Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Medical ethics wikipedia , lookup
Dental emergency wikipedia , lookup
Neonatal intensive care unit wikipedia , lookup
Patient safety wikipedia , lookup
Nurse anesthetist wikipedia , lookup
Nursing shortage wikipedia , lookup
Nurse–client relationship wikipedia , lookup
Anatomical terms of location wikipedia , lookup
Adherence (medicine) wikipedia , lookup
Wounds, Charts and Medication: Tips on teaching nurses Virginia Allum Introducing ..Virginia Allum • Co-author with Patricia McGarr of ‘Cambridge English for Nursing’ (Int Plus and Pre-Int) • Currently Staff Nurse in a private hospital (mix of private and NHS patients) • Productive Ward Project Leader and Infection Control Link Nurse Our session today • We’ll look at Wounds (an example of a nursing procedure ) / you’ll do some medical terminology activities • We’ll look at Charts (example of common writing skills needed by nurses) / you’ll complete a Wound Chart • We’ll look at Medication (use of maths terms and abbreviations) / you do a Find-a-Word Before we start , Why teach Specialist English for Nurses? Nurses leave NHS for better life abroad Daily Mail 7 Nov,2010 ‘An increasing number of overseas nurses are already arriving in Britain to fill the rising number of hospital vacancies. Last year Britain imported 8,500 nurses and midwives - many coming from poor countries such as India, Pakistan and the Philippines.’ What do stakeholders demand of overseas nurses? • • • • • • Ability to communicate effectively Safe practice High standards of technical knowledge Cultural sensitivity and awareness Good teamwork Ability to work with other Health Care Professionals www.nursepostcard.com Here to Stay? International Nurses in the UK 2003 (NMC) Four main areas of concern for hospital managers who employ overseas nurses 1. language 2. differences in clinical and technical skills 3. racism in the workplace 4. reaction of patients. Language areas of need • Everyday communication • Nurse-to-nurse communication • Technical knowledge (medical terminology) http://www.nursingtimes.net/pictures/182xAny/7/2/1/1205721_1205409_ nurse_talking_paperwork.jpg Let’s look at wounds... • Or any nursing procedure • Specialised language (look at wound websites, prefixes + suffixes) (R, S, L, W) • Recycle general English (asking for info, giving advice, assessing pain, giving directions) • Maths terms e.g dimensions of wound, amount of discharge • Opportunity for role plays A word about role plays • They are serious enough for ESP • Perfect opportunity to use specialised language in authentic situations (lots of handovers, telephone referrals in nursing) • Ss can write them and own them • Bring in guest speakers (e.g real nurses or student nurses ) to confirm authenticity Wounds: opportunity to look at... • Verbal descriptions e.g. in handover • Written descriptions e.g. Wound Chart • Abbreviations • Equipment e.g Dressings • Documentation: Care pathways • Staff in specialty areas: Infection Control Nurse, Tissue Viability Nurse What is there to say about wounds? • • • • Types of wounds (surgical, ulcers, lacerations Position on body (on the right ankle) Description ( order of adjectives) Colour (of the surrounding skin, wound discharge) • Size (width and depth) • Amount of exudate (small, moderate, copious) What else? • • • • • Presence of drains Equipment used (VAC) Dressings ,surgical tape, bandages Sutures, clips, staples and Steristrips Nursing jargon v medical term (healing v granulating ) Types of wounds • Vocab : use Pharmaceutical company websites e.g. http://int.hansaplast.com/medinfo/wound-care-beautiful-healing/types-ofwounds.html • Use pictures or diagrams ; match terms e.g. Match medical term to everyday term e.g contusion = bruise • Use nurse education on Pharmaceutical sites e.g. T.I.M.E on Smith & Nephew Warning: Pictures of wounds on next slide • Use authentic photos of wounds if possible • Be advised that some are pretty awful! • Next slide : not too bad but.. 1 1 3 2 4 Now, in pairs, do handout exercise 1. Photo number 1 2 3 4 Type of wound a) Pressure Ulcer b)Surgical wound c) Cut or laceration d) Bruise or contusion Describing a pressure wound What can you get out of it for a lesson? • Use body diagram (front and back) –see WSheet • Practice of body parts (everyday v medical term) • Practice of ‘ Where is the wound? (Position of the wound)- The wound is over the right lateral malleolus (ankle)’ • Exercise: Blank diagrams of the body with numbered wounds. In pairs, Where is wound (!)