneficence, and nonmaleficence in patients, especially amongst the geriatric population. By describing and focusing on three main points of the TCAB, safe and reliable care, patient-centered care, and value-added care and their relative goals and high leverages; this will show how they benefit the nurse’s care at the bedside as well as improving involvement from the patients. This paper examines the use of the TCAB model with several sources supporting the information presented. Transforming Care at the Bedside: Adhering to the Ethical Principles of Patient Autonomy, Beneficence, and Nonmaleficence The Nursing Role As nurses, making decisions on an everyday basis requires the use of ethical principles. Adhering to the American Nurses Association (ANA) code of ethics is a part of our professional duty. We will write a custom essay sample on Transforming Care at the Bedside or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page It is for this reason, a nurse led initiative, Transforming Care at the Bedside (TCAB) came about to develop and improve patient care. The TCAB was developed by the Robert Wood Johnson Foundation (RWJF) and the Institute for Healthcare Improvement (IHI), to improve care and the experiences on medical surgical units for patients and their family members; as well as improving teamwork, nursing retention and satisfaction (Lavizzo-Mourey amp; Berwick, 2009). The philosophy of TCAB involves all healthcare team leaders, but gives the power to bedside nurses to develop ideas and solutions for change to benefit the patient in accordance to the ANA code of ethics by addressing the patient’s autonomy, beneficence, and nonmaleficence. The TCAB model promotes the ANA code of ethics Provision 2, â€Å"the nurse’s primary commitment is to the patient, whether an individual, family, group or community† and Provision 3 â€Å"the nurse promotes, advocates for, and strives to protect the health, safety, and rights of patient† (American Nurses Association, 2011) in all goals and high leverage changes presented. The four main ideas of TCAB, safe and reliable care, patient-centered care, value-added care, and vitality and teamwork, are all implemented to assist in redesigning patient care and work environments for medical surgical units (Lavizzo-Mourey amp; Berwick, 2009). All four ideas are important to the TCAB framework, but only the first three will be explored to show how TCAB is positively influencing patient autonomy, beneficence, and nonmaleficence with its framework of principles and processes, especially for the geriatric population. In order to discuss the how the TCAB model effects the ethical principles of patient autonomy, beneficence, and nonmaleficence, one must know the definitions of these terms. Patient autonomy, as defined by the ANA (2011), is the patient’s right to make decisions freely and independently regarding their healthcare. In order to further assist patients in making these important decisions, nurses play a vital role in educating them about their concerns regarding their conditions, providing resources, and advocating for the patient when needed. The nurse’s role in patient autonomy is also intertwined with the ethical principles of beneficence and nonmaleficence. Beneficence is defined as the actions that promote the well being of others; nonmaleficence is referred to as the â€Å"do no harm† principle (American Nurses Association, 2011). Providing care for patients by promoting their safety, health and well being, is priority for nurses. Applying these ethical principles in every day care assists in providing quality care to all patients, but especially important to the geriatric population due to the declining health and frailty that is increased with age. Safe and reliable care, the first process of TCAB that influences patient beneficence and nonmaleficence, is defined by Rutherford, Moen, amp; Taylor (2009) as â€Å"care for the moderately sick patients who are hospitalized is safe, reliable, effective, and equitable†. In accordance to this theme, the TCAB design team developed goals and changes that would show improved outcomes. One of these â€Å"high-leverage changes† (Rutherford et al, 2009) was preventing patient injuries from falls. Patient falls is one of the high occurrences in patient safety and injury, as well as the leading cause of death of patients 65 and older (Rutherford et al, 2009). By incorporating the TCAB initiative, the pilot hospitals average of patient falls was reduced by fifty-two percent (Rutherford et al. , 2009). One of the ways that patient falls were reduced was by involving the personal care attendants (PCA) in making frequent rounds with patients and asking them if they were comfortable or if they needed anything. By involving the PCA’s in falls prevention, the study showed an average fall rate per one thousand patient days decreased from 6 to 4. 