Medical English Clear and Simple PDF

2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page i Medical English Clear and Simple A Practice-Based Approach to English for ESL...

2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page i Medical English Clear and Simple A Practice-Based Approach to English for ESL Healthcare Professionals 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page ii 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page iii Medical English Clear and Simple A Practice-Based Approach to English for ESL Healthcare Professionals Melodie Hull, RPN, MSc, MEd (TESOL), BA, PID Nursing Faculty College of the Rockies Cranbrook, British Columbia, Canada Nursing Tutor, Distance Education, Transitions to Nursing and Health Program Thompson Rivers University Kamloops, British Columbia, Canada International Adviser to the Department of Languages International University of Business, Agriculture, and Technology Dhaka, Bangladesh Nurse-Educator and Consultant Clayton International Consulting Cranbrook, BC, Canada 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page iv F.A. Davis Company 1915 Arch Street Philadelphia, PA 19103 http://www.fadavis.com Copyright © 2010 by F.A. Davis Company Copyright © 2010 by F.A. Davis Company. All rights reserved. This book is protected by copyright. No part of it may be repro- duced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, record- ing, or otherwise, without written permission from the publisher. Printed in the United States of America Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1 Acquisitions Editor: Jonathan Joyce Director of Content Development: Darlene D. Pedersen Senior Project Editor: Padraic J. Maroney Design and Illustrations Manager: Carolyn O’Brien As new scientific information becomes available through basic and clinical research, recommended treatments and drug therapies undergo changes. The author(s) and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication. The author(s), editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the con- tents of the book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised always to check prod- uct information (package inserts) for changes and new information regarding dose and contraindications before administering any drug. Caution is especially urged when using new or infrequently ordered drugs. Library of Congress Cataloging-in-Publication Data Hull, Melodie. Medical English clear and simple: a practice based approach to English for ESL healthcare professionals/Melodie Hull. p.; cm. Includes bibliographical references and index. ISBN 978-0-8036-2165-7 (alk. paper) 1. Readers—Medicine. 2. English language—Conversation and phrase books (for medical personnel) 3. English language—Textbooks for foreign speakers. 4. Medical personnel, Foreign—United States. I. Title. [DNLM: 1. Terminology as Topic—Problems and Exercises. 2. Communication—Problems and Exercises. 3. Language—Problems and Exercises. W 18.2 H913m 2010] PE1127. M4H85 2010 428.6'402461—dc22 2009042818 Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by F.A. Davis Company for users registered with the Copyright Clearance Center (CCC) Transactional Reporting Service, pro- vided that the fee of $.25 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license by CCC, a separate system of payment has been arranged. The fee code for users of the Transactional Reporting Service is: 8036-2165-7/10 0 + $.25. 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page v This book is dedicated to two very important and influential people in my life: My very good friend, Patty Sangri, of the Universidad Tecnologica de Cancun, who gave me my first job in English for Specific Purposes and who opened this whole new world to me. My wonderful husband, Steven, whose unwavering love and faith in me, as well as his incredible patience and support, has made this book possible. THANK YOU 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page vi 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page vii FOREWORD I met Melodie Hull, the author of this book, in 2006 when we all attended the International Sym- posium on English for Medical Purposes in Beijing, China. As one of the keynote speakers, she roused my attention when I read her research abstract. It offered a brief overview of literature on how the actual goals of the curriculum of English for Medical Purposes are defined. In the sym- posium, her speech was a great success and provided all the researchers, especially Chinese re- searchers, in the medical English field opportunity for critical thought regarding current curricu- lum design. In addition, her wit, her wealth of knowledge and experience, and her enthusiasm for the medical English field impressed all the attendees. In the following years, we have kept in touch with each other. I have gradually come to know many of her works, all of which are greatly applicable and in great demand. On behalf of all Chinese medical English researchers, I genuinely appreciate what Melodie has done and will do in this field. Medical English Clear and Simple is designed to help learners of medical English at an advanced level. The intended readers are medical and medical English students, medical professionals, and those involved in the medical field who have a strong desire to improve their medical English. This book guides readers through eight main sections, enabling them to explore and develop skills within certain systems or medical fields. Each unit enables readers to engage