Modul English I Revisi

Module 1
Introduction to
Health Professions
English for Medical Technologist 1
1.1 Language for Greetings and Introductions
1. Look at the following pictures. With your partner, match the people in the pictures
to their jobs.
1. ...................... 2. ...................... 3. ......................

.... .... ....
4. ..................... 5. ...................... 6. ......................

.... .... ....
Nurse radiologist (n) pharmacist (n)

/nɜːs/ /ˌreɪ.diˈɒl.ə.dʒɪst/ /ˈfɑː.mə.sɪst/
nutritionist (n) doctor (n) physiotherapist (n)

/njuːˈtrɪʃ.ən.ɪst/ /ˈdɒk.tər/ /ˌfɪz.i.əʊˈθer.ə.pɪst/
English for Nursing 1 -

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2. Quickly read the following dialogue between Sandra, Jessica, Susan and
Harrison. Where are they?
Sandra: Good morning Jessica
Jessica: Hi Nurse Sandra.
Sandra: Jessica, it’s now 07.30 am and I am going to end my

shift. This is Nurse Susan, your nurse for the next shift.
Susan: Hi Sandra, I’m Susan, your nurse. I will be in charge

of your nursing treatment during your hospitalization
in this shift, but I also will get help from other nurses,
like Sandra.
Jessica: Alright, Nurse Susan. Nice to meet
you. Susan: How are you feeling right now?
Jessica: I have a headache and feel nauseous. I can’t take any food or
have my breakfast either since the smell triggers my nausea.
Susan: You can eat bite by bite. Please do this.
Jessica: I’ll do it.
Susan: I’ll check in with you again at 9 am for vital signs.
Jessica: Ok, thank you.
In another session, Susan introduces Harrison to Jessica.
Susan: Hello, good morning Jessica
Jessica: Hi Susan, morning.
Susan: Jessica, I come here with Dr. Harrison.
Harrison: Hi Jessica, I’m Dr. Harrison, your primary doctor.
Jessica: Good morning, Dr. Harrison.
Harrison: I’m going to ask you some questions related to your

complaint
and examine you.
Jessica: Okay.
Harrison: Nurse Susan, may I know her situation?

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Susan: Jessica is 43 years old, her blood exam from the lab
shows that her random blood glucose is 280 mg/dl. She
now has a headache and is feeling nauseated.
Harrison: Alright, thank you nurse Susan. Ms. Jessica, how

is your nausea?
Jessica: It is quite bad I think, I feel like I’m going to throw up

every time I smell food, thus I couldn’t have anything,
not even a spoon of food.
Harrison: Okay, how many days have you been feeling
like this? Jessica: It’s been about 4 days, that’s why I am feeling
so weak. Harrison: Well, how about your headache?
Jessica: I feel a bit dizzy right now.
Harrison: Okay, Jessica we will continue observing your condition

and will run further examinations, for your body weight
as well as your blood glucose levels. Moreover, we will
ask a nutritionist to see you to discuss your diet and
food choices. For the meantime, I will prescribe an anti-
emetic for your nausea. Do you have any drug allergies
that you know of?
Jessica: No, I don’t have any drug allergies that I know of.
Harrison: Alright, I will visit you again tomorrow at 8 o’clock in the
morning. Jessica:Okay, thank you, Doctor.
Harrison: You’re welcome.
Susan: Alright Jessica I will organize to have a nutritionist come

see you in about a half an hour.
3. Answer the following questions.
1. Who is Sandra?
2. Who is hospitalized?
3. Who is Harrison?
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4. How did Sandra greet Jessica?
5. How did Sandra introduce Susan?
6. Who is the nurse in charge after the

morning shift?
4. Practice your pronunciation with your teacher and your peers. First, listen to
your teacher and repeat.
Hello / Hi
Good morning / good afternoon / good
evening Good / Nice to see you again
I’m glad / happy / pleased to see you.
Now, work in pairs and practice asking questions and answering

How are you? Fine, thanks. And you?
How have you been? Very well. And you?
How are things? Not too bad, thanks.
How is your ...? She/he is fine.
Listen to your teacher and repeat

May I introduce myself? My name’s ....
Let me introduce myself. My name’s ....
I’d like to introduce myself. I’m....
I don’t think we’ve met. I’m....
May I introduce a good friend of mine? This is....
Have you met ...? I’d like you to meet ....
Work with your partner and practice saying the following

How do you do? How do you do?
Nice to meet you. Nice to meet you,
too. Please, call me .... Then you must call
me....
4
English for Nursing 1 - Page 4
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5. Study the language expressions above. Identify which language expressions
are used...
a. to greet people
Write G (Greeting) after the expressions.
b. to introduce yourself
Write SI (Self Introduction) after the expressions.
c. to introduce others
Write IO (Introducing others) after the expressions.
6. What would you say if you met someone at the following time of the day?
Good morning
a. 7.00
b. 10.0
0
c. 12.0
0
d. 15.0
0
e. 18.0
0
f. 21.0
0
7. Complete the following conversations with the most appropriate words or phrases.
a. Anne Excuse me, I am Nurse Anne.
Luck …..............................................
y I’ll be your primary nurse.
Anne
b. Aaron …..............................................
Katherin Good to see you again.
e If you need a nurse’s help, please press the button.
Aaron
c. Diana Hi Natalie. This morning, I am with Doctor Cameron.
Camero ...............................................
n Nice to meet you, Doctor.
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Natalie

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d. Diana He will visit you every day at about 08.00 in the
morning. Natalie .................................................

Diana Ok, I’ll see you later.
Natalie .................................................
8. How would you reply to the following phrases? Choose an appropriate response.
a. Hi. ...........................................................
b. Nice to meet you. ...........................................................
c. Here is the nurse ...........................................................

today. She is Nurse
Dina.
e. How do you do? ...........................................................
f. I will introduce you to ...........................................................

Dr. Avicenna.
g. I don’t think we have met. ...........................................................
h. Please call me Jose. ...........................................................
9. Work in pairs or in a small group. Make a dialogue for one of the following
situations and perform it in front of the class.
a. You are a new nurse in the hospital. You are to introduce

yourself to the nurse in the same nursing station.
b. You are a primary nurse. You meet a patient for the first time.
c. You are a doctor on your first visit to an elderly patient.
d. A patient is introduced to another nurse before shift change.

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1.2 Grammar for Questions and Question Words
1. Match the profession and the responsibility. Check your answer with a partner.
1. doctor (n) a. provides and manages the care of

/ˈdɒk.tər/ individual patients
2. physiotherapist b. diagnoses symptoms and recommend

(n) treatment
/ˌfɪz.i.əʊˈθer.ə.pɪst/
3. midwife (n) c. provides medical treatment to women, on

issues related to the reproductive system
/ˈmɪd.waɪf/
4. nurse (n) d. offers individual care to pregnant women

and their babies
/nɜːs/
5. gynaecologist (n) e. assists patients in rehabilitating physical

problems caused by illness, injury,
/ˌɡaɪ.nəˈkɒl.ə.dʒɪst/
disability, or aging, through treatment
2. Now scan the following text and check your answers.
Hospital Teams
Many people work in hospitals with different jobs. Here is a list of the
professionals you will probably work with in certain hospitals. This team
generally consists of a client, the client's family and/or caregiver,
medical professionals, nurses, nutritionists, social workers, and
rehabilitation therapists (occupational therapists, physical therapists,
speech therapists, and recreational therapists). Typical members of a
healthcare team are a doctor and a registered nurse. In addition, there
are a nutritionist, a physical therapist, a psychologist, an occupational
therapist, and/or social workers who may be part of the team. Here is a
description of a medical team member’s duty.

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Doctor/Physician/General Practitioner
The doctors diagnose symptoms and recommend treatment, including
prescribing drugs for patients. They have a wide range of clinical
experience. They range from newly qualified junior doctors to senior
consultants. There are also specialists who work in their specific field,
for instance: surgeon, internist, pediatrician, and gynecologist.
Surgeons
Surgeon is a medical specialist who treats diseases, injuries, and
deformities by invasive, minimally invasive, or non-invasive surgical
methods. A surgeon also has to examine patients to obtain
information on medical conditions and surgical risk. A surgeon will
perform a surgery in an operation theatre.
Gynecologists
A gynecologist provides medical treatment to women, focusing on
issues related to the reproductive system. They may perform annual
testing and exams, diagnose illnesses and infections, treat hormonal
abnormalities, prescribe medication and counsel patients about birth
control or fertility options
Midwives
Midwives offer individual care to pregnant women and their babies.
They assist women during labor on the obstetric ward and in the
delivery unit.
Nurses
Nurses work in a variety of settings to provide and manage the care of
individual patients. They work closely with doctors and other
healthcare professionals. Nurses mainly take care of patients’
symptoms and basic needs for 24 hours. Nurses leave home at night
when it comes to a night shift. Furthermore, there are many advanced
practice nurses or nurse specialists such as wound care nurses,
osteoma nurses, maternity nurses, pediatric nurses etc.

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Ward managers / Head Nurse
The ward managers are senior nurses who oversee the budgets, staff
and medical care of patients on their ward.

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Dieticians/Nutritionists
Dieticians / nutritionists work with patients to promote nutritional
wellbeing. A nutritionist would assess patients’ and clients’ health
needs and diet. They provide counselling for patients related to
nutrition issues, healthy eating habits, and develop meal plans for the
clients.
Medical Technologist
Medical technologist is a highly trained health professional who tests
blood and tissue samples in a laboratory along with urine, stool, body
fluids, and specimens. Medical technologists are responsible for
operating and maintaining the equipment used to examine samples or
specimens from the patients. They ensure that all tests are performed
in a precise and timely manner so that the results and interpretations
are accurate.
Radiologists
A radiologist is a medical doctor who is trained in executing and
interpreting medical images such as X-rays, CT scans, ultrasounds, and
MRIs and using them to treat health problems in patients. Radiologists
perform image-guidedprocedures but do not normally handle the
general medical needs of a patient.

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3. Study the following Question Words and their functions.
Question Words
Here are four question words that can be used to ask certain types of
questions.
Question Function Example
Words
Who It is used when asking about people Who is he?

or a person.
Who are
they?
Wher It is used when asking in or at what place. Where is

e RSUD
Sardjito?
Where does
Dr. Ramli
work?
What It is used when asking for What is his job?
information about something.
What is his
name?
When It is used when asking about time. When is the labour?

When do
they leave?

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4. Read the above text again. With your partner, add the question words used and
then answer the following questions. The first one has been done for you.
a. What do doctors do?

Doctors have medical certification to treat people who are hurt or ill.
b. is a surgeon?
………………………………………………………………………………
c.does a gynecologist do in a counselling with patients?
………………………………………………………………………………
d. do midwives assist women during labour?
………………………………………………………………………………
e. do nurses leave home for a night shift?
………………………………………………………………………………
5. With a partner, use the information from the reading to write questions.
a. What...........................................................................................?
b. Who............................................................................................?
c. Where..........................................................................................?
d. When............................................................................................?
6. Ask and answer your questions with another pair.
14
1
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7. Decide on the most suitable question words (what, where, who, when) for
the incomplete sentences.
a. Andika ......... is Doctor Jose Rizal from?
Arif He is from Padang.
b. Rahma ........is Ms. Hanifa?
Ronald She is a nurse.
c. Hendry ....... do you start your night shift?
Irene Tomorrow night.
d. Celine ……..is the doctor’s name?
Merry It’s Dr. Mathew Wright
e. Alex ..... is in charge of Mrs. Merry’s treatment today?
Pauline It’s Nurse Maxy
8. Study the business cards of some medical teams and answer the following questions.
1. Where does Mr John Cardiac live?

r
2. What does Mr Harrington do?
3. Among them, who are doctors?
4. What does Mr Williams do?
5. Who mostly works or deals with young /child patients?

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9. First, study the schedule of nurses in a hospital.
10. Now complete the sentences with a question word. Check your answer in pairs.
a. .......... is the head nurse? Molly Snyder.
b. time is the swing shift in the Cardio Care Unit?
c. doesn’t Garcia Adam work?
d. is Lyndon Anderson?
e. do all employees work at the hospital?
f. is taking a vacation?
g. day is Trenton Kilroy on Jury Duty?

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11. Work in a group of three. Choose a role for yourself first and complete the first
row with information about yourself. Then ask questions to find out more about
the schedules of the other students.
For example, ‘What’s your role?’, ‘What days do you work during the week?’
or ‘What time does your shift start on Wednesday?’
Do you work on ....? Yes (√) if you work, No (X) if you

Name Profession don’t.
What time do you work on....? Write when you work
that
day.
Mon Tue Wed Thu Fri Sat Sun
1 ......... .........
2 ......... .........
3 ......... .........

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1.3 Vocabulary to Talk about Hospital Teams
1. Read the following text and underline all the words indicating medical equipment.
The first one has been done for you.
Medical equipment might refer to both very complex devices used

by professionals as well as to simple instruments. Let's see what
equipment is used when you catch influenza. Imagine you wake up
in the morning with a terrible headache, feeling feverish. You
quickly phone the boss and say you need a day off, then grab a
thermometer to take the temperature. Gosh, it's 102 degrees
Fahrenheit! You really need to go to the doctor. After you arrive at
your local clinic and wait some time in a queue, the GP asks you in.
She asks what is wrong and then puts a tongue depressor in your
mouth to see your throat. Then she asks you to take off your
sweater and uses a
stethoscope to listen to your chest.
What about other examples? Let's see what equipment might be

used in case of a broken bone. It's mid-February and you are skiing.
You are having an amazing time, but you fall and feel terrible pain in
both your shin and your arm. You have probably broken your arm
and your leg! It's so painful you can't move so you call out mountain
rescue. They come by chopper, put you on a stretcher, use a splint
to immobilize your limbs and take you to the hospital.
You are told you have broken your leg and it's put in a cast. If you're
lucky and your arm is not broken, it's only wrapped in a bandage
and you have to wear a sling. As a result, walking on crutches is out
of the question, so you leave the
hospital in a wheelchair.
Various types of medical equipment, ranging from basic tools to

highly advanced cutting-edge devices, are used in very different
situations. One thing is certain - each piece has been developed to
help us recover or even save
our lives. And we might need them at the very beginning of our lives -
as is the
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case with an incubator, which is used in neonatal units to help or
treat prematurely born children. 1
2. Check with your partner, did you get them all? Together, list the names of
medical equipment and write a brief description of what they are used for.
a. ................................................... = ................................................................
..................................................................................................................
................
b. ................................................... = ................................................................
..................................................................................................................
................
c. ................................................... = ................................................................
..................................................................................................................
................
d. ................................................... = ................................................................
..................................................................................................................
................
e. ................................................... = ................................................................
..................................................................................................................
................
f. ................................................... = ................................................................
..................................................................................................................
................
g. ................................................... = ................................................................
..................................................................................................................
................
h. ................................................... = ................................................................
..................................................................................................................
................
i. ................................................... = ................................................................
..................................................................................................................
................

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j. ................................................... = ................................................................
..................................................................................................................
................
1
MedicalEnglish. (2020). Medical Equipment. Retrieved from https://www.medicalenglish.com/unit/2/reading

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3. Now, use the words above to express your ideas in sentences.
a. ...................................................................................................................
....
b. ...................................................................................................................
....
c. ...................................................................................................................
....
d. ...................................................................................................................
....
e. ...................................................................................................................
....
f. ...................................................................................................................
....
g. ...................................................................................................................
....
h. ...................................................................................................................
....
i. ...................................................................................................................
....
j. ...................................................................................................................
....

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4. Below are tools commonly used by nurses. Match the word to the picture.
surgical mask thermometer gauze bandage
tweezers sphygmomanometer medical trolley
hand gloves stethoscope scales
1. 2……………………. 3…………………….
…………………….. . .
4……………………. 5……………………. 6…………………….

. . .
7……………………. 8……………………. 9…………………….

. . .

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5. In this pronunciation exercise, draw a line to match the phonemic transcription to
the vocabulary below. Practice pronouncing the words with your partner.
Words Pronunciation
1. surgical mask a. /‘θɚˈmɑː.mə.t̬ɚ’/
2. hand gloves b. /‘sɚdʒɪkl mæsk/
3. thermometer c. /‘ ɡɑːz ˈbændɪdʒ’/
4. gauze bandage d. /‘ sfig-mō-mə-ˈnä-mə-tər’/
5. medical trolley e. /‘hænd ɡlʌv’/
6. sphygmomanometer f. /‘medɪkl ˈtrɑː.li’/
6. The following words are taken from the reading texts in this unit and categorized
into nouns, adjectives and verbs. Draw a line to match each word with its definition.
Nouns Meanings
discharge all the chemical processes in your body, especially

those that cause food to be used for energy and
growth
respiration
official permission to leave a hospital
pulse
an uncomfortable feeling of nervousness
allergy
the action of breathing
anxiety
a medical condition in which your blood pressure is
extremely high
metabolism
the beating of the heart
hypertensio
n a damaging immune response by the body to a
substance, especially pollen, fur, a particular food,
or dust, to which it has become hypersensitive
Adjectives Meanings
acute causing or likely to cause harm.
chronic moving into all areas of something, difficult to stop
harmful very serious or severe
invasive poisonous

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toxic continuing for a long time
antenatal causing emotional or physical pain
painful relating to the medical care given to pregnant women

before their babies are born
Verbs Meanings
cure to order treatment for someone, or to say what

someone should do or use to treat an illness or
injury
diagnose
to make someone with an illness healthy again
prescribe
to become completely well again after an illness or
check injury
to cover or surround something with paper, cloth,
or other materials
wrap
to recognize and name the exact character of a
disease or a problem, by examining it
recover
to use a needle and syringe to put a liquid such as a
drug into a person's body.
immobiliz
e to make certain that something or someone is correct
inject or safe
to stop something or someone from moving
7. Match each of the words below to a stress pattern and check with your partner.
a. assessment ●●●●
b. thermometer
c. ●● ●●
sphygmomanometer
d. stethoscope
● ●● assessment
e. diagnose
f. nutritionist
●●●
g. anxiety

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h. dehydration ●●
i. hypertension
j. incubator ●●● ●●●
8. In pairs, complete the sentences with the words in the boxes
incubator (n) nutritionist (n) examine (v)
premature (adj) thermometer (n)
a..............................................is recording and transmitting fevers in real time.
b. Too much exposure to the sun can cause the

...............................................
aging of skin.
c. The newly born baby needed a special treatment. Therefore, she
was put in an .................................................
d. recommends the patient to have more fruits and
vegetables containing vitamin C such as orange, guava, broccoli,
and pumpkin.
e. A doctor......................................his exact physical condition immediately
after he was sent to the emergency room.

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9. As if you were a nurse, use the following words in sentences you would say to
your doctor about a patient.
dehydration (n) diagnose (v) painful (adj)

/ˌdiː.haɪˈdreɪ.ʃən/ /ˈdaɪ.əɡ.nəʊz/ /ˈpeɪn.fəl/
feel (v) bandage (n)

/fiːl/ /ˈbæn.dɪdʒ/
a. ………………………………………………………………………………………
b. ………………………………………………………………………………………
c. ………………………………………………………………………………………
d. ………………………………………………………………………………………
e. ………………………………………………………………………………………
10. Looking back through this unit, find and list five more words that are new for you
and hard to remember. Use them in an example sentence below. Identify their part
of speech (noun, verb, adjective or adverb).
Word Sentence

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1.4 Writing a MedTech Assessment Form
1. Read the text below quickly and put a cross “x” if you did not find the data in
the assessment form below.
◻ personal identity ◻ nationality ◻ family
◻ medical history ◻ recent history ◻ social background
◻ range of time ◻ name of medical staff

showing when
treated
25/07/2020
Notes
Dewi Wardoyo was admitted through the Children’s Emergency
Department for
acute meningoencephalitis as a result of a complication following
mumps.
Patient History
Address: 32 Sexton St,
Ekibin Phone: +62 85
1966 6231
Date of Birth: 23 May 2008
Admitted: 15 July
2012 Gender: Male
Discharged: 25 July
2012 Country of Birth:
Indonesia

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Social History
Parents: Miri and Abyasa Wardoyo, refugees arrived in Australia in
2011 Employment: Abdullah; Golden Circle Pineapple Factory, shift
worker and Miri Housewife
Accommodation: Recently moved to Rental Accommodation
Siblings: 2-year-old brother, Ahmad
Language: Bahasa Indonesia, Javanese
Interpreter needs: Abyasa understands spoken English but has limited
written skills. Miri has limited understanding of English.
Medical History
Parents state that both children had some kind of vaccination at birth,
but the vaccination record has been lost. Parents unaware of vaccine
for Mumps
Discharge Plan
Appear to have fully recovered from mumps and Acute
Meningoencephalitis. Will need advice on recommended vaccines for
both children. Will need neurological check-up.
Often a short chunk of language, i.e. word or phrase bears a complete message. We
can use some of the data contained in a nursing assessment form as examples.
2. Read the Nursing Assessment form again. Answer these questions.
a. What is the patient’s name? ......................................................
b. What was the diagnosis? ......................................................
c. Where does the father work? ......................................................
d. Who is Ahmad? ......................................................
e. What vaccination may the patient get? ......................................................

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3. Write at least 3 examples of the possible required data for a nurse assessment form.
a. Social history: ......................., ............................, ................................
b. Medical history: ......................., ............................, ................................
c. Discharge plan: ......................., ............................, ................................

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4. Read the case below and fill in the following nursing assessment form.
A male patient aged 42 years old is admitted to a clinic. He is diagnosed with

hypertension. The patient’s data are as follow: the patient feels uneasy, shortness of
breath, headache and backpain, blood pressure 145/90 mmHg, respiration rate
18x/minute, pulse 84x/minute, body temperature 36.50C.
Personal data
Name James
Hospital No Jacobson
Phone RH016458
number +628523459185
Address Sudirman street, no.22B. Semarang city,
Job Farmer
Admission 22 March 2020
Date Smoking 5 years
history
NURSING ASSESSMENT FORM
Patient Information
Patient’s initial ……………………………………………………………
name
Hospital Number ……………………
Age ……………………
Gender Female Male
Marital Status ……………………
Employment ……………………………………………………………
Address ……………………………………………………………
Medical Diagnosis ……………………………………………………………
Patient’s main ……………………………………………………………

complaint
Patient’s recent ……………………………………………………………

health history
……………………………………………………………
……………………………………………………………

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……………………………………………………………

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5. With a partner, each prepare a set of data on a patient. Ask your partner questions
in order to complete a Nursing Assessment Form following the instructions below.
a. You are working with another nurse.

b. You ask the nurse for a recent update on the condition of a patient.
c. Take notes on the data reported.
d. Fill in the data in a nurse assessment form.
NURSING ASSESSMENT FORM
Patient
Information ……………………………………………………………
Patient’s initial
name
HN ……………………
Age ……………………
Gender Female Male
Marital Status ……………………
Employment ……………………………………………………………
Address ……………………………………………………………
Medical Diagnosis ……………………………………………………………
Patient’s main ……………………………………………………………

complaint
Patient’s recent ……………………………………………………………

health history
……………………………………………………………
……………………………………………………………
……………………………………………………………
……………………………………………………………

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6. First, read the information about Annisa, Rizky and Fajar’s daily routines and
then complete the writing task below.
Annisa is a Rizky is a Fajar is a

Surgical Psychologi Nursing
Nurse
st Lecturer
7 – 8 am Meeting with her Wake up, have a Get up,

team, nursing pre- cup of coffee, take prepare
conference, begin a bath breakfast
work
8 – 10 Assess patients Go to the gym, Drive to work,
am drive to work give
consultation to
patients at clinic
10 – 12 Preparing patients Have a meeting Read some
am for surgical documents, write
procedures email, answer
phone
calls
12– 1 Have lunch, meet Have lunch, read Have lunch, hangs
pm with head nurse some reports out with colleagues
1 –4 Have nursing Teach a class Visit parents
pm round with
physician,
nutritionist and
other
nurses
4 –6 Pick up kids from Drive home, Go to cinema
pm daycare, cook do
some food housework
6 –9 Study some Have dinner, hang Prepare for night
pm reports, listen to out with friends shift at hospital,
music, watch tv report to his
supervisor

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7. Choose one of the people above. Write a short paragraph describing a daily
routine. Remember to use simple present and verb to be.

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2.1 Language for Making Requests
1. With a partner, discuss the following prompts
a. Have you ever seen a surgery room in a hospital?

b. What professions need to work together in surgery?
2. Read the dialogues and underline the request expressions with your partner.
For example: Doctor May I see the status of the patient who arrived this afternoon?
Nurse Of course, doctor, here it is.
Doctor: Good morning, nurse.

Nurse: Good morning, doctor. Dr Ahmer suggested I consult you on this patient.
If you are not too busy, would you have time at the moment?
Doctor: Of course. How is the patient’s condition? Are there any problems?
Nurse: Yes doctor, unfortunately, there are some problems. He ate
some salty fish, and as a result, his blood pressure is high. Is
there any additional medicine for him, doctor?
Doctor: Oh, yes, nurse. I am going to give you a prescription for
some tablets containing 10 mg of amlodipine and 5 mg of
candesartan 5.
Nurse: I am sorry, doctor. Can you repeat that, please?
Doctor: Amlodipine and candesartan. They are going to help him
achieve the normal blood pressure.

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37
Nurse: Thank you, doctor. May I continue my
work? Doctor: Of course. Thank you for the helpful
discussion Nurse: You’re welcome.
3. With your partner, identify the functional language phrases for making requests. If it
is a request, write a possible answer.
For example: Can I ask you something?

Yes, of course you can.
a request ✓
not a request 🗴🗴
✓ Yes, of
a. Can I ask you something?
course you can.
🗴🗴
b. Yes doctor, he ate a salty fish, so it has
kept his high blood pressure.
c. Could you lend me a stethoscope?
d. Would you mind giving me a prescription?
e. Can you repeat that, please?
f. May I continue my work?
g. Thank you for the helpful discussion.
h. Could you possibly buy this medicine?
i. Just call me and I will help you.
j. Will you ask him for me?
4. Look at the words below and how they are pronounced. Repeat the words
together and then practice with your partner.
English for Nursing 1 - 1

Page 3
38
a. how /au/
b. ate /et/
c. condition /kənˈdɪʃ(ə)n/
d. fish /fɪʃ/
e. sure /ʃʊə(r)/
f. prescription /prɪˈskrɪpʃ(ə)n/
g. pressure /ˈprɛʃə/
h. anesthetist /əˈniːsθətɪst/
5. Now listen to your teacher pronouncing the words in the conversation below.
Question Statement
a. How is her condition? Her condition will improve soon.
b. What did the He ate some salty fish.

patient eat?
c. What will you do? I will give her a prescription. She will also need
a
repeat script.
d. What is his blood His blood pressure numbers are 120/80 mm Hg

pressure? which are considered normal.
e. Who works in Anesthetists, surgeons, nurses and patients

an operating work in an operating room.
room?

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39
6. Below are some examples of phrases that can be used for making polite requests.
Use these to make requests for the situations below. When you have done this, take
it in turns to practise making and accepting these requests.
I wonder if you could…? Is there any chance you could…?
Could you possibly…? Would you mind +ing…?
Do you think you could….? Would it be possible…?
Will you ……? I need (to)... Can you help?
Would you help me with…..? Do you mind +ing...?
a. Ask a colleague for a favor
……………………………………………………………………………………………
b. Ask for directions to a ward
……………………………………………………………………………………………
c. Ask someone to open the door for you
……………………………………………………………………………………………
d. Ask another nurse to bring you something
……………………………………………………………………………………………
e. Ask someone to tell you the time
……………………………………………………………………………………………
f. Ask someone to repeat or clarify instructions
……………………………………………………………………………………………

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2.2 Read about Interprofessional Collaboration
1. In pairs, discuss the questions below.
a. What is collaborative practice in healthcare?

b. What important skills are required for good teamwork and/or collaboration?
c. What can be difficult about interpersonal collaboration?
2. Before reading, draw a line to match the following words with their definitions.
After checking with your partner, your teacher will say each word. Repeat each
word together.
1. collaboration a. to agree with and give

(n) encouragement to someone
/kəˌlæbəˈreɪʃən/
2. communication b. the process of two or more
(n) people or organizations
/kəˌmjuːnəˈkeɪʃən/ working together
3. interprofessional (n) c. occurring between or involving two
/ɪn'tɜ: prə'feʃənəl/ or more professionals
4. emergency (n) d. complete and include

/ɪ'mɜ:dʒənsɪ/ everything that is necessary
5. suspected (adj) e. a result or effect of an action or

/sə'spektɪd/ situation
6. recovery (n) f. a serious, unexpected, and

/rɪ'kʌvərɪ/ often dangerous situation
7. outcomes (n) g. transferring information from a

/'aʊtkʌmz/ person or group to another.
8. perspective (n) h. to think about a problem in a

/pə'spektɪv/ wise and reasonable way
9. comprehensive (adj) i. thinking possibly exists, is true, will

/ˌkɒmprɪ'hensɪv/ happen,
10. support (n) j. becoming healthy after an illness or

/səˈpoɚt/ injury 2
2
Cambridge Dictionary. (2020). Dictionaries. Retrieved from https://dictionary.cambridge.org/dictionary/

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41
3. Read the text quickly and decide what the main idea of the passage is. Then circle
the best title from the three choices below and write it in the space provided.
a. What Are Communication and Team Collaboration?

b. Barriers to Effective Communication
c. Known Benefits of Communication and Team Collaboration
…………………………………………………………………………..
Collaboration in health care is defined as health care professionals

assuming complementary roles and cooperatively working together,
sharing responsibility for problem-solving and making decisions to
formulate and carry out plans for patient care. Collaboration between
physicians, nurses, and other health care professionals increases
team members’ awareness of each other’s type of knowledge and
skills, leading to continued improvement in decision making. Effective
teams are characterized by trust, respect, and collaboration.
Teamwork is endemic to a system in which all employees are working
for the good of a goal, who have a common aim, and who work
together to achieve that aim. When considering a teamwork model in
health care, an interdisciplinary approach should be applied. Unlike a
multidisciplinary approach, in which each team member is
responsible only for the activities related to his or her own discipline
and formulates separate goals for the patient, an interdisciplinary
approach coalesces a joint effort on behalf of the patient with a
common goal from all disciplines involved in the care plan. The
pooling of specialized services leads to integrated interventions. The
plan of care considers the multiple assessments and treatment
regimens, and it packages these services to create an individualized
care program that best addresses the needs of the patient. The
patient finds that communication is easier with the cohesive team,
rather than with numerous professionals who do not know what
others are doing to manage the patient.3

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42
3
O’Daniel, M. & Rosenstein, A., H. (2008). Professional Communication and Team Collaboration. Retrieved from
https://www.ncbi.nlm.nih.gov/books/NBK2637/

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43
4. Read the text and then answer the questions on your own. When you have
finished, check with a partner.
Benefits of Interprofessional Collaboration in Healthcare
Why is interprofessional collaboration essential? Because when you

create a collaborative culture (and put communication strategies and
technology in place to support that culture), you improve patient care
and outcomes. For example, a patient walks into the emergency
department (ED) complaining of chest pains. An ED doctor checks him
out, followed by a cardiologist, who orders some tests and waits on the
results from the radiologist, who confirms what both doctors suspected:
the patient is having a heart attack. After having emergency surgery,
the patient spends a day in the ICU, where a team of nurses’ care for
him in 12-hour shifts, before transferring him to a cardiac unit, where he
meets his new team of rotating nurses. Each morning throughout his
stay, a medical professional (or perhaps his primary care doctor) stops
by during rounds. So does the cardiologist, and since the patient has
diabetes and chronic obstructive pulmonary disease, an endocrinologist
and pulmonologist. Depending on the patient’s recovery and lifestyle,
physical therapists, dieticians, and social workers might also get
involved.
Each of medical professionals has a unique perspective and valuable

insights about the patient. They notice different symptoms and consider
different possibilities. Together, they have a more comprehensive,
holistic view of the patient. But these people are rarely, if ever, in the
same room. At best, they share data via electronic health record (EHR),
but they often lack a way to communicate directly in real-time. Along
with care team meetings, many hospitals now encourage team-based,
patient-centered rounds that include the primary doctor, bedside nurse,
specialized physicians, and any other relevant team members. This
helps to foster both patient- centered care and interprofessional
collaboration in healthcare. It also helps to have hospital
communication technology that lets care teams communicate and
collaborate seamlessly and securely on the go or at the point of care —

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44
via text, voice, or video. 4
4
Tiger Connect. (2020). 5 Benefits of Interprofessional Collaboration in Healthcare. Retrieved from https://tigerconnect.com/blog/5-benefits-of-
interprofessional-collaboration-in-healthcare/

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45
1. What is interprofessional collaboration?
a. when 2 or more professions work together to achieve common goals
b. when 2 or more doctors work together to achieve common goals
c. when 2 or more nurses work together to achieve common goals
d. when 2 or more pharmacists work together to achieve common goals
2. Why is interprofessional collaboration essential?

a. Because it can improve patient incomes
b. Because it can improve patient care and outcomes
c. Because it can improve nurses’ incomes
d. Because it can improve doctors’ outcomes
3. The following statement is false about Interprofessional collaboration.

a. they share data via EHR
b. together, they have a more comprehensive, holistic view of the patient
c. they often lack a way to communicate directly in real-time
d. each only works with his perspective
5. Based on the information in the text, decide if the following statements are
True or False.
a. Interprofessional collaboration is not T F

essential.
b. Patient-centered care includes the primary doctors, nurses,
specialized
T F
physicians, and any other relevant team members.
c. You can’t improve patient care and outcomes with
interprofessional
T F
collaboration.
d. Each of medical professionals has a unique perspective and
valuable
T F
insights about the patient.
6. In groups of 3 or 4, discuss both the greatest benefits and challenges of

collaboration in a health care setting. Share your ideas with the class.

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46
2.3 Vocabulary to Talk about
Interprofessional Collaboration
1. In pairs, write down as many words as you can about the topic of
interprofessional collaboration. Remember to write the part of speech of each
word (noun, verb, adjective and adverb). Do this without using a dictionary.
INTERPROFESSIONAL COLLABORATION
(brain storming vocabulary)

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47
2. Listen to your teacher say each of these words and repeat after your teacher.
Listen for and identify the stressed syllable. Without a dictionary, write the part of
speech after each word (n., v., adj., adv.).
● ●
(n) b. social workers
a. patient
c. nurse d. dentist
e. doctor f. speech therapist
g. family h. neurologist
i. physiotherapist j. administrative staff
k. occupational therapist l. nutritionist
m. pharmacist n. surgeon
o. midwife p. analyst
q. anesthetist r. radiologist
If you are still unsure of the pronunciation, look up the phonetic script in your
dictionary and check with your teacher.

