Cambridge University Press

978-0-521-71540-9 - Cambridge English for Nursing

Virginia Allum and Patricia McGarr
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UNIT 1 Patient admissions

L Taking a patient history
L Using active listening
strategies
L Explaining how the heart works
L Putting a patient at ease
L Giving a nursing handover
L Charting blood pressure and
pulse

Taking a patient history

1 a In pairs, look at the picture and discuss the following questions.
1 What do you think the nurse is doing?
2 What information might you need to collect in this situation?
3 Why might this information be important?
4 What strategies have you found useful when greeting a
patient for the first time?

b 1.1 Shona, the Ward Nurse, is admitting Mrs Chad. Listen

to the conversation and answer the following questions.
1 Is Mrs Chad mobile?
2 Has she been waiting long?
3 Which hospital unit is she being admitted to?

c 1.1 Listen again and put the following sentences in the correct order.
How are you today?
I’d like to ask you a few questions, if it’s all right with you?
Not too bad, thank you.
Good morning, Shona.
Yes, of course. That’s fine.
& Good morning, Mrs Chad. My name’s Shona. I’ll be admitting you to the
ward today.

d 1.2 Listen to the rest of the conversation between Shona and Mrs Chad
and answer the following questions.
1 Why is Mrs Chad in hospital?
2 What happened to her last year?
3 Does she have any allergies?
4 Does she have a relative who can be contacted during an emergency?

6 Unit 1 Patient admissions

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Cambridge University Press
978-0-521-71540-9 - Cambridge English for Nursing
Virginia Allum and Patricia McGarr
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e 1.2 Listen again and match the questions (1–7) to the answers (a–g).

1 Can you tell me your full name, please? a Not that I know of.
2 Can you tell me why you’re here today? b No, I’m very lucky. I never have.
3 Have you had any serious illnesses in c It’s my son, Jeremy. Jeremy Chad.
the past? d Yes, I had a mild heart attack last
4 Have you ever had any operations?
year.
5 Now, are you taking any medications at the
e Well, I’ve got high blood pressure, and
moment?
I’m here for some tests.
6 Do you have any allergies to any
medications? f Yes, my doctor put me on some blood
7 Can you tell me the name of your next pressure tablets after my heart attack.
of kin? g Yes, it’s Doreen Mary Chad.

f In pairs, take turns to ask and answer the questions from Exercise 1e,
using the following information and your own name and next of kin.
L I had my appendix out when I was fourteen.
L I take aspirin every day for my arthritis.
L I’m here for a chest X-ray.
L I had pneumonia two years ago.
L I’m allergic to nuts.

g In pairs, discuss how you might change your approach for the following
patients.
1 An elderly patient who uses a walking aid
2 A young patient
3 A patient who has been waiting a long time

Communication focus: using active listening strategies

2 a In pairs, discuss the following questions.
1 What are active listening strategies?
2 Why do you think they are important?

b Complete the following active listening strategies using the words and
phrases in the box.
eye contact mm nodding your head hm I see

1 Using expressions such as Really?, Is that right?, and Yes or

No.
2 Making ‘listening noises’ like and shows that
you are interested in what the speaker is saying.
3 Leaning towards the other person and also shows interest.
4 Smiling while maintaining puts a patient at ease.

c 1.2 Shona uses several active listening strategies whilst taking Mrs Chad’s
details. Listen again and find examples in the audioscript on page 94.

d In pairs, practise taking patient details. Student A, you are Shona; Student
B, you are Mrs Chad. Remember to use active listening strategies. Swap
roles and practise again.

Unit 1 Patient admissions 7

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Cambridge University Press
978-0-521-71540-9 - Cambridge English for Nursing
Virginia Allum and Patricia McGarr
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e In pairs, prepare nurse–patient interviews. Student A, you are the nurse;

look at the Patient Admission Form and think about the questions you will
ask to complete it. Student B, you are the patient; read the patient details
on page 86. Swap roles and practise again using the patient details on
page 93.

(Patient Identification Label)

5)&
"-&9"/%3"
)041*5"-

PATIENT ADMISSION FORM

Patient details
Full name

DOB

Reason for admission

Past medical history

Past surgical history

Medication

Allergies

Next of kin

Share your knowledge

In small groups, discuss the following questions and then feed back
your group’s ideas to the class.
L Is the process for taking a patient history the same in your country?
L How has the introduction of privacy laws and Nursing Informatics
changed the way patient information is recorded and used?
L What do you know about Electronic Patient Records (EPR)?
L Are you familiar with coding for improved patient identification?