5 (Stefancyk, 2009). One of the main themes between the studies is preventing patient injury during their hospital stay. In doing so, the ethical principle of beneficence and nonmaleficence have been addressed. A second intervention was also implemented in reducing injuries to the elderly client was placing a sensory cart on the unit and to be utilizing it for patients who were experiencing altered metal status (Stefancyk, 2009). Some of these patients would pull at their intravenous lines; attempt to climb out of their beds or chairs, therefore posing a potentially harmful situation for them. The sensory cart held items such as fuzzy balls with tentacles for patients to hold and distract them from pulling at their intravenous lines, and stuffed animals to be placed on their laps when sitting in their chairs to prevent them from getting up and falling (Stefancyk, 2009). By using this sensory cart, patients were distracted from putting themselves in potentially harmful situations like falls; profuse bleeding from intravenous sites, and also reduced the need for restraints. These changes developed by TCAB model improved patient safety in the hospital setting, therefore decreasing patient injury and extended hospital stays, adhering to the ethical principles being discussed. The second theme in the TCAB framework, patient centered care, influences patient autonomy by using its vision described by Rutherford et al (2009) as â€Å"truly patient-centered care on medical and surgical units honors the whole person and family, respects individual values and choices, ensures continuity of care†. Providing patients with information and education, respecting patient preferences by encouraging input on plan of care goals, ensuring comfort with pain management, and addressing their needs, especially with medication administration and care times (Stefancyk, 2009), gives the patient a sense of empowerment, a voice and more involvement in their care, thereby adhering to the definition of patient autonomy. The goals for TCAB with this theme were to decrease readmissions by five percent, and that ninety-five percent of patients were willing to recommend the hospital (Rutherford et al, 2009). The goals for TCAB with this theme were to decrease readmissions by five percent, and that ninety-five percent of patients were willing to recommend the hospital (Rutherford et al, 2009). The assessment of patient satisfaction was based on surveys conducted on the patient’s willingness to recommend the hospital to their family and friends. One of the surveys conducted showed that sixty-six percent of patients selected the highest score available on a four point scale, indicating that they would definitely recommend the hospital (Rutherford et al, 2009). The TCAB goal was set for ninety five percent, so a different survey was conducted using a five point scale, which only ten of the participating pilot sites achieved (Rutherford et al, 2009). Another measure of patient centered care was readmission rates within thirty days of the discharge date. Out of the ten participating pilot sites, only four sites were able to reach this goal (Rutherford, 2009). In a different study conducted by Stefancyk (2009), postponing medication administrations provided nurses more time with direct patient care, such as teaching and education about medications, diagnoses and or conditions. By using data from the hospital’s personal digital assistants (PDA), Stefancyk (2009) was able to determine that direct patient care increased from fifty-two percent to seventy-six percent in just one month. Positive feedback was also given by nursing staff regarding the medication administration changes implemented, such as less stress at shift changes, more time with patients, and developing more information about their patients and conditions. This increased time at the bedside is especially beneficial to the geriatric population in order to discuss questions or concerns in regards to their healthcare and services that they may need upon discharge. These studies helped in making the patient a part of their own health care team, thereby supporting the ethical principle of autonomy, giving the patient the capacity to make informed decisions about their care. The third process, value-added care, also supports the patient’s beneficence. In value-added care, the process is â€Å"All care processes are free of waste and promote continuous flow† (Rutherford et al. 2009). The main goal in this theme is to increase time nurses spend at the bedside and reduce time wasted on activities that have little to do with their patients, such as decreasing redundant charting. According to Rutherford et al. (2009), medical-surgical nurses spend about