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48
3. Listed below is a range of professionals who work in health care and who maybe
required to collaborate with each other. Match the professional with their key role
and responsibilities.
physiotherapi analyst neurologist radiologis

st t
nutritionist social occupational anestheti
workers therapist st
pharmacist dentist surgeon midwife
nurse speech therapist
a. A… nutritionist … is a person who gives advice on how food

affects your health.
b. A……………………………. is a person who specialize in
diagnosing and treating injuries and diseases using medical
imaging procedures such as X-rays.
c. A....................................is a person who studies or examines data in
detail.
d. A....................................is a person who prepares and gives
out medicines in a hospital or shop.
e. A....................................is a person who helps people who have speech
problems.
f. A..............................................is a person who gives anesthesia during
an operation.
g. A....................................is a person who
treats patients using physical therapy and physical rehabilitation
h. A……………………………. is a person who studies and treats
diseases of the nerves
i. A....................................is a person whose job is to care for people who
are ill or injured, especially in a hospital.
j. A..............................................is a person who treats people's teeth and helps
with their patient’s oral hygiene.
k. A....................................is a person who is trained to help women when
they are giving birth.

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l. A....................................is a person who works with vulnerable children
and supports families in need of assistance.
m. A....................................is a person
who is trained to perform medical
operations.
n. A....................................is a person who treats injured, ill, or disabled
patients through the therapeutic use of everyday activities.
4. From the above exercises, choose 8 words and use them in a sentence
to demonstrate their meaning. The first one has been done for you.
a. For more information about clinical care of COVID-19 patients, see the WHO’s
full guidance.
b. …………………………………………………………………………………………
c. …………………………………………………………………………………………
d. …………………………………………………………………………………………
e. …………………………………………………………………………………………
f. …………………………………………………………………………………………
g. …………………………………………………………………………………………
h. …………………………………………………………………………………………
i. …………………………………………………………………………………………
5. In pairs or small groups, each choose 5 job roles from this lesson. Describe or give
a definition for the job role without using it. Try to use your own words, not the
definitions included in exercise 3. Your partner will try to guess what your word is.
For example, start your sentence with
a. This person usually…..
b. This person is responsible for…
c. This person’s role is to….

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50
2.4 Writing an Opinion
1. In groups, discuss the following questions
a. What reasons might there be for Type 2 Diabetes Mellitus case?
b. Why would interprofessional collaboration be important
for Type 2 Diabetes Mellitus?
2. Below is some vocabulary related Type 2 Diabetes Mellitus. With a

partner, discuss the meaning of each word.
Words Pronunciation Meaning in Bahasa
1. incision (n) / ɪnˈsɪʒ ən /
2. to deliver (v) /dɪ'lɪvə/
3. pregnant (adj) /'pregnənt/
4. uterus (n) / ˈyu tər əs /
5. abdomen (n) / ˈæb də mən/
6. costly (adj) /ˈkɒst.li/
7. rights (n) /'raɪts/
8. medical necessity /nɪ'sesətɪ/

(n)
9. trend (n) /'trend/
10. to estimate (v) /ˈes.tɪ.meɪt/

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3. Read the text and then discuss your understanding of Type 2 Diabetes Mellitus
and the issue raised in the article with a partner. Discuss the following prompts ….
 What are common and uncommon interferences in Hb A1c assays?

 What are known interference issues with the Hb A1c CE assay?
 What patient-related preanalytical factors could influence Hb A1c and its
measurement?
 How can the laboratory rule out interferences?
 How could incorrect Hb A1c results be misinterpreted or lead to unnecessary
testing?
CASE DESCRIPTION
A 70-year-old male with a history of type 2 diabetes mellitus (T2DM)

presented to an outpatient laboratory for routine venipuncture to
evaluate glycemic management and cardiovascular disease risk. The
patient arrived at the laboratory alert, with no apparent distress.
Hemoglobin A1c (Hb A1c) testing was performed along with a lipid panel
for routine screening of lipid disorders. The lipid panel results
demonstrated mixed hyperlipidemia, showing increased triglycerides
and decreased HDL cholesterol. The Hb A1c analysis by capillary
electrophoresis (CE) on the Sebia CAPILLARYS 3 TERA instrument
resulted with a flag for an atypical profile in the electropherogram and
no Hb A1c value was reported. Prior Hb A1c measurements throughout
the past year demonstrated Hb A1c concentrations ≥6.5%, consistent
with his diagnosis of T2DM, and revealed a downward trend in the Hb
A1c concentration. The patient was not receiving medical treatment or
medications known to affect red blood cells or Hb A1c measurement. The
inconclusive Hb A1c result was repeated with a different instrument and
another sample from the patient, collected at a different phlebotomy
location, showed similar inconclusive results as the previous specimen.
Compared to typical hemoglobin and Hb A1c migration patterns, this
patient’s specimens resulted in unusual shifts in hemoglobin peak
migration times as observed upon close review of the electropherogram,
suggesting a potential analytical interference of the Hb A1c
measurement.
PATIENT FOLLOW-UP
In communications with the assay manufacturer, it was suggested that a

potential cause of this type of interference could be markedly increased
leukocyte counts. In sharing this information with the clinical team, it was
recommended to the patient to return to the hospital to obtain a complete
blood count (CBC) for evaluation. Simultaneously, we opted to test Hb A1c in 2
unrelated specimens with markedly elevated white blood cell counts (>100
k/μL; reference interval: 4.30 to 11.30 k/μL), wherein we observed similar peak
shifts in the electropherograms. The patient’s follow-up test at the hospital
revealed a CBC with a highly elevated leukocyte count of 175.80 k/μL,
suggesting the abnormal Hb A1c result could be due to an interference caused
by leukocytosis. A manual differential confirmation demonstrated elevations in
myelocytes, metamyelocytes, promyelocytes, blasts, and basophils. During
this hospital visit, another Hb A1c measurement was performed by CE and
showed a Hb A1c concentration English forof 7.8%.
Nursing 1- This value correlated well with
Page 32
previous Hb A1c measurements and was consistent with the patient’s history 52
4. Consider the following question and discuss in small groups.
‘Do you believe Caesarean sections should only be done when medically
necessary OR do you think women should have the right to choose this option?’
To introduce your opinion, you can use phrases such as ..
a. In my opinion, I believe…..
b. From my point of view,...
c. As far as I am concerned, ...
d. Personally, my opinion is that …
5. After your discussion, write a short summary below. Use the opinion expressions
above as well as vocabulary from Exercise 2. Remember to give a reason for
your opinion. (100-150 words)
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
...................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................

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6. You are starting a new job as a Medical Technologist in a healthcare unit in
rural area and you want to support the patients as best you can.
In pairs, discuss your opinions and make some notes below.
a. What would be important when supporting a patient with type 2 DM

especially in healthcare unit in rural area?
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
b. What other parties would you collaborate or have to work with in this room?
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
c. What preparations might you be responsible for in a laboratory?
…………………………................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
....................................................................................................................................
7. What are your expectations of working as a nurse in a maternity ward in a hospital?
Share your opinions as a class. Start your sentence with one of the opinion
phrases from Exercise 3. You can also use ‘I would say that ... ‘ or ‘Speaking
personally, I believe….’
After your class discussion, consider whether your expectations were the same
or different from your peers.

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54
Module 2
Anatomy and Physiology

of the Human Body
3.1 Vocabulary to Talk about Parts of the Human Body
1. On your own and without your dictionaries, write down 25 words about the parts of
the human body. Once you are done, discuss your words with a partner.
2. Look at the list below. Did you include these parts of the body? Do you know the
location and function of each part? Discuss. If you are unsure, check your
dictionaries.
heart lungs spleen

liver artery vein
pancreas bone muscle
brain nerves abdome
n
3. Listen carefully to your teacher say each word and then repeat. Next, match the
vocabulary for parts of the human body with their correct definition. Work on your
own and then check your answers with your partner.
Vocabulary Meaning
1. heart (n) a. a large lobed glandular organ in the

/hɑːt/ abdomen, involved in many metabolic
processes
2. lungs
/lʌŋ/ b. a hollow muscular organ that pumps the
blood through the circulatory system by
rhythmic contraction and dilation

Page 49
3. spleen c. any of the tubes forming part of the
/spliːn/ blood circulation system of the body,
carrying in most cases oxygen-depleted
blood toward the heart
4. liver
/ˈlɪv.ər/ d. an abdominal organ involved in the
production and removal of blood cells
forming part of the immune system
5. artery
/ˈɑː.tər.i/ e. each of the pair of organs situated within
the rib cage, consisting of elastic sacs
with branching passages into which air is
drawn, so that oxygen can pass into the
blood and carbon dioxide be removed
6. vein
/veɪn/ f. any of the muscular-walled tubes forming
part of the circulation system by which
blood is conveyed from the heart to all
Vocabulary Meaning
1. pancreas a. (in the body) a whitish fiber or bundle of

/ˈpæŋ.kri.əs/ fibers that transmits impulses of
sensation to the brainor spinal cord, and
impulses from these to the muscles and
organs
2. bone
/bəʊn/ b. the part of the body containing the
digestive organs
3. muscle
/ˈmʌs.əl/ c. a band or bundle of fibrous tissue in a
human that has the ability to contract,
producing movement in or maintaining
the position of partsof the body
4. brain
/breɪn/ d. a large gland behind the
stomach which
5. nerves secretes digestive enzymes.
/nɜrvz/ e. any of the pieces of hard whitish tissue
making up the skeleton in humans
6. abdomen
/ˈæb.də.mən/ f. an organ of soft nervous tissue contained
in the skull, functioning as the
coordinating center of sensation and

Page 49
4. Below is an image of the human body. With your partner, can you identify the 11
parts of the body?
1. the brain 7. ……………………..

2. …………………….. 8. ……………………..
3. …………………….. 9. ……………………..
4. …………………….. 10. ……………………..
5. …………………….. 11. ……………………..
6. ……………………..

Page 51
5. Test your knowledge by matching the vocabulary with the meanings below.
Check your answers in pairs.
a. heart
1. a large lobed glandular organ
in the abdomen
2. organ that pumps the blood b. bone
3. an organ of soft nervous tissue c. liver

contained in the skull
4. digestive organs; the belly d. brain
5. the pair of organs situated within e. abdomen

the rib cage
6. the pieces of hard whitish tissue f. lungs

Page 52
3.2 Language for Talking about Allergies
1. With another student, discuss the following prompts
a. Have you ever experienced an allergic reaction?

b. What causes allergic reactions?
2. Match the common questions and their answers about allergies and
allergic reactions below. Was any information surprising? Discuss with
your group.
1. Do you think all a. There is no cure for food

allergies are harmless? allergies. The only prevention is
to avoid the food.
2. What are some of the
common symptoms b. The top nine allergens that trigger
of an allergic 90% of food allergies are peanuts,
reaction? eggs, cow’s milk, tree nuts, fish,
shellfish, soy, sesame and wheat.
3. Most people believe
peanuts are one of the c. Yes, food allergies are much more
most common triggers common in infants aged 12 months
for reactions. Is this and 2 than adults.
true?
4. Tree nuts can commonly d. Some of the signs of an allergic
cause an allergic reaction are vomiting, swelling
reaction. What are some around the mouth, red and itchy
examples of tree nuts? skin, difficulty breathing, sneezing
and/or watery eyes.
5. Can doctors cure
food allergies? e. Tree nuts include pistachios,
macadamias, walnuts, brazil
nuts, almonds and hazelnuts.
6. Can someone get
anaphylaxis reaction f. Allergies are certainly not
just from touching harmless. Some allergies can lead
food? to anaphylaxis and are potentially
life threatening.
7. Who are allergies
more common in - g. It is rare that touching a food
children or adults? causes a life-threatening
1
Allergy & Anaphylaxis Australia. (2020). The allergy awareness quiz. Retrieved from https://allergyfacts.org.au/resources

Page 52
3. Read the following conversation between friends Alice and Sam.
What is Alice allergic to? What are some of her symptoms?
Alice: Ahhchooo!
Sam: You've been sneezing a lot lately. Are you sick or
something? Alice: No. Every rainy season, I'm stricken with
allergies.
Sam: Oh really? I’ve never had any seasonal allergies.
Alice: Consider yourself lucky.
Sam: What are all the
symptoms?
Alice: Well, as you just saw, I sneeze a lot. Also, my nose becomes
very runny, my throat sometimes itches and my eyes start to
water.
Sam: That doesn't sound good.
Alice: No it's not. So, you don't have any type of allergies?
Sam: Well, I have a severe allergy to seafood. It runs in
the family. Alice: Everyone to some extent is allergic to
seafood, aren’t they?
Sam: Well, I get it pretty bad. My whole face turns red, including my
ears. My eyes become bloodshot, and I start to itch all over my
body.
Alice: That's pretty bad.
Sam: That doesn't stop me from eating seafood! Hahaha.
4. Listen to your teacher pronounce the following words. Repeat after your teacher.
Practice again with your partner and add another word below with the same
sound.

Page 52
/u:/ you soon
/e/ well …………….
/aʊ/ now …………….
/ai/ fine …………….
/θ/ thank …………….
s
/eɪ/ great …………….

Page 52
5. Listen to your instructor pronouncing the words in the conversation below and
repeat. What do you notice about the intonation?
Questions Statements
1. Are you sick? a. I have a fever.
2. What’s wrong with you? b. I am sneezing.
3. Is she sick? c. She often gets headaches.
4. Is he sick? d. He is not very healthy.

Page 55
6. Use words below to complete the dialogue between a doctor and a patient.
a. problem b. unwell c. you d. now
e. symptoms f. swollen g. see h. allergies
Doctor Good afternoon. How are ……..? What seems to be the......?

Patient I'm feeling ………..l. I ate some seafood for lunch and I have
tingling in my mouth and my lips feel ………………..
Doctor How long have you had these....................?
Patient Oh, I have been feeling ill for about 2 hours.
Doctor Do you often eat seafood? Do......usually get these symptoms

when you eat seafood?
Patient Sometimes, but it depends on what
I eat. Doctor............................................Do
you have any other................................?
Patient Not that I'm aware of.
Doctor: Do you also feel dizzy? Or is your tongue
swollen too? Patient Not that I know of.
Doctor: OK. Could you please open your mouth and say 'ah'? 2
2
Beare, K. (2019) English for Medical Purposes - Troubling Symptoms. Retrieved from https://www.thoughtco.com/english-for-medical-purposes-
troubling-symptoms-1211330

Page 56
7. Read the dialogue again. What questions were asked to find out more
information from the patient?
With your partner, choose a common allergy. Write a short dialogue between 2 people
discussing allergies or an allergic reaction.
This should involve 1 person asking questions to find out information.
What symptoms do you….?
How long have you…?
How often do you…?
Do you usually….? Do you feel…? Do you have any other…?
Is it common for you to….?

Page 56
3.3 Grammar for Past Simple and Past Continuous
1. There are three different ways to pronounce the 'ed' ending of regular verbs in
the simple past tense: / Id /, / t / or / d /.
Read through the explanation below with your partner and practise the example
past tense verbs together.
Past Tense Pronunciation for Regular Verbs (-ed)
-ed sounds like ‘t’ -ed sounds like ‘d’ -ed sounds like ‘id’
When a verb ends in When a verb ends in a When a verb ends

a in
voiceless sound, the voiced sound, the –ed a “t” or “d” sound
–
ed ending sounds ending sounds like “d”. already, the –ed
like
“t”. ending sounds like
“id” or “ud”.
A voiceless sound A voiced sound means

is when your your vocal chords
vocal chords vibrate.
don’t vibrate.
Voiced consonant
Voiceless consonant sounds
sounds
b, v, g, z, j, th, l, m, n, r
p, f, k, s, sh, ch, th
All vowel sounds are

voiced.
worked moved starte

droppe returne d
d d visited
3
3
Stonebrink, D. (2010). Past Tense Pronunciation for Regular Verbs Retrieved from http://www2.estrellamountain.edu/faculty/stonebrink/Esl021
2. The past tense verbs below are commonly used in a hospital environment.
Working with a partner, decide how the -ed ending is pronounced. Check
your answers with another pair and ask your teacher if you are unsure.
finished stayed engaged stopped transmitt

ed
studied coughed watched worsene attended
d
wiped dissolve infected leaked inserted
d
-ed sounds like ‘t’ -ed sounds like ‘d’ -ed sounds like ‘id’
3. Match the verbs to their phonemic transcription. Check the -ed endings and
practice with your partner.
1. finished a. /ɪnˈfɛktɪd/
2. transmitted b. /drɒpt/
3. attended c. /ˈfɪn.ɪʃt/
4. infected d. /əˈtɛndɪd/
5. coughed e. /kɒft/
6. inserted f. /trænzˈmɪtɪd/
7. dropped g. /ɪnˈsɜːtɪd/

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4. Review your understanding of the Past Simple and Past Continuous.
The past simple and past continuous tenses are used to talk about the past
Past simple
We use the past simple to describe a situation (an action, an event or
a state) which was true, or which happened at a particular time in the
past. It describes a situation which is not happening or not true now.
I checked Salam just before handover.
(= this action is now finished)
I had chemotherapy in 1998.
(= the patient had chemo more in that year, but it is finished now)
He was in quite a lot of pain when he first arrived.
(= it was true at that particular time; perhaps it is not true now)
+ statement He needed an X-ray.
- statement I did not need an X-ray
? question Did he need an X-ray?
Past Continuous
We use the past continuous to talk about a past activity that was in
progress at a particular time in the past:
At 8 am, I was eating breakfast.
`Where were you last night?' `I was sleeping.'
We use the past simple and past continuous together to talk about a
completed past event that happened when another activity was in
progress.
It started to rain while I was walking in the
park. I was watching TV when the phone
rang.
What were you doing when he arrived?
These sentences are often joined with while, when or as.

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5. Complete the sentences using the correct form of the past continuous. Check your
answers together with a partner.
a. Joanne.............................(make) a phone call to a patient when Cristina
arrived at work.
b. While he…..............................(sterilize) the tubes, he ran out of sanitizer.
c. They decided to go for a walk in the hospital gardens while the sun
…………………….. (still/shine)
d. I called the doctot this morning, but he didn't answer the phone.
…………………….. (He/see) another patient?
e. At 10pm last night, Manny…. . .(not/sleep).
He............................(talk) to his sister on the phone.
f. John had a car accident while he….........................(drive) to work. He
………………….. talk) on his mobile when he crashed into another car.
6. You are going to interview your partner. Ask your partner what he or she was doing
at the specific times mentioned. Swap roles so you are both asking and answering
questions.
8am this morning 9:30 am 12 noon 3pm on Tuesday

yesterday yesterday
5:30pm last night 7pm last night 10 pm on 12 midnight
Saturday
Example: What were you doing at 8am yesterday?

I was eating breakfast while I was getting ready for work.

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3.4 Read about Alternative Treatments for Depression
1. With a partner, discuss the following questions.
a. What are the symptoms of depression?
b. What are treatments for depression?
c. What advice would you give a friend who is suffering from depression?
2. Read the introduction to a text on alternative treatments for depression.

Which treatments that you discussed with your partner are mentioned in the
text?
Depression: Alternative Therapies
Alternative therapy for depression encompasses a variety of disciplines

that includes everything from diet and exercise to mental conditioning
and lifestyle changes.
A health treatment that is not classified as standard Western medical

practice is referred to as "alternative," or "complementary” or
“integrative.” Integrative therapy encompasses a variety of disciplines
that includes everything from diet and exercise to mental conditioning
and lifestyle changes. Examples of integrative therapies include
acupuncture, guided imagery, chiropractic treatments, yoga, hypnosis,
biofeedback, aromatherapy, relaxation, herbal remedies, massage and
many others.
There is some evidence that holistic treatment is effective for

depression. Using holistic psychotherapies can help patients go back to
the source of the depression in their lives and learn effective ways of
using tools to manage the symptoms and in many cases improve their
overall functioning.4

Page 59
4
Cleveland Clinic. (2020). Depression: Alternative Therapies. Retrieved from https://my.clevelandclinic.org/ health/treatments/9303-depression-
alternative-therapies

Page 59
3. Listen to your teacher and pronounce the following words.
alternative / ɒlˈtɜː.nə.tɪv / acupuncture /ˈakjʊˌpʌŋ(k)tʃə/
holistic /həˈlɪs.tɪk / yoga /ˈjəʊɡə/
therapy /ˈθer.ə.pi / chiropractic /ˌkʌɪrə(ʊ)ˈpraktɪk/
relaxation /riːlakˈseɪʃ(ə)n/ massage /ˈmasɑː(d)ʒ,məˈsɑː(d)ʒ/
integrative /ˈɪntɪɡrətɪv/ complementary /kɒmplɪˈmɛnt(ə)ri/
4. Match the words on the left to the correct definition on the right.
1. alternative (adj) a. a treatment that helps someone feel better, grow

stronger, especially after an illness
2. holistic (adj) b. the rubbing and kneading of muscles and joints of

the body with the hands, especially to relieve
tension or pain
3. therapy (n) c. dealing with or treating the whole of something or

someone and not just a part
4. relaxation (n) d. a thing that you can choose to do or have out of two
or more possibilities
5. acupuncture (n) e. based on the diagnosis and manipulative treatment

of the joints which are believed to cause
other disorders by affecting the nerves,
muscles, and organs
6. yoga (n) f. the state of being free from tension and anxiety
7. chiropractic (n) g. originating in India, this practice including breath

control, meditation and body postures, and is
widely practiced for health and relaxation
8. massage (v, n) h. a system in which fine needles are inserted in the

skin at specific points which is used in the
treatment of various physical and mental
conditions
.
E
nglish for Nursing 1 -
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5. Re-read the introduction. Highlight the words learned in the previous activity
and answer the questions below.
a. An alternative therapy is not classified as which standard medical practice?
b. What two synonyms for alternative are used in the text?
c. How are holistic treatments effective for depression?
6. Read the rest of the text and discuss these questions with a partner
a. What is integrative therapy?

b. What are some integrative therapies used to treat depression?
c. Herbal remedies
Before recommending any substance to treat reported depression or

mood imbalance, providers will take detailed medical history to look for
biochemical causes that may contribute to mood imbalance. The blood
tests may check levels of certain substances, such as Vitamin D and
folate, which may play a role in mood imbalance.
Of the wide variety of available herbal therapies, St. John's wort and
ginkgo biloba are the products most often used for treating depression.
St. John's wort has been used for medical purposes in other parts of the
world for thousands of years, despite the fact that it has not been
scientifically proven to treat moderate to severe depression. Ginkgo
biloba is thought to improve memory and other intellectual functions,
although the evidence is not consistent.
Any herbal supplement requires caution and should be taken only after
consulting your doctor. Your doctor can help you weigh the risks and
potential benefits so you can make an informed decision.

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Acupuncture
Acupuncture is an ancient Chinese method of healing that prevents and
cures specific diseases and conditions by sticking very fine, solid needles
into specific points on the body. Acupuncture stimulates the body's ability
to resist or overcome illness by correcting imbalances. It also prompts
the body to produce chemicals thatdecrease or eliminate painful
sensations.
In a recent clinical study, acupuncture has been shown effective in

decreasing depression at three months, compared to usual care. For
people who suffer from both pain and depression, acupuncture is better
than counselling and standard of care at reducing both symptoms.
Acupuncture is highly effective at treating pain, such as headaches;
menstrual cramps; and low back, neck, or muscle pain. It also can be
used to treat menopausal symptoms, allergy symptoms, and side effects
due to radiation and chemotherapy.
Massage
Massage uses touch to promote relaxation while decreasing tension and
stress. The release of serotonin and dopamine, and the decrease of
cortisol during a massage may help improve the symptoms of
depression, lessen pain and improve sleep. Massage supports the mind-
body connection, allowing for a better awareness of what is happening in
our bodies. Some variations of massage that can support the mind- body
connection and general relaxation are Swedish massage techniques,
Reiki, aromatherapy, and craniosacral therapies.
Guided imagery and relaxation

Guided imagery is a form of focused relaxation that helps create
harmony between the mind and body. Guided imagery coaches you in
creating calm, peaceful images in your mind—a "mental escape" for
therapeutic purposes. It can be a powerful psychological strategy to
enhance a person's coping skills. It can help people cope with—and
possibly overcome—stress, anger, pain, depression, and insomnia with
or without associated physical illness.

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Yoga
Yoga “meets you where you are,” even when you are depressed.
Practicing yoga teaches you breathing techniques that can help to
energize you when you are feeling down or to help calm you at the
times you may be feeling anxiety. The breath is the link between your
mind and your body. Changing your breath can help you feel better
mentally and physically. The postures and movements in yoga teach you
how to hold your body in a way that can make you feel stronger,
better able to breathe and function, and to create an improved sense of
overall well- being.5
7. According to the information in the article, are the following statements True or
False? Circle T or F next to the statements below.
a. Herbal remedies may contribute to mood imbalance.

T F
b. St John’s wort has been widely used for medical
purposes historically.
T F
c. Consulting a doctor before taking a herbal
remedy is unnecessary.
T F
d. Acupuncture is a better treatment for pain and depression
symptoms than counselling and standard care.
T F
e. Acupuncture is ineffective in treating the side
effects of radiation and chemotherapy.
T F
f. The increase in cortisol levels during a massage improves the
symptoms of depression.
T F
g. Guided imagery is a strategy that can help improve sleep. T F
h. People with anxiety cannot practice yoga. T F
5
Cleveland Clinic. (2020). Depression: Alternative Therapies. Retrieved from https://my.clevelandclinic.org/ health/treatments/9303-depression-
alternative-therapies

Page 64
8. Write a dialogue with a partner based on the following situation.
You are having a conversation with a friend who you know has depression.
He/she has seen a doctor and had blood tests, but also wants to find out
other things that people do to reduce the symptoms. He/she asks you what
you know about alternative therapies, trusting you because you are a nurse.
In the dialogue describe two alternative therapies and how they can be
useful for treating depression and other conditions.
You: Hi.............How are you feeling at the moment?
Friend: Oh….ok, I suppose. I saw the doctor like you suggested and told
her I’ve been depressed. We talked about taking medication and
counselling, and she did some blood tests.
You: That’s good. When will you get the results?
Friend: In a day or so. Hey… I was wondering… I don’t know if I want

to take medication or see a psychologist yet. What can you tell
me about other treatments?
You: Well,…
Friend
: You:
Friend
: You:
Friend
: You:

Page 64
4.1 Language for Assessing a Patient’s Condition
1. Match the equipment to the picture.
digital thermometer blood pressure cuff and monitor
scales pulse oximeter
1. ………………………... 2. ………………………...
3.. 4. ………………………...
………………………...

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2. Match the equipment with the correct function.
1. blood pressure a. weigh a patient

cuff
2. blood b. records blood oxygen saturation
pressure
monitor c. wraps around a patient’s arm
to take blood pressure
3. digital
thermometer d. takes a patient’s blood pressure
4. pulse oximeter
e. takes a patient’s temperature
5. scales
3. Listen to your teacher pronounce these words and repeat.
cuff /kʌf/ monitor /ˈmɒnɪtə/

thermomete /θəˈmɒmɪtə/ pulse /pʌls/
r
scales /skeɪlz/
oximeter /ɒkˈsɪmɪtə/
4. Quickly read the following dialogue between a nurse and patient.
Which of the equipment from the previous activity did the nurse use to check the
patient’s condition?
Nurse: Hello, Mrs Yulia. I’m Dewi. I’m on duty tonight and I’ll be
taking care of you. How have you been feeling?
Patient: Well, I have a sore throat and difficulty breathing. Could

you give me some medicine?
Nurse: Of course, but first I’ll need to assess your condition. Is
that ok? Patient: Sure.
Nurse: First, I’ll take your blood pressure. Can you put your arm out
straight so I can put the blood pressure cuff on, please?
Patient: OK (patient straightens arm, nurse adjusts cuff and looks at monitor)

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Nurse: (Machine beeps and the nurse records information on the chart).
That’s done. Now, can you hold out your hand? I’m going to
clip this lead onto your finger.
Patient: (Holds out hand) What’s that for?
Nurse: This will give me a reading of your oxygen
saturation. Patient: So, how’s it looking, nurse?
Nurse: Well, your blood pressure and oxygen saturation are normal,
but your respiratory rate is 26 times per minute.
Patient: What does that mean?
Nurse: It’s faster than normal which means that a doctor will need to
come andcheck you out. Then we can give you the right
medication to bring thatdown.
Patient: Ok, when can I get the medication?
Nurse: After the doctor’s seen you. Don’t worry, it won’t be long.
Patient: Thanks for your help.
Nurse: My pleasure. Don’t forget, if you need anything, just press the call
button.
Patient: Yes, sure.
a. What symptoms does the patient have?
b. What does the nurse check?
c. Which readings are normal?
d. Why does the doctor need to check the patient’s condition?

Page 68
6. Re-read the dialogue. Who says the following, Nurse (N) or Patient (P)?
a. How have you been feeling? (N)

b. Could you give me some medicine?
c. Of course.
d. Is that OK?
e. Can you put your arm out straight?
f. Can you hold out your hand?
g. How’s it looking?
h. What does that mean?
i. When can I get the medication?
j. Don’t worry, it won’t be long.
k. Thanks for your help.
l. My pleasure.
m. If you need anything, just press the call button.
7. Which of the expressions above are requests for something and which
are reassurances? Complete the table below.
Request Reassurance
Could you give me some medicine? Of course.

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8. Match the statement on the left with the most appropriate response on the
right. practice saying them with a partner.
1. How are you feeling a. She’ll be here shortly.

right now?
2. How long have you b. An hour or so.

been feeling like this?
3. Can you give me c. I will. Thank you, nurse.

something for the
pain?
d. I’m a little dizzy.
4. Is the doctor coming
soon?
e. Before I do that, I’ll just

5. Can you roll up
need to check your
your sleeve, condition.
please?
f. Thanks.
6. What does that mean?
g. Ok. Like this?

7. I’ll check in with you
again in 30 minutes.
h. Your blood pressure is a little
8. If you need low.
anything, please

Page 68
9. With a partner, write a dialogue between a patient and a Medical Technologist. The
patient has symptoms and is feeling stressed. The nurse has just commenced duty
and introduces herself/himself, asks how the patient is feeling and prepare to take
the blood samples. The Medical Technologist reassures the patient. The first line has
been written for you.
Nurse: Hello, ………………... I’m......................I’m on duty tonight and I’ll be

taking care of you. How have you been feeling?
Patient: Well, …
Nurse:
Patien
t:
Nurse:
Patien
t:
Nurse:
Patien
t:
Nurse:
Patien
t:
Nurse:
Patien
Page 68
t:
Nurse:
Patien
t:

Page 68
4.2 Grammar for the Present Perfect
1. With a partner, talk about things patients should or should not do before they
have surgery. Make a list in the space below.
For example: Don’t eat before surgery

Page 74
2. Now, read the descriptions of how we use Present Perfect.
Present Perfect Regular Verbs

We use the present perfect tense to ask questions or to talk about any
time in the past up to now.
To make a question
have/has + pronoun or noun + ever + past participle
“Have you ever visited a friend in the hospital?”
To answer a question
have/has + never + past participle
(negative) have/has + past participle
(positive)
“No, I haven’t. I have never visited a friend in the hospital.”

“Yes, I have. I have visited a friend in the hospital.”
With regular verbs, to form the past participle, add –ed to the
main verb. call  called
ask  asked
help  helped
talk  talked
walk  walked
visit  visited
Present Perfect Irregular Verbs
Some past participles do not end in –ed. Some past participles are spelled
differently in past tense. These past participles are irregular (not regular).
“Have you ever broken your

arm?“ “Have you ever had
surgery? “
Study the list below.
be was/were been  Have you ever been to the

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hospital? break broke broken  She has never
broken her leg.

Page 74
cut cut cut Have you ever cut your
 finger?
fall fell fallen They have never fallen down the
 steps.
go went gone I haven’t gone to the doctor in two
 weeks.
have had had Have you had your appointment
 yet?
see saw seen She hasn’t seen the doctor
 yet.
sit sat sat Have you ever sat in a doctor’s office for
 a long
time?
take took taken Have you ever taken
 medicine?
3. With a partner, choose three of the questions from above to ask your partner.
Practice using the present perfect with irregular past participles to ask and answer
questions.
Read the following dialogue between Nur and Nurse Aman. Nur has taken her sister
to hospital as she needs to have an operation. Nur discusses her sister’s medical
background with the nurse. Fill the gaps with the correct form of the verb in Present
Perfect.
Nurse: Good morning. I need to ask you questions about your sister’s
condition.
Has she had (have) any health problems in the past?
Nur: Yes. She has high blood pressure and heart disease. For the
past 10 years she (have) some problems with
asthma.
Nurse: How many years has she had these problems?
Nur: She
(manage) high blood pressure for 20 years
now.
Nurse: Oh ok. When was the last time she saw a doctor about her
medication? Nur: I know she (visit) her doctor
recently.
Nurse: And has she had any heart attacks or strokes?
Nur: Yes. Since she turned 40, she (suffer) 3 minor
heart attacks.
Nurse: Can you tell me if she had any operations for her heart or
any other problems?

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Nur: Yes. She (have) two operations for her heart. She
had one bypass surgery in 2000 and one in 2002.
Nurse: Has she been in the hospital for anything else?
Nur: No. She (have not be) in hospital for any other
issues. Nurse: Does she smoke?
Nur: No. She smoked before she had a heart attack, but she quit
recently. Nurse: That’s good to
know. Do you know if she has eaten anything today? Nur: Yes. I’m
pretty sure she (eat) breakfast
already.
4. Read the following descriptions of how we use Present Perfect for finding
out information about a patient’s past.
Present Perfect Questions
Present Perfect can also be used for asking questions about a patient’s
biography or medical history.
We cannot see the present result of this action or experience, but we are
interested in it now.
For example, use ever and/or before to mean at some time in the
past.
Nurse: Have you ever had an X-ray before?
(= do you have this experience in your medical
Patient Yes, I
: have.
Nurse: Have you ever had asthma before?
(= was there a time in the past when you had
Patient Yes. I have had asthma all my life.

: (= I had asthma when I was born and I have

Page 77
5. Work with a partner. Practice asking and answering questions. Ask follow
up questions to find out more information.
Begin your questions with “Have you ever …before?”
a. ….break a bone?
b. ….help a sick person?
c. ….sprain your ankle or wrist?
d. ….go to your GP more than once a year?
e. ….try alternative health therapy?
f. ….have an allergic reaction?
g. ….travel out of your home country?
h. ….administer medicine in an emergency?

Page 77
4.3 Read about Eating Well
1. Identify the foods below. With a partner, decide if they are a healthy food choice,
and why.