8 Unit 1 Patient admissions

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Cambridge University Press
978-0-521-71540-9 - Cambridge English for Nursing
Virginia Allum and Patricia McGarr
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Medical focus: the heart

Explaining how the heart works
3 a In pairs, answer the following questions.
1 What is the cardiac cycle?
2 What does the heart do during a heartbeat?
3 What symptoms does a person have if there is not enough blood flow
through the heart?
4 Why might nurses in the Cardiac Unit need to explain the cardiac cycle to
their patients?

b Read the patient information leaflet. In pairs, discuss what the following
parts of the heart do.

the atria the valves the ventricles the pulmonary vein

the pulmonary artery the aorta

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c In pairs, practise explaining how the heart functions. Student A, you are a
nurse; Student B, you are a patient. Swap roles and practise again.

Unit 1 Patient admissions 9

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Cambridge University Press
978-0-521-71540-9 - Cambridge English for Nursing
Virginia Allum and Patricia McGarr
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Communication focus: putting a patient at ease

Before discussing important lifestyle changes with a patient, it is important
to put the patient at ease. Sensitive topics can be broached more easily if the
patient feels relaxed and comfortable.

4 a 1.3 Listen to a conversation between a Nurse Educator, Susanna, and her

patient, Mr Hockings. What is the topic of their discussion and why is it
important?

b Susanna uses several informal expressions to create a friendly and relaxed

relationship with the patient. Match the expressions from the dialogue
(1–7) to their meanings (a–g).

1 have a chat a monitor

2 a bit of a shock b I’m going to sit down
3 a bit flushed c ruddy/red complexion
4 watch for d take notice of
5 I’ll just grab a chair e discuss
6 fired up f enthusiastic
7 keep an eye on g unpleasant surprise

c Complete the strategies for putting a patient at ease (1–4) using the words
in the box. Then match them to the rationales (a–d).
judgemental rapport positive same level

1 Sit at the as the patient. a This encourages patients in their attempts

at learning new information.
2 Make responses whilst b This shows respect for the patient’s right
nodding your head. to make decisions about healthcare.
3 Don’t make comments. c This can lighten the atmosphere and help
patients relax.
4 Use humour to establish a good d This helps patients feel that you are
with your patient. interested in talking to them rather than
over them.

d 1.3 Listen again and find examples of the strategies in Exercise 4c in the
audioscript on page 94.

e In pairs, practise putting a patient at ease. Student A, you are Susanna;

Student B, you are Mr Hockings. Remember to use active listening
strategies. Swap roles and practise again.

Share your knowledge

In small groups, discuss the following questions and then feed back
your group’s ideas to the class.
L What strategies do you use for putting a patient at ease?
L What difficulties have you encountered with anxious patients?
L What role does cultural sensitivity play when putting a patient at ease?

10 Unit 1 Patient admissions

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Cambridge University Press
978-0-521-71540-9 - Cambridge English for Nursing
Virginia Allum and Patricia McGarr
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Charting and documentation:

a nursing handover
Healthcare professionals write entries about patients in their care in the
Patient Record. The Patient Record documents patient care and, as such,
forms a permanent legal record of treatment. At the end of each nursing shift,
the outgoing nurses give a verbal handover to nurses on the incoming shift.
The nurses on the incoming shift are briefed on changes in patient progress
and patient care. The handover is usually performed face-to-face but some
institutions use recorded handovers. The information which is reported during
the handover is gathered from the Patient Record, the Care Plan and any other
charts which document specific patient care.

5 a In pairs, discuss the following questions.

1 What do you think are the features of a good handover?
2 What information does not have to be repeated in a handover? Why not?
3 What can happen if handovers do not communicate important information
from one shift to another?

b 1.4 Listen to Emily, a Ward Nurse, handing over a patient, Mrs Cho, and
answer the following questions.
1 What is her present medical problem?
2 What is her past medical history?

c 1.4 Listen again and mark the following statements True (T) or False (F).
1 She does not manage her ADLs at home by herself.
2 She has been quite distressed.
3 Her BP at 10 am was 200/105.
4 Her pulse was 88 at 10 am.
5 The porter has been booked for tomorrow.

d Abbreviations are often used in both Patient Records and verbal handovers.
Some are only found in written documents. It is important to check which
abbreviations are approved at the hospital where you are working, as there
may be some variance.