more actively with medical matter or content and encourages them to develop their own skills in medical English reading, listening, speaking, and writing. Throughout the book, topics are extended, interwoven, and deconstructed, with the readers’ understanding strengthened by tasks and follow-up questions. For the learners to take full advantage of the material, the book has included what the author be- lieves is most needed by them. Exercises and learning activities offer language-learning conditions that enrich their communicative competence and skills within the context of their careers. Written by an experienced researcher in the field, Medical English Clear and Simple is an essential resource for students and researchers of medical English. I, Xie Yu, sincerely wish that by reading and using this book, you will have a pleasant and instructive experience in improving your medical English. Xie Yu, MA English for Medical Purposes Lecture Capital Medical University Beijing, PRC Congratulations on the publication of this important book. Melodie Hull is a friend, colleague, and previous employee. While teaching nursing full time at a local university college, she worked as a staff nurse part time in one of my mental health care facilities. As I got to know her, I discovered her interest in teaching English for nursing and med- ical purposes. Her approach to the subject was (and is) quite unique. Her vision of the need for functional, career-specific English for health professionals is commendable and one which I share. This book does just that! I, like Melodie, appreciate the need for nurses or doctors to be in- volved in the creation and design of this type of material and coursework and have always sup- ported her in her endeavors to fill this need. We agree that English for Medical Purposes materi- als should be based in the context of the health professions at all times. Melodie is committed to best practices in health care and realizes that language skills and competencies play an enormous role in the delivery of safe, ethical, and professional care. Indeed, she believes this so strongly that beyond nursing, she has added a graduate degree in TESOL to her credentials to ensure her ma- terial is well-grounded in theory and practice. Medical English Clear and Simple is a comprehensive introduction to the language of the health professions. In my opinion, it is well suited to the needs of international medical graduates who wish to complete a residency in Canada, the USA, or to work in an English-speaking milieu eventually. It is also well suited for internationally educated nurses and nursing students whose vii 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page viii first language is not English. The text offers essential terminology for working with colleagues and patients, but it does more than that: the communication focus is paramount for career suc- cess in an English-speaking country. This book accomplishes that. Ronald I. Wong BS, MD Family Physician, registered in Vancouver BC, Canada, and Kingston, Jamaica Graduate University of British Columbia Medical School Internship at King’s County Hospital, Brooklyn, New York Family Practice Residency, Good Samaritan Hospital, Cincinnati, Ohio, and Ravenna General Hospital, Ravenna, Ohio, USA This is no ordinary text. Melodie Hull’s years of experience in international nursing, education, and theater arts provide an innovative approach to English-based medical terminology. The au- thor’s expertise in this area is evident in the selection of content and sequencing of tasks, but it is the love of learners and the desire to see them succeed that shines in the gentle, down-to-earth guidance included in the learning activities. By incorporating activities that address the various senses, the author taps into different learning styles and preferences, rather than relying solely on pronunciation and memorization. Her appreciation for the learner’s need to feel confident comes through in the design of activities that engage the adult in using new terms in a variety of contexts. Upon completion of this text, a learner can go to the workplace knowing he or she will effectively use medical terminology in verbal and nonverbal communications. This is the text that I wish I had written myself. Sharon L. Andersen, RN, BSN, MSN, MEd, EdD Clinical Nurse Specialist in Adult Mental Health Proprietor, Crone’s Nest Educational Consultants Retired Nursing Instructor, Kwantlen Polytechnic University and University of British Columbia, Canada Having used a previous book by Melodie Hull, I was honored to have been asked to write this foreword for the new textbook that she has written. This new work is a comprehensive book de- signed for non-native English-speaking students in health-care programs. Medical English Clear and Simple fulfills a need since it is health care oriented, but ESL/EFL accessible. As there are more and more non-native speakers of English medical professionals in the USA, the need for such a book has become critical. Medical English Clear and Simple assists students toward success in health- care programs by providing opportunities for reading, writing, speaking, and listening within their health-care career. It provides ample opportunities to apply what has been learned and helps students build their health-care related vocabulary. Medical English Clear and Simple is a useful resource as a communication teaching tool for in- structors in the health-care field and as a refresher or a professional development