Page 77
2. Scan the text below for understanding. Circle the best title from the three
choices below. Write the correct title in the space provided.
a. The effect of beverages on people.

b. The impacts of an unbalanced diet
c. How to lose weight
……………………………………………………
Nutritionists classify food by groups. They say that the human body
requires a balanced mixture of food from all the main food groups:
carbohydrates, protein, fats, vitamins, fibre and minerals. The secret of
good health is to eat a balanced diet, with the right amount of food, and
to take plenty of physical exercise. When there is an imbalance – for
example if you eat too little or too much, or when one of the food
groups is missing from your diet - this can cause vitamin deficiency,
illness, and even death. If there is no treatment and the diet does not
change, death is a possibility. One example of this is the problem of
obesity – this is when a person is dangerously overweight. Obesity is
most common in developed countries. The imbalance comes from
eating a diet which is high in fat, sugar and salt, and in not eating
enough fruit, vegetables and fibre, and not burning the extra calories
through physical exercise. In the case of eating disorders such as
anorexia nervosa and bulimia, the imbalance leads to weight loss, when
a person eats less than they need. Sufferers are mostly teenage girls –
they either starve themselves in order tolose weight, or eat a lot of food
at once (binge-eating) and vomit up all the food later.They often end up
in hospital, and after emergency life-saving treatment they receive
psychiatric help and counselling.6

Page 77
6
Grice, T. (2011). Oxford English for Careers Nursing 1 Practice File. Oxford University Press

Page 77
3. Choose the correct meaning of the following words based on their use in the text.
1. obesity (n) /əʊˈbiːsəti/
a. the state of being very fat, in a way that is not healthy.
b. the state of being malnourished.
2. anorexia (n) /ˌænəˈreksiə/
a. an emotional disorder, especially affecting young women, in

which there is an abnormal fear of being fat.
b. a short coat with a hood that is worn as protection against rain,

wind and cold.
3. bulimia (n) /buˈlɪmiə/, /buˈliːmiə/
a. an emotional disorder in which a person repeatedly eats too

much and then forces him or herself to vomit.
b. an object which out from something in a round shape.
4. Based on your information in the text, are the following statements True or
False? Circle T or F next to the statements below.
a. Food is classified by nutritionists into three groups. T F
b. Eating too much of some types of food can lead to T F

c. health issues.
d. Anorexia and bulimia lead to weight loss. T F
e. The secret of good health is to eat healthy foods. T F
f. Obesity is most common in developing countries. T F

Page 8
5. Answer these questions below in the space provided.
a. What combination of foods do people need for a balanced diet?
…………………………………………………………………………………………..
b. What are the 2 key factors in maintaining good health?
…………………………………………………………………………………………..
c. What are 3 possible outcomes of an unbalanced diet?
…………………………………………………………………………………………..
d. What are 3 types of food we should be eating a lot of?
…………………………………………………………………………………………..
e. What are 3 types of food we should limit in our diets?
…………………………………………………………………………………………..
6. Match the meanings of the words below as the words are used in the text.
something that is done to cure an illness or injury,

or to make somebody look and feel good
mixture
a person who suffers from a
imbalanc
e disease a combination of
overweig different things
ht too heavy in a way that may be unhealthy
treatmen
a situation in which two or more things are not the
t sufferer same size or are not treated the same in a way

Page 82
7. Work with a partner to categorize the foods listed under the table into the correct
food group. Note some of the options may be dairy, but also contain a lot of sugar
and fat. This food should appear in 2 columns. An example is shown below.
Sugars,
Grains Vegetables Fruits Dairy Protein
fat, salt
ice cream ice cream
avocado lemonade muffin muesli Whole meal smoothie

bagel
peanut butter milk chocolate bar zucchini grapes
ice cream pasta pumpkin cabbage brown rice
broccoli oats cheese mayonnaise cream

cheese
croissant eggs watermelon canned tuna avocado
steak apple baked beans tofu curry lamb kebab

Page 82
4.4 Vocabulary to Talk about the Circulatory System
1. With a partner, complete the following facts about the heart with the most
appropriate answer from the box below.
fastest 1893 115,000 smallest 1958
7,200 3,500 a minute 100,000 Monday
a. Your heart will beat about times each day.
b. Your heart pumps about litres of blood every day.
c. The first open-heart surgery occurred in the USA in .
d. The first implantable pacemaker was used in .
e. The youngest person to receive heart surgery was old.
f. The earliest known case of heart disease was identified in the remains of a
-year-old Egyptian mummy.
g. The fairy fly, which is a kind of wasp, has the heart of any
living creature.
h. The American pygmy shrew is the smallest mammal, but it has the
heartbeat at 1,200 beats per minute.
i. Most heart attacks happen on .
j. If you were to stretch out your blood vessel system, it would extend over
kilometres.7
7
Healthline Media. (2020). Fun facts about the heart you didn’t know. Retrieved from https://www.healthline.com/health/fun-facts-about-the-heart

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2. Match the word on the left with the correct pronunciation on the right. Listen to
your teacher pronounce the words and repeat.
1. capillary a. /səːkjʊˈleɪʃ(ə)n/
2. vein b. /ˈeɪtrɪəm/
3. mitral c. /kəˈpɪləri/
4. circulation d. /veɪn/
5. tricuspid e. /ˈmʌɪtr(ə)l/
6. atrium f. /trʌɪˈkʌspɪd/
7. artery g. /eɪˈɔːtə/ /eɪˈɔːtɪk/
8. aorta, aortic h. /ˈɑːtəri/
9. ventricle i. /ˈsɛptəm/
10. septum j. /valv/
11. pulmonary k. /ˈvɛntrɪk(ə)l/
12. valve l. /ˈpʌlmən(ə)ri/

Page 82
Page 82
3. Match the anatomical feature of the heart on the left with its correct meaning on
the right.
1. aorta a. a partition separating two chambers of the

heart
b. the continuous motion by which the blood
2. atrium (pl. travels through all parts of the body under
atria)
the action of the heart.
c. the main artery of the body, supplying

oxygenated blood to the circulatory
3. artery
system. In humans it passes over the heart
from the left ventricle and runs down in
front of the backbone.
4. capillary d. any of the tubes forming part of the blood

circulation system of the body, carrying in
most cases oxygen-depleted blood
5. septum towards the heart.
e. any of the fine branching blood vessels that

form a network between the arterioles and
6. valve venules.
f. any of the muscular-walled tubes forming

part of the circulation system by which
blood is conveyed from the heart to all
7. vein
parts of the body
g. the valve between the left atrium and

the left ventricle of the heart, which
has two tapered cusps.
8. ventricle
h. each of the two upper cavities of the heart
from which blood is passed to the
ventricles. The right atrium receives
deoxygenated blood from the veins of the
9. mitral (valve) body, the left atrium oxygenated blood from
the pulmonary vein.
i. a membranous fold in a hollow organ, such as

a blood
English vessel
for Nursing 1- which maintains the flow of
Page 82
j. denoting or relating to a valve formed of
10. tricuspid three triangular segments, particularly that
(valve)
between the right atrium and ventricle of the
heart.
11.
pulmona k. a hollow part or cavity in an organ; each of
ry the two main chambers of the heart, left and
(valve) right.
l. the semilunar valve between the left

12. aortic (valve) ventricle and the aorta.
m. the semilunar valve of the heart that lies
13. circulation between the right ventricle and the

pulmonary artery and has three cusps

Page 82
4. In pairs, match the names of heart parts with their location.
mitral right atrium septum tricuspid valve right ventricle

valve
left left atrium aortic valve pulmonary valve
ventricle

Page 89
5. Read the text below ‘Parts of the Heart’. Find 8 mistakes and correct them. The
first one has been done for you. Check your answers with a partner.
Parts of the Heart

fou
r
The heart is made up of six different blood-filled areas, and each of these
areas is called a chamber. There are two chambers on each side of the
heart. One chamber is on the top and one chamber is on the bottom. The
two chambers on top are called the capillaries. These are the chambers
that fill with the blood returning to the heart from the body and lungs.
The two chambers on the bottom are called the inferior vena cava. Their
job is to pump out the blood to the body and lungs. Running down the
middle of the heart is a thick wall of muscle called the aorta, which
separates the left side and the right side of the heart.
The atria and ventricles work as a team. The atria fill with oxygen, then
dump it into the ventricles. The ventricles then squeeze, pumping blood
out of the heart. While the ventricles are squeezing, the atria refill and
get ready for the next contraction. So when the blood gets pumped, how
does it know which way to go?
Well, your blood relies on four special veins inside the heart. Two of the
heart valves are the tricuspid valve and the aortic valve. They let blood
flow from the atria to the ventricles. The other two are called the mitral
valve and pulmonary valve, and they're in charge of controlling the flow
as the blood leaves the heart. These valves all work to keep the blood
flowing forward. They open up to let the blood move ahead, then they
close quickly to keep the blood from flowing backward.8
8 The Nemours Foundation. (2020). Your heart and circulatory system. Retrieved from https://kidshealth.org/en/kids/heart.html

Page 89
6. Read the text below ‘How blood circulates’ and fill in the gaps with words from the
box below (NOTE: two of the words are not needed in the text). Check your answers
witha partner.
How Blood Circulates
The blood moves through many tubes called arteries and veins, which
together are called blood vessels. These blood vessels are attached to
the heart. The blood vessels that carry blood away from the heart are
called (1) ....................................................................................The ones
that
carry blood back to the heart are called (2)
…………….
The movement of the blood through the heart and around the body is
called (3).............., and your heart is really good at it — it takes less than 60
(4)........................
to pump blood to every cell in your body. Your body needs this steady
supply of blood to keep it working right. Blood delivers (5).....to all the body's
cells.
The left side of your heart sends that oxygen-rich blood out to the
body. The body takes the oxygen out of the blood and uses it in your
body's cells. When the cells use the oxygen, they make (6)
and other
stuff that gets carried away by
the blood.
The returning blood enters the right side of the heart. The right
ventricle pumps the blood to the (7)

for a little freshening up. In the
lungs, carbon dioxide is
removed from the blood and sent out of the body when we (8).....What's
next? An inhale, of course, and a fresh breath of oxygen that can enter
the blood to start the process again. And remember, it all happens in
about a minute! 9
circulation oxygen arteries minute exhale
9 The Nemours Foundation. (2020). Your heart and circulatory system. Retrieved from https://kidshealth.org/en/kids/heart.html

Page 89
inhale veins lungs seconds carbon dioxide
10 The Nemours Foundation. (2020). Your heart and circulatory system. Retrieved from
https://kidshealth.org/en/kids/heart.html
Page 89
8. With your partner, write eight True or False statements about the parts of the heart
the circulatory system. Do not copy directly from the texts; use your own words.
Remember to write the correct answers below in the Answer Key.
When you have finished, test another group’s knowledge of the heart and circulation.
Test your knowledge by answering their questions.
Example The aortic valve is a valve in the human heart between the left
ventricle and the aorta.
1. .....................................................................................................................
.........................................................................................................................
2. .....................................................................................................................
.........................................................................................................................
3. .....................................................................................................................
.........................................................................................................................
4. .....................................................................................................................
.........................................................................................................................
5. .....................................................................................................................
.........................................................................................................................
6. .....................................................................................................................
.........................................................................................................................
7. .....................................................................................................................
.........................................................................................................................
8. .....................................................................................................................
.........................................................................................................................
Answer Key
1................... 5....................
... ....
2................... 6....................
... ....
3................... 7....................

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4.5 Writing a Process
1. In pairs, write as many words as you can about the topic of digestion. Remember
to write the part of speech (PoS) of each word (noun, verb, adjective and adverb).
DIGESTION

Page 91
2. With a partner, discuss the words in the table below and without using a
dictionary, write the meaning of the words in Bahasa Indonesian.
Word Phonemic transcript PoS Bahasa

Indonesian
/dʌɪˈdʒɛstʃ(ə)n/
a. digestion (n)
/dʌɪˈdʒɛstɪ/
b. digestive (adj
)
/ˈnjuːtrɪənt/
c. nutrient (n)
/ˈɔːɡ(ə)n/
d. organ (n)
/əbˈzɔːb
e. absorb (v)
/səˈlʌɪv(ə)ri ɡland/
f. salivary gland (n)
/ˈstʌmək/
g. stomach (n)
/bʌɪl/
h. bile (n)
/sɪˈkriːt/
i. secrete (v)
/ɪˈlɪmɪneɪt/
j. eliminate (v)
3. Listen to your teacher say each word and repeat each word after your teacher.

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4. Digestion is the way your body gets nutrients and energy from the food you eat.
Many organs help in digestion. Read the diagram below.

Page 91
5. Match the word for an organ on the left with the correct definition on the right.
Then, check your answers with a partner and practice pronouncing the words.
1. oesophagus /ɪˈsɒfəɡəs/ a. a long tube where nutrients are taken

from food
2. stomach /ˈstʌmək/ b. a tube where food goes down to

your stomach
3. small intestine /ɪn c. the organ that helps get rid of

ˈtɛstɪn/ harmful matter
4. large intestine /ɪnˈtɛstɪn/ d. a bag-like organ that helps dissolve

food
5. liver /ˈlɪvə/ e. the last tube where water is taken

out of eaten food

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6. In pairs, complete the chart below with the name of the correct digestive organ.
7. With your partner, write 20 verbs in the present tense that are used in describing
the digestive process. The first one has been done for you.
1. chew 11.
2. 12.
3. 13.
4. 14.
5. 15.
6. 16.
7. 17.
8. 18.
9. 19.
10. 20.

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8. With your partner, write the entire digestive process in humans, from food
entering the mouth to excrement exiting the body. Write in the present tense (150
words).
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................
...........................................................................................................................

Page 91
Module 3
Introduction to
the Hospital
5.1 Language for Admitting the Patient
1. In the following dialogue, a patient presents to Accident and Emergency with

back pain. Read the following dialogue on your own for understanding. Practice
the dialogue with your partner twice. Swap roles for the second practice.
Nurse: Hello. My name is Jennie, and I’m one of the registered nurses on
duty today. I’m going to assess you before we admit you.
Patient: Oh, hello Jennie.
Nurse: I see in your notes that you have back pain. Is
that right? Patient: Yes, I’ve got terrible back pain. It’s so
sore.
Nurse: Oh, that’s not good. Can you tell me how you hurt your back?
Patient: Yes, sure. I’ve got a little boy. He was crying in the next
room and I rushed to see why he was crying, but I slipped
over on one of his toy cars.
Nurse: Can you tell me where the pain is?
Patient: Well it’s mostly in my lower back. You know, right across my back.

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Nurse: And what’s the pain like?
Patient: It’s really awful. It’s so painful.
Nurse: What type of pain is it? Is it a sharp pain or a dull ache, for
example? Patient: It’s a sharp pain. It’s worse when I try to move.
Nurse: Okay. How would you rate your pain on a scale between 0
and 10? 0 is no pain, and 10 is the worst pain you’ve ever
experienced.
Patient: Oh, I’m not sure. It’s really bad but I’m not sure which number it
is.
Nurse: For example, 1 to 3 is a mild pain. It’s just a niggling pain that’s a
bit
annoying.
Patient: Well it’s more than that.
Nurse: 4 to 6 is considered moderate pain - when the pain

interferes with your daily activities. I mean when you can’t
concentrate on a book, or you find it difficult to get dressed
or have a wash. Pain that’s worse than that is severe pain.
That can be any number between 7 and 10.
Patient: I understand now. Actually, the pain is really bad. I would

rate it as an 8.
Nurse: Okay. I’ll explain what will happen now. The emergency doctor
will examine you first and you might have an X-ray. I’ll get
you some pain killers and some anti-inflammatories as well.
Patient: I’ve already had some pain killers. I took some at home, but they
didn’t do anything.
Nurse: We’ll give you some slightly stronger ones as well as

the anti- inflammatories.
Patient: That would be great. Thank you so
much. Nurse: You’re welcome. I’ll be back in a
minute.1

Page 99
1
Allum, V. (2014). English for Nurses: Back pain Admission. Retrieved from https://www.youtube.com/watch?v=siOhcYFMYP8

Page 99
2. In pairs, discuss the meaning of the following words used in patient assessment.
a. Registered Nurse
b. back pain
c. pain killers
d. scale
e. mild pain
f. moderate pain
g. niggling pain
h. severe pain
i. anti-inflammatories
j. recommended dose
3. Discuss with your partner the purpose of the following statements/questions.
a. Hello. My name is Jennie, and I’m one of the registered nurses on duty
today.
b. Can you tell me how you hurt your back?
c. Can you tell me where the pain is?
d. What’s the pain like?
e. How would you rate your pain on a scale between 0 and 10?
f. Okay. I’ll explain what will happen now.

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4. Now, write your own patient admission dialogue.
In pairs, write a conversation between a patient who having a blood test in the
laboratory and Medical Technologist. The Medical Technologist have to explain the
procedure on take blood sample to a patient.
Your questions will aim to determine how the procedure on drawing blood sample. And
also other questions such as:
 Have you ever had blood taken before? (If yes) How did it feel?
 How long ago was that?
 Are you scared of needles?
 Are you allergic to anything? (Ask specifically about latex, povidone iodine, tape.)
 Have you ever fainted when your blood was drawn?
 Have you eaten or drunk anything in the past two hours?
 How are you feeling at the moment?
Use the language in the dialogue above to help you.
Ensure you have a clear beginning and ending to your conversation.
When you have written your dialogue, practice role-playing with a partner. Take
turns to be patient and Medical Technologist. Record your dialogue on a mobile
device and listen to your own pronunciation. Afterwards, you will present your
dialogue to the class.

Page 99
Med Tech Hello. I’m......................................................, and I’m one of the Med
Tech/phlebotomist on duty today.
Patient ………………………………………………………………………………
Med Tech ………………………………………………………………………………
Patient …………………………………………………………………………………

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5.2 Grammar for Modals of Obligation and Advice
1. Look at the picture below. Discuss the questions with a partner.
a. Where do you think these people are?
b. What are they waiting for?
c. What rule are these people obeying in the photo?
English for Nursing 1 - Page

104
2. Discuss the expressions below and complete the table with the correct use for
each level of obligation.
must
should
could
Mild obligation, recommendation, can be substituted with “have

advice to”
Strong made as a often used with
obligation suggestion “if”
A possibility in decision making Can be substituted with “ought to” giving
advice

105
3. Below are the grammar rules for using talking about obligation, giving advice or
making suggestions. Read through the rules and check your understanding with
a partner.
Form of use
a. should subject + should + infinitive
b. shouldn’t subject + should + not (shouldn’t) + infinitive
c. must Subject + must + infinitive
d. must not subject + must + not (mustn’t) + infinitive
e. have to subject + have or has to + infinitive
f. don’t/doesn’t have subject + don’t have or doesn’t have to +

to infinitive
g. could Subject + could + infinitive without “to”
4. Use one of the above modals of obligation or advice, in the positive or negative
to complete the sentences below.
a. An obese person should reduce their daily kilojoule intake to

maintain their health.
b. You..................................exercise each day to keep your diabetes under
control.
c. A person with an infectious disease...................................mix with other
people.
d. A person with an infectious disease...................................stay at home
until they have recovered.
e. You..................................try another diet if this one does not suit you.
f. In Australia, people.....................................go outside to smoke.
g. In many countries, people don’t........................................to go to a pharmacy
for prescriptions.
h. The doctor told my brother that he.....................stay in the hospital
because he...............................have surgery on his arm.
i. The doctor told my sister that she could go home because she
………………………… have..................................surgery on her arm.

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5. Write sentences with must/ must not, have/has to or do/does not have to. Number
one has already been done for you.
Attend the night round to check if my patient’s results have arrived.
I must attend the night round to see if my patient’s results have arrived.
a. Put on my mask in the hospital area

…………………………………………………………………………………………
b. Check new patient’s temperature as she is very hot

………………………………………………………………………………………
c. Wash their hands before entering the hospital
…………………………………………………………………………………………
d. Keep distance at least 1.5 meters away from other people

…………………………………………………………………………………………
e. Isolate yourself for 14 days if you have been exposed to the virus
…………………………………………………………………………………………
f. Do a test immediately if you experience symptoms of the virus.
…………………………………………………………………………………………
6. Practice the following dialogue with your partner
Patient Nurse, I think I might have a fever. I feel cold and shivery!
And it has been three days since I got a cough.
Nurse Here, let me get a thermometer and check your temperature.
Mmmm.
Patient Do I have a
fever? Nurse Yes, you do.
Patient What is the reading?
Nurse It’s a bit high. Just over 38. Do you have a sore
throat? Patient Yes. A bit.
Nurse Have you been out of town
recently? Patient Yes. I went to Jakarta for a
business trip. Nurse Can you breathe
normally?
Patient Yes.
105
Nurse As a precaution, you must have a Rapid test for COVID-19
and the doctor will refer you to the hospital lab.
Patient Am I infected?
Nurse We do not know until we get the lab check, Until we get the
results, you have to follow all COVID-19 hospital procedures.
You have to socially distance from other patients, and
unfortunately you can’t have any visitors. You must wear a
mask at all times, and you should wash your hands frequently.
If the doctor says that he can leave, you must self- isolate at
home for 14 days.
Patient Oh my god. Okay, well that’s the way it goes.
Nurse You have to keep your body fit and you should eat healthy
food to increase your immune system.
Patient Yeah, I will. When will the doctor come?
Nurse Please wait, the doctor is on her way. You must not do
anything until the doctor checks your condition. You will be
fine.
Patient Yes, thank you. I'm so scared.
Nurse You're in good hands here! You’ll be okay.
7. Write 5 sentences about how nurses should look after themselves in a health
crisis. Example: I must wear PPE at all times while on duty.
a. ……………………………………………………………………………………………
b. …………………………………………………………………………………………...
c. …………………………………………………………………………………………...
d. …………………………………………………………………………………………...
e. …………………………………………………………………………………………...

105
8. Write 5 sentences about nurses who should look after others in a health
crisis. Example: I must wash my hands thoroughly after touching patients.
a. ……………………………………………………………………………………………
b. …………………………………………………………………………………………...
c. …………………………………………………………………………………………...
d. …………………………………………………………………………………………...
e. …………………………………………………………………………………………...

105
5.3 Reading about Admitting a Patient
1. In pairs, discuss the scenario in the image below.
2. Match the vocabulary with the definitions in the table below.
Vocabulary Definition
a. The part of a hospital designed for the
1. Patient admission treatment of people with health
problems who do not require a bed or
admission for
2. Emergency unit overnight care.
b. A patient’s documented history of
medical
3. Outpatient care with a health care provider.

department c. A unit of a hospital or a healthcare
facility where patients are
admitted for medical
4. Inpatient department
conditions that require appropriate care.
d. The room or department in a hospital
where
5. Medical record people who have sudden severe
injuries or health problems arrive.
e. The process of accepting someone
into a hospital, clinic, or facility for

105
3. With a partner, discuss which of the following would take place during a patient’s
admission to hospital? Tick the sentences with your choices.
a. The patient’s medical history is taken.
b. The patient’s identity (ID) bracelet is taken off.
c. The patient’s signs and symptoms are noted.
d. The patient is sent home and told to call later.
e. The patient is given the doctor’s phone number.
f. The patient changes into a hospital gown.
g. The nurse prepares the patient for surgery.
h. The patient’s medical record is signed off.
4. Read the following text. Check how many of your answers above are mentioned in the
text. In a small group of students, decide on the best title for the following text. Write
the title in the space provided below.
………………………………………………………..
There are several Duties and Responsibilities of the nurse during

patient admission. The patient can be admitted in the hospital from the
outpatient department (OPD) room or in the Emergency Unit. The
patient will get early examination or emergency treatment before the
patient is transferred to a suitable ward for admission or inpatient
treatment. The admission procedure will be recorded in the medical
record with the present medical history of the patient. The medical
record is noted at OPD containing etiology of disease and the patient
with admission papers duly signed by doctor-in-charge of admission
before being transferred to the inpatient department (IPD).
The duty nurse or nurse in charge in the ward is to take care of the
patient immediately and make the patient feel comfortable for
continuing treatment. The details of duties of a nurse while the patient
reports for admission are being described below:

105
● Receive the patient with courtesy.
● Facilitate the patient mobility
● Help the patient to prepare for doctor visits
● Preparing the patient comfort in the bed
● Make notes about the number, time and date of receipt of patient,
names of relatives or telephone number etc. On Temperature
Pulse Respiration (TPR) chart only name and bed number
● Prepare informed consent form for immediate surgery (take
signatures of patient or relative for anesthesia).
● Provide all nursing equipment like urinals, bed pans, feeding

cups etc., if patient needs.
● Take vital sign monitoring of the patient and note it in the patient's
chart.
● Ask the important advice from doctor
● Take diet monitoring of the patient and note it in the patient's chart.
● Monitor the treatment i.e. medicines, fluid etc.
● Prepare for diagnostic examination
● Prepare the patient for surgical preparation
● Provide the personal hygiene care for the patient
● Keep the patient safety and sterile
● Facilitate communication with family
● Manage the visitors coming
● If any medicine is to be purchased from the market, give a
slip to the attendant's relatives.
● Introduce the patient to the hospital environment, especially adjacent
to bed.2
2
Sam, A. (2017). Duties And Responsibilities of The Nurse During Admission of Patient. Retrieved from
https://notesread.com/duties-and-responsibilities-of-the-nurse-during-admission-of-patient/

105
5. Decide if the following statements are True (T) or False (F) based on information
in the article. Check your answers with another student.
a. The patient will enter the hospital during admission from T F

the outpatient department (OPD) room or from the
emergency unit
b. The patient will be transferred directly to a suitable ward T F
before admission
c. The patient’s admission form will be signed by the nurse T F

in charge before admitting the patient.
d. The medical record will specify the causes of any T F

disease if relevant.
e. After being examined, the patient will be transferred to T F

the outpatient department (OPD).
f. The family should prepare all the administration T F

forms during patient admission.
g. The duty nurse takes over patient care after admission. T F
h. The duty nurse facilitates communication with the T F

doctor during doctor visits.
i. After admission, the patient should be helped to T F

move if necessary.
j. The nurse will record the patient’s contact details. T F

105
5.4 Vocabulary to Talk about Measuring Vital Signs
1. What vital signs are usually measured when you visit the doctor? With a partner,
think about the last time you went to the doctor. Discuss which of these, if any, were
measured.
a. Temperature
b. Pulse
c. Respiration
d. Blood Pressure
Discuss with the class why doctors want this information? What is the purpose of
this information?
2. Answer the questions below with your partner.
a. Which 2 body measurements are used to calculate Body Mass Index (BMI)?
………………………………. and …………………………….
b. Fill in the gaps below to complete the BMI formula.
Body Mass Index = ………………. (kg) ÷..................(㎡)
c. What does a person’s BMI indicate?
………………………………………………………………………………………………

105
3. The 4 main vital signs routinely measured by health practitioners are listed
below. Briefly note what information these vital signs provide to a doctor.
a. Temperature .……………………………………………………………………
b. Pulse .……………………………………………………………………
c. Respiration ……………………………………………………………
d. Blood Pressure……………………………………………………………
4. In pairs, briefly note what information the following indicators provide to a doctor.
a. pulse rate .…………………………………………………………
b. body weight .…………………………………………………………
c. body height .……………………………………………………………
d. blood pressure . ……………………………………………………………
e. respiratory rate .……………………………………………………………
f. body temperature .……………………………………………………………
5. With a partner, fill out the table below with the information.
a. Your partner’s body weight ……………….
b. Your partner’s body height ……………….
c. Your partner’s pulse rate ……………….
d. Your partner’s respiratory rate ……………….
MEASUREMENT YOUR PARTNER YOU
a. weight
b. height
c. pulse rate
d. respiratory rate

105
6. Read the following text, and with a partner, choose the best title for the text. Write
the correct title in the space provided.
a. The effect of blood pressure on health
b. How Is Blood Pressure Measured and What Do the Numbers Mean?
c. The symptoms of low blood pressure
……………………………………………………………..
When you visit your healthcare provider, a blood pressure measurement

is one of the most important routine tests you’ll have.
Blood pressure is the force exerted by your blood against your arteries. As
your heart pumps, it forces blood out through arteries that carry the blood
throughout your body. The arteries keep tapering off in size until they
become tiny vessels, called capillaries. At the capillary level, oxygen and
nutrients are released from your blood and delivered to the organs.
Types of Blood Pressure

There are two types of blood pressure: Systolic blood pressure refers to
the pressure inside your arteries when your heart is pumping; diastolic
pressure is the pressure inside your arteries when your heart is resting
between beats.
When your arteries are healthy and dilated, blood flows easily and your
heart doesn't have to work too hard. But when your arteries are too
narrow or stiff, blood pressure rises, the heart gets overworked, and
arteries can become damaged.
Measuring Blood Pressure

Blood pressure is measured with an instrument called a
sphygmomanometer. First, a cuff is placed around your arm and inflated
with a pump until the circulation is cut off. A small valve slowly deflates
the cuff, and the doctor measuring blood pressure uses a stethoscope,
placed over your arm, to listen for the sound of blood pulsing through the
arteries. That first sound of rushing blood refers to the systolic blood
pressure; once the sound fades, the second number indicates the diastolic

105
pressure, the blood pressure of your heart at rest.

105
Blood pressure is measured in millimeters of mercury (mm Hg) and
recorded with the systolic number first, followed by the diastolic number.
For example, a normal blood pressure would be recorded as something
under 120/80 mm Hg.
Blood pressure readings can be affected by factors like:

▪ Smoking
▪ Coffee or other caffeinated drinks
▪ A full bladder
▪ Recent physical activity
Blood pressure is also affected by your emotional state and the time of
day. Since so many factors can affect blood pressure readings, you should
have your blood pressure taken several times to get an accurate
measurement.
What Is Normal Blood Pressure?

Experts consider normal blood pressure to be less than 120/80 mm Hg.
Based on population data, about 42 percent of American adults have
normal blood pressure. At one point, blood pressure at or above 120/80
and less than 140/90 was considered normal to high; these numbers are
now considered pre-hypertensive. Blood pressure consistently at or above
140/90 is considered high blood pressure or hypertension.
Blood pressure normally rises as you age and grow. Normal blood
pressure readings for children are lower than for adults, while blood
pressure measurements for adults and older teenagers are similar.
Blood pressure can also be too low, a condition called hypotension.

Hypotension refers to blood pressure lower than 90/60. Symptoms of
hypotension include dizziness, fainting, and sometimes shock.3

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3 Everyday Health. (2020). How Is Blood Pressure Measured and What Do the Numbers Mean? Retrieved
from https://www.everydayhealth.com/hypertension/understanding/what-does-blood-pressure-
measure.aspx

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7. Fill in the missing information using one of the words provided below.
coffee hypertension blood pressure
sphygmomanometer hypotension
a. A person’s................................is often taken during a visit to the doctor.
b. is the term used to describe blood pressure
which is too high.
c. Drinking.........................may affect a person’s blood pressure reading.
d. is the term used to describe blood pressure which is too low.
e. A......................................is a device which measures blood pressure.
8. On your own, answer the questions below. Check your answer with a partner and
take turns to explain the meaning of each answer.
a. What is blood pressure?
…………………………………………………………………..
b. Name the 2 different types of blood pressure readings.
Explain what these 2 readings refer to.
…………………… ……………………………………………………………………..
…………………… ……………………………………………………………………..
c. Note 4 factors which can affect a person’s blood pressure reading.
…………………… …………………… ……………………
……………………
d. What is considered to be the normal range of blood pressure?……………
e. What blood pressure reading indicates hypotension?
……………………

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9. Examine the ‘Step-by-Step’ diagram below on your own.
Step-by-Step checking your blood pressure
a. Write down the instructions for each step. Check that

you have used the correct technical vocabulary for the
medical device shown.
b. Learn each step.
c. Work with a partner and take turns to explain to each
other the 8 steps of taking a blood pressure reading,
without referring to your notes.
1. …………………………………………………….
2. …………………………………………………….
3. …………………………………………………….
4. …………………………………………………….
5. …………………………………………………….
6. …………………………………………………….
7. …………………………………………………….
8. …………………………………………………….

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5.5 Writing a Hospital Notice
1. Discuss the following questions with a partner.
a. How important is it for a hospital to be clean and hygienic?

b. Who is primarily responsible for hygiene in a hospital environment?
c. How much time do nurses spend cleaning in a hospital or clinic?
d. How do staff find out about hygiene and cleanliness procedures?

2. In pairs, label each picture correctly. Use the given words in the box.
1…………………….. 2…………………….. 3……………………..
4…………………….. 5…………………….. 6……………………..
clinical waste bin soap dispenser disposable gloves

/ˈklɪnɪkəl weɪst bɪn/ /səʊp dɪsˈpɛnsə/ /dɪsˈpəʊzəbl glʌvz/
cleaning bucket cleaning bleach mop

/ ˈkliːnɪŋ ˈbʌkɪt / / ˈkliːnɪŋ bliːʧ/ / mɒp/

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3. The Ward Sister and the nurse on duty are discussing the result of a recent
hygiene inspection. Read the dialogue between the two nurses. Check any new
vocabulary with your partner.
Ward Sister: Good morning Nurse. I need to talk to you about the
hygiene inspection.
Nurse: Good morning Sister. How was our
score? Ward Sister: Unfortunately it was only
three out of ten
Nurse: Oh dear. That is terrible score. Unfortunately, the inspectors
came at a very bad time this morning. We were all very
busy.
Ward Sister: Well, I have their report here and I want to run through the
important things. For example, under 'Ward hygiene, it says
'Door handles are not regularly cleaned. Beds are not always
cleaned between patients. Toilets must be cleaned three
times a day, but they are only cleaned once a day. Floors
must be cleaned four times a day, but they are only cleaned
once a day.' Under 'Spillages of bodily fluids'. the report says
that the average time was thirty-five minutes to clean up a
spillage of urine. And it says 'Nurses' knowledge of MRSA is
good, but they don’t always wear gloves.
Nurse: We certainly need to improve, but we are very short
staffed at the moment.
Ward Sister: It also says here, 'Nurses must wash hands before putting
on gloves and after removing gloves.'
Nurse: Thank you Sister. We must improve hygiene practices together. 4
4. Why did the ward fail their hygiene inspection? Make a list of the major
problems below.
………………………………………………………………………………………………
………………………………………………………………………………………………
………………………………………………………………………………………………
………………………………………………………………………………………………

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………………………………………………………………………………………………
4 Grice, T. (2007). Nursing 1 Students Book. Oxford University Press: Oxford.

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5. Review the rules for modals of obligation. With a partner, match these examples
with rules that need to be followed in a hospital.
must We use must in rules and to say when things are

necessary.
mustn't / We use mustn't to say it is necessary that you do
must not NOT do something.
have to We use have to to talk about things that other people

oblige us to do.
don't have to We use don't have to to say something is not necessary.
need to We use need to to say it is necessary to do something
a. We must follow procedures more carefully = to say when …
things are necessary…..…
b. Sorry. I have to go. I'm on duty in ten minutes. = to say when

…………………
c. You must not forget to put gloves on= to say when.

………………………………
d. We need to clean the floors more often = to say when. …………………………
e. You don't have to wash her face. She can do it herself = to say
when………….………
f. All visitors must wash their hands before entering the ward. = to say when
……….………
6. With a partner, review rules for a hospital environment. Decide what level of
obligation is required for each rule. Check your answers with another pair and
discuss why you chose your answers
a. You...............................................wear a nurse’s uniform while on duty.
b. You................................................have a name tag on your uniform.
c. You'll.....................................mop the floor- there's been a spill.
d. The patient.....................................smoke after surgery. It won’t help his

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recovery.

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e. You.......................................the bins. They are full and overflowing. He
Ward Sister............................complete a hygiene report on a weekly basis.
f. You.................................fill the soap dispenser in the bathroom. It’s empty.
g. You.......................................turn off your mobile phone when you enter the
hospital.
h. You.................................change your gloves after contact with each

patient.
7. Imagine you are working in a hospital. The Ward Sister has asked you to write a
notice reminding nurses about good hygiene practice. Write a list of rules and
instructions for the nurses on your ward. Write at least 10 rules using a variety
of modals from above.
HOSPITAL NOTICE
1. You must report all spillages immediately.