twenty to thirty percent of their time on direct patient care; the rest of their time is spent on activities such as finding supplies, documentation, and care coordination. A high leverage change in this area is improving medication administration by changing the times they were being ordered for. According to Stefancyk (2009), by coordinating with physicians and pharmacists, medications that were priority would still be given at eight o’clock in the morning and the rest at ten o’clock. In doing so, the nurses can reduce the â€Å"bottleneck† (Stefancyk, 2009) at the beginning of their shift, and give more patient care; thereby reducing the need to get medications quickly after receiving patient report, increasing patient beneficence. In an article by Popkin (2007), it was hypothesized that increasing the time spent at the patient’s bedside by the nurse would decrease fall rates, nosocomial pressure ulcers, and infections. Pressure Ulcers are detrimental to the elderly patient due to declining health that may already be present and decreased healing time (Arora, Johnson, Olsen, Podrazik, Levine, Dubeau, Sachs, amp; Meltzer, 2007). Small changes to the unit were made such as installing nurse workstations outside the patient’s room to allow for documentation, and placing items needed closer to patient rooms to decrease the amount of time spent on looking for supplies. By implementing these small changes falls rate on the unit decreased from 2. 7 to 2. 5, restraint rate decreased to three percent, and the pressure ulcer rate is 0. percent (Popkin, 2007). In another study conducted by Lorenz, Greenhouse, Miller, Wisnewski, amp; Frank (2008), decreasing wait times and increasing the amount of time a nurse is interacting with patient improved their patient satisfaction scores by thirty percentiles in five months. Also by streamlining area flow and efficiencies, treatments for patients were more available, such as increasing the supply of onsite platelets, which decreased the wait time for treatment by fifty minutes (Lorenz et al, 2008). Labeling blood tubes to flag the laboratory staff of results needed before treatment was also implemented. Turnaround times for results decreased from fifty-four minutes to nineteen minutes on creatinine results, and forty-seven minutes to seventeen minutes for complete blood counts (CBC) results (Lorenz et al, 2008). Improving every day flow of treatment, and reorganizing supply areas for easier use, nurses can spend more time with patients decreasing injuries sustained in the hospital such as falls or pressure ulcers, thereby empowering the ethical principle of beneficence for patients and increasing patient satisfaction and trust within the healthcare field. Conclusions and Implications The TCAB model is the foundation for staff to generate ideas for health care delivery improvement; create and implement changes through pilot tests; assess the results of change; determine whether to adopt or abandon the tests of change; and participate in ongoing assessment of changes and reports of improvement (Lorenz et al, 2008). The TCAB model itself is easy to implement; and also encourages and requires the involvement of health care staff members to provide increased satisfaction among the patients and their families, thereby improving patient care outcomes throughout the process (Lorenz et al, 2008). Organizational leaders have to adopt effective strategies in order to spread the ideas and successful changes with the TCAB model from pilot unit studies to other sites within a hospital or health care system. Utilizing resources to assist in sustaining and supporting the TCAB model provided by the RWJF and IHI is the first step in implementing the TCAB initiatives. Through TCAB, a movement has begun to transform the care delivered on medical surgical units that better serve the patients and staff to support the professional nursing practice and collaborative teamwork at the bedside (Rutherford et al, 2009). The nursing role is vital in the TCAB model, as well as for patients. Nurses are at the front lines of patient care and are often the person patients interact with the most. Using the TCAB model promotes the nursing role by addressing the changes that are being brought forth by nurses to increase bedside care, safety, health and well being of patients. In doing so, the risk of developing a prevalent geriatric related condition such as dementia, pressure ulcers, and urinary incontinence, is decreased and nursing quality care is increased (Arora et al. , 2007). Nurses applying the ethical principles of patient autonomy, beneficence, and nonmaleficence help patients increase their level of satisfaction and involvement with their healthcare, and more importantly, increase trust in the healthcare team providing that care.