course for international health-care professionals. Melodie Hull has achieved her purpose of providing a valuable resource for health-care stu- dents or professionals who are of non-English speaking backgrounds. Medical English Clear and Simple is the answer to the needs of health-care or ESL/EFL instructors who are looking for a comprehensive book that will help their students improve their health-related language skills. Barbara Jonckheere Lecturer/Academic Senate Representative American Language Institute University College and Extension Services California State University, Long Beach In Medical English Clear and Simple, Melodie Hull has presented a practical step-by-step guide for learning career-specific English with a communication focus. The guide is a valuable resource, especially for students in health studies programs and health professionals who are of non-English speaking backgrounds. viii Foreword 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page ix In reviewing the draft copy of the Annotated Table of Contents and the Introduction, as well as a discussion about the book with the author, I have come to appreciate the communicative focus of the text, integration of cultural concepts of health and wellness, and opportunity for crit- ical thinking through exercises provided in the book. The content is organized in eight units using a medical systems format that is familiar to inter- nationally educated health professionals. Having my basic nursing education (BScN) from India and 40 years of experience in nursing education as a teacher and an administrator in Canada has given me the understanding and appreciation of the value of meaningful and effective verbal and written communication skills for health professionals. The author’s approach to a workbook for- mat in the book provides opportunity for learning to communicate English within the context of the health-care system. I recommend this book to students in health studies programs who are of non-English speak- ing backgrounds and foreign-educated health professionals. Chinnama Baines, RN, BScN (CMC, Madras, India), MScN (UBC, Canada), PhD (GU, MO, USA) Nursing Education Consultant (Retired Dean of School of Nursing, UCC (Thompson Rivers University), Kamloops, BC, Canada Foreword ix 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page x 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page xi REVIEWERS Reneé T. Burwell, ASN, BSN, MSEd, EdD Aprille Haynie, MSN, RN Coordinator of Health Science Programs Evaluation Committee Chairperson, Advanced Charlotte Technical Center Medical-Surgical Nursing and Nursing Port Charlotte, Florida Leadership Course Coordinator Huron School of Nursing Susan C. Engle, RN, MSN East Cleveland, Ohio Medical-Surgical Nursing Instructor Napa Valley College Marlene Rogers Hancock, RN, MSN Napa, California Instructor Lane Community College Nancy J. Gay, RN, BSN Eugene, Oregon Instructor, Nurse Aide Training Program Pickens Technical College Anita L. Huse, RN, MSN, EdD Aurora, Colorado Nurse Educator and Owner Huse Healthcare Educational Consultants Deborah S. Gilbert, MBA, EdS, RHIM Londonderry, New Hampshire Associate Professor of Office Administration (Medical Assisting and Medical Transcription) Jule B. Monnens, RN, MSN Dalton State College Program Director, Nursing Dalton, Georgia Community College of Denver Denver, Colorado Jacqueline Guhde, MSN, RN, CNS Assistant Professor of Clinical Nursing Sharon Moore, RN, BSN, Graduate The University of Akron College of Nursing Certificate in Nursing Education,Certified Akron, Ohio Medical-Surgical Registered Nurse Practical Nursing Program Coordinator Deborah B. Hadley, RN, MSN, CNOR Forsyth Technical Community College Nursing Instructor Winston-Salem, North Carolina Alcorn State University Natchez, Mississippi Tara L. Narcross, PhD Coordinator, Language Institute and Basic Sharyn Haran, Med English Department Instructor, Business and Office Occupations Columbus State Community College (Business and Allied Health; Medical Office Columbus, Ohio Clerk Program) South Seattle Community College Cindy Neely, MSN, RN Seattle, Washington Nursing Campus Clinical Laboratory Coordi- nator and Professor of Nursing Sharon Harris-Pelliccia, Registered Physician Oklahoma City Community College Assistant, Board Certified, BS Oklahoma City, Oklahoma Department Chair, Medical Studies Mildred Elley Diane O’Hara, BSN, MS, EdD Latham, New York Healthcare Services Specialist Erie 2–Chataqua-Cattaragus BOCES School of Joanne Hartzell, Certified Professional Practical Nursing Coder, BS Derby, New York Director Practical Nursing Lanier Technical College-Forsyth Cumming, Georgia xi 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page xii Martha Olson, RN, BSN, MS Karen Moore Schaefer, PhD, RN Nursing Instructor and Assistant Professor Interim Chair Designee/Associate Chair Iowa Lakes Community College Temple University Department of Nursing Emmetsburg, Iowa Philadelphia, Pennsylvania Christine Ouellette, RN, MS, GNP, BC Delores Lori Stephens, MN, RN, CLNC Adjunct Faculty Nursing Faculty Quincy College Skagit Valley College Quincy, Massachusetts Mount Vernon, Washington Denise Pelletier, RN, MSN Thelma Allen Stich, PhD, RN Nursing Instructor President and Owner Montachusett Regional Vocational Student Nurse Coach LLC Technical School Staten Island, New York Fitchburg, Massachusetts Esperanza Villanueva-Joyce, BSN, MSN, EdD, RN Carla E. Randall, RN, PhD Associate Dean for Academics Assistant Professor of Nursing The University of Texas at