2. All visitors have to leave the ward by 8pm.
3. Visitors should….

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6.1 Language for Giving Directions
1. With your partner, discuss the following questions with a partner.
a. Where do you think you would find a floorplan like the one below?
b. What would visitor do if they could not find the location of a
certain unit in the hospital?
c. Who could they ask for assistance?
d. What other forms of information may be available?
2. Find the words in the floor plan which correspond to the definitions
below. Write the words in the space provided.
1. a door or gate by which you can access a building or place ……………………
b. a person or office which accepts payments for hospital costs

……………………
c. department in a hospital which uses medical imaging to diagnose

and treat diseases ……………………
d. a place to pick up medications or medical supplies

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3. Use the expressions in the box to practice asking for directions around the hospital
in the floorplan.
“Excuse me. How do I get to the lifts please?”

“Pardon me. Where are the nearest toilets please?”
“Sorry to bother you, but. I’m looking for the Polyclinic. Can you direct me there?
4. Write your own questions asking for directions to the following places in the
floor plan. Use the language structure from the previous activity.
VIP Unit …………………………………………………………………
Nurse Station …………………………………………………………………
Canteen …………………………………………………………………
5. Use the language in the box below to direct a person to the following places in the
hospital floorplan. The person is at the entrance to the hospital. Write the
directions in the space provided.
Turn left/turn right at the Go past/around

…… …….
Walk down/along the The ,,,,, is on your
……. left/right.
The ……. Is opposite The ……. Is next to the …..
….. .
The …. Is between the …… and the ………
.
Lifts ………………………………………………………………………
Toilets ………………………………………………………………………
Polyclinic ………………………………………………………………………
Nurse Station ………………………………………………………………………
VIP Unit ………………………………………………………………………
Canteen ………………………………………………………………………

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6. You are going to draw a floor plan for a small hospital with a partner. Your
floorplan has 2 levels, and will include the following services and medical units:
Ground floor First floor
Carpark Nurses’ station
Information desk Medical imaging
Cafeteria Intensive care unit (ICU)
Cashier Respiratory unit
Gift shop Cardiac unit
Stairs Stairs
Restrooms Restrooms
Lifts Lifts
7. Work in pairs to create 2 short dialogues which involve asking and giving
directions, using the map you created in the previous activity. Practice speaking
the dialogue with your partner.
Try to use different language for each dialogue.
Dialogue 1: A patient who is being discharged from the Cardiac Unit

needs to pay the bill at the Cashier. Write a nurse / patient dialogue in
which the patient asks for directions and the nurse gives directions.
Your dialogue should be about 8 – 10 lines.
Dialogue 2: A visitor is at the Information Desk on the ground floor.

He wants to visit a relative in the Cardiac Unit and needs directions.
Write a receptionist / visitor dialogue in which the visitor asks for
directions and the receptionist gives directions. Your dialogue should
be about 8 – 10 lines.
8. Practice the speaking the dialogues with your partner.

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6.2 Grammar for Prepositions of Place
1. Read the descriptions below of why and how prepositions of place are used.
A preposition is a word which shows the relationship between a noun and the
other words in a sentence.
A preposition of place is used with a noun, pronoun, or noun phrase to show

direction or location (place).
A preposition of place allows us to be very specific when talking about where

an action takes place or when discussing important details when we
communicate.
Preposition Rules:
a. The subject and the verb always come before the preposition.
b. A preposition is always followed by a noun.
c. A preposition is never followed by a verb.
d. A preposition comes before its object.
Prepositions of Place
general specific
in on at
indicates inside an
indicates a indicates a
enclosed
space surface point
in spaces d places with on a surface a specific

an
plate, table, location
boundaries floor streets, addresses
neighbourhoo roads islands building
ds cities transportation corner of
countries home,
work

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2. Complete the following table with diagrams which show the meaning of
the preposition. The first answer has been done for you.
up down around from to across between through
to the
in front
behind above over under below towards right/left
of
of

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3. Look at the picture above with your partner.
Describe the location of the following people or objects in sentences using the most
accurate preposition. There may be different ways to describe where someone or
something is located. You are describing locations from your perspective.
a. the nurse The nurse is sitting behind the desk.

The nurse is to the left of the
picture.
b. the reception sign ………………………………………………………….
c. the door ………………………………………………………….
d. the woman ………………………………………………………….
e. the man ………………………………………………………….
f. the visitor at the desk ………………………………………………………….
g. the pot plant ………………………………………………………….
h. the window ………………………………………………………….

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4. Complete the table with the correct information
Part of
Vocab Definition
speech
pharmacy a place where medications are prepared and sold (n) ˈfɑːməsi/
a narrow passage or hallway leading to

rooms or other spaces
describing an area which has plenty of room
the place or point where two or more things

meet
a mechanism for moving people or
objects up or down to different levels
elevator noun adjectiv

e
/ˈspeɪʃəs/ intersection pharmacy
corridor spacious /ˈɛlɪveɪtə/
nou noun /ˈkɒrɪdɔː/

n
ˈfɑːməsi/ /ɪntəˈsɛkʃ(ə)n/ noun
5. Read the following dialogue and underline the prepositions of place.
Patient: Good afternoon, Nurse. Can you help me?
Nurse: Good afternoon. Yes, sure. What can I do for you?
Patient: I have to buy the medicine prescribed for me. But I can’t
find the pharmacy. I have walked around this unit several
times, but I can’t find it.
Nurse: Well, the pharmacy is on the first
floor. Patient: Can you show me how to
get there?
Nurse: Sure. You have to walk along this corridor until you find
the stairs, then go down to the first floor. Then turn right
until you find the intersection of two corridors. Turn left,
and you will see a spacious waiting room near the exit.
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The pharmacy is in the corner of the room, in front of the
payment counter.

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But if you use the elevator, you will get out at the
intersection and you won’t have to look for it. To get to
the elevator, from here, just follow this corridor. It’s on
your left, at the end of the corridor.
Patient: It seems faster by elevator,
right? Nurse: Yes, you’re right.
Patient: Ok. So, I need to walk down this corridor until I find
the elevator at the end. I go downstairs then I will
find the intersection. Turn left then I will find a
spacious waiting room close to the exit and the
pharmacy is in the corner, in front of the payment
counter. Have I got it right?
Nurse: Yes, you’ve got it.
Patient: Ok, thank you so
much Nurse: My pleasure!
6. Read the following case notes and use the correct prepositions to fill in the gaps.
on unde next to in next

r to to
to in up to outsid aroun on
e d
Mr. Diarta is being admitted ……. Sanglah hospital today, to undergo
an appendectomy tomorrow morning. The nurse takes Mr. Diarta
................................................................................................the
elevator
………….. his room and orients him..........the floor. The capacity of the room is
for two patients. His bed is located closest ……. the door. The bed....the
window, ……………. his bed is still empty. The bathroom is.....the corner of
the room. The light switch is …, the wall. The nurse station is just the room
and he can use the button to call the nurse. The television remote is the
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table, and, there is a small storage cupboard....this table.

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7. Complete the sentences below using the correct preposition.
a. My father was admitted to the respiratory ward which was …………
the fourth floor of the hospital, the East Wing.
b. The nurse wore a mask............her face.
c. The nurse placed the thermometer............the patient’s tongue.
d. The child minding center is.....the back of the building.
e. The delirious patient tore......his bandages.
f. The man arrived ……. a stretcher complaining of severe pain his head.
g. The telephone was connected.....his room.
8. In pairs, take turns to give your partner directions to a location on your campus.
Your partner will try to guess which location you are directing them to.
9. In a group of five, describe a place of interest or a landmark near your campus.

The students in your group will try to guess which location you are describing.

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6.3 Vocabulary to Talk about Hospital Departments
1. Think about a time you visited a hospital. Was it easy or difficult to find your
way around the hospital? Discuss your experiences with your partner.
2. Look at the list of hospital departments you would find on entering a hospital. Match
the department with its key role below.
a. dispenses medicine …..

……………………………………
b. specializes in the brain
and its
nerves…..
……………………………………
c. treats kidney diseases..
……………………………………
d. for labour and birthing

……………………………………

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e. for the elderly ….. ……………………………………
f. plans treatment programs and
physical exercises for patients …..
……………………………………
g. specializes in the health of the
heart…..
……………………………………
h. radiotherapy treatment for diseases
like cancer…
…………………………………
i. specifically for sick children…..

……………………………………
j. specializes in the health of kidneys,
bladder and adrenal glands…..
……………………………………
5
Grice, T. (2007). Nursing. Oxford University Press: Oxford.
130
3. Match the names of the following departments in a hospital to their stress pattern
below. When you are finished, listen to your teacher pronounce these words.
Then practise in pairs.
a. Cardiology
●●●
b. Neurology
c. Pediatrics
● ●●●
d. Pathology
e. Physiotherapy
●● ●●
f. Surgery
g. Gynecology
●● ●●●
h. Pharmacy
i. Radiotherapy
●●● ●●●
j. Oncology
k. Urology

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4. Complete the sentences by putting the places in a hospital into the sentence gaps.
Pathology Labour Room Pharmacy Surgery
Physiotherapy Cardiology A&E Oncology
a. My daughter is having a baby. Which way is it to...................please?
b. My friend was in a serious crash on his bike. He arrived in the
ambulance a few minutes ago. Where is ?
c. Matima is in ……………….. now. The operation on her knee will take
about 3 hours.
d. My husband is meeting his cardiologist today. Could you direct me to
……………………., please?
e. I’m starting my chemotherapy treatments today. Which way is.............?
f. I need to pick up some antibiotics for my wife. Can you direct me to the
…………………….?
g. I’ve just finished my appointment with my doctor and he has asked me to

have
some blood samples taken. Where can I find...................?
h. My son had a terrible motorbike accident and is learning to walk again.
He is here today having therapy. Could you direct me to ?

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5. Prepositions of place are used to help describe the place where something is or
about movement from one place to another.
Look at the directions below which may be used to help a patient, their family member,
or a colleague in a hospital. By yourself, circle which preposition you think is correct and
then check with your partner.
a. Walk through / near reception, and take the lift to / at / in the third floor.
b. Go around / along / past this corridor, and it is the third door on / at the left.
c. If you go past / through / behind the swing doors, you will see the waiting room.
d. The toilets are at the bottom of / over the stairs.
e. Physiotherapy is in front of / opposite this department, so just go across /out of
the corridor.
f. Go past /down the restaurant and take the stairs up to / along /on the
second floor, and the ward is out of / opposite the lift.6
6
Grice, T. (2007). Nursing. Oxford University Press: Oxford.

130
6.4 Writing a Formal Email
1. Discuss the following statements about sending emails with your partner. Do
you agree or disagree? Why?
a. Be concise and to the point. Avoid long emails that are discouraging to
read.
b. You shouldn’t write in CAPITALS in letters, but this is ok in emails.
c. Leave the message thread in your email to save the recipient
time and frustration looking for earlier messages.
d. Proof-read your email before you send it.
e. Only copy in other people if they know why they are receiving a
copy of the message.
f. It is ok to use abbreviations and emoticons in work emails. 7
2. Match the following nouns used to talk about emails with their meanings.
Nouns Meanings
1. spam (n) a. confirmation that you have read

something
2. an attachment (n) b. the history of correspondence
3. a message thread (n) c. a combination of symbols, e.g.⌣¨

used in an email to express a
particular emotion.
4. read receipt (n) d. unwanted emails, usually advertisements
5. an emoticon (n) e. a file, e.g. a document, photo or

computer program, which is joined
to an email
7
Lingahouse. (2020). Writing emails. Retrieved from https://www.linguahouse.com/esl-lesson-plans/business-english/writing-
emails

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3. Email language can be formal or informal depending on who you are writing to.
Decide which of the phrases below should be used in formal or informal writing.
I am writing to Can you ...? Just to follow up Don't forget to ...

inform you that ... from our chat
on ...,
I've attached for you How are I look forward Please be

... you doing? to seeing you reminded
on ... to…
Best regards…. See you soon So, I’ve included I hope this
your appointment email finds
time for you. you well.
FORMAL phrases INFORMAL phrases

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4. Scan the email below. Can you identify the parts of the email? Circle or underline
with a partner.
1. sender 2. salutation 3. subject line
4. signature block 5. email address 6. closing
From: admission@johnhopkinshospital
Subject: Reservation Mrs. Ramos OG-180619007
Date: 15 June 2020 13.20
To: sofia Ramos [email protected]
Dear Mrs. Ramos,
I hope this email finds you well.
I am writing to inform you that your booking via the Health.Mu

application on Monday, 15 June 2019 has been confirmed.
We can confirm your appointment for Wednesday, 18 June 2019 with

D. Ghulam Manar, Sp.OG (K) at Obstetrics unit. Your registration
number is OG-180619007. Prior your medical check, please show your
registered ID at the Polyclinic admissions desk.
Please find attached directions on how to find us:
UNIMUS Hospital
Jl. Kedungmundu No.18, Kedungmundu, Kec. Tembalang, Kota
Semarang, Jawa Tengah 50273, Indonesia.
The polyclinic is located on the third floor. From main entrance, follow
the corridor until you find an elevator. From there, go up to the third
floor. From elevator, turn left, follow the corridor, and you will find the
Obstetrics unit on your right after the pharmacy.
The clinic is well sign posted. Please do not hesitate to ask one of our
friendly staff for assistance should you require it.
Best
regards,
Annisa
Admission team

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5. Read the email again and then answer the questions.
a. What is the purpose of the email?
b. Is the email formal or informal? How do you know?
c. How has the patient been addressed in the email?
d. What important information has been included?
6. With a partner, write a formal email welcoming a new nurse to your ward.
Provide information for their first day including what time to arrive and how to get
your new ward in the hospital complex.
In your email, include
a. a well-constructed subject line

b. brief, direct and formal writing including salutations and closing
c. timelines for actions and responses when necessary.
d. a clear layout for readability
e. an email signature
Ask your classmate to reply to your email.

130
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7.1 Vocabulary to Ask about Places in a Hospital
1. Discuss the scenes in the images below with your partner.

Without using a dictionary, identify each department and match with the following names.
Write the names in the spaces provided.
Waiting Room Neurology Pharmacy Outpatient clinic
b. ………………………………………
a. …………………………………
c. ……………………………………… d ……………………………………

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2. Your teacher will say each word. Repeat each word together after your teacher.
outpatient clinic neurology (noun)

(noun)
/njʊəˈrɒl.ə.dʒi/
/ˈaʊt.peɪ.ʃənt/ /ˈklɪn.ɪk/
waiting room pharmacy (noun)

(noun)
/ˈfɑː.mə.si/
/ˈweɪtɪŋ ru:m /
3. Read the following dialogue between a nurse and a nursing student (NS) and
decide where the conversation takes place.
a. in a canteen
b. in a hospital
c. in the kitchen
NS: Good morning, Nurse. I’m a nursing student here.

Nurse: Good Morning. I’m the nurse in this hospital who looks after
student nurses. My name is Annisa. Can you tell me your
name? Are you new here?
NS: Oh sorry, I forgot to introduce myself. My name is Dewi. Yes,
Annisa, today is my first day here. Would you like to explain
more about this hospital to me? I need more information
about it.
Nurse: Because you are new, I’ll explain to you about the different
units in this hospital. This is the east wing, right. The Accident
and Emergency Department is near the entrance, with A & E
signs. This is a department where patients come without prior
notice.
NS: A & E … Accidents and Emergency. Ok yes, that’s clear, Annisa. What
about those who are not in danger?
Nurse: Well, patients who are not severely injured and whose life is
not in danger, are asked to consult a specialist at one of our
clinics for a detailed diagnosis. Can you see a large sign

130
saying 'Neurology' on your right?
NS: Neurology. Yes, I think I’ve heard of that before.
Nurse: Patients are sent there if their condition is related to problems
with their nervous system. Opposite is a sign which says
'Cardiology', where

130
patients suffering from heart disorders are sent. After assessing
a patient, the doctor may prescribe medications, which the
patient can pick up from the pharmacy at the end of the hall.
NS: Neurology on my right, Cardiology on my left & the Pharmacy at
the endof the hall. I’ve got that. What about people who only
come for treatmentbut are not admitted?
Nurse: We call these patients outpatients, and they go to the
Outpatient Clinic which is next to Cardiology.
NS: Outpatients. OK. What about people who are brought in after
accidents or with serious conditions, you know, when an
ambulance brings them in?
Nurse: Well, they are taken upstairs, where we will go now. This is
where patients with severe injuries or diseases are
transported. On your left you can see the operating rooms,
where surgery is performed.
NS: Pardon, could you repeat that please, Nurse?
Nurse: S U R G E R Y. That means when someone has an operation.
NS: Ok, surgery means operations. I’ve learnt a lot. Thank you Annisa for
all
of your helpful information.
4. Read the text again, and identify language which:
a. asks for information or

b. repeats information as confirmation of understanding or gives
further explanation
Put the expressions into one the correct column below. The first one has been
done for you.
Asking for Information Repeating
Can you tell me your name?

130
130
5. Practice the dialogue with another student. Take turns in the different roles.
6. Practice your pronunciation of the following vocabulary from the dialogue. Match
each phonetic spelling to one of the words below.
hospital department patient

danger system disorde
r
treatment lef send
t
a. /ˈhɒs.pɪ.təl/
b. /ˈdeɪn.dʒər/
c. /send/
d. /left/
e. /dɪˈsɔː.dər/
f. /ˈpeɪ.ʃənt/
g. /ˈtriːt.mənt/
h. /ˈsɪs.təm/
i. /dɪˈpɑːt.mənt/

130
7. Google a floorplan of a hospital in your local district. Use the plan to give directions in
the following activity.
Write a short dialogue for scenarios 1 & 2. Practice the dialogue with your partner.
Record the dialogue on a mobile device so that you can listen to your pronunciation.
Scenario 1:
You are working at the Information Desk on the ground floor at the
entrance of the hospital. Someone is asking you for directions to the
department where she is due to have an X-ray. Her English is not that
good, so you will need to explain and repeat information when she asks
you to clarify.
Scenario 2:
You are a medical technologist who has been asked to show a small
group of high school students who are thinking of studying Medical
Laboratory Technology, around the hospital. You will meet them at
the Entrance, and introduce yourself, and then guide them around
the hospital (or a part of it). Be sure to use accurate medical
language to explain to them about the different departments and
where they are in relation to each other(left, right, next to, upstairs
etc). Also, be ready to answer their questions.

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7.2 Grammar for Present Perfect and Past Simple
1. Explain the difference between the past simple tense and the present perfect tense
to another student.
past simple present perfect
past future past future

present present
Present Perfect Forms
Forming present perfect positive

subject + has/have + past participle.
He has been admitted to hospital.
Forming present perfect questions

(auxiliary) + subject + has/have + past participle
Have you been admitted to hospital?
The past perfect in the negative

subject + has/have not (hasn’t/haven’t) + past participle
They have not been admitted to hospital.
Present Perfect Uses
The present perfect is used to describe an event which happened in

past, but without reference to a specific time.
Time expressions such as this year/last month/since/today are often

used with the present perfect.

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2. Using the grammar rules above, complete the following table with the present perfect.
Tense Positive Negative Question

Present The nurse
Simple comforts the
patient.
The doctor didn’t
Past Simple
operate on him.
Present Have we been tested

Perfect for COVID?
3. Scan the article below. Choose the best title for text from the options
below. Write the title in the space provided at the top of the article.
a. Health Service for Coronavirus in Royal Liverpool Hospital

b. Coronavirus Medical Care in Royal Liverpool Hospital
c. Coronavirus: Royal Liverpool Hospital opens Unit
…………………………………………………………………..
Part of the new £335m Royal Liverpool Hospital will open earlier to help
patients recover from Covid-19.
On Monday 25 patients will transfer to a "step-down" unit where

mostly older people will be helped to regain their independence
before being discharged. Ultimately, up to 65 patients will be
cared for by a 130-strong team of medical, nursing and therapy
staff.
The hospital was due to open in March 2017 but has been beset
by problems, delaying its full opening until 2022. Carillion
collapsed in 2018 and building work on the hospital ground to a
halt in February last year.
'Amazing achievement'
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The building was found to have major structural flaws with three
out of its 11 floors requiring strengthening.
Chief executive Steve Warburton said the new unit did not mean
the rest of the new 646-bed hospital would open early, although
the unit could be expanded if needed. He said: "Our construction
partners and suppliers have worked quickly to create this
fantastic facility, but equally our staff have demonstrated their
ingenuity and innovation to plan the way in which they'll give our
patients the best possible care.
"It's an amazing achievement to have created this unit in such a

short time, and we're very grateful to everyone involved. "The
unit, consisting entirely of single-bed rooms, has been created in
what will become the Acute Medical Unit. Patients from the Royal
Liverpool University Hospital or Aintree University Hospital will be
transferred to the unit to support their recovery. Most of the
patients will be older people, who will then be returned to nursing
homes, care homes or their own home.8
4. Pronounce these words after your teacher. Then, identify the meaning of each
word by choosing the most appropriate definition below according to the text.
regain verb /rɪˈɡeɪn/
a. to get back something you no longer have, especially an ability or a quality

b. regain something (literary) to get back to a place that you have left
therapy noun /’θerəpi/
a. the treatment of mental illness by discussing patient’s childhood

b. the treatment of a physical problem or an illness
collapsed adjective /kəˈlæpst/
a. having fallen down or in suddenly, often after breaking apart

b. having failed suddenly or completely 9

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8
BBC. (2020). Coronavirus: Royal Liverpool Hospital opens unit. Retrieved from https://www.bbc.com/news/uk-england-merseyside-52483971
9
Oxford University Press. (2020). Oxford Learners Dictionary. Retrieved fromhttps://www.oxfordlearnersdictionaries.com/

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5. Complete the sentences below using Present Perfect tense or Past Simple tense
by circling the correct option. Check your answers with another student.
a. The hospital … (has been beset/was beset) by problems in March 2017.

b. Chief executive Steve Warburton said, "Our construction partners
and suppliers (have worked/worked) quickly to create this fantastic
facility”.
c. The hospital (has been/was) due to open in March 2017.
d. The new unit (did not mean/has not meant) the rest of the new 646-bed
hospital would open early, although the unit could be expanded if
needed.
e. The unit, consisting entirely of single-bed rooms, (has been
created/created) in what will become the Acute Medical Unit.
6. Choose the correct answer below by circling True (T) or False \(F) according to
the text. Check your answers with another student.
a. The hospital will open in 2022 . T F

b. Carillion failed in 2018 and construction of the hospital T F
ceased.
c. If required, the “step down” unit could be enlarged in the T F
future.
d. The “step down” facility will house only elderly people. T F
7. Match each verb below with the correct definition.
a. strength i. to move locations

en
ii. to become greater in size, number or
b. expand
c. iii. to come or go back from one place to
demonstrate another
d. iv. to show something clearly by offering
transfer evidence
e. return v. to become more powerful or effective

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8. Write 5 sentences using the verbs from the previous exercise in the present
perfect tense.
a.
b.
c.
d.
e.
9. Write a short set of discharge notes describing the medical treatment of a patient.
Your notes should include reasons for admission, recent treatment and medications
prescribed. Include sentences using either the present simple or present perfect
tense.

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7.3 Vocabulary to Talk about Health Professional Roles
1. Read the following text. Underline the words indicating nurse activities. The first
one has been done for you.
A Day in the Life of a Nurse
Nurses are highly trained members of medical staff. They use their
knowledge and skill sets to support patients through operations and
procedures, develop treatment plans and offer advice on outpatient
care. Most nurses have a varied schedule so a day in the life of a nurse
can include a wide range of duties.
Nurses work as part of a team of frontline healthcare professionals who

diagnose and treat patients in various settings. Nurses work with
multidisciplinary teams including surgeons, physicians, specialists,
assistants, technicians and other healthcare providers. Their daily
duties may include different tasks including taking patients' vital signs,
measurements, and medical histories. In another time, they can ask
about the patient's symptoms, perform physical examinations, or draw
blood samples. Other activities are like conducting diagnostic tests.
Further, the nurses possibly recommend care options to physicians,
administer medication, or maintain accurate and detailed records. If
necessary, they consult with other healthcare providers or educate
patients on how to manage their conditions. Providing emotional
support to patients and their families is another task.
Moreover, they implement and assess care plans or recommend

sources ofsupport for patients. For certain occasions, they share
relevant patient informationat shift change such as admissions,
discharges, and changes in patient's conditions, set up treatment
rooms. Parts of what they may do are sanitizing and assembling
medical equipment. Further, they may check and count medication,
assess patients and administer wound care and change dressings. 10

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10
Indeed Career Guide. (2020). A Day in the Life of a Nurse: Typical Daily Activities and Duties of a RN. Retrieved
from https://www.indeed.com/career-advice/finding-a-job/day-in-the-life-of-a-nurse

130
2. Write 10 activities nurses may do at a hospital.
a. take patient’s vital signs
b. …………………………………………..
c. …………………………………………..
d. …………………………………………..
e. …………………………………………..
f. …………………………………………..
g. …………………………………………..
h. …………………………………………..
i. …………………………………………..
j. …………………………………………..

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3. In pairs, match the nursing activity with the pictures below.
a. antenatal b. hecting c. wound care d. ROM

care
e. f. g. pre- h. breastfeeding
withdrawi diagnosi conference
ng fluid ng
sympto
ms
i. blood j. k. foot care l.

transfusion performi emotiona
ng ECG lly
supportin
g
1. …... 2. …... 3. …...

……………… ……………… ………………
4. …... 5. …... 6. …...

……………… ……………… ………………
7. …... 8. …... 9. …...

……………… ……………… ………………

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4. Look at Question 3 again. Where do nurses do these activities? Write the
possible places from the table below.
emergenc hospital ward materni ICU

y ty
departme polyclini
nt c
nurse station operating cardiac ward general
and surgery polyclinic
room
Nurse activities Rooms
a. ………………………………………………… ……………
b. ………………………………………………… ……………
c. ………………………………………………… ……………
d. ………………………………………………… ……………
e. ………………………………………………… ……………
f. ………………………………………………… ……………
g. ………………………………………………… ……………
h. ………………………………………………… ……………
i. ………………………………………………… ……………
j. ………………………………………………… ……………

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5. Study how the words above are pronounced. Your teacher will say each word and
you will repeat each word after your teacher.
Words Pronunciation
a. / əˈses /
1. assess (v)
b. / sʌkʃn /
2. suction (n)
c. / wuːnd ker /
3. wound care (n)
d. / æntiˈneɪtl ker /
4. antenatal care (n)
e. / nɜːrs ˈsteɪʃn /
5. nurse station (n)
f. / wɔːrd /
6. ward (n)
g. / ˈpɑːliklɪnɪk /
7. polyclinic (n)
h. / ˈsɜːrdʒəri ruːm /
8. surgery room (n)

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6. Go to the reading text ‘A Day in the Life of a Nurse’. In the table below, list 5 or
6 nouns, adjectives, and verbs and their meanings.
Nouns Meanings
Nurse a person trained to care for the sick, especially in a

hospital
Adjectives Meanings
Verbs Meanings

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7. With a partner, match the verbs below to one of the 5 possible stress patterns.
Once completed, confirm your answer by checking a dictionary.
Verbs Stress Patterns
a. assist (v)
●● ●
b. implement (v)
c. provide (v)
● ●●
d. assess (v)
e. develop (v)
●●●
f. request (v)
g. conduct(v)
● ●
assist (v)
h. consult (v)
i. educate (v)
● ●●
j. recommend(v)

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8 Complete the sentences with the verbs below. You can use each verb once
only. Remember to conjugate the verb for each sentence.
take insert draw dispose monitor
a. The nurse........................the patient’s heart rate regularly.
b. “I need to.......................................your vital signs to make sure that your

temperature, pulse, respiration and blood pressure are okay,” said the nurse.
c. It is necessary to........................blood from patients in a manner in which it

does not cause them any pain or complication.
d. Gently and quickly..............the needle into the chosen vein with a smooth
motion.
e. of the used needle immediately after using it on the patient.
9 Using the verbs from Exercise 8, write 5 of your own sentences to describe
hospital activities. Each sentence must have at least 15 words in it. The first one
has been done as an example
a. The nurse is taking care of the patient in the ward by monitoring

his blood pressure.
b. ……………………………………………………………………………………………
……………………………………………………………………………………………
c. ……………………………………………………………………………………………
……………………………………………………………………………………………
d. ……………………………………………………………………………………………
……………………………………………………………………………………………
e. ……………………………………………………………………………………………
……………………………………………………………………………………………

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10 On your own, write a short paragraph to describe a nurse’s usual daily activities in
a certain part of a hospital, for example, a surgical ward, operation theater or
nurse’s station.
11 Use at least 10 verbs to explain the nurse’s activities in your paragraph. Write in
the present tense. Check your spelling, grammar and punctuations carefully writing
a minimum of 100 words.
………………………………………………………………………………………..………..…
………………………………………………………………………………………..………..……
………………………………………………………………………………………..…………..…
…………………………………………………………………………………………..…………..
……………………………………………………………………………………………..…………
..…………………………………………………………………………………………..…………..
………………………………………………………………………………..……………..………
……………………………………………………………………………………..…………..……
……………………………………………………………………………………..……………..…
…………………………………………………………………………………..……………..……
……………………………………………………………………………………..……………..…
………………………………………………………………………………………..……………..
…………………………………………………………………………………………..……………
..……………………………………………………………………………………..………………..
………………………………………………………………………………………..…………

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7.4 Read about a Nursing Career
1. Discuss the pictures with a partner and decide which specialized field the nurses are in
from the choices below. Write the correct answers under each image.
geriatric nurse intensive care nurse theatre nurse
paediatric nurse flight nurse neonatal nurse
a. b.
…………………………………. ………………………………….
c. d.
…………………………………. ………………………………….
e. f. ………………………………….
………………………………….

130
2. Listen to your teacher say each of these words and repeat.
occupation (n) bound (to) (adj)
/ˌɒk.jəˈpeɪ.ʃən/ /baʊnd/
field (n) passionate (adj)

/fiːld/ /ˈpæʃ.ən.ət/
3. Match the words in column A with the meaning in the column B, without the use of
a dictionary.
A B
1. occupation a. having very strong feelings or emotions
2. bound (to) b. an area of activity or interest
3. field c. certain, most likely to
4. passionate d. a person’s job

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4. Choose the best title for the following article. Write the title in the space provided at the top
of the text.
a. Nursing Occupations
b. Which Nursing Career is Right for You?
c. Great Careers in Nursing
……………………………………………………………………………
Nursing is the fastest-growing occupation in the United States, due to factors

such as an aging population and a high demand for nurses. With so many
specialties to choose from within the nursing field, you're bound to find a
specialty you'll be interested in. Choosing a career in the nursing field will be the
right fit for you as long as you're passionate about helping people.
Neonatal Care
Neonatal nursing involves caring for new-born infants born with a variety of
problems, including prematurity, birth defects, infection, cardiac malformations,
and surgical problems. As a neonatal nurse, you may work in a hospital, but you
can also expect to work in the community, providing home care or follow-up for
high-risk patients.
LPN A licensed practical nurse cares for those who are sick, injured,
convalescent, or disabled. Being a licensed practical nurse requires you to
perform a variety of daily tasks, ranging from dressing wounds to feeding
infants. LPNs are in high demand and will grow 22% by 2020.
Holistic Nurse
As defined by the American Holistic Nurses' Association, holistic nursing is the
art and science of caring for the whole person. This practice recognizes the
totality of the human being -- caring about the patient's relationships,
spirituality, and overall well-being.
Occupational-Health Nursing
As an occupational health nurse, you provide for and deliver health and safety
programs and services to workers, worker populations and community groups in
order to identify health and safety needs in the workplace. It is typically a
Monday through Friday job, but may vary depending on your work environment,
position and responsibilities.
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Travel Nursing
Travel nurses fill in during shortages at hospitals and facilities. When full-time
nurses need a break, agencies pay for your living expenses to work on
assignments that typically last between 8-13 weeks in different parts of the
country.
Nurse Informatics Specialist

Nurse informatics specialists are at the forefront of changing technology in the
medical world, using their technical skills to setup and maintain hospital
11
networks.
5. Choose the right answer by circling True or False based on information in the text.
a. Demand for nursing is growing in the UK, due to an T F

ageing
population.
b. Neonatal nurses are able to work in more than one T F

location.
c. The demand for LPNs grew 22% in 2020. T F
d. Occupational-Health Nursing generally has regular T F

hours.
e. A travel nurse fills temporary vacancies in hospitals. T F
6. Write sentences of your own, related to the subject of nursing, using the vocabulary below.
All of these words can be found in your text in Exercise 5.
a. occupation (n) …………………………………………………………………
…………………………………………………………………
b. passionate (adj) …………………………………………………………………
…………………………………………………………………
c. caring (adj) …………………………………………………………………
…………………………………………………………………
d. hospital (n) …………………………………………………………………
…………………………………………………………………

130
11
Dressamed. (2016). What Nursing Career Is Right For You? Retrieved from https://vimeo.com/172148007

130
e. population (n) …………………………………………………………………
…………………………………………………………………
f. demand (n) …………………………………………………………………
…………………………………………………………………
g. career (n) …………………………………………………………………
…………………………………………………………………
h. provide (v) …………………………………………………………………
…………………………………………………………………
7. Discuss with a partner or in a small group which area of Medical Laboratory Technology
interests you the most and why? Share your ideas with the class.

130
7.5 Writing a Reflection
1. With a partner, brainstorm the different types of nurses that work in healthcare.
Compare your answers with another pair. How many types of nursing careers can
you list?
2. Scan the text “Nursing in Today’s World’ and rank these nursing jobs from highest to
lowest.
a. Nursing officers ………………………
b. Auxiliary nurses………………………
c. Student nurses………………………
d. Staff nurse………………………
e. Charge nurse………………………

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Nursing in Today’s World
Nowadays nursing is a career with a three-or four-year training,

qualifications, grades, unions and pensions. In some Western countries,
every nurse is on a grade. The grade depends on the nurse’s experience
and skills, and each grade has different responsibilities and pay.
On the bottom grade are unqualified auxiliary nurses who do the routine
work in the hospital wards. On the top grades are nursing officers, who
are usually administrators. Auxiliary nurses are on the bottom grades,
but student nurses get the lowest pay. However, students don’t stay at
the bottom of the pay scale forever.When they qualify, they start working
on a middle grade. As they gain moreexperience, they can get promoted
and move up the ranks to become a staff nurse,then sister or charge
nurse and perhaps eventually a nursing officer.
Many nurses work shifts, and they often work overtime to earn additional
income. After their basic training, many nurses choose to do further
study and become specialists in a particular field or area. Nurses can in
fact specialize in many different fields. For example, they can become
triage nurses working in Emergency Departments or psychiatric nurses
who treat the mentally ill. There are also health visitors who visit patients
in their own homes, practice nurses working in GP surgeries and also
midwives who deliver babies.
Many nurses say they do not get enough pay and respect for the work
they do. They say that the work is physically and mentally demanding
and that they work long hours and get very tired. However, nurses will
also say that there are many great rewards which have nothing to do
with money and that nursing is an incredibly satisfying career. 12

130
12 Grice, T. (2007). Nursing. Oxford University Press: Oxford.

