Side effects; assisting patients with medication

Speaking 1 Work in pairs. Discuss these questions. Then compare your ideas with the rest
of the class.
1 What are side effects of medication?
2 Make a list of five common side effects.
Listening 2 Listen to Les, a nursing lecturer, talking about side effects to a group
of student nurses and tick .I the side effects he mentions.
D dizziness D skin rash D tremors
D diarrhoea D stomachache D constipation
D headaches D swelling D drowsiness
D nausea D vomiting D loss of appetite
3 Put the words in 1-5 in the correct order to make sentences. Then listen again
and check your answers.
1 some patients / suffer / as you know, / side effects / and others don't
2 might feel nauseous / may suffer dizziness / some people / and others
3 even headaches / to have diarrhoea, / it's also possible / vomiting,
4 may cause swelling at the injection site / for some patients / injecting
drugs intravenously
5 Valium / drowsiness / patients who take / may experience
Language

I,"',n.ht
I'
11 11
,.

We use may/might + infinitive to talk You may feel some nausea. (It is possible but not 100 percent sure.)
about actions or events that are possible He might suffer some swelling from the injection.
now or in the future. It may take several months to heal up completely.
We might carry out more tests after we take off the bandages.
11 11

4 Use these prompts to write sentences with mayor might. Put the verbs in
brackets in the correct place.
1 you / a little dizzy after you take your medication (feel)
2 some patients / abdominal pains or sweating (experience)
3 your husband / some side effects but most patients don't (suffer)
4 you / some side effects to this drug (get)
5 we'll monitor him as we / to reduce his dosage (need)
6 it / a few weeks for the wound to heal completely (take)
Vocabulary 5 Look at the audio script for track 34 on page 77. Find words for side effects that
match these definitions. Underline the words as you read.

D 11 11
an illness where a condition when the patient no longer having shaking
the patient where the feels sleepy a desire for food movements in
frequently patient cannot your body that
passes solid pass solid waste you cannot
waste, often in a from the body control
liquid form

6 Medkation
 Speaking 6 Sometimes patients forget to take their medication. Work in pairs. What
techniques can they use to help them to remember? Discuss.
take the medication at the same time of day
Reading 7 Read this patient brochure and answer the questions.

Ask questions about your medicines. Your doctor, pharmacist and nurse can
help you learn about your medications and why they are important.
2 Check labels. Be sure you are taking the correct medication and have the
correct dosage.
3 Avoid mistakes - don't take medication in the dark!
4 Tell your doctor if you take over-the-counter remedies such as vitamin tablets,
herbal medicines and aspirin. These sometimes react with other medications.
5 Report any new side effects. You may need to take a different dosage or your
doctor may decide to try a different medication.
6 Always carry a list of your medications. This is helpful to a health team in an
emergency.

1 Why is it important to read the label of a medication?

2 Why is it important not to take medication in the dark?
3 Give two examples of over-the-counter medication.
4 Why is it important to tell the doctor about new side effects?
5 Why is it a good idea to carry a list of medications?
Listening 8 &4~'
Listen to a conversation between a nurse and Doris, a patient, and
complete 1-6 in Doris' medication record. Then compare your answers with
a partner.

Personal medication record Patient: Dorie MacDonald G_~H

General Central Hospital

How much &

Medication Reason for use Form Route Side effects
when?
headaches, itchy, red
(1) glaucoma right + left eye
eyes temporary

six units, every

insulin (2) injection
six hours

(3) (4) mouth diarrhoea

nausea, vomiting
Tamiflu (5) mouth
(take with food)

(6) general health tablets 1 mgaday

Speaking 9 Student A, look at Doris' medication record in 8. Student B, look at the

information on page 7l. Ask each other questions to complete the medication
record.
Why is Doris taking ...?
What form of the medication is she taking?

Medication • 49
 Communicating with relatives by phone

Listening 1 Look at this list of things nurses say and do on the telephone. Which two are
not recommended? Discuss.
1 2
1 Say the name of the ward/department. D D
2 Say your name. D D
3 Offer to help. D D
4 Correct the caller's English. D D
5 Ask the caller to repeat something. D D
6 Put the caller on hold. D D
7 Apologise if there is a lot of noise in the background. D D
8 Talk to another person at the same time. D D
2 &.,14 Listen to two telephone conversations and tick .I the actions in 1 for
each nurse.