El Paso University of Southern Maine El Paso, Texas Lewiston, Maine Judith Webb, MS, Adult NP-BC, Palliative Dana Reeves, MSN Care NP-BC Assistant Professor, BSN Program Clinical Instructor, Nursing University of Arkansas–Fort Smith SUNY Institute of Technology Fort Smith, Arizona Utica, New York Debra L. Renna, MSN, CCRN Carol S. Yoder, MSN, RN Clinical Assistant Professor, Nursing ESL Advisor, Nursing and Allied Health Florida International University Norwalk Community College North Miami, Florida Norwalk, Connecticut xii Reviewers 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page xiii ACKNOWLEDGMENTS It is with pleasure that I take a moment here to acknowledge people who have been significant influences on my work. First, I want to honor Dr. Sharon Andersen, my friend, colleague, and mentor who taught me so much about writing nursing degrees, curricula, and courses. I can’t thank her enough. She is truly my hero. A very special thanks to Jonathan Joyce, Acquisitions Editor at F.A. Davis who first approached me about my work with English for nurses and med- ical professionals. His openness to a new paradigm for teaching career-specific language and his understanding of the need for this book have been instrumental in the development of the final product. He saw my vision and ran with it. I am forever grateful. Also at F.A. Davis, I want to say thank you to Padraic Maroney, Senior Project Manager, whose valuable guidance and great sense of humor made completion of the manuscript a pleasure. And thank you to Barbara Tchabovsky, Development Editor, for all her work, including those grammar and accuracy checks for both English and Medicine. Thank you also for her patience and ability to make sense of my writing and ideas. Incredible work!    Melodie Hull, Author xiii 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page xiv 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page xv CONTENTS 1 Introduction to American and Canadian Health Care and Cultural Concepts of Health and Wellness 1 Concepts of Health and Wellness 1 Perspectives on Health Care in the New Millennium 1 Health Is a State of Optimal Well-Being 7 Professional Caring 10 Professional Caring 10 Holistic Care 13 Health-Care Professionals: Members of the Health-Care Team 16 Professional Caring: History Taking and the Illness Experience 20 The Drugstore 24 Drugstores and Pharmacists 24 Filling a Prescription 28 Writing a Medication Order 33 Calling the Doctor’s Office 35 Phone Call to a Doctor’s Office 35 2 The Musculoskeletal System 53 Anatomy and Physiology 53 Organization of the Body 53 The Musculoskeletal System 57 Body Movement, Posture, Gait, Ambulation, and Position 63 Bones and More 63 Joints 68 Treatments, Interventions, and Assistance 74 Use of Emergency Rooms 74 A Visit to the Walk-In Clinic 79 3 The Cardiovascular System 93 Anatomy and Physiology 93 North American Health Concepts 93 The Cardiovascular System or Circulatory System? 96 Assessing Function and Failure of the Cardiovascular/ Circulatory System 99 Physiology of the Pulse 99 Blood Pressure 104 xv 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page xvi Congestive Heart Failure 107 Angina and Myocardial Infarction 113 Treatment, Interventions, and Assistance 115 Calling 911 for Help 116 Angina 120 Head-to-Toe Assessment 125 Admission to the Emergency Department 127 4 The Respiratory System 141 Anatomy and Physiology 141 The Purpose of the Respiratory System 141 Anatomy and Physiology of the Lung 144 Common Disorders and Diseases of the Respiratory System 147 Chronic Obstructive Pulmonary Disease 148 Acute Bronchitis and Asthma 152 More About the Lungs and Respiratory System 155 Lung Cancer and Demographics 158 Treatments, Interventions, and Assistance 161 Respiratory Symptoms 161 Making a Simple Diagnosis 165 Lack of Oxygen 168 5 The Gastrointestinal System 185 Anatomy and Physiology 185 The Gastrointestinal System 185 Nutrients 193 The Process of Elimination 195 Common Complaints of the Gastrointestinal/Digestive System 198 Assessment and Pathology of the GI Tract 198 Constipation 203 Treatments, Interventions, and Assistance: Food Safety and Stomach and Bowel Upset 206 Case Studies 206 Pharmacology for Treatment of Disorders of the Gastrointestinal System 210 Food Safety and Food Poisoning 213 6 The Neurological System 231 Anatomy and Physiology 231 The Nervous System 231 Divisions of the Neurological System 237 The Brain 241 xvi Contents 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page xvii Common Complaints and Disorders of the Neurological System 245 Potential Causes of Neurological Dysfunction 246 Pain and Headaches 250 Epilepsy 254 Treatments, Interventions, and Assistance 258 Head Injuries 258 Cerebrovascular Accident 263 Diagnostic Tool: Pain Scales 267 7 Wounds, Viral and Bacterial Infections 283 Pathophysiology 283 Wounds 284 Some Disease-Causing Microorganisms: Viruses and Bacteria 289 Common Disorders and Diseases 293 Decubitus Ulcers 293 Common Viral Diseases 299 A Common Bacterial Infection: Tuberculosis 305 Treatments, Interventions, and Assistance 310 Chain of Infection and Infection Control 310 Wound Healing 315 8 Pharmacology and Medication Administration 337 Pharmacology, Pharmacodynamics, and Pharmacokinetics 337 All Things Pharmacological 337 Side Effects or Adverse Effects? 