130
3. Read the article again and decide if these sentences are true (T) or false (F).
a. The more responsibility you have, the higher your grade. T / F

b. Nursing officers are the same as auxiliary nurses. T/F
c. Students are paid less than auxiliary nurses. T/F
d. Many nurses say that the job is rewarding, but the pay is low. T/F
4. Look at the sentence starters in the box below.
Take turns to choose one of the sentence starters and complete the sentence about
yourself. Try to add as much detail as you can. Take turns to ask follow-up questions and
keep each other talking. Keep going until all the sentence starters have been used.
One day, I hope…. The subject I’m I want to be a nurse

studying at the because….
moment that I like the
most is……
In the future, I’d like What I really enjoy The hardest aspect of
to…..
about….. nursing is….
I’m particularly What I think is most Next year, I …

interested rewarding about a
in…… career in nursing is…..
An area of nursing An area of nursing I’d What I think I’m really

I’m wouldn’t like be interested in good at is….
to … is…

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5. Write 3 paragraphs related to your dream of having a career in nursing.
Follow the suggested plan below.
Paragraph 1: Explain why you aspire to be a nurse and outline the

qualities which you believe make you suitable for a
nursing career.
Paragraph 2: Describe the area of nursing which interests you,

and why. Explain how you are suited to this field
of nursing.
Paragraph 3: Outline the studies you will need to undertake in order to

qualify in this field. How many years will it take?
Swap your writing with other students and read their work. Is it similar or different to your
writing?
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..
……………………………………………………………………………………………………..

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8.1 Language for Giving Instructions and Commands
1. Look at the following pictures. With your partner, identify the items a nurse may use
when treating a patient.
a. .......................... b. ......................... c. ..........................
d. ......................... e. ......................... f. ..........................
What other equipment or instruments do nurses use when working? Make a list.

130
2. Read the following dialogue between nurses.
Laura is a head nurse in a surgical ward. In every morning shift, she leads
the morning meeting with her teams (night shift and morning shift) at
07.00 AM. Today, they will be discussing 3 patients.
Laura: Good morning team, how about our patients last night?
Sarah: In total, I am taking charge of 2 patients staying in room 1, but I
am goingto report one specific patient that is Mr. June. He is in
his post-surgery period for his right leg or femur dextra. Today
is his 3rd day in this ward, Ihave reported his condition to Dr.
Shinta and we have agreed on applying a further activity
treatment for him, so we will train him to sit on the bed and any
other possible mobility for the patient.
Laura: Thank you, Sarah, and how about your patient, Jack?
Jack: I have 2 patients last night, the patient Mr. Abraham in the 2 nd
room still has fever 39.50C since last night and the patient Mr.
Moore, being diagnosed with lung cancer stage 3, he stays in
the 3rd room, he told me that he feels nauseated and couldn’t
finish his meal.
Laura: OK, I please contact and discuss further with the physiotherapy to
handlethe patient in room 1, Mr. June. And according to his
medical record, he should get wound care this morning.
Ingrid, please take care of the patient in the 1st room for the
wound care and call the physiotherapist.
Ingrid: OK Laura, I will handle patients in the 1 st room. I plan to finish
wound carefor him around 9 Am so I think the physiotherapist
can work with him at 10AM. How about that?
Laura: OK, that sounds good. For the 2nd room patient, is it the time for
laboratorycheck? Please ask laboratory staff to withdraw blood for
the routine hematology (blood) test. Rico, I hand over this patient
to you. For the last patient, Mr. Moore he is with lung cancer
and hasn’t been eating very well for the last 3 days after his
chemotherapy, it’s time to gethis blood test as well and call the
nutritionist for nutrition treatment. Later we will observe and
see whether or not he’s ready for the radiotherapy. Vina, I hand
over the last patient to you!

130
Vina: OK Sarah. I will ask the laboratory staff to withdraw these 2
patients’ blood this morning. I will call the laboratory staff at
08.00 AM and the nutritionist, too.

130
Laura: Thank you, team, for this morning’s meeting. Take a rest for
the night shift and do your best for your morning shift.
3. Discuss these questions in pairs.
a. Who leads the meeting?

b. Whose patient is the one in the first room?
c. Does Jack have a patient with an eating problem and wound?
d. What will Nurse Vina do?
e. What equipment does every nurse need?
4. Reread the text and match the nurse with the patients he/she takes care and
their recent health conditions as below
leg surgery nauseated could not finish the food
needs blood check wound care suggested physiotherapy
Nurse Patients Health Conditions
Sarah
Ingrid
Jack
Vina

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5. Study the language expressions below to give instructions and commands.
The following sentences taken from the above conversation among nurses are
examples of giving instructions and commands
a. Ingrid, please handle the patient in the 1st room and call the
physiotherapist.
b. Please ask laboratory staff to handle it.
To give commands and instructions, we often use an imperative

a. Wash your hand before performing medical procedures.
b. Wear your mask well.
c. Do not forget to check her blood pressure before leaving the ward.
There are a number of ways to make instructions sound more polite.

We can add please at the end of what we say or before what we say.
a. Ask Max to sign this form and then send it off immediatelyplease, Gwyn.
b. Please tell the patient’s family to observe how Devi eats her breakfast.
c. Please report her progress immediately.
We can use an introductory phrase to soften the order/command.

For example, using a phrase instead of using an imperative. Here are some
common ways of phrasing an order, in order of the most indirect to the
most direct:
Would you mind possibly… (+ ing) (Most indirect)
Would you mind possibly moving the patient now? She is
starting to look uncomfortable.
I was hoping you could … (+ infinitive without to)
I was hoping you could spare me a few minutes this
morning. Do you think you could … (+ infinitive without
to)
Do you think you could do this photocopying
for me? If you have a couple of minutes
spare…
If you have a couple of minutes spare, the office needs tidying up.
I’d like you to…
I’d like you to file this correspondence for me.
I want you to…
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I want you to finish this by tomorrow. (Most direct)

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6. Read the language expressions to give instructions and commands. Repeat
and check with your partner.
a. Would you mind possibly… (+ ing) (Most indirect)

Would you mind possibly moving the patient now? She looks uncomfortable.
b. I was hoping you could … (+ infinitive without to)

I was hoping you could spare me a few minutes this morning.
c. Do you think you could … (+ infinitive without to)

Do you think you could do this photocopying for me?
d. If you have a couple of minutes spare…

If you have a couple of minutes spare, the office needs tidying up.
e. I’d like you to…

I want you to finish this by tomorrow.
7. Read the short dialogues below. With a partner, choose instructions or commands
for each example.
Head Nurse Linda …………………………………………………………………………
Nurse Jackie Sure, I’ll check the vital signs of the patient in the 1st
room now.
Nurse …………………………………………………………………………
Ingrid Patient 1 I have been feeling better this morning. Thank you.
Nurse Ingrid I want you to ………………………………………………………
Head Nurse I’m still waiting for another progress report by Dr

Kennedy. Can you wait for it?
Linda:
Nurse Laura …………………………………………………………………………
Nurse Sorry, I can’t do it right now because I’m going to assist

Vina the
patient in postpartum care. I’ll give you the list right

after that.

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8. In pairs or small groups, write your own dialogues giving instructions and
commands in the contexts below.
a. In a patient ward
b. In a surgical ward
c. In a nurse station

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8.2 Grammar for the Zero and First Conditional
1. Think about the following questions. List what happens if each circumstance
takes place. Check your answer with a partner.
If people always consume healthy food, ……………….
they are healthy.

they will not spend much money at the hospital.
If patients suffer from diabetes type 1, ………………
they need insulin injections.

they will regularly check their condition at the hospital.
2. Read the following text between Nurse Alea and a patient named Charles on
you rown. Then read it out loud in pairs.
Charles: Nurse, I think I might have a fever. It's so cold

in here! Nurse: Here, let me check your forehead.
Charles: What do you think?
Nurse: You feel a bit warm, right?
Charles: Yes.
Nurse: If you feel a bit warm now, I need a thermometer to
check. Charles: How do I raise my bed? I can't find the controls.
Nurse: Here you are. Is that
better? Charles: Could I have another
pillow?
Nurse: Certainly, here you are. Is there anything else I can do for you?

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If you can’t rest well, I will definitely get you something
else.
Charles: No, thank you.
Nurse: OK, I'll be right back with the thermometer.
Charles: Oh, just a moment. Can you bring me another bottle
of water, too?
Nurse: Certainly, I'll be back in a moment.
Nurse: (coming in the room) I'm back. Here's your bottle of
water. If you feel very thirsty, you drink the water
before I put the thermometer under your tongue.
Charles: Yes. (drinking the water)
Nurse: Please put the thermometer under your
tongue now. Charles: Thank you. (puts the thermometer
under the tongue)
Nurse: Yes, you have a slight fever. I think I'll take your blood
pressure as well.
Charles: Is there anything to worry about?
Nurse: No, no. Everything's fine. It's normal to have a bit of
fever after an operation like yours. The doctor will
discharge you soon if your condition improves gradually.
Charles: I'm so glad that everything went well, and I hope that
I can be discharged soon.
Nurse: You're in good hands here! If you need more assistance,
we are ready to help.

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3. Review the following explanations for the Zero and First Conditional Sentences.
Zero and First Conditional Sentence
Examples of conditional sentences from the above dialogues
1. If you feel a bit warm now, I need a thermometer to check.

2. If you can’t rest well, I will definitely get you something else.
3. If you feel very thirsty, you drink the water before I put the thermometer
under your tongue.
4. If you need more assistance, we are ready to help.
5. The doctor will discharge you soon if your condition improves gradually.
What number belong to zero conditional and what number belong to first conditional?
Use the following explanation to answer the above question.

All conditional sentences talk about a result that is dependent on a condition. The
sentences, therefore, have two parts, or clauses. In English, we use the word “if” to
determine the condition in the first clause, and the result (which depends on the
condition) in the other clause.
There are different types of conditionals, and in this unit zero conditionals, and first
conditionals are studied. We use these structures depending on how probable the
condition and its result are. See the table below for a rough guide.
Type Tenses in the two clauses Probability condition will happen
Zero conditional [If + present], + [present] 100% – will always happen.*
1st conditional [If + present], + [will] 50%-90%- will probably happen.
*For zero conditional, when can be used to replace if.

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4. In pairs, decide if the sentences below are written as zero conditional sentences
or first conditional sentences. Write Z for zero conditional sentences, write F for
first conditional sentences. Share your answers with other students.
Sentence Zero /First

Conditiona
l
1. If it rains, we’ll get wet.
2. If it rains, I will not go to the clinic for my routine

check-up.
3. If I eat more cheeseburgers, I will be sick.
4. If you don’t have money, you can’t buy anything.
5. If the temperature is below 0 Celsius, water freezes.
6. If I get sick, I will not attend my therapy session.
7. If today is Friday, tomorrow is Saturday.
8. If you come to my office, I will introduce you to

my co- workers.
9. They will give you herbal medicine if you don’t like

the
medicine your doctor prescribed yesterday.
10. Your parents will see the family doctor if they have
problems with their health.
5. Continue the sentences below using correct zero conditional.
a. If you eat fast food, ……………………………………………..
b. If you work well with other nurses, ……………………………………………..
c. When I work in a morning shift, ……………………………………………..
d. I always wash my hands if……………………………………………..
e. When the patients show their improvement, ………………………………………

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6. Continue the sentences below using correct first conditional.
a. If I meet Nurse Melati this afternoon,
…………………..…………………………………………………………….
b. If my night shift ends early, ………………………………………………..
c. The doctors will prescribe you another asthma medicine if
……………………………………………………..………………………….
d. I will lend you my key if …………………………………………………….
e. She will not get better if…………………………………………………….
7. Read the following dialogues between a nurse and a patient. Complete the
missing information using the correct conditional form.
Conversation 1
Nurse Now, hold on. I’m sure you’ll be alright if you..........(listen)
to your mother
Kid I want to see my friends. I miss them.
Nurse I know. I’m sure they miss you too. But you need to stay
for a while here if you want …………..….(be) healthy
again.. You can’t rush, or you might break your leg
again.
Kid How long will I use these crutches?
Nurse It......................(not be) long if you listen to my advice.
Kid Can I play with my ball again?
Nurse Sure. So, promise me?
Kid (no verbal response given)
Nurse Ok. goodbye.
Conversation 2
Mr.Sharma Good morning, nurse.
Nurse Good morning, Mr.Sharma. You look unwell again now.
What’s wrong with you? Did you sleep well last night?
Mr.Sharma I didn’t unfortunately. I have been suffering from fever
since
last night.

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Nurse If you have problems with your sleep again, you
……….…….(call) us. Okay? Do you have any other
symptoms?
Mr.Sharma Alright. I also feel headache and shivering.
Nurse Let me take your temperature. At this time, the
fever is 102 degree. Don’t worry. There is nothing
serious with you. I will give you the medicine
prescribed by the doctor, and you will be all right.
Mr.Sharma Thank you, nurse.
Nurse If your condition has no improvement, the doctor
………………. (observe) your condition again
and…...................(prescribe) you different medication.
8. Use either zero or first conditional to give advice in each of the medical
scenarios below. An example has been done for you.
Scenario Advice
Dealing with patient’s vomiting If you vomit, contact your doctor.
Taking insulin injection If you take insulin, ……………………….
Delivering chemotherapy ……………………………………………...
Asking the patient to lie down on the gurney ……………………………………………...
Offering help ……………………………………………...
Transferring a patient to a new ward ……………………………………………...
Checking vital signs of a patient ……………………………………………...
After drawing patient’s blood ……………………………………………...
Dealing with patient with low vision ……………………………………………...

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Explaining the medication taken by a patient ……………………………………………...
Informing the patient’s family about ……………………………………………...

post- treatment undertaken by the
patient
9. In pairs, write a dialogue from one of the above scenarios using correct zero
and/or first conditional sentences. Act it out in front of the class.

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8.3 Read about Medical Equipment
1. Talk with your partner. How many pieces of medical equipment – that you’ve had
experience using – can you name together?
2. Look at these pictures. Can you identify these items of medical equipment?
a. ……………………….. b. ………………………..
… …
c. ………………………..… d. ………………………..
…

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3. Scan the text and underline the vocabulary related to medical equipment. How
many items are mentioned? Check your answers with your partner.
Medical Equipment
When hearing the term 'medical equipment', a typical layman, whose

only knowledge about health care comes from an annual check-up at a
local surgery and TV shows such as 'House, M.D.' or 'ER', might think of
complex devices like a defibrillator, the star of the show in every scene
in which somebody's life is saved.
However, medical equipment might refer to both very complex devices

used by professionals as well as to simple instruments which you might
even use yourself. Let's see what equipment is used when you catch
influenza.
Imagine you wake up in the morning with a terrible headache, feeling

feverish. You quickly phone the boss and say you need a day off, then
grab a thermometer to take your temperature. Gosh, it's 102 degrees
Fahrenheit! You really need to go to the doctor. After you arrive at your
local clinic and wait some time in a queue, the GP asks you in. She asks
what is wrong and then puts a tongue depressor in your mouth to see
your throat. Then she asks you to take off your sweater and uses a
stethoscope to listen to your chest. Finally, she tells you that you have
caught the flu, prescribes you some medicine and says you must stay
at home for a couple of days.
As you can see, several pieces of equipment are used even in such a
common procedure like diagnosing flu, some of which you may even
have at home. What about other examples? Let's see what equipment
might be used in case of a broken bone.
It's mid-February and you are skiing in the Rockies. You are having an
amazing time, but you fall and feel terrible pain in both your shin and
your arm. You have probably broken your arm and your leg! It's so
painful you can't move so you call out mountain rescue. They come by
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chopper, put you on a stretcher, use a splint to immobilize your limbs
and take you to the hospital. You are told you have broken

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your leg and it's put in a cast. If you're lucky and your arm is not
broken, it's only wrapped in bandage and you have to wear a sling. As a
result, walking on crutches is out of the question, so you leave the
hospital in a wheelchair. But how do the doctors make sure your limb is
broken or not? Well, you have an X-ray taken.
What other gear is used in hospitals? Let's study a case of a person

brought to an A&E department with a head injury. The person is
brought by paramedics, who have already put a brace on his or her
neck in order to prevent further injury. Firstly, diagnostic equipment is
put to use in order to check the person's condition.
An MRI scan is taken to check for bleeding and swelling in the brain. If
immediate surgery is required, the patient is administered an anesthetic
by means of a syringe. Then a surgeon uses a scalpel to cut into his or
her body and forceps to manipulate the tissues. After the surgery is
performed, a catheter is inserted for the time when he or she is
immobilized.
Various types of medical equipment, ranging from basic tools to highly

advanced cutting-edge devices, are used in very different situations.
One thing is certain - each piece has been developed to help us recover
or even save our lives. And we might need them at the very beginning
of our lives - as is the case with an incubator, which is used in neonatal
units to help or treat prematurely born children.

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4. Match the following words from the text with their definitions. After checking with
your partner, your teacher will say each word. Repeat each word together.
Words Definition
1. thermometer a. a small piece of wood used by

/θəˈmɒm.ɪ.tər/ a doctor to hold someone's tongue
down in order to examine their
mouth or throat
2. tongue
depressor b. a device used for measuring temperature, esp. of
the air or in a person’s body
/ˈtʌŋ dɪˌpres.ər/
3. stethoscope
c. a long, firm object used as a support for a broken
/ˈsteθ.ə.skəʊp/
bone so that the bone stays in a particular position
4. stretcher / while it heals:
/ˈstretʃ.ər/ d. a piece of medical equipment that
doctors use to listen to your heart and
5. splint
lungs
/splɪnt/
e. a light frame made from two long poles with
a cover of soft material stretched between them,
5. Read the text again and answer the following True/False questions according to
the text.
a. A thermometer is used for measuring your body temperature. T / F
b. The doctor listens to your chest by using a stethoscope. T/F
c. An MRI scan is taken to check for the function of the brain. T/F
d. A tongue depressor is used to see your tongue. T/F
e. When you have broken on your limbs, a splint is T/F

used to immobilize it.

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a. What medical equipment is used when someone gets influenza?
b. How would a nurse help a patient with a broken leg?
7. Tell your partner about an experience you’ve had using medical equipment
during your clinical practice. Tell them what the situation was and why you had to
use it. Give as much detail as you can.

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8.4 Read about Items New Nurses Should Have in
Their Bag
1. In pairs, label each picture correctly. Use the given words in the box.
1…………………….. 1…………………….. 1……………………..
1…………………….. 1…………………….. 1……………………..
thermometer (n) reference book (n) micropore

medical tape
/θəˈmɒm.ɪ.tər/ /ˈref.ər.əns ˌbʊk/
(n)
/ˈmed.ɪ.kəl teɪp/
blood tongue depressor (n) torniquet (n)
pressure /ˈtʌŋ dɪˌpres.ər/ /ˈtʊə.nɪ.keɪ/
apparatus
(n)
/ˈblʌd ˌpreʃ.ər
ˌæp.əˈreɪ.təs/

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2. Read the following text entitled “14 Items That New Nurses Should Have in
Their Bag”. What is the most frequently used equipment by new nurse?
14 Items That New Nurses Should Have in Their Bag
If you are a nursing student or new nurse, you are probably wondering what you
will need in your work bag. Aside from your personal stuff, what are the things you
bring that signifies you are a nurse?
These nursing supplies listed below are a must if you want to do your job
efficiently. The most common supplies nurses have in their bags are:
1. Stethoscope
This is one of the most important tools of the trade. Nurses use this tool to
listen to things such as the heart, veins, and intestines to make sure proper
function. According to Best Stethoscope Reviews, here are the 6 best
stethoscopes to buy. As you surely know, it's one of the most important tools
for a patient's assessment.
One of today's leading stethoscope brands is Littmann. You can choose from
the classic style to the most advanced kind.
2. Books
A handy reference listing down common medicines and conditions. MIMS
provides information on prescription and generic drugs, clinical guidelines,
and patient advice. Nurses can also use Swearingen's Manual of Medical-
Surgical Nursing, a complete guide to providing optimal patient care.
3. Scissors and Micropore Medical Tape

Bandage scissors are used for cutting medical gauze, dressings, bandages and
others. Nurses need to have these in their pockets for emergency use,
especially for wound care. Micropore tape is also important and should be
readily available, for example, when your patient accidentally pulls his/her IV.

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4. Lotion and Hand Sanitizer
Nurses never forget to wash their hands several times throughout the day,
leaving their skin dry. That's why having lotion in their bags is important to
keep the skin in good condition. Meanwhile, the sanitizer helps nurses steer
clear of germs, along with other contagious agents.
a. Six saline flushes

b. Retractable pens
c. Sanitary items - gauze, sterilized mask and gloves, cotton balls
d. OTC pharmacy items (cold medicines, ibuprofen)
e. Small notebook - for taking notes from observations of your patients.
f. Thermometer
g. Tongue depressor
h. Tourniquet
i. BP apparatus
j. Watch with seconds hand
On Nurse Nacole’s website, she shares that she carries a drug handbook,
intravenous medications, makeup mirror, tape measure, towel, lotion,
wipes, 4 in 1 pen and a homemade cheat sheet for her patients. Also, in
Miss D Makeup's What's In My Work Bag Youtube video, she has a box of
batteries, tapes, a pack of gum, toothbrush, sanitizer, coupons, snacks,
umbrella, stethoscope, pens, folder of her report sheet and information
sheet, tampons, charger, name tag, ID, makeup bag, eye drops, lotion, hair
clips, highlighter, pen light, and journal.
So, What's in My Bag?

In my bag, I have a 4-in-1 pen, a highlighter, IDs, bandage, journal to write
some new information when I surf the net, my phone with medical e-books
and medical dictionary in it, and other stuff like alcohol, sanitizer, over-the-
counter meds (such as paracetamol, cold medicine, pain killers,
multivitamins), eye drops, handkerchiefs, floss, toothbrush, nail file, band
aids, and food.

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Aside from my knowledge in providing quality patient care, I also bring things
that can help me get through my shift. In an effort to make things more
compact and easier for a nurse to get access to, most common nursing
supplies are available in a portable kit. The size and styles are developing as
new ways of making a nurse's shift easier.
These are just few of the essential nursing paraphernalia that a new nurse
needs. 13
3. Write the meaning of these words. Use a dictionary if you need to.
a. efficiently (adv)
b. prescription (n)
c. guideline (n)
d. advice (v)
e. observation (n)
f. shift (n)
g. generic (adj
h. readily (adv)
i. essential (adj)
j. signify (v)
13 Diversity Nursing. (2020). 14 Items That New Nurses Should Have in Their Bag. Retrieved from
http://blog.diversitynursing.com/blog/bid/185999/14-Items-That-New-Nurses-Should-Have-in-Their-Bag

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4. Read the text again and answer the following questions.
a. What is stethoscope used for?
……………………………………………………………………………………………
b. What does the word “leading” in paragraph 2-line 4 mean?
………………………………………………………………………………………….
c. What does MIMS provide?
……………………………………………………………………………………………
d. Why do nurses need to have scissors and micropore medical

tape in their pockets? Give example.
……………………………………………………………………………………………
e. Why are lotion and hand sanitizer important for nurses to have?
……………………………………………………………………………………………
5. Work in a group of 3 and discuss the function and significance of each

medical equipment below for nurses. Write your answer in the given boxes.
Medical Equipment Function & Significance
1 Six saline flushes Function:

Significance for nurse:
2 Retractable pens Function:

3 Sanitary items Function:

4 OTC pharmacy items Function:

5 Small notebook Function:


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6 Thermometer Function:
7 Tongue depressor Function:

8 Tourniquet Function:
9 BP apparatus Function:
10 Watch with Function:

seconds hand
6. Work in pairs to read the following article. Answer the questions that follow the
text and discuss in groups.
Innovative Nursing Equipment
So, what do these new technological developments in nursing

equipment consist of? There are a range of devices available to
nursing teams, and all of these are important to know about.
Electronic patient records

Electronic patient records have been the norm in the healthcare sphere
for some time now. These online systems allow healthcare professionals
to access patient histories instantaneously, whilst tracking their
progress and checking the results of tests. Learning about EPRs is a
central part of nurse training.
Smart phone apps

Nursing apps are become increasingly important for nurses who work in
busy healthcare settings. These can be put to a variety of uses, from
contacting colleagues to checking information about medications and
conditions. Nursing apps can act as alternatives to consulting books or
senior members of staff every time a

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nurse is unsure of the next step. The Nursco App facilitates this with its senior
nurse adviser service, where nurses can contact a professional for advice.
Non-invasive diagnostic and monitoring tools

One area of technology that is certainly improving patient experience
is noninvasive diagnostic tools. These tools are used to help nurses
evaluate patients, without having to use traditional methods such as
probing and injecting. Not only does this make patients more
comfortable, it also lowers the risk of infection, and often delivers more
accurate results. Similarly, nurses can monitor their patients’ condition
wirelessly using chips and sensors that are integrated into beds and
bedding. These chips are able to report on blood pressure, movement,
weight and more during sleep. This extra element of observation is
intended to help patients avoid things like bedsores and falls. Nurses
will be alerted to changes in patients’ status and able to act quickly.
Medication trackers
A key aim of technology in nursing is to reduce the margin for human
error. Today, there are a range of medication trackers available, from
ventilators that measure the precise amount of medicine inhaled, to
implantable devices that administer medication depending on their
prescribed dosages. This means that patients can recover without
being disturbed by nurses unnecessarily – particularly valuable during
sleep.
Patient lifts
For many nurses, the introduction of patient lifting machines to the
ward will be a huge relief. Many facilities are adopting these machines
to aid nurses in lifting patients from bed to bed – often a difficult task
with heavier patients. This reduces a nurse’s chance of injury, and also
means that multiple nurses are not needed to simply move a patient,
freeing them up for other more pressing tasks.
Wireless Communication Systems

Some healthcare settings are now implementing wireless badges or
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headsets to integrate the purposes of outdated technology such as
phones and pagers into

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one integrated piece of tech. These wireless devices may have ‘smart’
capabilities,
enabling them to automatically route calls about certain subjects or

patients to specific nurses or use data from sensors and medical
equipment to report patients’ state. Not only do these devices reduce
response times from colleagues, but they also alert healthcare
professionals in case of an emergency, allowing nurses to act quickly.
Often, this can have a dramatic effect on patient outcomes, especially
in acute care wards.
GPS location services

GPS location services are vital for many nurses. Whereas once, nurses
had to spend precious time searching for important nursing equipment,
now, a chip or code embedded in the equipment allows them to
pinpoint the location of the equipment via GPS. This also prevents
equipment misuse, reducing funds being spent on repairs and
replacements of vital equipment. This technology can also be used to
protect patients suffering from mental illnesses or dementia. Integrated
into a wristband or badge, electronic tracking can help nurses see
where the patient is, and electronic borders can be set to alert
caregivers if the patient goes outside a set area where they may be at
risk14.
a. What are electronic patient records used for?
b. What are the benefits that a nurse gets in using smartphone apps?
c. Why is it important for nurses to use noninvasive diagnostic and monitoring

tools?
d. What benefits do nurses get with chips installed in their patients’ bed and
bedding?

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e. Mention two types of medication trackers and their functions?
14 Nursco Healthcare. (2020). How tech is revolutionising nursing equipment. Retrieved from https://www.nursco.com/revolutionising-nursing-
equipment/

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7. Based on the text “Innovative Nursing Equipment” in Exercise 6, answer these
questions with True (T), False (F) or Not Given (NG)
a. Electronic Health Records access the patients’ T / F /

history
immediately
NG T /
b. Novice nurses can consult all nursing problems
with the senior nurse by using nursing app
F / NG
c. Technology that can be used by patients to
invasive diagnoses tools
T / F /
d. Machine precision is very useful for reducing
human error especially in nursing field such as
ventilator measurement
NG T /
e. Patients lifting machine very useful for patients
with long bed rest for the first mobilization
F / NG
f. Wireless communication system important in
acute and chronic phase
T / F /
g. GPS can be used for tracking schizophrenia
patients
NG T /
F / NG T
/ F / NG

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Module 4
The Health Care

Process
9.1 Language for Requesting Personal Information
1. Discuss the following questions with your partner.

a. Have you ever been to a hospital or clinic when you are sick?
b. What information do you need to provide when being admitted to hospital?
2. Read the dialogue between a nurse and a patient. Underline sentences which have
a function of making requests, giving instructions or asking questions
Patient: Good morning.
Nurse: Good morning, can I help you?
Patient: I want to meet the doctor. I have felt dizzy for
three days. Nurse: OK. Let me write your data. What is your
name?
Patient: I’m Alisha.
Nurse: How old are you?
Patient: 22 years old.
Nurse: What is your address
please? Patient: 17 Sudirman
Street.
Nurse: What is your phone number
please? Patient:08187654321
Nurse: Are you single?
Patient: Yes, of course.
Nurse: What do you do?
Patient: I am a student in
college.

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Nurse: Who is your next of
kin? Patient: My father.
Nurse: What is your father’s name?
Patient: Mr. Adam.
Nurse: May I have your father’s ID card?
Patient: Sure, I will ask him (a few minutes later) Here, it is.
Nurse: OK thank you, Ms. Alesha. You can wait in the waiting room.
3. Identify the function of the sentence below based on the dialogue above. Discuss
your answers with your partner.
Sentence Function of the sentence
a. Can I help you? a question
b. Let me write your data.
c. What is your address please?
d. Yes, of course.
e. Please wait in the waiting room and I

will call you later.
4. Listen to your teacher pronouncing the words in the conversation below. Practise
the sentences in pairs.
Question Statement
What is your name? My name is Mrs Brown.

How old are you? I am 32 years old.
What is your phone number please? My number is 085-123-456-789
How do you feel? I feel dizzy.
Do you have any allergies? No actually.

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5. Below is a dialogue between a nurse and a patient. With your partner, arrange
these dialogue lines into logical order.
a. I am 20 years old.
b. How old are you?
c. I have a headache and a stomachache.
d. How do you feel?
e. I live in Mawar Street.
f. What is your name?
g. Where do you live?
h. No, I am married.
i. Your number please.
j. What do you do?
k. I am Olivia.
l. 081229911900.
m. Are you single?
n. What do you do?
Nurse: Good afternoon. What is your name?
Patient: ..........................................................
Nurse: ..........................................................
Patient: ..........................................................
Nurse: ..........................................................
Patient: ..........................................................
Nurse: ..........................................................
Patient: ..........................................................
Nurse: ..........................................................
Patient: ..........................................................

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Nurse: ..........................................................
Patient: ..........................................................
Nurse: ..........................................................
Patient: .........................................................
6. Complete the conversation between a nurse and a patient who is being admitted to
hospital. The patient wants to register for a medical checkup. The nurse asks for the
name, address, marital status, next of kin and reason for contact.
Nurse: Good afternoon, can I help
you? Patient:
...................................................
.......
Nurse: Is it the first time for you?
Patient: Yes, of course.
Nurse: ..................................................
Patient: My name is Johnson.
Nurse: ................................................
Patient: I live in Anggrek Street.
Nurse: ..............................................
Patient: I am 15 years old.
Nurse: ............................................
Patient: My father. His name is Mr Harry
Nurse: OK, please wait until I call you.
Patient: …………………………………………….
Nurse: You are welcome.
7. Imagine you have had a high fever for 2 days. You decide to go to the hospital to
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check your condition. Write a dialogue between yourself and a nurse, who on
admission asks for your personal information. Check your dialogue with a partner and
role play.

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9.2 Grammar for Present Simple and
Present Continuous
1. Read the conversation below and answer the questions which follow.
Nurse Angel: Good afternoon.
Nurse Anne: Good afternoon.
Nurse Angel: What are you
doing?
Nurse Anne: I am looking for a needle. Do you know where it is? I

need to give a paracetamol injection to the patient
in the Amanda Room. She has a fever of 41 degrees
Celsius.
Nurse Angel: Here it is.
Nurse Anne: Oh, thank you. The patient needs a quick

treatment to decrease their fever.
Nurse Angel: How old is he?
Nurse Anne: He’s 65 years old.
Nurse Angel: Does he feel out of breath?
Nurse Anne: Yes, he feels quite out of
breath.
Nurse Angel: Have you given him an oxygen
mask? Nurse Anne: No, but thank you for
reminding me.
a. What is Nurse Anne doing?

b. What happened to the patient?
c. How old is the patient?
d. Does he feel breathless?
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e. What is the solution for breathlessness?

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2. Read the conversation again.
a. Can you identify a sentence which uses the present simple?
b. Can you identify a sentence which uses the present continuous?
c. Why do we use these tenses?
3. In which of the following situations would we use a) present simple and b)

present continuous?
a. If we want to talk about a fixed habit or routine which usually doesn’t

change
b. If we talk about action which is happening now but will soon finish.
c. If we talk about a past event
4. With your partner, read the following sentences and choose the correct verb
form. Together, discuss why your answer is correct.
a. Look! He leaves / is leaving the room.
b. Quiet please! I write / am writing a nursing report.
c. She usually walks / is walking to the hospital.
d. But look! Today Dr. James goes / is going by bike.
e. Every month, we go / are going to the hospital to have a medical

checkup.
f. He often goes / is going to the physiotherapy clinic.
g. We play / are playing monopoly at the moment to reduce the patient’s

stress.
h. The child seldom cries / is crying.
i. I do not / am not doing anything at the moment.
j. Does he watch / is he watching the news regularly?

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5. Complete each sentence below using either the present simple or
present continuous.
Every morning, doctors and nurses................(go) to the hospital

Every morning, doctors and nurses go to the hospital.
a. Are you.............(come) tonight?
b. Does he.............(eat) rice every day?
c. I.............(work) at the moment.

d. Does he............(come) to hospital often?
e. He..............(play) tennis now.
f. He.............(not/play) golf now.

g. They.............(go) to a physiotherapy clinic every Saturday.
h. She..............(not/go) the hospital very often.
i. You usually............(arrive) late.
j. He normally............(eat) dinner at home.

k. Do you............(study) every night?
l. Do they............(work) late usually?
m. I..............(not/work) tonight.
n. Is she............(work) at the moment?
o. Julie.............(sleep) now.
6. Please fill the blank with the appropriate verb tense
This is Mrs. Tata. She is (be) a nurse in PKU Hospital. She _lives (live) in
Indonesia and ……………….. (be) married to John. They................(have)
three children. They all ……………….. (love) animals, but they...........(not,
have) any pets because they................(live) in apartment.

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Ms. White....................(work) for an international hospital. However,
she……………….. (not work) today, because she...............(not feel) well.
She has phoned in sick.
Dr. Brown’s son, Arnold……………….. (not like) shopping but he………………..
(love) hanging out with his friends. They usually............(go) to the local
park where they...................(play) football and basketball. Today, however
……………….. (not play) football and basketball; he….............(skateboard)

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9.3 Read about Taking Blood Pressure
1. Scan the article and decide which of the following statements is the most
accurate about the text.
The purpose of this text is to…
a. explain the meaning of blood pressure.

b. give advice to patients about keeping healthy.
c. explain how to take blood pressure with a manual device.
d. discuss the importance of taking blood pressure readings.
Taking Blood Pressure Manually

Check the condition of the device and the cuff size to ensure the
reading is accurate. A small hole or crack in any part of the device e.g.,
rubber tubing, bulb, valves, and cuff can lead to inaccurate results. A
cuff that is too small or too big may produce an incorrect high blood
pressure reading.