Speaking 3 Work in small groups. Why is conversation 1 in 2 a bad example of how

to communicate with people on the phone? Why is conversation 2 a good
example? Make two lists.
In conversation 1, the nurse is stressed.
In conversation 2, the nurse is polite.
Language

Will
We use will + infinitive to talk about the future. I'll just check he is awake.
Will he be out of surgery at eleven? Yes,he will./No, he won't.

4 Complete this conversation with will and the verbs in the box.

arrive be check not come take transfer wait

Nurse: Patients' Ward 2, Nurse Willard speaking. How may I help you?
Caller: Yes, hello, I'd like to speak to my husband in room 255, please. I
want to tell him that I (1) at the hospital very soon. But
I (2) by car today. I (3) the bus, so I (4) __
probably __ late.
Nurse: Sorry about the noise here. Could you repeat the room number?
Caller: Room 255.
Nurse: Room 255. No problem. I (5) __ just __ he's awake and then I
(6) you. The medication we're giving him makes him a bit
tired. Can I just put you on hold?
Caller: Sure, I (7) - __

50 11 Medication
 Listening 5 MiJCf. Listen to the first part of a telephone conversation between a nurse
and a patient's relative and answer these questions. Write the answer or choose
the correct words in italics.
What is the name of the hospital?
G C H _
2 Which ward does the man call?
Emergency Room / Orthopaedics Ward
3 Why is the man's sister in the hospital?
She is giving birth. / She had an accident.
4 What is the patient's surname?
WestL _

Speaking 6 MiJCI:I Put the second part of the conversation in 5 in the correct order. Then
listen and check your answers.
Nurse: o Do you have something to write with?
Caller: o Thanks very much. I appreciate it. Bye.
Nurse: o It's too early to tell. You'll need to speak to her doctor.
Caller: o Thanks. I'll be there as soon as I can.
Caller: [gJ Oh my goodness! Do you know if she's OK?
Nurse: o Right. I'll inform your sister's doctor that you're coming.
Caller: o Yes, go ahead.
Nurse: o I'm afraid I can't give you any more information. You'll need to
speak to her doctor when she's out of surgery. Would you like to
come and wait at the hospital?
Caller: o Are you sure? I really need to know if she's OK.
Nurse: DJ Ah, I see now. Your sister arrived at the ER this morning. She's in
surgery at the moment.
Nurse: o It's 22 Kennedy Road. There's a visitors' car park.
Caller: o Yes, I think I'll do that. What's the address?
Nurse: o Goodbye.
7 Read the conversation in 6 and underline examples of will.

Pronunciation 8 Read this information. Then draw the links between the words in the sentences.

In English we often link words together when we are talking.

consonant ---+ vowel: Could I speak to ...?
<;»
consonant ---+ word beginning with [u]: I'll tell her doctor.
'--'
,~ ,,'= "r"" .~. =s= "'
How can I help you?
How can I help you?
<;»
1 I see you're worried about her.
2 She's in surgery at the moment.
3 I'll help her when she's out of surgery.
4 I will inform her doctor that you're here.
9 Work in pairs. Take turns to read the conversation in 6. Link the words as
you speak.

Speaking 10 Work in pairs. Practise a conversation between a nurse and someone asking
about a relative in hospital. Include all the recommended elements in 1. Then
swap roles and repeat the activity.