Match the abbreviations (1–14) to their meanings (a–n).

1 BP a activities of daily living
2 P b four times a day
3 qds c Senior House Officer
4 MI d electrocardiogram
5 GTN e sublingual, or under the tongue
6 SHO f myocardial infarction, or heart attack
7 4° g blood pressure
8 c/o h complain of
9 sl i observations
10 O2 j four hourly, or every four hours; also 4/24
11 ECG k patient
12 ADLs l glyceryl trinitrate; also called nitrolingual
13 Pt m pulse
14 obs. n oxygen

Unit 1 Patient admissions 11

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Cambridge University Press
978-0-521-71540-9 - Cambridge English for Nursing
Virginia Allum and Patricia McGarr
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e 1.4 Listen again and complete the following extract using the
abbreviations in Exercise 5d.

Right, now Mrs Cho in bed number five. Mrs Cho was readmitted yesterday
because of uncontrolled hypertension. You’ll probably remember her from
last week. She went home but couldn’t manage her (1) 69Ah by herself. Her
daughter had to come in every morning to give her a shower and help her
during the day. She’s been quite distressed about it, according to her daughter.
She presented to the unit with uncontrolled hypertension, despite a change
in medication. She has a past history of (2) this year in June. Um, this
morning she complained of chest pain. The (3) was called. Her
(4) at the time – er, that was 10 am – was two ten over one oh five,
and her pulse was one hundred. She had an (5) done and was given
(6) sublingually. We gave her some (7) via the mask and she
seemed to settle. She’s in for cardiac catheterisation tomorrow to assess the
extent of the damage to her heart. I’ve booked the porter already. Strict four
hourly BP and pulse and report any chest pain immediately, of course. She’s
had no chest pain this shift.

f A Patient Record contains entries from every member of the patient’s team. As a
nurse, you must read all entries in order to plan patient care efficiently.

Another patient, Mrs Smits, is handed over. Use information from the
Patient Record to complete what was said.

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Surname: Smits
Given names: Livia
PATIENT RECORD DOB: 10.12.31 Sex: Female

DATE & TIME Add signature, printed name, staff category, date and time to all entries
MAKE ALL NOTES CONCISE AND RELEVANT
Leave no gaps between entries

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relieved within a couple of minutes.

12 Unit 1 Patient admissions

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Cambridge University Press
978-0-521-71540-9 - Cambridge English for Nursing
Virginia Allum and Patricia McGarr
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g 1.5 Listen to Nick handing over Mrs Smits and check your answers. In
pairs, practise the handover using only the written Patient Record.

h In pairs, practise giving a handover using the Patient Record. Student A,

look at the record on page 86; Student B, look at the record on page 93.

Charting blood pressure and pulse

Mrs Small has been admitted with hypertension, which has been poorly
managed at home. Her doctor decides to review the medication she is taking
to control her high blood pressure. For the first day after admission, her blood
pressure and pulse will be observed regularly. The admitting doctor has placed
her on four hourly observations of blood pressure and pulse.

6 a In pairs, look at the chart on page 86 and discuss the following questions.
1 Are you familiar with this type of chart?
2 What other styles of Observations Chart are you familiar with?
3 Who has access to the chart?
4 Who is responsible for completing the chart?

b 1.6 Jenny, the Ward Nurse, is handing over Mrs Small to the afternoon
shift. Listen to the conversation and answer the following questions.
1 How long will Mrs Small be in hospital for?
2 Why did Dr Fielding come to see her?
3 What did Jenny do just before handover?

c 1.6 Some of the information in the Obs. Chart on page 86 is incorrect.

Listen again and correct any mistakes.

d Blood pressure readings are spoken as the first number on or over the
second. For example, 90/60 is ninety over sixty or ninety on sixty. How
would you say the following blood pressure readings?
1 110/70 3 142/99
2 150/90 4 86/40

e Look at Mrs Small’s handover in the audioscript on page 94 and find

phrases describing changes in her pulse or blood pressure readings. What
other phrases could you use? Add them to the table.

increase stabilise decrease

f In pairs, practise handing over Mrs Small. Student A, you are Jenny;
Student B, you are a nurse on the afternoon shift. Use the Obs. Chart on
page 86, the audioscript on page 94 and the phrases in Exercise 6e. Swap
roles and practise again.

Unit 1 Patient admissions 13

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