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It’s important the patient feels comfortable and relaxed. Reassure the patient that
there are no risks or complications associated with this screening.
Have the patient relax and sit with their arm slightly bent on the same
level as their heart and resting comfortably on a table or other flat
surface.
Place the inflatable blood pressure cuff securely on the upper arm
(approximately one inch above the bend of the elbow). Make sure the
cuff is touching the skin. You may have to ask your patient roll up their
sleeve or remove their arm from the sleeve. Close the pressure valve
on the rubber inflating bulb and pump the bulb rapidly to inflate the
cuff. The cuff should be inflated so that the dial reads about
30 mm Hg higher than your patient’s at-rest systolic pressure. (Tip: If
at-rest pressure is unknown, inflate the cuff to 210 mm Hg or until the
pulse at the wrist disappears).
If using a stethoscope, place the earpieces in your ears and the bell of
the stethoscope over the artery, just below the cuff. If the cuff has a
built-in stethoscope bell, be sure to position the cuff so the bell is over
the artery. The accuracy of a blood pressure recording depends on the
correct positioning of the stethoscope over the artery and making sure
the stethoscope bell does not rub on the cuff or the patient’s clothing.
Now slowly release the pressure by twisting or pressing open the

pressure valve, located on the bulb. Some blood pressure devices can
automatically control the rate at which the pressure falls, but generally
the patient’s pressure should decrease about 2 to 3 mm Hg per
second. Listen through the stethoscope and note on the dial when you
first start to hear a pulsing or tapping sound—this is the systolic blood
pressure. If you have trouble hearing the start of the pulse, you can
find the patient’s systolic blood pressure by asking your patient to tell
you when they can start to feel the pulse in their wrist and noting the
level on the dial.
Continue letting the air out slowly. The pulsing or tapping sounds will
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become dulled and finally disappear. Note on the dial when the sounds
completely stop— this is the diastolic blood pressure. Finally, release
the remaining air to relieve all pressure on your patient’s arm.

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Suggest the patient write down their numbers along with the date and
time. They can use the Team Up. Pressure Down. journal to keep track.
Remind the patient to take their blood pressure regularly to ensure
their medications are working appropriately1.
2. Read the passage again and answer the following questions. Check your
answers with a partner.
1. Where should the inflatable blood pressure cuff be fitted?

a. On the wrist.
b. On the upper arm.
c. In the bend of the elbow.

d. About an inch below the elbow.
2. Which one of the following statements is true?
a. The cuff must be pumped to inflate the cuff.

b. The pressure valve must be closed before pumping starts.
c. The dial should read dial about 30 mm Hg.
d. The inflated bulb should cover the wrist.
3. The accuracy of the blood pressure reading
a. Depends on using the stethoscope.
b. Is determined by the bell over the

artery.
c. Making sure that the stethoscope bell does not touch anything.
d. Depends on the what the patient is
wearing.
4. A nurse can hear blood pressure by listening for a tapping sound.

True/False?
5. There is only one type of blood pressure. True/False?

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1 Million Hearts. (2020). Hypertension Control. Retrieved from https://millionhearts.hhs.gov/files/HTN_Change_Package.pdf

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3. Use the information from the text to complete the following summary. Insert 1, 2 or
3 words.
Taking Blood Pressure Manually
When taking a person’s blood pressure, it is important to check that the

condition
of the device is a). ……………………, otherwise there could be
an b)
…………… in the patient’s blood pressure reading. Additionally, it is
necessary for practitioner to c) ……………. and d) the patient before
taking the reading.
The patient’s arm should be e)..........................with the heart and be
resting
on a f) …………….. surface. At the end of the process, the patient
should be encouraged to write down their blood pressure reading, as
well as noting g)
……………………………………. . Patients can h)......................their numbers
in the Team Up, Pressure Down Journal. It is important to remind the
4. Examine the diagram below which shows complications associated with hypertension.
Look up any medical terms you do not understand and discuss them with your partner.
Write down simple, everyday expressions to describe the technical language, for
example - hypertension = blood pressure

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5. Create a group presentation about Blood Pressure. It will be a short seven slide,
7- minute PowerPoint presentation. The information will be in bullet points, and
each slide will be titled as follows:
Slide 1: Introduction to
presentation Slide 2: What is blood
pressure?
Slide 3: What is hypertension?
Slide 4: Two types of blood
pressure
Slide 5: Complications of untreated hypertension
Slide 6: Risk factors
Slide 7: Managing hypertension with lifestyle

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changes Slide 8: References

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9.4 Read about Physical Assessment Techniques
1. In pairs, discuss the following questions
a. Have you ever seen a nurse do a nursing assessment?

b. Nurses use physical assessment skills to ..
i. Obtain baseline data
ii. Enhance the nurse-patient relationship
iii. Both of the above?
2. Match the following words with their definitions. Look up any words that are new.
Words Definition
1. temperature (n) a. a measurement of a child's head around

/ˈtɛmprəˌtʃuɚ/ its largest area
2. respiratory rate (n) b. quantitatively expressing hot and cold

/ˈrɛspərəˌtori ˈreɪt/
3. heart rate (n) c. the distance from the bottom to the top
/ˈhɑɚt ˈreɪt/ of something or the highest point or the
greatest degree.
4. blood pressure (n) d. a measure of the effect of gravity

/ˈblʌd ˈprɛʃɚ/
5. oxygen saturation (n) e. a distressing feeling often caused by

intense or damaging stimuli
/ˈɑːksɪʤənˌsætʃəˈreɪʃən/
6. pain (n) f. the fraction of oxygen-saturated

hemoglobin relative to total
/ˈpeɪn/
hemoglobin in the blood.
7. weight (n) g. the force of your blood pushing
/ˈweɪt/ against the walls of your arteries2
2 Cambridge Dictionary. (2020). Dictionaries. Retrieved from https://dictionary.cambridge.org/dictionary/

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8. height (n) h. the number of times your heart
/ˈhaɪt/ beats in 1 minute
9. head circumference i. measured by counting the number of

(n) breaths for one minute for how many
/ˈhɛd sɚˈkʌmfrəns/ times the chest rises
10. blood sugar level (n) j. a level for blood sugar test results
/ˈblʌd ˈʃʊgɚ ˈlɛvəl/
3. Read the text quickly and decide what the main idea of the passage is. Then circle
the best title from the three choices below and write it in the space provided.
a. Patient history
b. General appearance
c. Vital signs
d. Physical assessment
…………………………………………………………………………..
Baseline observations are recorded as part of an admission assessment
and documented on the patient’s observation flowsheet. Ongoing
assessments of vital signs are completed as indicated for your patient. It
is mandatory to review the VICTOR graph at least every 2 hours or as
patient condition dictates to observe trending of vital signs and to
support your clinical decision-making process.
Temperature: tympanic temperatures for children older than 6 months.

Less than 6 months use digital thermometer per axilla.
Respiratory Rate: count the child’s breaths for one full minute. Assess
any respiratory distress.
Heart Rate: Palpate brachial pulse (preferred in neonates) or femoral

pulse in infant and radial pulse in older children. To ensure accuracy,
count pulse for a full minute.
Blood Pressure: Baseline measurement should be obtained for every

patient. Selection of the cuff size is an important consideration. A rough
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guide to appropriate

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cuff size is to ensure it fits a 2/3 width of upper arm. For neonates
without previous hospital admissions do a blood pressure on all 4 limbs.
Oxygen Saturation: Monitor as clinically indicated. Note oxygen

requirement and delivery mode.
Pain: Use FLACC, Faces, numeric scale, Neonatal Pain Assessment Tool
as appropriate to the age group. Areas such as PICU and NICU use
specialized pain scales for intubated and sedated patients. E.g. Modified
Pain Assessment Tool (MPAT), Comfort B. Review current pain relief
medications/practices3.
4. Read the text and then answer the following questions together with your partner
Assessment Techniques
Whether you are performing a comprehensive nursing assessment or a

focused assessment, you will use at least one of the following four basic
techniques during the physical exam: inspection, auscultation, percussion,
and palpation. These techniques should be used in an organized manner
from least invasive to most invasive to the patient (Jarvis, 2012).
Inspection is the most frequently used assessment technique. When you

are using the inspection technique, you are looking for conditions you
can observe with your eyes, ears, or nose. For example, you may
inspect the patient’s skin color, location of lesions, bruises or rash,
symmetry, size of body parts and abnormal findings, sounds, and odors.
Inspection can be an important technique as it leads to further
investigation of findings (Jarvis, 2012).
3
The Royal Children's Hospital. (2020). Nursing assessment. Retrieved from
https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Nursing_assessment/

210
Auscultation is usually performed following inspection, especially with
abdominal assessment. The abdomen should be auscultated before
percussion or palpation to prevent production of false bowel sounds.
When auscultating, ensure the exam room is quiet and auscultate over
bare skin, listening to one sound at a time. Auscultation should never be
performed over patient clothing or a gown, as it can produce false
sounds or diminish true sounds. The bell or diaphragm of your
stethoscope should be placed on your patient’s skin firmly enough to
leave a slight ring on the skin when removed. Be aware that your
patient’s hair may also interfere with true identification of certain
sounds. Remember to clean your stethoscope between patients. The
diaphragm is used to listen to high pitched sounds and the bell is best
used to identify low pitched sounds (Jarvis, 2012; Edmunds, Ward &
Barnes, 2010).
Palpation is another commonly used physical exam technique, it

requires you to touch your patient with different parts of your hand
using different strength pressures. During light palpation, you press the
skin about ½ inch to ¾ inch with the pads of your fingers. When using
deep palpation, use your finger pads and compress the skin
approximately 1½ inches to 2 inches. Light palpation allows you to
assess for texture, tenderness, temperature, moisture, pulsations, and
masses. Deep palpation is performed to assess for masses and internal
organs (Jarvis, 2012).
Percussion is used to elicit tenderness or sounds that may provide clues

to underlying problems. When percussing directly over suspected areas
of tenderness, monitor the patient for signs of discomfort. Percussion
requires skill and practice. The method of percussion is described as
follows: Press the distal part of the middle finger of your nondominant
hand firmly on the body part. Keep the rest of your hand off the body
surface. Flex the wrist, but not the foreman, of your dominant hand.
Using the middle finger of your dominant hand, tap quickly and directly
over the point where your other middle finger contacts the patient’s
skin, keeping the fingers perpendicular.

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1. The most frequently used assessment technique is:
a. palpation
b. inspection
c. percussion
d. auscultation
2. How many nursing assessment techniques are described in the text?

1. one
2. two
3. three
4. four
3. What is the name of the technique that you can observe with your
eyes, ears, or nose?
1. inspection
2. auscultation
3. palpation
4. percussion
4. What technique that requires you to touch your patient with

different parts of your hand using different strength pressures?
a. inspection
b. auscultation
c. palpation
d. percussion
5. What technique is used to determine tenderness or sounds that

may provide clues to underlying problems?
a. inspection
b. auscultation
c. palpation
d. percussion

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5. Read the statements below and circle True (T) or False (F) for each statement.
a. You will use at least one of the four basic T/F

techniques during a physical exam.
b. Auscultation is the most frequently used T/F

assessment technique.
c. Palpation is usually performed following inspection. T/F
d. Deep palpation is performed to assess for T/F

masses and internal organs.
e. Percussion is used to determine tenderness or sounds. T/F
f. The diaphragm is used to listen to high pitched sounds. T/F
g. The bell is best used to identify high pitched sounds. T/F
h. In light palpation, you press the skin about ½ inch T/F

to ¾ inch with the pads of your fingers.
i. Deep palpation allows you to assess for texture, T/F

tenderness, temperature, moisture, pulsations, and
masses.
6. In groups, prepare a role play in which a medical technologist undertakes a

health assessment with a new patient.
Make sure to follow the correct assessment order when doing your assessment
(inspect, auscultation, percussion, palpation). Look at their belly first. Then listen with
your stethoscope for 15 seconds in each quadrant. Then percuss with your fingers.
And lastly, palpate by pressing lightly around their belly.

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9.5 Writing a Physical Assessment
1. Discuss the following questions with a partner

a. Have you ever seen a patient while she/he is being given a
physical examination?
b. Why did she/he have a physical examination?
c. What do you know about examination techniques?
2. In pairs, discuss the words in the table below and without using a dictionary,
write the meaning of the words
Words Pronunciation Meaning in Bahasa
1. examination (n) /ɪgˌzæmɪ'neɪʃən/
2. observation (n) /ˌɒbzə'veɪʃən/
3. visual (adj) /'vɪʒʊəl/
4. to detect (v) /dɪ'tekt/
5. physical data (n) /'fɪzɪkəl 'deɪtə/
6. gentle pressure (adj) /'dʒentəl/
7. deep pressure (adj) /'di:p/
8. significant (adj) /sɪg'nɪfɪkənt/

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9. characteristic (n) /ˌkærəktə'rɪstɪk/
10. to tap (v) /'tæp/
11. fingertips (n) /'fɪŋgə 'tɪps/
3. There are 4 types of assessment techniques used when doing a physical

examination. Read the text below and discuss the differences in the 4 techniques with
a partner.
ASSESSMENT TECHNIQUES
Physical assessment findings, or objective data, are obtained through

the use of four specific diagnostic techniques: inspection, palpation,
percussion, and auscultation. Usually, these assessment techniques are
performed in this order when body systems are assessed. An exception
is in the assessment of the abdomen, when auscultation is performed
prior to percussion and palpation, as the latter two can alter bowel
sounds. These four techniques validate information provided by a
patient in the health history, or they can verify a suspected physical
diagnosis. Inspection, palpation, percussion and auscultation are
examination techniques that enable the nurse to collect a broad range of
physical data about patients.
Inspection The process of observation, a visual examination of the patient’s body

parts to detect normal characteristic or significant physical signs
Palpation Involves the use of the sense of touch. Giving gentle pressure or
deep pressure using your hand is the main activity of palpation
Percussion Involves tapping the body with fingertips to evaluate the size,
borders, and consistency of body organs and discover fluids in body
cavities.
Auscultation Listening to sounds produced by the body.

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4. Based on the reading4 above, decide which technique would be most appropriate
for the examinations described below.
Activity Technique
a. inspecting a patient’s mouth and/or throat inspection
b. examining a patient’s respiratory system
c. asking a patient to stand up to examine for scoliosis
d. observing the colour of patient’s eyes
e. observing the movement of air through patient’s lungs
f. testing the patient’s deep tendon reflexes using a

hammer
g. checking the patient’s tender areas with your hand
h. pressing the patient’s abdomen deeply to check the

condition
of his/her internal organ
i. establishing good lighting, so you can observe the
patient’s
body parts
When you have finished, check your answers in groups and discuss with your teacher. Be
prepared to give reasons for why you chose your answer.
5. Below are 4 pictures showing different kinds of physical examinations. Discuss what
is happening in each picture with a partner. Try to use the vocabulary from exercise 2.
On your own, write a brief description of each examination
Start each description, by explaining what you are going to do. Use verbs in the
present tense.
4
Adapted from Pratiwi, I. (n.d.). English for the Professional Nurse (2 ed.). Malang: Muhammadiyah University of Malang.
nd

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First, I’m going to apply gentle
pressure……………
……………………………………………
……………………………………………
……………………………………………
It’s time for me to……………………….
……………………………………………
……………………………………………
……………………………………………
……………………………………………
To begin with, I’m going to….
……………………………………………..
……………………………………………..
……………………………………………..
……………………………………………..
………………………………………………
………………………………………………
………………………………………………

6. Choose one physical assessment technique from above. In pairs, do some more
research on this technique. Using the present tense, write a summary
explaining…
a. What the technique is;
b. When to use it;
c. How to do it.
Write a minimum of 150 words.

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10.1 Language for Responding to How a Patient
Feeling
1. With a partner, read the following dialogue between a nurse and patient aloud.
Nurse: Good morning, My Bayu. I’m nurse Dodi, and I’m in charge of this shift.
Patient: Good morning, nurse Dodi.
Nurse: How did you sleep?
Patient: I didn’t sleep well at all. I had some trouble breathing.
Nurse: Oh, that’s no good. So, how are you feeling today?
Patient: I’m feeling a bit better, but I’m still having some trouble breathing.
Nurse: I see. Well, maybe it’s better for you to sit in a half sit position.
Let me help. (The nurse helps the patient to sit in a half sit position). Do
you feel better now?
Patient: Umm…. yes, that feels a little more comfortable. What’s the latest on my
condition?
Nurse: Well, you’re having trouble breathing because there is a problem

in your lungs. I’m sorry Mr Bayu, but I can’t tell you the exact
problem before we do a physical examination. So, today at
around 10 am you are going to have a thorax x-ray.
Patient: I’m a bit nervous. You see, I’ve never had an x-ray before. Is it painful?
Nurse: No, it isn’t painful, and I’ll be there if you need any help.
Patient: That’s good. So, what will the x-ray show?
Nurse: Well, I don’t know exactly yet, but hopefully we can find out what the
problem
is. After the doctor sees the image of your lungs, she’ll explain it to you.
Patient: Well, ok.

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Nurse: Do you need anything, Mr Bayu?
Patient: No thanks. I’m ok right now.
Nurse: Don’t forget if you need any help whatsoever, please just press the call
button.
Patient: Yes, sure.
2. Answer the following questions about the dialogue.
a. Why didn’t the patient sleep well?

b. Has his condition improved today?
c. What assistance does the nurse give the patient to help him feel better?
d. What kind of physical examination will the patient undergo?
e. Why is the patient concerned about the examination?
f. Who will explain the findings of the examination to the patient?
3. Which of the following expressions from the dialogue are examples of…
a. a nurse checking a patient’s condition

b. a patient describing how he/she is feeling
c. a nurse reassuring a patient or
d. none of the above?
Match the expression a-d with the example, the first one is done for you.
For example. Good morning. (d)

1. How did you sleep?
2. I didn’t sleep well at all.
3. I had some trouble breathing.
4. Oh, that’s no good.
5. How are you feeling today?
6. I’m feeling a bit better.
7. I’m still having some trouble breathing.
8. I see.

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9. Do you feel better now?
10. That feels a little more comfortable.
11. What’s the latest on my condition?
12. I’m a bit nervous.
13. Is it painful?
14. I’ll be there if you need any help.
15. That’s good.
16. Do you need anything?
17. I’m ok right now.
18. If you need any help, please press the call button.
4. With a partner, write three appropriate responses to each of these cues.
a. How did you sleep?

Not too bad, thanks.
I couldn’t sleep much. It is so noisy in this room.

I slept a little, but I had some pain in my right
hip.
b. How are you feeling right now?
c. Can I get you anything?
d. Remember to press the call button if you need anything.
e. I couldn’t sleep because my back hurts.
f. The smell of food is making me nauseous.
g. I’m worried about the results of my tests.

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5. With a partner write a dialogue between a patient and a nurse. The patient
is frustrated/angry because his/her symptoms have not improved.
The nurse calmly explains the situation to the patient and reassures him/her.
Include at least 6 examples of the patient expressing how he/she feels and
appropriate responses from the nurse.
Patient: (In a loud voice) Excuse me, nurse! Nurse!
Nurse: Good afternoon...................................(name of patient). How can I

help you?
Patient:
Nurse:
Patient:
Nurse:
Patient:
Nurse:
Patient:
Nurse:
Patient:
Nurse:

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10.2 Grammar for Making Comparison
1. Look at the words below. What parts of speech are they? What is the difference
in meaning? Discuss as a group.
pain ill ache sick hurt
2. Read the following descriptions to check if your group was correct. Discuss
the differences in British English and American English5.
PAIN and ACHE
Both of these words are most commonly used as nouns. They refer to
unpleasant sensations that you feel in your body, although they are slightly
different feelings. A pain is usually used to refer to a kind of sharp
discomfort that is difficult to ignore.
Yesterday I suddenly felt a lot of pain in my stomach. I was taken to

hospital where they discovered I had appendicitis.
Ache is similar to pain, but it usually is used to refer to a duller kind of

discomfort that may continue for longer than a pain might. Common
examples are:
Headache, stomach ache, backache, heart ache.
Note that heartache is used to refer to a kind of emotional pain, for example
if you are in love with someone and they are not treating you well you can
say He is causing me a lot of heartache.
Less commonly, both pain and ache can be used as verbs. Pain in this form
means to cause someone unhappiness. Note that you cannot use pain in the
progressive or continuous form in standard UK or US English.
5
BBC Learning English. (2020). Ask About English. Retrieved from https://www.bbc.co.uk/worldservice/learningenglish/language/askaboutenglish/
2010/03/100323_aae_sick_pain_page.shtml

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For example:
It pains me to think of you being so unhappy with your life – meaning it makes
me feel unhappy that you are so sad.
You can also use ache as a verb. Unlike pain, ache can be used in the
progressive form. For Example:
My back is really aching.
I wish my leg would stop hurting, it really aches.
Interestingly, you can also use the expression ‘aches and pains’ to refer to a
general
feeling of being unwell.
SICK and ILL
Both of these words are most commonly used as adjectives as in:
I feel sick.
Ed had to leave school early because he was ill.
In American English, these two words have more or less the same meaning –
they refer to a feeling of being unwell, whatever the problem might be. On
the other hand, in British English, they have more distinct meanings. Sick
most commonly refers to feeling as if you are going to vomit, as in:
I think I’m going to be sick
…while ill refers to any other feeling of being unwell. However, there are some
phrases
which are commonly used where sick has a more general meaning. F
I’ve been off sick for ten days. – meaning I haven’t been to work/school for ten
days because I’ve been feeling unwell.
Sick can also be used as a noun to refer to vomit.
If you have children, you can be sure that you will have to clear up some sick
at least once during their childhood.

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HURT
Hurt is a little bit different to the others in that it is commonly used as a verb
and an adjective and, less commonly, as a noun. Of the above words, hurt is
probably most similar to pain and ache and it can also mean the same as
injure or injured. The key difference between hurt and pain and ache is that
usually if you are hurt, it means the discomfort you experience is clearly
caused by something outside of yourself.
However, pain and ache suggest a more internal reason for the unpleasant
physical feeling.
Be careful on that ladder, you might hurt yourself if you fall – used as a
verb He was badly hurt in the train crash – used as an adjective
When it’s used as a noun, hurt usually refers to some emotional pain.
When he told her he wanted a divorce she could hear a lot of hurt in his voice.
3. Below are the explanations for the Comparative and Superlative Adjective. Can
you add the words to the explanation below?
nouns Comparative smallest
compared to faster Superlative
………………. adjectives are used to compare differences between the two objects
they
modify (larger, smaller,........, higher). They are used in sentences where two
…………. are compared.
For example:
a. Exit wounds are larger than entrance wounds.
b. Physical memory is smaller than virtual one.
c. A new study suggests taller women have heightened risk for ovarian cancer.

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………………. adjectives are used to describe an object which is at the upper
or lower limit of a quality (the tallest, the , the fastest, the highest). They
are used in
sentences where a subject is........................a group of objects.
For example:
a. When the smallest thing gets in your eye, it can hurt very much.
b. The highest death rates are among occupants of motor vehicles in traffic.
c. People need the fastest treatment for severe cases.
4. Forming comparatives and superlatives depends on the number of syllables in the

original adjective. Read the following explanations for forming regular
comparatives and superlatives and add more of your own examples to the boxes.
Forming regular comparatives and superlatives
a. One syllable
Add -er for the comparative and -est for the superlative. If the
adjective has a consonant + single vowel + consonant spelling, the
final consonant must be doubled before adding the ending.
Adjective Comparative Superlative
sharp sharper sharpest
b. Two syllables
Adjectives with two syllables can form the comparative either by adding -
er or by preceding the adjective with more. These adjectives form the
superlative either by adding -est or by preceding the adjective with most.
In many cases, both forms are used, although one usage will be more
common than the other.
If you are not sure whether a two-syllable adjective can take a

comparative or superlative ending, play it safe and use more and
most instead. For adjectives ending in y, change the y to an i before
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adding the ending.

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careful more careful Most careful
c. Three or more syllables

Adjectives with three or more syllables form the comparative by putting
more in front of the adjective, and the superlative by putting most in
front.
important more important most important
5. Read the following explanations for forming regular comparatives and superlatives.
Add more of your own examples for three or more syllable irregular comparatives
and superlatives.
Forming irregular comparatives and superlatives

These very common adjectives have completely irregular comparative and
superlative forms.

Good Better Best
Bad Worse Worst
Little Less Least
Much More Most

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6. Read the sentences with your partner. Complete the gap exercise together.
a. A pain refers to a kind of............discomfort that is difficult to ignore.
b. Ache usually is used to refer to a duller kind of discomfort

that may continue for than a pain might.
c. Pain, ache, ill, sick and hurt have quite..........meanings and uses,
d. In British English, sick and ill have..............................meanings.
e. There are some phrases which are commonly used where

sick has a....meaning.
7. Based on the examples above, which word is the Odd-One-Out, meaning which
word is different from the others? With your partner, give a reason for WHY each
word doesn’t belong?
a. bossy cooperative sneaky selfish
b. colleague partner boss co-worker
c. talking listening thinking feeling
d. ambitious competitive aggressive affectionate
e. supportive helpful critical sympathetic

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8. In pairs, ask and answer questions using the correct form of the adjective as in
the example below. Ask follow-up questions to find out more information.
Speaker A: Asking a question that uses either a comparative or superlative

adjective.
Speaker B: Answer the question using a complete sentence
Who is...............(wonderful)
A Who is the most wonderful person you’ve ever known?

B Hmm, probably my mother is the most wonderful person I’ve ever
known.
Can you give me a reason why?
A
a. What is…...............(important)
b. Who is…..............(famous)
c. What is................(good)
d. What is...............(dangerous)
e. Whose hair is.................(long)
f. What is................(interesting)
g. What country is..............(beautiful)
h. Which car is..............(luxury)
i. What job is..................(busy)
j. What sickness is................(horrible)

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10.3 Reading about Pain Assessment
1. With another student, discuss the following prompts.

a. If you find someone in pain, what should you do?
b. What problems do you think there might be in assessing a patient's pain?
2. Before reading, scan the article for the following vocabulary. Decide on the meaning
of each word by choosing the correct definitions based on how each word is used in
the text.
scales (n) /skeɪl/

a. a range of numbers used to measure or compare things
b. to climb up a steep surface, such as a wall or the side of a
mountain, often using special equipment
c. the relation between the real size of something and its size on a
map, model, or diagram
objective (adj) /əbˈdʒek.tɪv/

a. something that you plan to do or achieve
b. based on real facts and not influenced by personal beliefs or feelings
c. influenced by
or based on personal beliefs or feelings rather than based on facts
duration (n) /djʊəˈreɪ.ʃən/

a. able to last and be used for a long time without becoming damaged
b. the length of time that something lasts influenced by
c. to do something again that has already been done

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onset (n) /ˈɒn.set/
a. the final part of something such as a period of time
b. the moment something unpleasant starts
c. a small part of something that is left after most of it has been used:
3. Scan the text6 below for understanding. Circle the best title from the three
choices Write the correct title in the space provided.
a. How to Assess Pain

b. The Challenges of Pain Assessment
c. Understanding Pain Assessment Scales
………………………………………………..
The assessment of pain is a complex activity that involves a

consideration of the physical and psychological aspects of the
individual. Because pain is a subjective experience, the nurse needs to
be able to summarize the information gained against some objective
criteria. This is essential for diagnosis and for evaluating the
effectiveness of interventions.
Only the person experiencing the pain knows its nature, intensity,
location and what it means to them. One of the most seminal, widely
used and accepted definitions of pain was put forward by McCaffery
(1979, p.18), who suggests that pain is ‘whatever the experiencing
person says it is and exists whenever he says it does’.
Assessments of the patient’s pain experience

To begin with, it is essential to identify the characteristics of the
client’s pain. This
means that the nurse should consider the following
6
One Stop English (2020). Pain Assessment. Retrieved from https://www.onestopenglish.com/esp-lesson-plans/pain-assessment/156842.article

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The type of pain: is it crampy, stabbing, sharp?
How the client describes the pain may help in diagnosing its cause.
Myocardial (heart) pain is often described as stabbing, but biliary pain
as cramping or aching.
Its intensity: is it mild, severe or excruciating? Pain assessment scales

are helpful here. The nurse can ask the patient to rate the pain on a
scale of 0 to 10; zero being no pain and 10 being intolerable pain. With
children, a range of pictures showing a child changing from happy to
sad can be used. Colour ‘mood’ charts, with a series of colours from
black through grey to yellow and orange, have also been used and are
very useful for clients who have difficulty grasping numbers or
articulating exactly what their pain is like.
The onset: was it sudden or gradual? Find out when it started and in
what circumstances. What makes it worse? What makes it better?
What was the patient doing immediately before it happened?
Its duration: is it persistent, constant or intermittent? Changes in the

site: there may be tenderness, swelling, discolouration, firmness or
rigidity. With appendicitis, a classic sign is the movement of pain from
the umbilicus to the right iliac fossa. In a myocardial infarction (a heart
attack), pain classically radiates down the arm, and with biliary pain it
can radiate to the shoulder.
Its location: ask the patient to be as specific as possible, for example,

indicating the site by pointing.
Any associated symptoms: Chart below shows some of the common

symptoms of disease that can influence the response to pain. Signs
such as redness, swelling or heat.

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4. Read the text again and then answer the questions below. Check your answers with
a partner.
a. What are the aspects that nurses should consider in pain assessment?
b. How to rate the pain on scale?
c. How to identify any associated symptom?
d. What signs can indicate pain?
5. Below are words that patient may use to describe their pain. Match the
following words with their definitions 7.
Words Definition
1. tingling (adj) a. to feel ongoing heat, or a sharp, prickly pain

/ ˈtɪŋglɪŋ/
2.stabbing (adj) b. to have a feeling of sharp points

being put quickly and lightly into
/ˈstæb.ɪŋ/
your body
3.aching c. feels like it starts and stops in time with your
(adj) heart
/ ˈeɪ kɪŋ /
4./ˈbɜː.nɪŋ/ (adj) d. a sudden sharp pain
/ˈblʌd ˈprɛʃɚ/
5.throbbing (adj) e. a dull or constant pain
/ˈθrɒb.ɪŋ/
6.sharp (adj) f. sudden and intense pain
/ʃɑːp/
7

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6. You are an Medical Technologist on duty at emergency room. A patient is
complaining of heartburn, lack of appetite and nausea. You as a nurse must
assess the patient’s pain. Try to use the vocabularyfrom this lesson.
Create a dialogue with your partner and then role play for the class.

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10.4 Vocabulary to Talk about Pain Assessment
1. Below are some words used to describe pain. Discuss these words – their
meaning and how they would be used - with your partner.
subjective (adj) intensity (adj) duration (n) evaluate (v)

/səbˈdʒektɪv/ /ɪnˈten.sə.ti/ /djʊəˈreɪʃən/ /ɪˈvæljueɪt/
tender (adj) onset (n) objective (adj) excruciating (adj)

/ˈtendər/ /ˈɒnset/ /əbˈdʒektɪv/ /ɪkˈskruːʃieɪtɪŋ/
After your discussion, practise the pronunciation with your teacher and then with your
partner.
2. Match the following words to their definition
1. subjective a. very strong or unbearable pain
2. onset b. influenced by someone's beliefs or feelings, instead of

facts
3. duration c. sore or painful when touched
4. excruciating d. the amount of time that something lasts
5. tender e. based on real facts and not influenced by personal beliefs

or feelings
6. objective f. the beginning of something, usually something

unpleasant
7. evaluate g. to consider or study something carefully first
8. intensity h. being felt strongly or having a very strong effect 8
8

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3. With your partner, fill the gaps in the sentences
a. Duration is the amount of time something lasts.
b. A pain is….......................................when you cannot bear it.
c. A description is................................when it is based on the individual’s

experience or perceptions.
d. The...................................of a pain is when it begins.
e. The....................................of a pain describes the degree to which the

patient feels it.
f. In order to.................................a patient’s pain, a nurse needs to know its

characteristics.
g. Being..........................................means relying on facts, rather than personal

beliefs or feelings.
h. When part of your body is sore or uncomfortable, it can be

………………………… to touch.
4. Pain can be rated on a scale. Match the expressions for describing pain to a
number from the pain scale (0-10) below. Check your answers with the class.
mild and tender pain moderate pain no pain
strong pain excruciating pain

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5. With your partner, decide what level of pain the following health conditions might
cause a patient. Decide where the pain would be felt and how it could be described
by the patient.
a. a heart attack b. appendicitis c.

tonsillitis
d. a headache e. food poisoning f. labour

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10.5 Writing a Pain Report
1. In pairs, brainstorm as many words as you can think of about the word pain. Check
as a class.
2. Below is an example of a Pain Report. Read the example.
PAIN REPORT
Subjective Data
On Tuesday, April 2nd 2020 at 23.00, Mrs. Adrian complained of sharp

pain in her post-operative wound located in the region of her lower
abdomen. She had a grimace on her face. Mrs. Adrian stated that the
pain ranged from moderate to severe and got worse when she moved.
After receiving Mrs. Maria’s report, Doctor Saaed gave instructions to
the nurse to give the client an analgesic injection.
On Wednesday 3rd April 2020, at 08.00 (today), a nurse did an

evaluation of Mrs. Adrian. The client stated that her type of pain had not
changed, but it now occasionally ranges from mild to moderate.
However, when she experiences the pain, it is much worse. Mrs. Adrian
says that she feels she is suffering a lot.
Patient’s name: Mr. Adrian
Date/Time Location of pain Pain frequency Pain intensity Pain

type
Tue, lower constant Moderate to sharp

severe
02/04/2020 abdome
23.00 n
Wed, lower occasional Mild to moderate sharp
03/04/2020 abdome
08.00 n

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3. In pairs, discuss the following questions.
a. What key information is included in a Pain Report?
b. Why is the pain report formatted like this?
c. What is NOT written in a pain report?
4. Using the model, write a pain report about a patient with appendicitis with
your partner. Consider the following key information.
a. What is the timing of events?

b. Where is the pain?
c. What does the pain feel like?
d. How strong is the pain?
e. What sets the pain off?
f. What makes the pain better?

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PAIN REPORT
Subjective Data
………………………………………………………………………………………………...
………………………………………………………………………………………………...
………………………………………………………………………………………………...
………………………………………………………………………………………………...
………………………………………………………………………………………………...
………………………………………………………………………………………………...
………………………………………………………………………………………………...
………………………………………………………………………………………………...
………………………………………………………………………………………………...
Patient’s name: ……………….
Date/Time Location of pain Pain frequency Pain intensity Pain type
5. Swap your report with another pair of students’ pain report.

Proof-read another pair’s Pain Report. Make suggestions if any information is
unclear
or needs further detail.
Re-write your pain report and submit one copy of your pain report (per pair)
to your teacher for assessment.