Medication

•
 Moving and handling patients
Speaking 1 Work in small groups. Discuss these questions.
When do nurses need to move patients? Make a list.
when the patient changes departments
2 What do nurses need to think about when they move a patient? Make a list.
the patients weight
Vocabulary 2 Work in pairs. Label these pieces of equipment for moving and handling
patients with the words in the box.

~~~a board hand blocks hoist monkeypole rope ladder

Listening 3 WhpM Listen to three conversations. Which piece of equipment in 2 do the

nurses use for each patient?
2 _ 3 _

4 Listen again and complete these sentences with the words in the box.

pull up roll over sitting slide o~~on,!wi'!,g ~v

1 She can herself to a position.

2 Now your legs the side of the bed.
3 You can the chair.
4 We're going to you onto your left side.
52 • The hospital team
 Language

The fu.Jht::~egoing to, will . m", ,Sl'

-~

Nurses use be going to + infinitive to explain an intention or First I'm going to roll you onto your side.
a procedure (to the patient) before they do it. Are you going to get a wheelchair?
Nurses use will for decisions made at the moment of speaking, I'll go and find a wheelchair.
for an offer (of help) or for predictions. We'll help you up now.
She'll need some help to get out of bed.
•• :1 -
..
..,
.~ =>~

5 Complete this conversation between two nurses, Simin (S) and Phi! (P), and a
patient, Abdel (A), with the correct form of be going to or will and the verbs
in brackets.
S: Hello, Abdel. Phi! and I (1) (help) you into a wheelchair so
you can go and sit in the TV room. What do you think? (2) _
(you / be able) to use the monkey pole?
A: I think so.
S: Good. And then Phi! (3) (help) you into the wheelchair.
A: This is great. I really want to see the football.
P: I (4) (go) and find a wheelchair, Simin.
S: OK. Abdel, I (5) Gust / loosen) the sheets on your bed first.
Now, can you pull yourself up? Hold onto the handle with both hands. Good,
good, well done.
P: Wait a minute. I (6) (bring) the wheelchair closer to make
it easier for you. That's better. Now hold onto me and I (7) _
(help) you into the wheelchair. There we go. How's that now, Abdel?
A: Great, thanks.
6 Work in groups of three. Practise the conversation in 5.

Reading 7 Read this training brochure and put the stages in the correct order. Then look
at the conversation in 5 again and find examples for some of these stages.

Moving and handling procedure

D Encourage the patient to co-operate.
D Adjust the height of the bed and/or loosen bed linen if necessary.
D Give clear instructions to the patient at each stage.
[1] Explain what you are going to do and the reason for the move.
D Check if the patient is comfortable after the move.
D Explain your actions as you are performing them.
D Check that the patient agrees.
D Check the patient's level of independence.
~ .

Speaking 8 Work in groups of three. Student A, you are a patient. Students Band C, you are
nurses. Read situation 1 below and think which piece(s) of equipment you need
to move the patient. Roleplay the scenario, using the expressions and stages in
4 and 7 to help you. Then swap roles and do the same for situations 2 and 3.
1 Help a patient who is too weak to move from their bed to a wheelchair to go
for a CT scan.
2 Turn a patient over and move them up their bed so that they are
more comfortable.
3 Help an overweight patient onto their feet to go for a short walk.

The hospital team I 7 53

 Communicating with team members by phone
Speaking 1 Work in pairs. Answer these questions.
1 Why do nurses need to communicate with other medical staff by phone?
They need to book a porter to transfer patients to a different department
or room.
2 What other ways are there to communicate with members of the team?
Listening 2 Three nurses call to ask for porters to transfer their patients. Listen
and complete the patient information.

Name: Tony Montana Name: Ali Murad Name: Karina Abramowicz

ID W: 811956 IDN°: _ ID W: 783359
Patient room -+ Paediatrics -+ Patient room 210 -+
Occupational Therapy Radiology

3 Complete this telephone conversation with the words and phrases in the box.

accompany ask for double five ID number

medical notes porter spell transfer
---
Hello, Porter's Office, Susie speaking. How can I help you?
Susie:
Davy: Yes, good afternoon, Susie. This is Staff Nurse Dayy Morris in ER. I'm
calling to (1) a(n) (2) to (3) Sylvia
Tyler to the Orthopaedics Department, please.
Susie: Could you give me the name of the patient again, please? And their
(4) ?
Davy: Yes, it's Ms Sylvia Tyler. ID number 5521146. Would you like me to
(5) that for you?
Susie: I think it's OK. Can you just repeat the ID number for me?
Davy: Yes, it's (6) two double one four six.