Periphrasis Definition - Glossary of Rhetorical Terms

Periphrasis Definition - Glossary of Rhetorical Terms In rhetoric  and  prose style, periphrasis is a roundabout way of saying  something:  the use of an unnecessarily lengthy expression in place of one thats more direct and concise. Periphrasis is a  type of  verbosity. Periphrasis (or circumlocution)  is commonly considered a stylistic vice. Adjective: periphrastic. EtymologyFrom the Greek, talking around Examples NBC Sunday Night Football. Two groups of stalwart men will compete for the possession- and conveyance- of a midsize leather ovoid!(What to Watch. Entertainment Weekly, September 6, 2013)The Elongated Yellow FruitOn the late Boston Transcript, a feature writer, with a fondness for using three words where one would do, once referred to bananas as elongated yellow fruit. This periphrasis so fascinated Charles W. Morton . . . that he began collecting examples of Elongated Yellow Fruit writing. Samples:In the New York Herald Tribune a beaver was almost incognito as the furry, paddle-tailed mammal.The Denver Post elongated mustache into under-nose hair crops.To the Associated Press, Florida tangerines were that zipper-skinned fruit.In the Lincoln [Neb.] Sunday Journal-Star a cow did not give milk; the vitamin-laden liquid came from a bovine milk factory. . . .The Boston Americans ski columnist could not decide whether to call snow the elusive white subtance or the heavenly tapioca. And in Travel magazine, skiers slid down the slopes on the beatified barrel staves.(Elongated Fruit. Time, Aug. 10, 1953) Periphrasis in Euphemisms and the Grand Style Periphrasis occurs when a single word is replaced by several others to form a longer phrase that names the same thing: for instance, briny deep for ocean, or the manly art for boxing. . . . Its often used in euphemisms to speak around, and thus spare readers from any distasteful associations the more direct, single-word variant might trigger: little girls room for toilet, or passed on to greener pastures for died. Writers also use periphrasis to elevate their prose, to raise it from the informality of the low and middle styles to the formality of the high one, as in the following example, And those who hope that the Negro needed to blow off steam and will now be content will have a rude awakening if the nation returns to business as usual. And there will be neither rest nor tranquility in America until the Negro is granted his citizenship rights. The whirlwinds of revolt will continue to shake the foundations of our nation until the bright day of justice emerges. (King, I Have a Dream) Periphrasis can also lend prose a poetic or even archaic flavor. As Katie Wales notes, periphrasis is at work in the kennings of Old English poetry (swan road for sea, or heath stepper for deer).(Chris Holcomb and M. Jimmie Killingsworth, Performing Prose: The Study and Practice of Style in Composition. Southern Illinois University Press, 2010) Fowler on the Periphrastic Style The periphrastic style is hardly possible on any considerable scale without much use of abstract nouns such as basis, case, character, connexion, dearth, description, duration, framework, lack, nature, reference, regard, respect. The existence of abstract nouns is a proof that abstract thought has occurred; abstract thought is a mark of the civilized man, and so it has come about that periphrasis and civilization are by many held to be inseparable. These good people feel that there is an almost indecent nakedness, a reversion to barbarism, in saying No news is good news instead of The absence of intelligence is an indication of satisfactory developments. Nevertheless, The years penultimate month is not in truth a good way of saying November.Strings of nouns depending on one another and the use of compound prepositions are the most conspicuous symptoms of the periphrastic malady, and writers should be on the watch for these in their own composition.(H.W. Fowler, A Dictionary of Modern English Usage, rev. by Ernest Gowers. Oxford at the Clarendon Press, 1965) Pronunciation: per-IF-fra-sis Also Known As: circumlocution

Difference Between a Chemical Reaction and the Equation

Difference Between a Chemical Reaction and the Equation What is the difference between a chemical reaction and the chemical equation? The terms are often used interchangeably, but they are technically different terms. A chemical reaction is a process that occurs when one or more substances are changed into one or more new substances. For example: Hydrogen and oxygen gas combine to produce water.Sodium chloride (table salt) dissociates in water to form sodium and chlorine ions.Methane combusts in oxygen to form carbon dioxide, heat, and water. A chemical equation is a symbolic representation of a chemical reaction. Atomic symbols are used to represent the elements that take part in a reaction. Numbers are used to represent the ratios of reactants and products to produce the reaction and arrows point the direction a reaction occurs where the arrow points from reactants to products. For example, using for the above chemical reactions: 2 H2(g) O2(g) → 2 H2O(ℓ)This chemical equation reads: Two hydrogen gas molecules and one oxygen gas molecule produce two molecules of water.NaCl(s) H2O → Na(aq) Cl-(aq)One molecule of sodium chloride dissociates in water into one sodium ion and one chlorine ion.CH4 2 O2 → CO2 2 H2O (DeltaH -891 kJ/mol)This equation shows one methane molecule and two oxygen gas molecules form a carbon dioxide molecule, two water molecules and release 891 kilojoules of heat. To review:Chemical reactions are processes where reactants become new products.Chemical equations are a symbolic representation of chemical reactions.

Daoism, Confucianism, and Shinto Essay Example | Topics and Well Written Essays - 500 words

Daoism, Confucianism, and Shinto - Essay Example Too much of something is poisonous. For example, overeating results in physiological harm; therefore, it is crucial to pay attention to the body’s self-regulating mechanisms. The passage also cautions against reliance on material things as the ultimate source of happiness by inferring that people only need what is enough to lead a prosperous happy life. For example, social relationships that nurture and provide affection are crucial for sustaining happiness. In my opinion, this passage stresses on the importance of understanding oneself before attempting to understand others. In doing so, one will be able to behave in a manner that mirrors their principles while at the same time respecting the opinions of those around them. For example, when one understands that dishonesty appalls them, they will behave in a trustworthy manner, which in turn sends out a signal to others to do the same while interacting with the individual. Daoist teachers negated principles advanced by adherents of Confucianism. They focused on comprehending the nature of reality, ordering life morally, practicing rulership, increasing longevity, and regulating their diet and consciousness (Molloy, 2010). At the core of their ideologies lay naturalness (ziran), effortless action (Wu wei), and teachings about how to become a realized person (zhenren) or sage (shengren) (Molloy, 2010). In addition, they believed it was useless to try to oppose the nature by intervening, as they believe nature had its own way of intervening to end imbalance in the society. For example, Daoist teachers implored rulers to refrain from using weapons as a means of ending social problems, as they believed nature would mitigate the problem. Daoist teachings in their entirety mirror its adherents’ belief in change, which they inferred defined life’s reality. They also believed that the â€Å"Dao† was inexplicable, as it surpassed all conceivable phenomena. However, it was attainable through effortless