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11.1 Grammar for Units of Measurement
1. With a partner, list the information a healthcare professional collects from a

patient who is being admitted to hospital. Divide your information into WORDS
and NUMBERS. Why is it necessary to collect this information?
WORDS NUMBERS
Example - First name Date of birth
2. Match the expression on the left, with the correct meaning on the right.
a. the force at which blood pushes against the

1. weight
artery walls during contraction and relaxation of
the heart.
b. commonly referred to as "sats" is the fraction of

2. height oxygen- saturated hemoglobin relative to total
hemoglobin (unsaturated + saturated) in the
blood.
3. temperature c. also known as ‘resps’, is the number of breaths a
person
takes per minute.
4. blood
d. The lower number in a blood pressure reading,
pressure
refers to the pressure inside the artery when the
heart is at rest and is filling with blood.

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5. systolic e. a measurement of the heart rate, or the number
pressure of times the heart beats per minute.
f. a body's relative mass or the quantity of matter

6. diastolic
contained by it, giving rise to a downward force; the
pressure
heaviness of a person or thing.
7. g. the measurement of someone or something from

respirati head to foot or from base to top.
on rate
h. the degree of internal heat of a person's body.
8. pulse
i. The higher number in a blood pressure reading,
9. oxygen refers to the pressure inside the artery when the
saturation heart contracts and pumps blood through the body.
3. Read the dialogue below between patient Samira and nurse Bessie with a partner.
Fill the gaps with the correct expression from the box below.
weigh temperature blood

t pressure
pulse respiration oxygen sats

rate
Bessie: I’m just going to take your Obs now.

Samira: OK.
Bessie: I’ll just pop this in your ear and wait for
the beep. Samira: So
what’s my 1
?
Bessie: It’s thirty-seven three. That’s
good. Samira: What’s next?
Bessie: I’ll get the rest of the information from this machine.
Lift up your arm for me, please. That’s it. I’ll wrap the
cuff around your arm.
Samira: Is that OK?
Bessie: Yes, that’s fine. Now, I’ll just clip this lead on your finger.
Samira: What’s that for?
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Bessie: It measures that amount of oxygen in your
blood. Samira:OK
Bessie: I’ll turn the machine on now.
Samira: What does it say?
Bessie: Mm. Your 2
is one hundred over sixty-
eight. That’s fine. Your 3
is 64. That’s
OK
too. Your 4
are 98%. That’s the
percentage of oxygen in your blood.

Samira: Is that good?
Bessie: Yes, it’s fine. That’s all from this machine. Your
5
is 18 breaths a minute. I counted
them while you were watching the machine.
Samira: I didn’t even know you were doing it.
Bessie: I know. Now, can you step on these
for me? Samira: OK.
Bessie: Great. Let’s see your 6
is 45
kilos. Samira: Am I finished now?
Bessie: Yes. That’s it.

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4. Read the following information about units of measurement used in
hospital admissions and observations.
UNITS OF MEASUREMENT
Unit Conversions
(abbreviation)
Height Meter 1 meter = 100 centimeters

(m) (cm) 1 meter = 3.28 feet
(ft, ‘ )
Weight Kilogram 1 kilogram = 1,000 grams

(kg) (g)
1 kilogram = 2.20462
pounds (lb)
Temperature Degree 1-degree Celsuis (oC) = 33.8 degree
Celsius Fahrenheit
(oC) (oF)
5. Look at the examples of written and spoken abbreviations. With your partner,
practise saying the spoken abbreviations.
Sign Written Spoken
Temperature T 37° Temp thirty-seven
Pulse P 64 Pulse sixty-four
Blood Pressure BP 100/68 BP one hundred over sixty-eight
Respiration Rate RR 18 Resps eighteen
Oxygen saturation O2 SATS 98% Sats ninety-eight percent

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11.2 Grammar for Quantifiers
1. With a partner, discuss the following questions.
a. What kinds of drugs do you commonly use in relieving your

pain, such dizziness?
b. What do you know about the common treatments dealing with

your illness when you were in hospital?
c. Mention the familiar English terms related to medication.
2. Read the passage and answer the following comprehension questions.
Smart about Medicine
Medicines can help people fight illnesses and get better faster and can
keep people from getting sick in the first place. But if they aren’t taken
correctly, medicines may cause more harm than good. Read on to learn
more about responsible medicine use.
DO take all your antibiotics.
Here’s a scenario: After three days of taking the medicine your doctor
prescribed for strep throat, you feel great. You still have seven days’
worth of pills left. Is it OK to stop taking them and shove them to the
back of the medicine cabinet until the next time you get sick?
Nope! Always finish taking all the antibiotics (bacteria-fighting drugs)

prescribed by your doctor, even if you start to feel healthy again. “When
bacteria are undertreated, they have a chance to multiply,” says Dr.
Tanya Arora, a pediatrician at Children’s Hospital Los Angeles. “You get
bacteria that no longer respond to the antibiotic.” Some antibiotics
don’t just get rid of bacteria, Arora adds. Some also help prevent other
problems. For instance, strep throat that is not fully treated can lead to
rheumatic fever, an illness that can damage the heart.

247
DO make sure you are taking the correct dose.
Every week, approximately one in 10 kids use some kind of cough and
cold medicine, according to experts at Boston University. Cough and
cold medicines can be a big help when you’re sniffling and sneezing.
But because you can buy them without a prescription, many people
don’t realize just how dangerous those drugs can be if they are
misused.
While cough medications may have different names, they often have
the same or similar ingredients. For example, the ingredient
diphenhydramine, which treats coughs, can make you stop breathing if
you take too much.
“These medications are not meant to take away all your symptoms and
make you feel back to normal—they only help a little bit,” Arora says.
Taking more than you should won’t help your symptoms.
DO find out whether your medicine shouldn’t be mixed.
Sometimes, drugs can interact with other drugs, foods, or vitamins. For
example, iron supplements can keep tetracycline, a common antibiotic,
from working. Grapefruit juice affects a number of medicines, such as
ones for heart disease and allergies, as well as some that fight
infections.
Certain vitamins and supplements for athletes can have damaging

effects on the kidneys and liver. “It is important that your doctor know
[what you are taking] so that they avoid prescribing medications that
may worsen that damage,” says Virginia Cox of the Consumer
Healthcare Products Association.
Don’t take expired meds.
Some medicines don’t work as well as time passes or if they are kept in
high temperatures. Expired medicine may not work as intended. That is
why it is better to always go to the doctor rather than try to figure out
on your own what you ought to do.9

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3. Answer the following questions based on the information in the text.
9
Magrid, J. (2017). Smart About Medicine. Retrieved from https://studylib.net/doc/25195649/smartaboutmedicine1000

247
1. According to the text, how many teenagers think there is nothing
wrong with taking prescription drugs without a doctor’s
prescription?
a. One out of ten teenagers
b. One out of four teenagers

c. One out of three teenagers
d. About half of teenagers
2. The text gives readers a list of things they should and should
not do with medicines. Which of the following does the writer
include in the text?
a. You do not always need to finish taking all the antibiotics prescribed.
b. You can take someone else’s medicine.

c. You can mix medicine with any other foods, drugs, or vitamins.
d. You should not take expired medicine.
3. Sometimes food or other medications can interfere with the

effectiveness of a drug. What evidence from the text supports this
conclusion?
a. “Grapefruit juice affects a number of medicines, such as

ones for heart disease and allergies, as well as some
that fight infections.”
b. “Always finish taking all the antibiotics (bacteria-fighting

drugs) prescribed by your doctor, even if you start to
feel healthy again.”
c. “Some medicines don’t work as well as time passes or if they are
kept
in high temperatures. Expired medicine may not work as intended.”
d. “Certain vitamins and supplements for athletes can have

damaging effects on the kidneys and liver.”
4. Based on the text, which of the following is

correct?
a. All medicines are safe to mix with other drugs, foods, or vitamins.
b. People always take all of their antibiotics.

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c. Many people do not use medicines correctly.
d. No one ever shares their medication with other people.

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5. What is this text mostly about?
a. How to take medicine responsibly.

b. How to get a prescription for an illness.
c. Different kinds of medicine.
d. How to take medicine for a cold.
6. Read these sentences from the text.

Some medicines don’t work as well as time passes or if they are kept
in high temperatures. Expired medicine may not work as intended. As
used in the text, what does the word "expired" mean?
a. Very sick
b. Prescribed
c. Past a certain date
d. Before a certain date
7. Choose the word that best completes the sentence.

Grapefruit juice can affect a number of medicines,........you should ask
your doctor if it is safe to drink it with your medication.
a. Before
b. So
c. Because
d. After

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4. Read about the use of quantifiers in sentences and their definitions.
QUANTIFIER DEFINITION EXAMPLES
Many Used with plural, 1. There aren’t many nurses in the

countable nouns public health center today.
2. Many people don’t realize just
how dangerous medicine can
be if it is misused.
Much Used with 3. The hospital doesn’t have

singular, much funding.
uncountable
nouns
Some 1. Refer to an 4. Paracetamol can help people to
unknown number fight some illnesses.
or quantity 5. Some medicines don’t work as
2. Used with well as time passes or if they
uncountable and are kept in high temperatures.
countable nouns
6. Grapefruit juice affects a
3. Used with singular number of medicines, such as
and plural nouns ones for heart disease and
4. Used in allergies, as well as some that
positive fight infections.
sentences
Any 1. Refer to an 7. You don’t need to take any drugs
unknown number If
or quantity you feel tired instead of taking a
rest.
2. Used with
uncountable and
countable nouns 8. Do you have any problem with
3. Used with singular your stomach?
and plural nouns
4. Used in
negative
sentences
5. Used in questions
6. Used in positive
sentences to mean
“it doesn’t matter
which”
5. Select the correct quantifier (in brackets) to complete the sentence.
a. We need to have...........apples for antioxidants. (some – any)

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b. scientists say that alternative treatments are not scientifically tested.
(many – much)
c. Nurses have.............responsibility in caring patient. (many -much)
d. people think it’s better to eat healthily than to exercise a
lot. (some or any)

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11.3 Read about Taking Medications
1. Match the vocabulary with the pictures below. Discuss the difference in these types
of medication and what they might be used for.
syrup ointment tablet capsule (n)

(n) (n) (n) /ˈkæpsəl/
/ˈsirəp/ /ˈoɪntmənt/ /ˈtæblət/
a. .………………………………………. b. ……………………………………….
c. .………………………………………. d. ……………………………………….

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2. Work in pairs, discuss the meaning of the words. Match the meaning from the
following box.
Words Meaning
1. side effect (n) a. to think or talk about
something to make changes
/ˈsaɪd ɪˌfekt/ or decisions
2. resistance (n) b. an often harmful and unwanted
/rɪˈzɪs.təns/ effect of a drug that occurs
3. prescription (n) c. a very small organism that

causes disease
/prɪˈskrɪp.ʃən/
4. germs (n) d. a measured amount of something

/ˈʤɚm/
5. a dose (n) e. the ability to prevent

/ˈdoʊs/ something from having an
effect
6. to review (v) f. a written message from a

/rɪˈvjuː/ doctor that officially tells
someone to use a medicine or
therapy
3. Read the article quickly. Discuss with your partner, what is the main point of
this article? In a few sentences, sum up the main point of the article.
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………
………………………………………………………………………………………………………

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Are You Taking Medication as Prescribed?
Medication adherence, or taking medications correctly, is generally defined

as the extent to which patients take medication as prescribed by their
doctors. This involves factors such as getting prescriptions filled,
remembering to take medication on time, and understanding the directions.
Common barriers to medication adherence include…
● the inability to pay for medications

● disbelief that the treatment is necessary or helping
● difficulty keeping up with multiple medications and complex dosing
schedules
● confusion about how and when to take the medication
Poor adherence can interfere with the ability to treat many diseases, leading
to greater complications from the illness and a lower quality of life for
patients. Here are some examples of areas in which medication adherence
can pose challenges, along with tips for taking medications correctly and
talking with health care professionals about your questions and concerns.
Taking Antibiotics
If you feel better and no longer have symptoms, you may think your illness is
cured. But if you have a bacterial infection, this can be a dangerous
assumption.
If the full course of antibiotics is not taken, a small number of bacteria are
likely to still be alive. These surviving germs are likely to have some natural
resistance to the antibiotic. As they multiply and spread, a new strain of
resistant germs may begin to develop. This may be one way that Methicillin-
Resistant Staphylococcus Aureus (MRSA) infections occur. MRSA is a type of
bacteria that’s resistant to certain antibiotics. It’s important to use antibiotics
appropriately and to take the medication exactly as directed.
● Take all doses of the antibiotic, even if the infection is getting better.
● Don’t stop taking the antibiotic unless your doctor tells you to stop.
● Don’t share antibiotics with others.
● Don’t save unfinished antibiotics for another time.

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Taking HIV/AIDS Medications
People with HIV/AIDS can have a particularly difficult time taking medications
as prescribed, according to Richard Klein, the HIV/AIDS program director for
the Food and Drug Administration’s (FDA) Office of Special Health Initiatives
(OSHI).
Some of the main reasons:
Multiple drugs may need to be taken at different times, which can be hard to
remember. The side effects of certain drugs can sometimes make people feel
worse instead of better. When people feel okay, they may not feel the need
to take their drugs. They don’t have the ‘physical reminder’ to take the
medications.
People may not be aware of the risks of drug resistance that can occur if
they stop treatment or skip or lower doses.
When you skip doses or stop taking a prescribed medication, you may
develop strains of HIV that are resistant to the medications you are taking
and even to some medications you haven’t taken yet. This may result in
fewer treatment options should you need to change treatment regimens in
the future.
FDA has given expedited reviews to several fixed dose combination

medications like Atripla (a combination of efavirenz, emtricitabine and
tenofovir) and Combivir (a combination of retrovir and epivir) to treat HIV.
Fixed dose combination tablets contain two or more anti-HIV medications
that can be from one or more drug classes.
“These fixed dose combinations are examples where the constituent drugs
were already approved,” says Klein, “but the agency expedited review
because the combined formulations simplified dosing, and thus were likely to
improve adherence.” A standard drug review time is 10 months, while an
expedited review of fixed dose combination tablets is generally completed
within 6 months.10
10
FDA. (2020) Are You Taking Medication as Prescribed? Retrieved from https://www.fda.gov/consumers/consumer-updates/are-you-taking-
medication-prescribed

257
4. Work in pairs. Read the text then look at new vocabulary and add your words into
the table below
Vocabulary I Know Vocabulary I’m Not Sure Vocabulary I Don’t

About Know
5. Read the text again. With your partner, decide if the following statements are true
or false.
a. Patients should take the medication on time. T/F

b. People sometimes stop taking medication when
they feel better. T/F
c. Not taking antibiotics for the full course means germs

can still spread and develop. T/F
d. It’s important to use antibiotics exactly as directed. T/F

e. If you have several drugs to take, you should take
them all at one time. T/F
f. Some side effects of drugs make patients feel

worse first, before they feel better. T/F
g. When you skip doses of a prescribed medication,

you may develop resistance. T/F
h. A standard period to review your medications is

every 10 months. T/F

258
6. In small groups, discuss the following questions.
a. Do you take any prescription medications (medicine you can only get
with a note from your doctor)?
b. Do you take any over the counter medications (medicine you can
buy at any drugstore)?
c. What should you do before you take your medications?
d. Have you or anyone you know suffered any side effect from their medication?

258
11.4 Read About Injections
INJECTION /ɪnˈdʒek.ʃən/ (noun)

the act of putting a liquid, especially a drug, into a person's body using a
needle and a syringe (= small tube)
1. With a partner, discuss what you think is happening to the child in the image
below. What is his reaction? What reactions can patients have to injections?
2. Quickly read the text below. How many types of injections are mentioned?
Injections
In medical terminology injection is referred as a shot or jab and is a

popular way of infusing liquid medicines into a patient's body. Besides
taking oral medicines for health problems or topical applications of
medicines in the form of lotions and creams, there are injections, which
are considered the most frequently used medical procedures.

258
According to a report by the World Health Organization (WHO), an
estimated 20 billion injections are administered each year world-wide11.
What is an injection?
An injection is defined as a process by which a small area of the skin is

pierced or punctured with a syringe and needle to insert a substance for
prophylactic, curative, or recreational purposes. An injection follows a
parenteral route of administration; that is, medicines are administered not
through the digestive tract.
Methods of injections: Types of injections
Injections can be given intravenously, intramuscularly, intradermally, or

subcutaneously. Each type of injection is used for a specific health
problem, specific purpose, but the procedures for preparing the injections
are the same.
Intradermal Injections
This technique involves the injection of the fluids into the top layer of
the skin, which is soft and pliable. Mainly used for treating certain
health problems, including many allergies and tuberculosis. The liquid
medicine is inserted with an intradermal injection, which will lie just
beneath the skin’s surface in between the layers of skin. The needle
is extremely tiny, and it inserts the fluid properly under the surface of
the skin.
Intramuscular Injections
This is the most common way of injecting medication directly into a

patient. For rapid absorption of the medicine this is a very useful
process because the medicine from this injection is inserted directly
into the muscle. This allows the medicine to gain easy access to the
blood stream and quickly begin its healing work. Intramuscular
injections are the best and the safest way of injecting medication into
a patient.
Subcutaneous Injections
Such type of injections are used where the medicine needs to be

258
absorbed slowly. In this type of injection, the needle has to go
through the first 2 layers of
Pharmaceutical and Drug Manufacturers. (2020). Injection. Retrieved from http://www.pharmaceutical-drug-

11
manufacturers.com/pharmaceutical-drugs/injections.html

258
skin that is the epidermis and dermis. The needle should further
penetrate into the fatty layer of the skin, known as the subcutaneous
tissue. Medicines administered through subcutaneous injections have
the least chances of having an adverse reaction. Insulin is one type of
medicine that is injected in this way, so also a number of
immunizations.
In all these injections, the size of the needle varies. The deeper the
injection, the longer the needle should be. In intramuscular injection,
the needle is at least a few inches long. Subcutaneous injections have
needles which are approximately an inch long. Intradermal injections
use the shortest needle because they are only inserted just beneath
the first layer of skin.
Intravenous Injections
Intravenous therapy is a therapy that delivers fluids directly into a

vein. The intravenous route of administration can be used both for
injections, using a syringe at higher pressures, as well as for
infusions, typically using only pressure supplied by gravity.
Intravenous infusions are commonly referred to as drips12.
3. Now read the text more carefully and choose the correct meaning of the
following words based on their use in the text.
1. intramuscular (adj)
a. situated or applied under the skin
/ˌɪntrəˈmʌskjʊlə/
2. intradermal (adj) b. existing or taking place within, or

/ˌɪntrəˈdəːm(ə)l/ administered into, a vein or veins
3. subcutaneous (adj)
c. situated or applied within the layers of
/ˌsʌbkjuːˈteɪnɪəs/ the skin
4. intravenous d. situated or taking place within, or

(adj)
administered into, a muscle
/ˌɪntrəˈviːnəs/

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12
Wikipedia. (2020). Intravenous therapy. Retrieved from https://en.wikipedia.org/wiki/Intravenous_therapy

258
4. Match the injection type with the images below.
intramuscular intradermal
subcutaneous intravenous
a. ………………………. b. ………………………..
c. ………………………. d. ……………………….
5. Based on the information in the text, are the following statements True
or False? Circle T or F next to the statements below.
a. The World Health Organization reports that, globally, in
T F
excess of 20 billion injections are given annually.
T F
b. Preparation procedures vary between injection types.
c. The safest way of injecting medication into a patient is
T F
intradermally.
d. Insulin is the only type of medicine that is injected
T F
subcutaneously.
e. An intravenous injection relies on the pressure of gravity to
T F
deliver fluids directly to a vein.

Page 26
6. Based on the information in the text, answer these questions below in the
space provided.
a. What is a parenteral form of administration?
b. Why is the needle of an intradermal injection smaller than other types?
c. What are two benefits of intramuscular injections?
d. What is an advantage of subcutaneous injections?
e. How does an intravenous injection differ from an intravenous infusion?
7. Work with a partner to categorize the medications and substances listed under the
table into the most appropriate injection method. Sometimes more than one
injection method is correct.
Intramuscular Intradermal Subcutaneous Intravenous
Chickenpox vaccine
Chicken
Blood transfusion MMR Vaccine Allergy test Saline
pox
Vaccine
Antibiotics Parenteral Heroin Insulin EpiPen

nutrition

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11.5 Vocabulary to Talk about Medication
1. With a partner, write as many nouns, verbs, and adjectives as you can related
to MEDICATION in the table below. No dictionaries or notes.
MEDICATION
Nouns Adjectives Verbs
2. Match the phonemic vocabulary to the phonemic script. Practice pronouncing

the words with your partner.
Nouns/Adjective Pronunciation
a. laxative /ɪˈmɛtɪk/
b. sedative /antɪˈsɛptɪk/
c. antiseptic ˌan(ə)lˈdʒiːzɪk,ˌ
d. emetic /ˌantɪbʌɪˈɒtɪk/
e. analgesic /ˈlaksətɪv/
f. antibiotic /ˈsɛdətɪv/

264
Adjectives Pronunciation
a. drowsy /əˈləːdʒɪk/
b. intravenous /ˈdraʊzi/
c. allergic /ˌɪntrəˈviːnəs/
Verbs Pronunciation
a. hospitalize /ɪnˈheɪl/
b. induce /ˈstɪmjʊleɪt/
c. inhale /ˈhɒspɪt(ə)lʌɪz/
d. overdose /prɪˈskrʌɪb/
e. stimulate /ɪnˈdjuːs/
f. prescribe /ˈəʊvədəʊs/
3. Match each word with its meaning.
Noun/Adjectives Meaning
a. laxative (of a drug) acting to relieve pain
b. sedative a medicine or other substance which causes

vomiting
a medicine (such as penicillin or its derivatives)
c. antiseptic that
inhibits the growth of or destroys microorganisms
d. emetic a medicine tending to stimulate or facilitate
evacuation
e. analgesic of the bowels

a drug taken for its calming or sleep-inducing
effect
f. antibiotic
preventing the growth of disease-causing
microorganisms

264
Adjectives Meaning
of a damaging immune response by the body to a

a. drowsy substance, especially a particular food, pollen,
fur, or dust, to which it has become
hypersensitive
b. intravenous
causing sleepiness or lethargy
c. allergic existing or taking place within, or administered

into, a vein
or veins
Verbs Meaning
raise levels of physiological or nervous activity in

a. hospitalize (the body
or any biological system).
b. induce
bring on a condition artificially, typically by the use
of drugs
c. inhale
take an excessive and dangerous dose of a drug
d. overdose (of a medical practitioner) advise and authorize the

use of
(a medicine or treatment) for someone, especially in
e. stimulate writing
admit or cause (someone) to be admitted to hospital
f. prescribe for
treatment
breathe in (air, gas, smoke, etc.)

264
4. Match each word in the box to a stress pattern in the table below and check with
your partner.
laxative sedative antiseptic induce emetic inhale
analgesic overdose allergic intravenous drows prescribe

y
●● ● ● ●●● ●
● ● ●
●● ●
laxative
5. Complete the sentences below with a word from the box.
allergic emetic stimulate hospitalize

d
antiseptic inhale analgesic prescribe
a. Patients................a topical anesthetic that numbs their nasal passages

and throat.
b. A calcium supplement can..............bone tissue growth.
c. Paracetamol is a common …………….
d. Doctors are authorized to..............medication to patients.
e. By effectively using an............., bacteria are killed, and disease is less
likely to spread.
f. Asthmatics often have an.............reaction to dust.
g. The child was immediately given an...........to ensure he did not
absorb the poison he drank.
h. The child needed to be..............for observation following the accident.

264
6. Use the following words in sentences as if you were a nurse speaking to a patient or
a doctor.
antibiotic sedative induce laxativ

e
drowsy overdose intravenous
For example: Nurse speaking to a patient “The doctor has prescribed this antibiotic for
your infection. It needs to be taken three times a day with food.”
a.
b.
c.
d.
e.
f.

269
11.6 Writing a Procedure
1. Look at the procedure below for 90 seconds. Try to remember as many details
as possible

269
2. Working with a partner and without looking at the poster on the previous page,
answer the following questions.
a. What is the purpose of the poster?
b. Which organization produced the poster?
c. Who is the poster targeting?
d. When should this process be followed?
e. What is the recommended duration of the procedure?
f. How many steps are detailed in the poster?
g. How many different ways are the hands rubbed together?
Demonstrate with your partner.
h. What three things are required to effectively complete the process?
i. What verbs are used in steps 0 - 2?
3. When you have finished, look at the poster to check your answers. Underline
the verbs in the instructions. What form are the verbs in the poster?
4. Re-write the following sentences using the imperative form of the verb.
Example: It’s a good idea to study for the exam = Study for the exam.
a. You need to take a ticket to enter the staff carpark.
b. You should wait here for service.
c. They recommend that we do not drink the water.

269
5. Sometimes more information is added to an instruction. It might describe a condition
or another action occurring before or after the instruction. The imperative verb is not
used in these clauses, it is used in the instruction.
Examples If you drop the injection on the floor, don’t use it.
Dry your hands on a towel after rinsing them.
Re-write these instructions using the imperative form.
a. Students need to read the instructions carefully before starting the exam.
b. Once you finish the exam, you should hand in your paper and leave
the room quietly.
c. Before entering the secure area, it’s necessary to swipe your ID

card on the screen.
6. With a partner, look at the pictures below and discuss the procedure for preparing
an intravenous injection.

269
7. With your partner, read the following instructions and underline all the imperative
verb forms. Then put the instructions in the correct order 1 – 10. The first one has
been done for you.
Preparing an intravenous injection
a. After pushing the air out, place a sterile cap over the tip of the
needle to protect it and place it on a sterile surface until you’re ready
to use it.
b. Take out a clean, unused needle and insert the tip into the medicine
vial.
c. Then, gently tap the side of the syringe to knock any air bubbles to the
surface
d. Depress the plunger just enough to press the air out of the syringe.
e. Draw the correct dosage into the syringe by pulling back on the
plunger of the syringe.
f. Administer the exact dosage prescribed by the doctor only.
g. Before handling the medication or needle, wash your hands

thoroughly with warm water and soap. (1)
h. Do not allow the prepared needle to come into contact with any
non-sterile surface.
i. Then, rinse your hands and dry your hands completely using a
clean towel or clean paper towels.
j. After you have drawn the required amount of medication into the
syringe, turn the syringe so that the needle is pointed up. .
13
13
Wikihow. (2020). How to inject into a vein. Retrieved from https://www.wikihow.com/Inject-Into-a-Vein

269
8. The following instructions explain how to find a vein. With your partner, put the
words in each instruction in the correct order. The first one has been done for you.
How to find a vein
Example: patient / the / ensure / hydrated / is

Ensure the patient is hydrated.
a the / look / vein / on / a / near / arm / the / of / the / elbow

. / inside / for
………………………………………………………………………………………………
b. around / bring / vein / tourniquet / wrap / surface / arm / to / to
/ the / the
………………………………………………………………………………………………
c their / the / to / hand / open / close /
. patient / tell
………………………………………………………………………………………………
d vein / fingers / with / the / your /
. palpate
………………………………………………………………………………………………
e. veins / warm / a / compress / if / area / visible / aren’t / still / the
/ apply / the / to
………………………………………………………………………………………………
g rubbing / with / clean / the / vein / a / you / area / alcohol /
. viable / once / identify / a
………………………………………………………………………………………………
9. With your partner, discuss and then write a procedure for inserting and injecting
an intravenous injection.
Inserting and injecting an intravenous injection

269
12.1 Language for Clarifying Information
1. Look at the pictures below. Discuss in groups what the nurses are doing.
2. Look at the following words and write the word type, the first one is done for you.
a. Assessment /ə
ˈses.mənt/ Part of
speech: noun
Meaning: evaluation of the patient using patient history, physical examination,

laboratory, imaging etc…
What do we need to make sure that the goal is achieved?
……………………………….

269
b. clinician /klɪˈnɪʃ.ən/
Part of speech ……………
Meaning: someone, such as doctor, who is very skilled or has a

qualification in an area of healthcare
Is she part of health care team? ……………………………….
c. implementation /ˌɪm.plɪ.men
ˈteɪ.ʃən/ Part of speech
……………
Meaning: putting an instrument or plan into action
Is it a plan or an action? ……………………………….
3. Look at some examples of functional language used for asking and giving
clarification. With your partner, divide the phrases into two columns. The first
one has been done for you.
Could Could you put Do you Sorry, could Sorry, let me

you it differently mean…? you ……? explain…
clarify please?
that
please?
Is that right? Could you In other words, Let me Let me put it
repeat, please? … clarify it for in another
you… way…
What I mean To say this Could you Let me Could you
is…. differently… explain what explain… explain
you mean that,
by…? please?
Asking for Clarification Giving for Clarification

269
Could you clarify that please?

269
4. Working in groups of four, read the following dialogue together.
Mrs. Amanda is admitted to the medical ward. She is with her daughter
when the nursesdo a bed side report at the end of their evening shift.
Nurse 1: Mrs. Amanda, this is Nurse Shirley, she is the

oncoming Nurse that will be your nurse for the next
eight hours.
Nurse Shirley: Good evening, Mrs. Amanda. I am Shirley and I’ll take care of
you tonight.
Mrs. Amanda: Glad to see you Nurse Shirley.
Nurse 1: Mrs. Amanda, we’ll be here to do a nursing bed side
report. In other words, we will check your medical
record, your lab results and any care we have planned
for you.
Mrs. Amanda: Ok, thank you. Sorry, could you also explain this to my
daughter? She is concerned about my condition.
Nurse 1: Of course. We encourage you to ask questions
about any medical information related to your
mother’s condition. Ok, Nurse Shirley. We can start
our bed side report now. This is Mrs Amanda, 59
years old. She was admitted to the
emergencydepartment yesterday complaining of
chest pain and breathingdifficulty. She has no
history of allergies.
Diagnosed with anterior STEMI. How long have
you had hypertension Mrs Amanda?
Mrs. Amanda: For about 5 years. We have a family history of hypertension
too.
Nurse Shirley: Can I clarify, how about your chest pain? Are you feeling
well for now?
Mrs. Amanda: Yes, sure. I feel slight pain but overall, I feel good.
Nurse Shirley: Can you explain to me how much pain you feel on
the scale? Mrs. Amanda: It is about 2-3.
Nurse 1: To say this differently, the pain is mild but
uncomfortable. Is this right?
Nurse Shirley: Ok, let me check your line Mrs Amanda. Your IV line is
good, and so is your catheter. When was the last time
269
the urine was removed? It’s empty.
Daughter: About half an hour ago. I removed it because it was
almost full. Pardon me, could you explain what you
mean by STEMI? Is my mother going to be ok?

269
Nurse 1: Of course. Sorry, let me explain. STEMI is a condition
where we found the rising of your mother’s ECG wave.
Do not worry. As long as your mother takes the
medicine properly, following the care plan, she will be
fine.
And Nurse Shirley, Mrs. Amanda is scheduled for a
full blood lab and serial ECG examination tomorrow
morning.
Mrs. Amanda: Does that mean that tomorrow I can walk my way
out of the room?
Nurse 1: Not yet. Let me put it in another way. You can’t walk
because your heart hasn’t fully recovered yet.
Tomorrow we will learn how to move gradually.
Nurse Shirley: Ok, Mrs. Amanda. You may take a rest now. I’ll come to
takeblood samples tomorrow morning. Good night.
5. Reread the text. Underline the examples of language asking for and
giving clarification. Did you find the same examples as your partner?
6. With a partner, write a short dialogue between a patient and a nurse in a

hospital where the patient has been admitted. The patient initially arrived with a
fever and feeling dizzy.
a. The patient would like to know the cause of their symptoms.

b. The nurse would like to know how the patient is feeling after
receiving medication.
Practice your dialogue with your partner, taking turns to be the patient and the
nurse.

269
12.2 Grammar for Giving Reasons
1. Look at the picture below and discuss the questions with your
partner. 2.
a. What is the doctor doing?

b. What are her responsibilities during an examination?
c. Why is it important that she records the results of an examination?
d. Who is the information for?

279
3. Read the following dialogue. Discuss any unfamiliar vocabulary with your partner.
Nurse Diana, a nurse in Kasih Ibu Hospital, entered the room with an
observation sheet. She is speaking to Mrs Ainun who is there with her
daughter.
Nurse Diana: Good afternoon.

Mrs. Ainun: Good Afternoon, Nurse Diana. Do you want to
check mydaughter’s vital signs?
Nurse Diana: Yes, I do because I need to write a few things
on this observation sheet.
Mrs. Ainun: Do I need to wait outside?
Nurse: Since you are family, you can stay here. Because of your
daughter’s condition, I will need to ask you some questions
too.
Mrs. Ainun: Ok. And can I ask you some questions too?
Nurse: Did the doctor explain to you your daughter’s condition?
Mrs. Ainun: The doctor has explained because of the seriousness
of her condition, she must stay in hospital. However,
there are some things that I don’t understand.
Nurse: Ok. I understand. I will check her vital
signs first. Mrs. Ainun: So, how is my daughter?
Nurse: Let me see. Her blood pressure today is 160/900
mmHg, still high. Her pulse is 90x/minute, her
respiratory rate is 18x/minute. It is normal and her
temperature is 37.8ºC. This is good as she has
improved compared to last night.
Mrs. Ainun: So, what happened to her exactly?
Nurse: Well, as the doctor told you. Your daughter suffered a
head injury because of the accident. Based on the data
that I read in the medical record, your daughter had a
very hard impact on her head because she was
bounced and did not wear a helmet when her
motorcycle was hit from behind.
As the impact was so hard, she now has swelling in
the brain. As long as the swelling is not treated your
daughter will not wake up.
Mrs. Ainun: Ok, I got it. And why are her hands tied?
Nurse: Oh, your daughter’s hands are restrained because
she was restless and without her knowing she was
trying to pull the IV line and catheter.

Page 2
4. In this dialogue, the Nurse explains what she is doing as well as giving reasons
for what she is doing. Review the following explanations for clauses which
express reason.
How to express reason with because, because of, since and as
BECAUSE (conjunction) is used to link two clauses.

It is followed by a subject and verb
I was worried because Nurse Sally was

late. I was tired because I did the night
shift.
BECAUSE OF (preposition) + noun

This is a preposition, so it is not followed by a clause with
a verb. It is followed by a noun or noun phrase
She was late because of the traffic

I was tired because of the hard work I did during the night shift.
AS / SINCE (conjunction)
These conjunctions are formal. In a less formal language we would use SO
As it's raining again, we'll have to stay home.

(= It was raining again, so we have to stay
home)
Since it's too late, I think we should stop now

(= it was too late, so I think we should stop)
We often use as and since when we want to focus more on the result
than the reason. These clauses often begin the sentence:
Since my patient spoke no Indonesian, we had to communicate in

English
Since it's too late, we should leave the patient’s blood pressure
check for tomorrow.
5. Look at the dialogue again. Underline all the examples of language which
express reason. How many did you find? Check with your partner.