? Body Diagrams • Terminology (body position – anterior, posterior etc) – on the back of.. • Parts of the body e.g where pressure ulcers may occur - on her sacrum • Everyday terms versus medical terminology - shoulder blade – scapula Now, in pairs, do Exercise 2 • Look at the numbered diagrams of the body • Complete the table using terms in the box below • Further activities: make up double-side cards (everyday term one side, medical term reverse side) – pr work. • Speed work, 2 groups , complete table on WB . First team to get rid of cards, wins Humerus Outside ankle bone back of the head Number Everyday term 1 Heel calcaneus inside ankle bone Thigh bone Medical terminology (Heels) 2 Lateral Malleolus (Malleoli) 3 Medial Malleolus (Malleoli) 4 Greater Trochanter (s) 5 Sacrum 6 Ischial Tuberosity (Tuberosities) 7 vertebrae 8 Occiput 9 Ears 10 Shoulders 11 Scapula (Scapulae) 12 Elbow (Elbows) 13 Iliac Crest Humerus Outside ankle bone back of the head calcaneus inside ankle Humerus back of the head calcaneus inside ankle bone Thigh bone boneOutside ankle bone Thigh bone pinna shoulder blade hip bone lower back Olecranon process spine flank Matching cards - example Haemat- -oma erythr- Ven- Necro- -itis Ser- Esch- scab red blood Swelling plasma dead Inflammation of Vein Using websites for inspiration • http://news.bbc.co.uk/1/hi/health/1751163.stm 'Living bandages' for wounds The technology for the 'bandage' was adapted from drinks cartons Online: BBC Radio Transcripts http://www.bbc.co.uk/radio4/science/casenotes_tr_ 20050208.shtml RADIO SCIENCE UNIT CASE NOTES 9. - Wound Healing Use clips on websites: Wounds UK http://www.wounds-uk.com/ • • • • Use demonstration videos as Listening Practice. Prepare worksheets (missing terms) Vocab matching Ss design a teaching session e.g. How to set up a negative pressure wound treatment / in prs teach each other Charts and Documents • • • • • • Legal documents Completed each shift Used as communication between shifts Nursing Care Plans Integrated Care Pathways (Wound Charts) Policies and Procedures What are Nursing Care Plans? http://www1.us.elsevierhealth.com/MERLIN/Gulanick/Constructor/index.cfm?plan=32 • Use the online resource to create a printable Care Plan • Use as vocab resource • Use as ‘Handover Resource’ – S (nurse) gives information about wound care during handover e.g I’ve encouraged increase intake of proteinrich foods to help healing. Integrated Care Pathways Wound Chart • • • • ICPs require nurse to tick correct box Reading > Writing Specific terms used Assessment often uses grading system (Grade 1: not too bad → Grade 5 : very serious Wound Chart on p2 of worksheet • Vocab work – prefixes and suffixes flashcards • Description of wounds – recycle descriptive language, order of adjs • Grade of pressure ulcer – match photos • Wound drainage (discharge) –jargonpurulent discharge = pus, discharge = ooze Example of wound chart Now, Exercise 3: Where is the wound? • Complete the Wound Chart using information in the scenario WOUND CHART NAME: Mrs A. Patient WOUND TYPE TICK Abrasion Haematoma Laceration Ulcer Surgical incision DOB: 30/ 11/ 1924 WOUND Tick Wound Tick APPEARANCE Drainage Blister Purulent (pus) Erythema Haemoserous (Redness) (Blood-stained fluid) Inflammation Nil Maceration (over-moist) Slough Eschar (black, hard scab) Epithelialisation (healing tissue) Pain Tick Site Dressing change continuous intermittent When limb elevated Nil Mrs Anna Patient has a 3 cm long laceration on her left forearm caused by a dog bite. The skin around the wound is red and inflamed . There is a moderate amount of greenish pus in the wound caused by an infection which is being treated with oral antibiotics. The wound dressing is being changed every two days at the Outpatient Clinic. The patient reports a small amount of pain when the dressing is changed. She takes a painkiller before the dressing change. The Wound Chart ex can be .. • A practice of handovers (write a dialogue using given info / complete missing terms in dialogue/ practise as a role play ) • Used for different scenarios (dog bite, fall , burn, operation) • Used to recycle language ( She’s got a .. , The ulcer’s on her sacrum...) • A practice of vocab of body parts / areas Scenarios..here is another • Mr D Hatworth was repairing his fence when he accidentally dropped a piece of wood which grazed his right lower leg. He left the wound untreated for two weeks apart from dabbing on a bit of antiseptic cream. Now, the wound is painful to touch and is red and inflamed. There is a small amount of blood-stained discharge Answers – students complete wound chart • Wound: abrasion • Wound Appearance: erythema, inflammation • Wound Drainage: Haemoserous • Pain: Site Also, wound charts are a chance to.. • Do vocab exercises e.g prefix and suffixes e.g necro-, -osis, haemat- , -oma, erythro- , ven-, • Make matching cards / flashcards • Practise communication skills e.g Advise patient on after care of wound dressing - It’s important to keep the dressing dry, You’ll have to come back next week for a new dressing → make an appointment / make a phone call to confirm appointment with patient Wound Chart language • Wound Type – ‘It’s a ..’ • Wound Appearance - ‘ It’s got.. , It’s got an area of..’ • Wound Drainage – ‘There’s a small amount of..’ • Pain - ‘ Is it painful? , Do you have any pain?’ When is the wound painful? Medications – important area! • • • • • • • • Safe and accurate practice is essential Legal and patient health implications Oral medications (tablets, liquids) Nebulizers and inhalers Injections: IMI ,IVI, IV fluids PR medications (suppositories, enemas) Oxygen Language skills needed • • • • Abbreviations (R, W, L and S) e.g bd, tds Maths terms e.g. Morphine 15mg – pronun. practice Measurement terms e.g ml, mcg, 80, mg/ml, units Medication use: e.g Read entries in BNF or MIMS e.g side effects • Check for interactions with other drugs e.g (R) literature on drug in blurb or on internet • Handover information e.g (S) intolerance to pain killer Medications : opportunities for? • Research practice – journals, EBP online • Writing practice e.g develop a Public Health Poster on Hypertension drugs → present to class (speaking practice) • Reading and comprehension practice –e.g. Compare drugs used for diabetes- small group work, present to class → teamwork Medication : language practice • • • • • Abbreviations e.g sc, prn Terms e.g nocte, mane Instructions e.g. Take this medication after food Polite advice e.g It would be a good idea to.. Warnings e.g you must keep the medication in the fridge The Medication Chart • • • • • Understand terms used in the chart Get a copy of a medication chart for practice Latin terms Maths terms Use flashcards, cross-words, Find-a-Word to practise terms Drug Chart - example Allergies Adverse Drug Reactions BD QDS TDS Anticoagulants Slow Release Ex 4: Medication Table • Read through the terms in the medication table • Ask your ‘teacher’ if you don’t understand any terms • Now, take turns to find a term explain the meaning to your partner • Hint: break into chunks or students will not survive this exercise! Medical terms for medications a.c amps. b.d (or b.i.d) Inh. IM or IMI IV or IVI IV Fluids mane Neb. Needle gauge Meaning NI nocte OD or daily oral p.c per NG pr prn q.i.d or qds R s.c s.l stat (statim) t.d.s top. units Venflon W Nurse Initiated medication e.g. Paracetamol, Coloxyl with Senna. At night Once a day By mouth After meals through the nasogastric tube (through nose into the stomach) Per rectum e.g. a suppository whenever needed ( for pain, indigestion, constipation) Four times a day (quad= 4) .Doesn’t have to be in 6 hour intervals. Refused by the pt. (written on the medication chart) Subcutaneous ie an injection given into the subcutaneous layer of skin Sublingual or under the tongue immediately e.g. a stat dose of insulin Three times a day (Ter in diem) Topical ie a cream or ointment e.g antibiotic cream Insulin is prescribed in units. E.g. 24 units of Insulotard Type of intravenous cannula. Abbrev to IVC . Withheld (written on the medication chart) e.g. Digoxin because the pulse was 58. 1/24 2/24 4/24 6/24 or 10 or 20 or 40 or 60 Before meals Ampoules . This is the container for liquid medication for injection. Twice a day (bi= two) Inhaler e.g Salbutamol inhaler Intramuscular ie an injection given into a muscle Intravenous ie an injection given into a vein Fluids given through an IV cannula. Also called a ‘drip’ In the morning Nebulizer e.g Salbutamol nebulizer Size of the needles eg 19g (drawing up needle) 21g (IM injections ) 23g (fine for sc injections) Hourly or every hour Second hourly or every two hours Fourth hourly e.g. 4/24 T P R (Note: this is 6 times a day) Every six hours (Note: this is 4 times a day) Medication Find-a-word • In pairs, find a word relating to medication administration in the Find-a-Word • Tell your partner what it means • Use previous glossary to help you In pairs, identify a term in the Find-a-Word below using the table above. Explain the meaning of the term to your partner. A N M P F O E R O R O A U L O D E C B S T U M T B A E L N I E N H L U I E N N I J G T E U S C N T I Q E N D I S A R B O V S C T A E I O T O N P F L L A I C Good medication calculation sites for nurses – lots of related terms • Medication Terms • http://home.sc.rr.com/nurdosagecal/Conversions. htm • http://www.jcu.edu.au/cgi-bin/nursing/test.cgi (if you have problems go to www.jcu.edu.au and Search: Nursing Calculations Practice Other medication activities • Reading a Medication chart – use scenario • The IV Prescription Chart • The 5 Rights of Drug Administration – research and make an educational poster • Practice of role plays for medication administration / recycle questions / asking for information ‘Do you need something for pain?’ / giving advice ‘ It’s best to take this tablet with food’ Tips : Use websites • http://www.bhf.org.uk/living_with_a_hear t_condition/treatment/medicines_for_the_ heart.aspx • http://www.proprofs.com/flashcards/story .php?title=types-wounds Invite guest speakers • • • • Nursing lecturers Nursing students Nurses Ask them to show authentic charts and documentation (make sure any identifying information is obscured first) e.g hospital logo Any questions? Thank you for having me PS: answers to the exercises are on my blog http://englishfornursingandhealth.blogspot.com/