Financial Statement on Netflix Essay Example | Topics and Well Written Essays - 500 words

Financial Statement on Netflix - Essay Example Looking at the cash flow statement of the year, certain major components stand out. During this year, they bought back $90 million worth of their own stock. The buying of this stock was made possible due to the large increase in price (Houston and Brigham, p. 248). In the year 2013 and 2014, the company spent over half of the total revenues on subscription. Expenses on subscription were 57.2% of the total revenue in 2013 and 55.1% of the total revenue in 2014. It therefore means that subscription expenses increased by 14.1%. These subscription expenses are as a result of shipping off DVDs to customers. They also result from buying of content from distributors. Shipping costs include package, postage and labels. In 2013, more DVDs were shipped since there were more subscribers. The operating expenses for Netflix include expenses incurred on technology and development, marketing and administration. There was an increase of 26.3% for expenses on technology and development between 2013 and 2014. The increase in these expenses was because of need for more personnel to stream content on the internet. In terms of total revenue, these expenses were 6.2% in 2013 compared to 5.7% in 2014. Expenses incurred on marketing reduced by 8.5% from 2013 to 2014 and comprised 15.6% of total revenues in 2014 compared to 16.8% in 2013. The reduction in marketing expenses is a reflection of Netflix’s resolution to decrease its advertisements to potential customers. In terms of assets, cash and cash equivalents accounted for 94% of current assets owned by Netflix in the year 2013. In 2014, cash represented 47% of Netflix’s current assets. This reduction in cash is attributed to the company’s use of cash for short term-term investments. The company invested in corporate debt securities, asset and mortgage backed securities and agency securities (Houston

night Essays -- essays research papers

Night is an autobiographical novella written by Elie Wiesel a young jewish boy who tells of his experiences during the Holocaust. Elie is from the small town of Sighet, Transylvania. This book begins in late 1941 and chronicles Elie's life through the end of the war in 1945.He had two older sisters, Hilda and Beatrice Wiesel and a younger sister, Tzipora Wiesel. Elie spoke many languages including Hungarian, Romanian, German and he grew up speaking Yiddish. At the beginning of the book Elie has a very strong faith in God and the Jewish religion, but this faith is tested when he is moved from his small town by the Nazi's. Elie has to deal with the death of his family, the death of his, innocence and the death of his God at the very young age of fifteen. He tells us of the horrors of the concentration camp, starvation, beatings, torture, illness, and hard labor. He comes to question how God could let this happen and to redefine the existence of God in the concentration camp. In 1944, when Elie was fifteen years old, him, his parents and younger sister were taken to Auschwitz. There him and his father were separated from his mother and small sister. Within a year his father and him had been moved to several different concentration camps such as Buna, Gleiwitz, Auschwitz and Buchenwald. He tried his best to stay with his father every time they were moved. His father and him watched out for each other, till his father’s death in 1945. The Holocaust all began because Hitler blamed the Jews for Germanys defeat in World War 1. He also blamed the Jews for all the problems Germany had at the time such as poverty, unemployment, starvation and disease. In early 1942, Hitler decided to carry out what he called "The Final Solution," which he hoped would bring an end to the Jewish population. He ordered millions of European Jews to be arrested and deported to special camps. This is how concentration camps became death camps. In Night, the description, settings, presentation of exciting incidents and sadness was outstanding. Language was good. Elie wrote everything he saw and he heard and everything was straightforward. The plot of this book was good, as there was no false leads, no unexpected turns and no misleading information. Elie Wiesel was the main character and narrator of this book. The story takes place in many concentration camps or Europe. Elie sa... ...led them by their names. Think of yourselves their, running, behind u officers with guns. If u stop, you’ll die. It seemed to be the end of the world. After so much of struggle Wiesel n his father n many other of Jews were evacuted from Auschwitz just a head of the Russian army and taken on a long death-filled journey to Buchenwald. His father survives the trip but dies in early 1945 at Buchenwald. The story ends shortly there after, Wiesel freed from the camp in 1945. For the first time after 1944,Elie sees his own face. It is April 1945 and Buchenwald, the last camp he endured, has been liberated for a little over two weeks. Looking at himself, he sees someone, some thing he has never known. The dead eyes that stare at him confront him with all the lived pain he has endured and the destruction of his own selfhood - This passage is very powerful. It illustrates the horrendous crimes of the Nazis. In their Final Solution they succeeded in destroying the Jews- not only thos e who were massacred, but also those who survived. Elie Wiesel is unable to recognize the shell that stares back at him in the mirror. Although he has physically survived the Holocaust, Elie has also been killed.