281
6. Review your understanding by choosing a suitable connector such as “because
of,
because, since, as” for each sentence. Sometimes there is more than one answer.
a.she is getting better, her IV line was removed.
b. She was admitted to the hospital...................her high body
temperature
c. The physician suggested he have a CT scan..................he complained
of regular headaches.
d. The nurse applied an ointment on his hand.................the itching.
e.breathing is something we do automatically, we
rarely think about it.
f. She spoke quietly.....................she didn’t want the patient to hear.
g.a lot of information is recorded digitally, there’s no
need for paper record keeping any more.
h. Are you feeling unwell....................you ate too much?
7. Rewrite the following sentences using a suitable connector. There may be more
than one way to connect these sentences.
1. The nurse suggested he drink a glass of warm water. He is dehydrated.
…………………………………………………………………………………………
b. He had a shortness of breath. The nurse gave him oxygen.
………………………………………………………………………………………………
c. The baby can now breathe independently. The baby was

moved from Intensive Care to the baby room.
………………………………………………………………………………………………
d. His condition is getting worse. He was admitted to the intensive care unit.
………………………………………………………………………………………………
e. His condition is worsening. He will need to be referred to another

hospital.
281
………………………………………………………………………………………………

281
8. In small groups, read the statements below. Discuss your opinions and give
reasons why using connectors.
a. In your opinion, why are there more female nurses than male?
I believe there are more female nurses because women have traditionally looked
after others and they have a very caring manner.
b. Why is being a team player so important in healthcare industry?
c. Do you think that a hospital could function without nurses?
d. Is nursing a rewarding job?
e. Being a nurse can sometimes be stressful.
f. Why is a nurse’s role important during a patient's treatment?

281
12.3 Read about Avoiding Common Medical
Documentation Errors
1. Look at the following picture. What documentation is commonly used by nurses in

a hospital?
2. Documentation plays an essential role in the nursing process. Discuss with your
group the reasons for clear and accurate documentation in the following
contexts.
a. Communication between healthcare workers

b. Communication to individuals or family
c. Decision making
d. Legislation

281
3. Scan the following summary about nursing documentation. What benefits of
documentation in a nursing context are listed? Underline them in the text. Are they
the same or different to your answers in exercise 2?
Documentation is the process of preparing a complete record of a

patient’s care and is vital tool for communication among health care
team members. Accurate, detailed documentation shows the extent and
quality of care that nurse provide, the outcomes of that care, and
treatment and education that the patient still needs. Thorough,
accurate documentation decreases the potential for miscommunication
and errors.
Documentation is a valuable method for demonstrating that the nurse

has applied nursing knowledge, skills, and judgement according to
professional nursing standards. In a court law, the client’s health record
serves as the legal record of the care provided to that patient.
Accrediting agencies and risk managers use the medical record to
evaluate the quality of care a patient receives. Insurance companies
use documentation systems to verify the care received. Nursing
documentation in the medical record may also be used for research and
education as well as for quality improvement programs.
4. Decide on the meaning of each word by choosing the correct definitions below.
accuracy (n) /ˈæk.jə.rə.si/
a. happening by chance
b. a situation in which a fact or measurement is not completely correct
c. the fact of being exact or
correct liability (n) /ˌlaɪ.əˈbɪl.ə.ti/
a. someone that causes you a lot of trouble,

b. being legally responsible for something
c. when someone must make the
decision malpractice (n) /ˌmælˈpræk.tɪs/
a. failure to act correctly or legally when doing your job

b. an agreement in which you pay a company money
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c. if you lose or damage something, or have an accident, injury

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verify (v) /ˈver.ɪ.faɪ/
a. to prove that something is not true

b. to prove that something exists or is true
c. to prove a person or an argument to be wrong1
5. Scan the article below. Check any new vocabulary with your partner and
discuss together.
Nursing Documentation: How to Avoid the Most Common Medical

Documentation Errors
When it comes to nursing documentation, knowing how to accurately

document a patient can literally mean life or death. Some of the most
common medical documentation errors can also be the most disastrous.
Plus, improper documentation can open up an employer to liability and
malpractice lawsuits. For nurses, who are on the front lines of defense in
the medical field, being adequately trained early on proper
documentation can help avoid such medical errors, save lives and help
protect their employers. So how can we avoid the most nursing
documentation errors, to ensure patients receive appropriate, and,
possibly life- saving care? By ensuring our nursing students are getting
the training they need on electronic medical records (EMRs) – also
known as electronic health records (EHRs) – while still in school.
EMRs are a digital version of a patient’s paper chart. They’re easy to

find, search, and update, and provide tools like reminders, alarms, and
automated processes that improve clinical accuracy. U.S. healthcare
organizations have been transitioning from paper-based medical
records to electronic health records for over a quarter of a century.
They allow organizations to minimize the high rate of medical errors
occurring throughout the healthcare industry by verifying information
and acting as a tool for increasing patient safety and decreasing the
overall cost of healthcare.
By providing the EMR training software to these students to use in the
classroom, they can practice various nursing simulation scenarios and
become proficient in clinical simulation in a safe, guided environment
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overseen by an instructor.
1

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Because the truth is that the majority of medical errors don’t occur as a
result of incompetence or recklessness by nurses or healthcare staff.
They occur due to faulty systems and fragmented processes – with
faulty documentation being a main culprit.
Here are some of the top 9 types of medical documentation errors:

1. Sloppy or illegible handwriting
2. Failure to date, time, and sign a medical entry
3. Lack of documentation for omitted medications and/or treatments
4. Incomplete or missing documentation
5. Adding entries later on
6. Documenting subjective data
7. Not questioning incomprehensible orders
8. Using the wrong abbreviations
9. Entering information into the wrong chart
Take #1 above, for example – sloppy or illegible handwriting. This can
lead to a patient care provider receiving mixed messages about the
patient’s history and directives. Some common transcription mistakes,
for example, include typing “hyper” instead of “hypo,” or vice versa, or
typing “she” instead of “he.” A wrong diagnosis can get embedded in a
patient’s chart and not only affect their care, but the error can affect
when that patient changes insurance companies and a pre- existing
condition is noted.
Also, a combination of the above common nursing and medical

documentation errors can also lead to medication errors. Consider this:
every day, at least one death in the U.S. happens a result of a
medication error, and approximately 1.3 million people annually are
injured due to medication errors. Nurses face more challenges today
than ever, and, on top of increasing patient care demands, they must
adapt to new technology to help them handle the workload. It is
incumbent upon nursing schools to ensure tomorrow’s nurses are
adequately trained on EMRs. If nurses aren’t comfortable with and
proficient in the technology when they encounter EMRs or EHRs on the
job, chances for nursing documentation error skyrockets.2
2
Wolters Kluwer. (2018). Nursing documentation: How to avoid the most common medical documentation errors. Retrieved
from https://www.wolterskluwer.com/en/expert-insights/nursing-documentation-how-to-avoid-the-most-common-medical-
documentation-errors
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6. Based on the text “Nursing Documentation”, answer these questions with True
(T) or False (F). Check your answers with your partner.
a. Being trained early on proper documentation can T/F

save patient lives.
b. EMRs are different to a patient’s paper chart. T/F
c. Paper-based medical records are becoming less T/F

popular and increasingly replaced with EMRs.
d. EMRs result in organizations recording higher rates of T/F

medical errors.
e. EMRs decrease the overall cost of healthcare. T/F
f. Training in EMR software should be done in school, in a T/F

simulated environment.
g. Poor and careless handwriting is a common T/F

medical documentation error.
h. There isn’t much difference between writing “hyper” and “hypo”. T/F
i. Using the wrong abbreviation is a kind of medical T/F

documentation error.
j. Medical documentation errors can also lead to deadly T/F

medication errors.
k. Nurses do not need to adapt on new technology to T/F

handle their workload.

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7. Based on the text again, complete the summary by filling in the blanks using
words from the box
professional signing documentation important electronic
communicate include keep provide statement
Nursing documentation is (1) component of nursing practice

and interprofessional (2) that occurs within the client health record.
Documentation – whether paper, (3) , audio or visual - is used to
monitor a client’s progress and (4) with other care providers. It also
reflects the nursing care that is (5) to a client.
Nurses are required to make and (6) records of their (7)
practice. Failing to keep records as required, falsifying a record, (8) or
issuing a document that the member knows (9) (
a false or misleading (10) .
8. Working in pairs, imagine you are explaining the importance of bedside

nursing documentation reports to a new nursing student. What are you going
to say?
Take turns in the role of the nurse and the nursing student and role play your
conversation to the class.

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13.1 Language for Discharging a Patient
1. Describe the scenes in the pictures below with your partner.

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2. Match the words to the definitions.
1. surgery a. a medicine, or a set of medicines or drugs, used to

improve a particular condition or illness
2. pain b. the treatment of injuries or diseases in people or

animals by cutting open the body and removing
or repairing the damaged part
3. medication c. a feeling of physical suffering caused by injury or

illness
3. Repeat each word together after your teacher
surgery (noun) pain (noun)

/peɪn/
/ˈsɜː.dʒər.i/
medication condition
(noun) (noun)
/med.ɪˈkeɪ.ʃən/ /kənˈdɪʃən/
4. Read the following and decide where the conversation takes place.
a. in the ward of a hospital
b. in front of the hospital
c. at the nurses’ station
Doctor: Alright, Ms. Adams, we got you all set. Your nurse
will be in shortly.
Mr. Adam: Are you doing okay?
Mrs. Adam: Yeah, honey, I'm alright, thank you.
Nurse: Hi, Ms. Adams. How are you feeling this
morning? Mr. Adam: I'm glad the surgery is over. I'm
pretty sore.
Nurse: I know you are, Ms. Adams. Can you rate your pain for me,
please?
You know that scale where one means it hurts just a little

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bit and ten is the worst pain you've ever felt? What's your
pain right now?
Mrs. Adam: Oh, I'd say it's at least a seven or an eight.

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Nurse: Well, the doctor has ordered some pain medicine to help
you. We are going to give this to you now so that it's
working when we get you out of bed a little bit later. It's
really important to get you moving so that you don't
develop any blot clots or trouble with your breathing.
Mrs. Adam: I don't want that to happen.
Nurse: I agree. And while you're here with us for the next couple
of days, we want to make sure that you and your family
feel comfortable with our daily routine so that you can
continue to work on it on your own once you're
discharged. That's why we have the word IDEAL written
out on the board here. It stands for: Include, Discuss,
Educate, Assess and Listen. It really helps us to work
together to begin preparing for your discharge.
Mr. Adam: Discharge? Already? I'm not ready to take her home.
She's in a lot of pain, and I'm not a nurse.
Nurse: I understand, but talking about this now and throughout
your hospital stay will help to ensure that when Ms.
Adams is ready for discharge, you both feel comfortable
with what you need to do to continue to help her heal
and get better.
Mr. Adam: Okay, well, getting her stronger is my goal too. So, we're
a team? Nurse: Yep. Let's begin working on this today. Now, as you
said, Mr.
Adams, your wife is in a fair amount of pain. One of the
things that we can do is to get her up and walking after
her pain medication has taken effect.
Mrs. Adam: Wait, I don't know if I'm really ready to do that today. I
don't think you understand how sore I am.
Nurse: Well, this pain medicine is pretty strong, and it usually
works really well for most patients. We'll make sure your
pain is under control before we get you out of bed.
Mrs. Adam: I would appreciate that. And, you know, they've been
giving me a lot of fluids in this IV, so I go to the bathroom
pretty often. I want to make sure I can go to the bathroom
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before we walk in the hallway.
Nurse: Absolutely.

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Mr. Adam: Can we actually plan when we'll do this? I need to go into
the office for an hour or two, but I want to be here to help.
Cause I think you're right. That will make me feel much
better at home when it's just the two of us.
Nurse: Sure. Let's write out a timeline for today.
Mr. Adam: Honey, the kids are coming to visit around 2 o'clock so
you don't want to be walking then. That's the kind of
thing that you would need to know, right?
Nurse: That's exactly what I mean. You were due to be given
some medications at 11 o'clock. We can give you your
pain medicine at noon right after lunch. It should be
helping by 1 o'clock, so you could take your walk then.
How does that sound?
Mr. Adam: Works for me. I could be back by 1
o'clock. Nurse: Great, that works out perfectly.
Mrs. Adam: It does. After I walk, I can rest and then watch my
favorite show too. 3
5. Put these words below into the column according to their pronunciation.
trouble doctor blot clot
under discharge discuss under
hall come lunch walk
/ʌ/ / ɑː/
trouble doctor

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3
AHRQ Patient Safety. (2015) CUSP: IDEAL Discharge. Retrieved from https://www.youtube.com/watch?v=3C5EWVbIU5k

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6. Read the dialogue again and identify language which expresses the
following functions.
Expressing doubt Reassuring
I find it difficult to believe. It’ll be fine.
7. Research the discharge planning plan for one of the medical conditions below.
a. discharge plan for patient who has been treated for gastroenteritis
b. discharge plan for patient who has been treated for dengue hemorrhagic
fever
c. discharge plan for patient who has been treated for typhoid fever
d. discharge plan for patient who has been treated for diarrhea
Write a 20-line dialogue which depicts a nurse explaining to a patient how to take their
medications and how to look after themselves when they get home.
The patient will be very insecure about going home and will express doubts.
The nurse will need to explain procedures clearly and use reassuring language.
Write the dialogue with a partner.
Role play the dialogue with your partner.

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13.2 Read about Planning for Patient Dicharge
1. In a group, look at the pictures, then answer the questions below.
a. What should you do before discharge planning?

b. What shouldn’t you do before discharge planning?
Educating a patient Checking vital signs
Doing an exercise Runaway patient
Angry patient

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2. Look at the vocabulary below and practice your pronunciation with your teacher.
transition (n) /trænˈzɪʃ.ən/
preparation (n) /prep.ərˈeɪ.ʃən/
assessment (n) /əˈses·mənt/
3. Now match the word with its definition.
1. transition a. a judge or decide the amount, value,

quality, or importance of something
2. preparation b. the things that you do or the time that

you spend preparing for something
3. assessment c. the things that you do or the time that

you spend preparing for something
4. Read the text and decide what the main idea of the passage is. Then circle the
best title from the three choices below and write it in the space provided.
a. Advising a Care Plan

b. Assessing Care Needs
c. Post-Hospital Care: What to Do Before Transitioning Back Home

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………………………………………………………………………………………….
When a relative goes into hospital, for something routine or an unplanned

visit, it can be a worrying time. As well as considering the treatment and care
they receive, you must think about what will happen when it is time for them
to return home. How will they transition?
Your relative’s care should not end the minute they leave hospital. Plans
should be in place to help them with post-operative care at home. Each
hospital will have its own policy and arrangements for discharging patients
and should provide information about this. However, here are some general
guidelines to help you prepare and ask the right questions.
Assessing care needs
If your relative has been seriously ill, undergone surgery, or has suffered a fall,
they may well require care once they return home. As part of the discharge
process, your relative should be allocated a member of hospital staff who will
assess their needs and discuss a suitable care package to help once they are
discharged.
If your relative’s care needs have changed substantially from before their
hospital stay, they should get a needs assessment. This assessment is free
and forms the basis of any and all follow-up care that your relative is found to
be entitled to.
This kind of assessment can recommend things like:
* Walking frames.
* Help from a career.
* Changes to your relative’s home to help them manage day-to-day tasks.
The needs assessment may also recommend moving your relative into a care
home. The hospital staff can help to arrange the assessment, either while your
relative is still in hospital or before their six weeks of intermediate care is up.
Once your relative’s needs have been assessed, staff should discuss the
options for meeting them and should produce a care plan detailing the

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assessed needs.
Some of the questions or observations the needs assessment covers are:
* Can your relative manage steps or stairs?
* How do they manage with personal care, such as bathing and washing?

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* Can your relative prepare your own meals?
* Is any financial support required?
It can take several days to plan a discharge, especially if a number of different

services need to be arranged. But it will ultimately provide a much smoother
transition for your loved one if staff know exactly what is required to help
them stay happy and healthy once they return from hospital.
Intermediate care and re-enablement
If your relative no longer needs to be in hospital, but still requires extra

support to aid recovery, it is called Intermediate care. It lasts for up to six
weeks and can be provided in your home or in a residential setting. When this
period of intermediate care or re- enablement finishes, your relative will be
assessed to see whether any ongoing social care or NHS support is required.
Before discharge
Before your relative is discharged from hospital the following requirements must be
met:
* Support at home has been agreed and is in place.
* Services required for recovery or care are ready to start.
* Any home adaptations have been made — including appropriate

equipment delivered or installed.
Before your relative leaves hospital for home a member of staff who is
responsible for overseeing the discharge should make sure:
* They have clothes to go home in, money and front door keys.
* You or someone else is collecting your relative, or a taxi or hospital

transport has been booked.
* You have a copy of their plan.
* You understand any new medicines they’ve been given, and you have a
supply to take home.

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* You’ve been shown how to use any equipment; aids or adaptations they need.

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* Their GP knows about their discharge and any extra help you need has
been arranged.
If your relative is being discharged to a care home, the care home should also
be told the date and time of your discharge and have a copy of your care plan.
What will a care plan cover?
A care plan details the health and social care support your relative needs after
they leave hospital. You and your relative (if they are able) should be fully
involved in making this plan. The care plan should include details of:
* Treatment and support your relative will get when they’re discharged.
* Who will be responsible for providing support, and how to contact them.
* When, and how often, support will be provided.
* How the support will be monitored and reviewed.
* The name of the person who is coordinating the care plan.
* Who to contact if there’s an emergency or if things don’t work as they should.
* Information about any charges (if applicable) to medications, treatments etc.
After discharge
Once your relative has returned home, been placed in a suitable care home or
arrived at the place they will fully recover the care they receive should be
monitored and reviewed as set out in the care plan prepared for them. The
care plan should also include details of who to contact if things don’t work as
planned. If the care plan includes any services from a local authority, it should
include provision to check that their care package is working well within two
weeks of your discharge. However, If your relative lives alone, this should take
place within the first few days of discharge. After the initial review, the care
plan should be reviewed at least annually. 4
4
Cavendish Professionals Homecare. (2020). Post-hospital Care – What to Do Before Transitioning Back Home. Retrieved from

289
https://cavendishhomecare.com/help-centre/advice-and-guidance/what-to-do-before-transitioning-back-home/

289
5. Answer these questions based on the text.
a. What shouldn’t do before the discharge?

b. What should a care plan cover?
6. On your own, choose the right answer by deciding if you Should or Shouldn’t follow
the statements. Check your answers with a partner.
a. Plans done to help them with post-operative care at home
(Should/Shouldn’t)
b. Hospital provides information about its own policy and
arrangements for discharging patients (Should/Shouldn’t)
c. Allocating a member of hospital staff who will assess their needs
and discuss a suitable care package to help once they are
discharged
d. When the relative’s needs have been assessed, staff decides the
options for meeting them and produce a care plan detailing the
assessed based on the patient’s want (Should/Shouldn’t)
e. The care plan made including details of anyone the relatives can meet

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7. Find the words below in the reading text and match them based on the definition.
1. discharge a. not planned or expected
2. unplanned b. judging or deciding the amount, value,

quality, or importance of something
3. assessing c. a change from one form or type to another,

or the process by which this happens
4. treatment d. the things that you do or the time that you

spend preparing for something
5. care plan e. the act of observing something or someone
6. manage f. once every year
7. observation g. the way you deal with or behave towards

someone or something
8. preparation h. to succeed in doing or dealing with

something, especially something difficult
9. transition i. the plan of protecting process for someone or

something and providing what that person or
thingneeds
10. annually j. to allow someone officially to leave

somewhere, especially a hospital

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8. With a partner, imagine you are a nurse at a hospital. You are talking to a
patient over the phone who is about to come in for minor surgery.
Write a short dialogue advising them what they should and shouldn't do when
they are in the hospital. Roleplay your phone conversation to another pair or
share with the class.

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13.3 Read about Discharge Planning
1. With another student, examine the steps in the diagram below. Compare the processes
for simple and complex discharge of patients. Take turns to explain the procedures for
both types of patient discharge.

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2. Scan the article below and decide on the best title for the text from the choices. Write
the title in the space provided at the top of the article.
a. Patient Planning
b. The Importance of Effective Discharge Planning
c. Supporting Discharged Patients
…………………………………………………………………………….
Planning for a patient’s discharge from hospital is a key aspect of

effective care. Many patients who are discharged from hospital will have
ongoing care needs that must be met in the community. This ongoing
care comes in many forms, including the use of specialized equipment at
home such as a hospital-type bed, daily support from careers to complete
the activities of daily living, or regular visits from district nurses to
administer medication.
There is a wide variety of care available in the community, but it needs to

be planned in advance of the patient’s return home, to ensure that there
is no gap in the provision of care between the discharge from hospital
and the initiation of community services. Furthermore, information about
the patient must be handed over from the hospital team to the
community team so an informed plan of care can be put into place.
Discharge planning is the process by which the hospital team considers

what support might be required by the patient in the community, refers
the patient to these services, and then liaises with these services to
manage the patient’s discharge. Poor discharge planning can lead to
poor patient outcomes and delayed discharge planning can cause
patients to remain in hospital longer than necessary, taking up valuable
inpatient beds when they could be more easily and comfortably cared for
in the community.
While the guideline committee affirmed the value of discharge planning

based on experience, they wanted to review any evidence available
about the efficacy and cost implications of discharge planning for

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patients following a medical emergency. 5
5
National Institute for Health and Care Excellence. (2018). Discharge planning. Retrieved from
https://www.nice.org.uk/guidance/ng94/evidence/35discharge-planning-pdf-172397464674

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3. Decide on the meaning of each word by choosing the correct definitions below based
on how each word is used in the text.
discharge (v) /dɪsˈtʃɑːdʒ/
a. to give somebody official permission to leave the police or the

armed forces; to make somebody leave the police or the armed
forces
b. to allow somebody to leave hospital because they are well enough to
leave
c. to allow somebody to leave prison or court
administer (v) /ədˈmɪnɪstə/
a. manage and be responsible for the running of an organisation

b. give or dispense something
c. to give help to make the life of others easier
ensure (v) / ɪnˈʃʊə /
a. to make someone less fearful

b. to make sure that what has been planned happens
c. to protect against attack
initiation (v) /ɪˌnɪʃɪˈeɪʃn/
a. the introduction of someone to a particular activity or skill

b. a ritual admitting someone into an organisation
c. the beginning or enactment of a plan
liaise (v) /lɪˈeɪz/
a. a secret connection
b. act as a link to communicate between different groups
c. form a friendship
outcomes (n) /ˈaʊtkʌm/
a. the results of something

b. the conclusion of a discussion
c. the continuation of something that must be done.

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affirm (v) /əˈfəːm/
a. to validate someone’s feelings

b. to make something emotionally uplifting
c. to uphold the importance of something
4. Match the words below based on the definitions of the text.
1. a. very useful or
equipment important
2. b. items needed for a particular
provision purpose or
activity
3. c. a person who stays in a hospital
medication while
receiving treatment
4. d. a drug or another form of medicine
valuable taken to
prevent or to treat an illness
5. e. the act of supplying somebody with
inpatient something
f. that they need or want; something that
is
5. Choose the right answer by circling True (T) or False (F) below based on the text.
a. Forward planning is central to a patient’s discharge from T F

hospital.
b. Ongoing care is defined by regular visits from nurses. T F
c. Planning in advance ensures a gap in the provision of T F
care.
d. Poor discharge planning can result in poor patient T F
outcomes.

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6. Write short answers to the following questions in the space provided.
a. Why may patients require a discharge plan?
……………………………………………………………………………….
b. List 4 forms of ongoing patient care.
………………….. …………………..
………………….. …………………..
c. Who is involved in the discharge planning process?
……………………………………………………………………………….
d. Why does discharge planning need to be done on time?
……………………………………………………………………………….

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7. Examine the Patient Discharge Form for a patient suffering from emphysema and
COPD. With a partner research the conditions and prepare a simple discharge plan.
Patient Name:
Medical Record Number:
EFN8439200 Admission Date:
Discharge Date:
Attending Physician:
Condition on Discharge:
Final Diagnosis: emphysema, COPD
Procedures:
History of Present Illness:
Discharge Medications:
Discharge Instructions: 6
6
Word Templates Online. (2020). Discharge Summary Forms. Retrieved from htps://www.wordtemplatesonline.net/discharge-summary-forms-general-
format/

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13.4 Vocabulary to Talk about Discharge Planning
1. One of the responsibilities that you may have as a nurse is to help plan for
patient discharge. Discuss the following questions with a partner.
Patient discharge is….

a. the release of a patient from the hospital
b. the release of a patient from taking medication
c. a patient releasing bodily fluids
d. the release of information to a patient
The final decision for patient discharge is made by …

a. the patient themselves
b. the nurse on duty
c. the attending physician responsible for the patient
d. the family
It is important to make sure the patient is safely discharged so…

a. the chance that the patient will have to be readmitted is minimized
b. the hospital can have as many free beds as possible
c. patients can be looked after by family at home
The overall discharge process needs to take into consideration…

a. the patient's overall health condition,
b. their living situation
c. their ongoing access to care
d. all of the above

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2. Read the following passage. With your partner, decide what situation is being discussed
in the text above. What kind of documentation is discussed?
Leaving the hospital
A trip to the hospital can be an intimidating event for patients and their
families. As a caregiver, you are focused completely on your family member’s
medical treatment, and so are the hospital staff. You might not give much
thought to what happens when your relative leaves the hospital. Yet, the way
this transition is handled—whether the discharge is to home, a rehabilitation
(“rehab”) facility, or a nursing home—is critical to the health and well-being of
your loved one. Studies have found that improvements in hospital discharge
planning can dramatically improve the outcome for patients as they move to
the next level of care.
Patients, family caregivers, and healthcare providers all play roles in

maintaining a patient’s health after discharge. And although its a significant
part of the overall care plan, there is a surprising lack of consistency in both
the process and quality of discharge planning across the healthcare system.
So, what are the keys to a successful transition from hospital to home?
Caregivers should be provided with checklists to help ensure the best care for
a loved one. If you are a caregiver, you play an essential role in this discharge
process: you are the advocate for the patient and for yourself.
What Is Discharge Planning?

Only a doctor can authorize a patient’s release from the hospital, but the
actual process of discharge planning can be completed by a social worker,
nurse, case manager, or other person. Ideally, and especially for the most
complicated medical conditions, discharge planning is done with a team
approach.
In general, the basics of a discharge plan are:
 Evaluation of the patient by qualified personnel
 Discussion with the patient or his representative
 Planning for homecoming or transfer to another care facility
 Determining whether caregiver training or other support is needed
 Referrals to a home care agency and/or appropriate support
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organizations in the community

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Arranging for follow-up appointments or tests
The discussion needs to include the physical condition of your family member
both before and after hospitalization; details of the types of care that will be
needed; and whether discharge will be to a facility or home. It also should
include information on whether the patient’s condition is likely to improve;
what activities he or she might need help with; information on medications
and diet; what extra equipment might be needed, such as a wheelchair,
commode, or oxygen; who will handle meal preparation, transportation and
chores; and possibly referral to home care services7.
3. The words below can be found in the text ‘Leaving the Hospital’.
Based on how the words have been used in the text, match the words with a definition
below
rehabilitation improvement discharge plan evaluation( referral (n)

(n) (n) (n) n)
hospitalization commode (n) home care (n) caregiver advocate

(n) (n) (v)
a. When a condition gets better …………………………………….

b. Health and social care services provided to a person in his or her own
home by a health visitor …………………………………….
c. A treatment design to facilitate the proccess of recovery from injury or
illness to a normal condition as possible …………………………………….
d. A receptacle suitable for use as a toilet …………………………………….
e. Confinement in a hospital as a patient for diagnostic
study and treatment …………………………
f. Directing a patient to another practitioner with more knowledge
……………………..
g. Someone who takes care of a person who is young, sick or old
………………………
7
Family Caregiver Alliance. (2020). Hospital Discharge Planning: A Guide for Families and Caregivers. https:// www.caregiver.org/hospital-discharge-
planning-guide-families-and-caregivers

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h. An assessment to determine a person’s condition or state
………………………
i. A plan of action before someone officially leaves the hospital
………………………
j. To speak in support of an idea …………………………………….
4. Put the words in correct order to make a good sentence. Check your answers together
with a partner.
a. booked – clinic – a – into – he – rehabilitation – himself
He booked himself into a rehabilitation clinic.
b. documenting - are - Nurses - for - condition. - the - responsible -

patient’s
Nurses…
c.made - A - - the - - is - by - -
evaluation medical physician attending
A medical…
d. dehydration – hospitalization – required – is – to – occasionally –

combat
Hospitalization…
e. maybe - home - a - assistance- nurse. - provided - by - care
Home…
f. with - approach - discharge - is - team - done

- a - planning
Discharge….

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5. Complete the sentences about discharge planning with a word from the table.
observe include discharge planner educate
approach nursing treatment prevent
a. Discharge planning can.........future admission.
b. The nurse should........the family and the patients as full partnership in

discharge
planning process.
c. Nurses need to...........................family and patient about the patient’s

condition in
plain language.
d. Ensuring safe transition from hospital to home requires a

systematic………………………
that include the patient and their family in the discharge process
e. A day or two before you expect to leave the hospital, ask to meet with your
………………………
f. At the ICU, the nurse needs to.......................patient’s vital sign
g. Jeff’s mother now lives in a.........................home as he is unable to look after

her
himself.
h. A nursing care plan may include both a short or long-term.................plan

depending on the condition.

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13.5 Writing an Early Discharge Summary
1. Discuss with your partner the risks of discharging someone from hospital too
early. List some things that could go wrong?
2. How would you classify the text below?

a. an article in a newspaper
b. a report following an investigation
c. a personal story in a medical journal
Mrs. T died in her granddaughter’s arms after being discharged too soon with
severe stomach pain
‘Just as the ambulance left, Mrs. T collapsed and died in her granddaughter’s arms.’
What happened
Mrs. T, who was in her late 90s, fell ill at home. Her granddaughter called a
GP to see her, who diagnosed a bladder infection and also noticed that Mrs.
T’s stomach was swollen. She became unwell overnight, so her
granddaughter called an ambulance who took Mrs. T to hospital.
The ambulance crew also noticed Mrs. T’s stomach was swollen. At the
hospital Mrs. T was examined by a doctor who ordered a urine test but did
not focus on the severe stomach pain she was having. Mrs. T was told she
had a bladder infection. She was discharged and the doctor advised her to
drink more fluids.
Just after the ambulance had dropped her home and left, Mrs. T collapsed
and died in her granddaughter’s arms. A postmortem showed Mrs. T had
died from an infection in her large intestine and an infection of the tissue
that lines the tummy; symptoms of both included abdominal pain.

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What we found
Mrs. T was very unwell and had the doctor physically examined her stomach,
it’s highly
unlikely that she would have been sent home. If she had been examined, it
would have
been clear to Mrs. T’s family that she was very ill and that there was a risk of
her dying. Instead she was discharged home where she died suddenly,
causing Mrs. T’s granddaughter a great deal of shock and distress.8
3. Decide if the following statements are True (T) or False (F) based on the information in
the text. Circle the correct answer.
a. Mrs. T collapsed at the hospital. T F

b. Mrs. T became unwell and she called an ambulance. T F
c. No one noticed anything about Mrs. T’s stomach. T F
d. Mrs. T was diagnosed with intestinal issues. T F
e. The doctor did not examine Mrs. T’s stomach. T F
f. Mrs. T died from a bladder infection. T F
4. Write a 50-word summary of the report about Mrs. T.
……………………………………………………………………………………………………
……………………………………………………………………………………………………
……………………………………………………………………………………………………
……………………………………………………………………………………………………
……………………………………………………………………………………………………
……………………………………………………………………………………………………
8
Parliamentary and Health Service. (2016). A report of investigations into unsafe discharge from hospital. Retrieved from Ombudsman
https://www.ombudsman.org.uk/sites/default/files/page/A%20report%20of%20investigations%20into%20unsafe%20discharge%20from%20hospital.pdf

303
5. Identify the parts of the text which correspond to the descriptions below. Check
your answers with your partner.
a. a report on what happened and recommendation for what should have

been done
b. description of the events
c. summary in one sentence of the story
d. a dramatic quotation
6. Using the structure of the text as a model, write your own report of a discharge story
which did not go according to plan. Your text should contain the following sections.
a. dramatic quote
b. what happened and where it happened
c. what the outcomes were
d. what recommendations were made after an investigation
Swap your writing with a partner and give them 3 ideas on how to expand on the ideas in their
report.

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Module 1

1. ...................... 2. ...................... 3. ......................

4. ..................... 5. ...................... 6. ......................

Nurse radiologist (n) pharmacist (n)

nutritionist (n) doctor (n) physiotherapist (n)

English for Nursing 1 -

Sandra: Good morning Jessica

Jessica: Hi Nurse Sandra.

Sandra: Jessica, it’s now 07.30 am and I am going to end my

Susan: Hi Sandra, I’m Susan, your nurse. I will be in charge

Jessica: Alright, Nurse Susan. Nice to meet

you. Susan: How are you feeling right now?

Susan: You can eat bite by bite. Please do this.

Jessica: I’ll do it.

Susan: I’ll check in with you again at 9 am for vital signs.

Jessica: Ok, thank you.

In another session, Susan introduces Harrison to Jessica.

Susan: Hello, good morning Jessica

Jessica: Hi Susan, morning.

Susan: Jessica, I come here with Dr. Harrison.

Harrison: Hi Jessica, I’m Dr. Harrison, your primary doctor.

Jessica: Good morning, Dr. Harrison.

Harrison: I’m going to ask you some questions related to your

Harrison: Nurse Susan, may I know her situation?

English for Nursing 1 -

Harrison: Alright, thank you nurse Susan. Ms. Jessica, how

Jessica: It is quite bad I think, I feel like I’m going to throw up

Harrison: Okay, how many days have you been feeling

so weak. Harrison: Well, how about your headache?

Jessica: I feel a bit dizzy right now.

Harrison: Okay, Jessica we will continue observing your condition

Harrison: Alright, I will visit you again tomorrow at 8 o’clock in the

morning. Jessica:Okay, thank you, Doctor.

Harrison: You’re welcome.

Susan: Alright Jessica I will organize to have a nutritionist come

3. Answer the following questions.

5. How did Sandra introduce Susan?

6. Who is the nurse in charge after the

Now, work in pairs and practice asking questions and answering

Listen to your teacher and repeat

Work with your partner and practice saying the following

a. Anne Excuse me, I am Nurse Anne.

English for Nursing 1 -

morning. Natalie .................................................

b. Nice to meet you. ...........................................................

c. Here is the nurse ...........................................................

e. How do you do? ...........................................................

f. I will introduce you to ...........................................................

g. I don’t think we have met. ...........................................................

h. Please call me Jose. ...........................................................

a. You are a new nurse in the hospital. You are to introduce

c. You are a doctor on your first visit to an elderly patient.

d. A patient is introduced to another nurse before shift change.

English for Nursing 1 -

1. doctor (n) a. provides and manages the care of

2. physiotherapist b. diagnoses symptoms and recommend

3. midwife (n) c. provides medical treatment to women, on

4. nurse (n) d. offers individual care to pregnant women

5. gynaecologist (n) e. assists patients in rehabilitating physical

2. Now scan the following text and check your answers.