345 Abstract 351 Safety and Accuracy in Medication Administration 355 Medication Administration: Safe Practice Strategies 355 Protection from Medication Errors: Preventative Action 362 Interpretation of Medication Orders Depends on Interpretation of Career-Specific Abbreviations 367 Treatments, Interventions, and Assistance 373 Treatments Involving Medications 373 Interventions with Medications 376 Assistance with Medication Administration 379 Contents xvii 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page xviii 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page xix INTRODUCTION Welcome to Medical English Clear and Simple, a career-specific language resource. This book has been written in response to a growing need for career-specific language skills training in health care. While many English language books for nurses or other health profes- sions tend to focus on medical terminology, Medical English Clear and Simple does not. The author believes the narrow focus offered by a vocabulary-building focus based strictly on medical termi- nology lacks a communication focus. As a result, it is generally ineffective in meeting the com- municative and functional needs of English Second Language or English Foreign Language (ESL/EFL) health professionals. Medical English Clear and Simple encourages a broader, commu- nicative and functional use of English that includes opportunities to think critically and in a reflective, analytical manner required in nursing and the health professions. PURPOSE AND AUDIENCE Medical English Clear and Simple has been designed for those students in health studies programs or health professionals who are of non-English speaking backgrounds (NESB). It is an excellent companion text or resource for student success in health studies. Individuals wishing to find work in the USA or Canada will find the book an invaluable resource and study companion for profes- sional licensure exams. Medical English Clear and Simple deals specifically with the teaching and learning of career- specific English for health professionals. The book is directed at the level of English for Specific Purposes and assumes the learner will have an intermediate level of English language compe- tency and skills. The text also presupposes a definite, distinct language and culture for health pro- fessionals consisting of general English, professional and academic English, as well as colloquial English related to patient care. Readers do need a minimum intermediate command of the English language. Prior technical knowledge in one of the health disciplines is a necessity, or the reader should be concurrently en- rolled in a health sciences or health studies program. This textbook lends itself to use by health and/or language instructors. Both will find the inclusion of an Answer Key with accompanying rationale very helpful should they not have these dual qual- ifications. It is recommended that instructors should have a knowledge and skill base in English for Specific Purpose or advanced, general ESL/EFL. A background in nursing, medicine, or any allied health profession would be an absolute asset and is recommended by the author. APPROACH This book is different. It was conceived to answer some key questions about the language needs of health professionals of non-English speaking backgrounds. These were: How can students of non-English speaking backgrounds be assisted toward success in co-occurring health studies/health sciences programs through language? What language skills are of priority importance to health professionals wishing to live and work in English-speaking North America? How are safe practices and quality care influenced positively or negatively by English lan- guage competencies and skills in the health-care setting? What value do health professionals from countries other than the United States of America and Canada place on the interpersonal relationship between the patient and the care provider? xix 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page xx To what degree is optimal health-care delivery dependent on the ability of the care provider to speak both professional and colloquial, common English? What cultural factors influence professional practice in health-care delivery? How can these differences in professional health-care practices, if they exist, be addressed through language learning? How can NESB health professionals be assisted to learn to use English within the context of Canadian and American health-care systems and culture? Communication and the ability to work as a health professional safely and effectively in the English language are key philosophical concepts of the text. Developing the capacity to interact with professional colleagues, treatment teams, clients (patients), families, and the community are considered essential language skills required by the learner and are addressed throughout the exercises and learning activities within this book. The pedagogical approach of the text is to teach medical English in a lexical and communicative manner, combined. To be understood and to be able to understand is paramount to the provision of safe, competent care. Safety to practice is a core concept threaded throughout the text. The book is unique in this.1 Medical English Clear and Simple comprehensively teaches career-specific language as a subspecialty of English for Specific Purposes, building not only a language repertoire, but also the ability to use language in meaningful ways. AUTHENTICITY OF MATERIAL Melodie Hull’s background as a health professional and in health education allows her the priv- ilege of firsthand linguistic experience within this context. She is also a qualified teacher and ma- terials designer in Teaching