My Choice Is Reading Essay

By reading books, people can learn how to get through problems in their own lives by relating to characters. Readers can see what characters did to get out of bad situations, and what they learned from them. In Uglies by Scott Westerfield the reader grasps that what someone looks like on the outside doesn’t matter, and it is what is on the inside that counts. The Fault In Our Stars and Looking For Alaska by John Green both deal with death at a young age and losing loved ones. Love is a serious topic in all of these books, and an important lesson learned is that love is blind. The Fault In Our Stars is a love story between Hazel and Augustus who are both battling cancer at the same time. They meet at a cancer support group and fall in love, but then the cancer in Augustus comes back and ends up killing him. John Green does a considerable writing job in making whoever reads the book fall in love with both characters. That is why it is extremely sad in the end because when Gus dies, the reader undergoes the same sadness that Hazel has. Loosing a loved one is also a theme in Looking For Alaska. Miles decides to go to a boarding school, and while there, he makes friends for the first time. More importantly though, he meets Alaska whom he loves from the first moment he saw her. Alaska already has a boyfriend and she will not cheat, but she lugubriously reflected a secret love for him. Unfortunately she perishes in a car crash so their relationship will always be a great perhaps. Miles’ love story is a little different than Hazel’s in a way that Hazel got to really experience the love before it was torn, whereas Miles’ was an unexplored mystery. People everywhere love differently like in the books by John Green, but both stories are similar because the characters have to deal with the loss of a loved one. Everybody deals with losing loved ones in different ways. In Looking For Alaska the whole book is written in the parts before and after Alaska’s death. This shows that Miles is unable to separate his own life from her death. In The Fault In Our Stars Hazel deals with the death of Augustus quite differently. She tells her story building up to his death, and after his death skips to the present day to say that even though Gus is gone, she still loves him. Hazel was able to separate her life from his death in a way Miles was not able to with Alaska,  while still indicating that their love survived even his death. Looking For Alaska deals with a lot of growing up. Miles and his friends throughout the whole book are trying to grow up to be who they want to be. In The Fault In Our Stars Hazel has to find ways to cope with the imminence of her own death, and rather than growing up she has to deal with the process of dying. Hazel has to find her place in death while Miles has to find his place in life. In the book Uglies the theme of growing up to be who you want to be is very important. Scott Westerfield’s book Uglies is a dystopian book much like Maze Runner or Hunger Games. In Tally’s world people live by what they look like. At the age of 16 people get the transformation to turn them into a pretty from an ugly. When someone gets the pretty operation they look like everybody else, but they also get their brain changed. Tally is forced to grow up and get the operation but she rebels and runs away. Tally finally finds out who she is and who she loves just by being who she wants to be. This book deals with he subject of appearance, which is relevant to society today. Everybody thinks that in order to be happy, that you have to be perfect looking. This book teaches the reader that it is what is on the inside that counts. Just like in The Fault In Our Stars, Hazel does not think anybody will love her because she is dying of cancer. Then Gus does. This deals with the saying that love is blind. When someone loves someone they can look past all the flaws and only see perfection. All three of the books read deal with this topic. It is so important to read. Reading makes the reader fall in love, cry, and get angry or excited. Books open people up to reoccurring themes and make them learn really valuable lessons. The books The Fault In Our Stars, Looking For Alaska and Uglies all relate in different ways, and all deal with very diverse content. The most important lesson learned from these books is to be whom you want and to love unconditionally.