Susie: OK, thanks. And who will (7) the patient?
Davy: I will.
Susie: OK. Finally, can you confirm that all the patient's medical documents
are ready?
Davy: Yes, we have the (8) , drug chart and all the nursing
documentation.
Susie: Great, we'll send you a porter right away.
Davy: Thank you very much for your help. Goodbye.
Speaking 4 Work in pairs. Practise calling a porter to transfer one of the patients in 2. Use
the conversation in 3 to help you. Change the underlined information. Then
swap roles and repeat the activity.

54 7 The hospit al team

 Language

Past si~ple of be ;,

We use the past simple of be to talk about the past. The patient was in ER this morning.
I wasn't in the handover meeting yesterday.
Was his temperature up? Yes it was./No, it wasn't.
iI JI

5 Nurses Jenny and Pat are discussing the patients in 2 and 3. Write four short
conversations about these patients using the past simple of be. You can invent
some information. Then ask a partner to check your use of the past simple of be.
Jenny: Tony Montana was in the Emergency Department. Where is he now?
Pat: He wasn't in his room. I think he's in Occupational Therapy now.
Jenny: OK, thanks. I wasn't sure.
Listening 6 &111. Listen to a telephone conversation between two colleagues, Sam and
Glenda, and choose the correct words in italics.
1 Sam leaves / takes a message.
2 Glenda leaves / takes a message.
7 Read this training brochure about how to communicate effectively on the
phone. Then listen again and tick.l stages 1-7 as you hear them.

Effective telephone communication between hospital staff

1 0 Answerthe phone- giveyour 4 0 Readbackthe message.
name,positionand ward/50 Ask for confirmation.
department. 6 0 Askfor clarificationof details
2 0 Offerto takea message. if necessary.
3 0 Takethe caller'snumber. 7 0 Endthe call.
.r.

8 Listen again and complete this telephone message.

(1) tocal/(2) inPathologyaboutMsShapiro's

(3) ; ext. (4) _

9 Look at the audio script for track 41 on page 78 and underline expressions for
the different stages in 7.

Speaking 10 Work in pairs. Practise taking telephone messages. Use the information on the
first telephone message card and roleplay the conversation with your partner.
Then swap roles and do the same for the second card.

Caller: Nurse Salih Caller: Sister Carter

Ext.: 44239 Ext.: 23350
Message for: Eddy Bull Message for: Ksrine Jagger
Dept: Radiology Dept: Summer Ward
About (patient name): Rosie Hill About (patient name): Ms Sandy Boyce
Message: book appointment for X-rayon Message: check patient details
3rd Dec. in afternoon

The hospital team

11
 Ordering supplies
Vocabulary 1 In a hospital supply room, items are often colour coded. Work in pairs. Look at
illustrations A-L and put the items in the correct category.

1!.i§Mili~ D

1IIII
I ,
I I

Name
Nom
Nombre_--I~

'~@fi~!'~9i,i!ii:======~JD~ ~c~_~
.'!·!I§I§iI"!I§,mi!M~¥i'·L
11

Yellow: urinary items Blue: patient room items

catheter set pillow

Listening -lit- Staff Nurses Cynthia and Louis are checking the inventory and
ordering supplies. Listen to their conversation and tick ./ the items in 1 that
you hear.

3 Listen again and answer these questions.

1 For which rooms does Louis order supplies? For which floor?
2 What does Louis do to complete the order?
3 What did the hospital do a lot of this week?

56 11 The hospital team

 Language

Any, .ri~U~h •

=
:t"~

'"
, c"

We use any in negative sentences and questions with I can't find any pillows.
countable and uncountable nouns. Do we have any gauze?
Enough means 'as many or as much as is needed Do we have enough surgical tape?
or wanted: We can use it with countable and Do we have enough sterile cups?
uncountable nouns. Is/Are there enough? No, there isn't/aren't enough.
Remember: we use much and many when we ask How much disinfectant is there?
questions with countable and uncountable nouns. How many towels have we got?
I. JI ••:..:t: _ ~ii 'sur ~lii:1l!"', .'~
4 Complete these sentences and questions with much, many, any and enough.
1 'Do we have gowns?' 'Yes we do, but we don't have _
How do we need?'
2 How blood do I need to take?
3 How gauze do we need? Do we have for the rest of the week?
4 'Are there sterile cups in the storage room?' 'I think so.' 'How
____ are there?'
5 'Do we have disinfectant in the OR?' 'No, we don't have _
'How do we have?'
6 How surgical tape do I put on this bandage? Is this ?
Vocabulary 5 Match answers a-f to questions 1-6 in 4.
a) Just one specimen tube. _
b) Yes. About three centimetres is enough._
c) There are about five boxes of 50. _
d) No, we need to order 30 packs. _
e) We need 28. _
f) There are two bottles. _
6 Match 1-4 to a-d to make phrases.
1 a box a) of disinfectant
2 a pack b) of gauze
3 a roll c) of bandages
4 a bottle d) of tape
Speaking 7 Work in pairs. Student A, look at the information on this page. Student B, look at
the information on page 71. Follow the instructions.
Student A
1 You are a nurse and you need to order supplies. Phone Student B and order the
items on your list.

A: Hello, this is Nurse ... at ... Hospital.

We need:
"* gauze(100rolls)
I'm calling to order some supplies.
"* surgical tape (50 rolls)
No problem. What do you need?
"* bandages (4 boxes)
We need ...
"* scissors (150)
"* disinfectant (60 bottles)
"* syringes (5 boxes of 50)
"* specimen tubes (80)
"* hospital gowns (45)

2 Swap roles. Listen to Student B ordering supplies and write the items you hear.

The hospital team 11

 Giving simple safety instructions
Vocabulary 1 Match the words in the box to these definitions. Then label the illustration with
the words in the box.

1
apron disposable gloves eye protection

This protects your mouth and nose. _

mask sharps box
1-
2 This protects your clothes. You tie it around your waist. _
3 This container makes it easy and safe to dispose of needles. _
4 You wear these to protect your hands from the patient's blood and body
fluids. _
5 This helps protect your eyes. _

a)
b)----
c)

d)----
e)

sharps = sharp
objects

Language

Past simple: regular verbs 11 11

To form the past simple of most regular verbs, we add -ed to the verb. show - showed
clean - cleaned
Be careful of spelling Changes:
• verbs that end in -e: add -d. arrive - arrived
• verbs that end in consonant + -y: drop the -y and add -ied. carry carried
• verbs that end in one vowel + one consonant: double the consonant and add -ed. drop - dropped
We use the past simple to talk about actions and situations that started and finished She disinfected the wound.
in the past.
U 11

2 Look at the title of this article. Say what you think sharps injuries are. Then
complete the article with the correct past simple form of the verbs in brackets.

Eliminating sharps injuries in the OR: a hospital tells its success story

Many years ago a team at Wilfred Johnson Hospital (include) clear directions for the staff who (7) _
(1) (organise) a project to reduce the number (use) sharps. The hospital (8) (purchase)
of sharps injuries. The OR supervisor, the hospital large boxes and put them in each OR. The team also
safety officer and a general physician (2) _ (9) (create) a new 'sharps zone; where staff
(participate) in the project. They first (3) _ members (10) (pass) needles and knives
(review) the information about injuries from the year on trays. After six months the number of sharps injuries
before. This (4) (show) that there were too (11) (decrease). In 2008 the staff only
many injuries with sharps, so the team (5) _ (12) (report) six sharps injuries. In 2009 the
(decide) to write new 'sharps safety rules' to explain the number (13) (continue) to go down - to only
importance of safety. The new policy (6) _ three injuries!

58 11 The hospital team

 Pronunciation 3 Listen and repeat.
1 Id/: ordered, tied, changed
The endings of
2 It/: worked, fixed, stopped
regular verbs in
the past simple
3 IId/: disinfected, protected, needed
sound different. 4 Write the verbs in 2 in the correct group. Then listen and check your
answers.
Idl It! IIdI

Language

Expres In ,obligation: always/never + if clause

We use always or never + if clause Always wear gloves if you do a blood test.
to talk about an obligation. Always wear a mask if the patient has tuberculosis.
If you use other materials, never put them in the sharps box.

5 Read this conversation between Sarah (S), a senior nurse, and Anja (A), a
student nurse, and choose the correct words in italics.
S: If you give an injection, (1) always I never throwaway the needle in the
sharps box here.
A: What about the cap?
S: (2) Always I Never recap the needle. Just drop it in the box.
A: Why?
S: So you don't injure yourself with the needle. And we have a special place
where we throwaway the sharps boxes. If you want to throwaway other
materials like gauze or surgical tape, (3) always I never put them in the
sharps box. Sharps boxes are very expensive and we have a special waste
room in the hospital where we throw them away.
A: OK, I understand.
S: And if you take blood, (4) always I never use disposable gloves.
A: That's also part of the Universal Precautions Policy, right?
S: Yes. For your safety and your patient's. And in the OR, if you pass sharps
like needles and knives, (5) always I never use your hands. (6) Always I
Never use a tray.
A: OK. I can do all of that.
Speaking 6 Work in pairs. Practise the conversation in 5. Then swap roles and repeat
the activity.

- ----------------------------------------------~~--
The hospital team