English to Speakers of Other Languages (TESOL) at the graduate level. This absolutely makes Medical English Clear and Simple unique. Readers will find the material and exercises truly relevant to their work and studies. ORGANIZATION OF THE TEXT Medical English Clear and Simple proceeds in a progressive, step-wise fashion. Units contain three distinct sections, one flowing into the other. At each step, the reader is invited to discover, ex- plore, and use language within the context of American and Canadian health care. Generally, the units are arranged as follows: Anatomy and Physiology Chronic or Acute Diseases or Conditions Treatments, Interventions, and Assistance There are two exceptions to this organizational format. Chapter 1 introduces the context and culture of health care and its professions. Chapter 8 focuses on pharmacology and medication administration. COMPONENTS AND FEATURES Medical English Clear and Simple focuses on the knowledge, skills, and competencies required for practice, including principles of safe practice, while building English language skills. 1 Safety to Practice is a concept used by nursing educators to guide and assess nursing students. It speaks to their responsibility to act as gatekeepers for the profession. Safe practice is what nurses actually do. xx Introduction 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page xxi Themes of the text: 1) safety to practice 2) culture of health professions 3) culture and context of health-care delivery in Canada and the USA 4) focus on the adult (with the addition of an interview and case study of an ill child) 5) interprofessional communication 6) professional, interpersonal communication with clients (patients), families, and the public Medical English Clear and Simple also includes: reading, writing, listening, and speaking exercises professional, academic, technical, and colloquial lexis, including anatomy and physiology, naming equipment, reading lab reports, and understanding diagnostics dialogues, interviews, and opportunities for pair and group work case studies the language of treatment and caring interventions, including pharmacology and medica- tion administration the skills of charting, information reports, procedures, clinical pathways, and flow charts exposure to diverse clinical settings including hospitals, clinics, and a pharmacy readings and exercises that build cultural competency grammar highlights and reviews vocabulary alerts pronunciation hints using phonetics and audio links to Taber’s Cyclopedic Medical Dictionary, 20th Edition, F.A. Davis Company suggested audio-video clips on the Internet to enhance listening and speaking skills concept reviews and discussions reading and writing in various genres reading for gist interpreting and writing journal abstracts critical thinking exercises at the end of each chapter provide an opportunity to apply essential content reflective questions and essay writing comparing and contrasting the reader’s professional practice and culture with that of the USA and Canada an answer key that includes rationale for safe, competent practice within the culture and context of Western health care (i.e., Canada and the USA) STUDENT GUIDE Medical English Clear and Simple has been written with you in mind. The workbook format has dedicated spaces for your answers and responses. Each and every unit is designed to: provide opportunities for reading, writing, speaking, and listening all within the context of your career in health care support your ongoing learning by providing practical applications for new vocabulary and language skills Introduction xxi 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page xxii Example: WRITING EXERCISE A) Use your new vocabulary. Write a sentence or two by combining these words in a meaningful way. men muscles injury lifting pain relief ice heavy back B) Use a key word from the previous exercise to complete a new sentence. 1) Tisha’s arm hurts today. She may have strained a playing baseball yesterday. provide practical applications for language and medical knowledge, combined assist you to build a comprehensive and continuous language repertoire in the context of the health professions and delivery of health care include photos and illustrations that promote clarity and understanding of new material present opportunities for reflective and personal writing exercises to help you explore your own thinking and approach to your professional practice in the mode of the English language Example: WRITING EXERCISE—REFLECTIVE QUESTIONS The text talks about the changing lifestyles of women in North America over the past 50 years and suggests that this has caused a greater incidence of coronary artery disease. What are your thoughts about this? How does it compare with your country of origin? Write your reflections here. assist with professional writing through skill-building techniques of learning structure and form and choosing appropriate terminology develop multiple-choice test-taking skills xxii Introduction 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page xxiii Example: Multiple Choice 5) Professional caring means having high standards of care, knowledge, and skills to help people meet their health-care needs. In this context, professional caring can best be described as a) requiring advanced education, training, and preparation. b) a function that can be done by anyone with compassion and a will to help. c) simply a synonym for caring. 6) Veronica has high standards of cleanliness for herself, her home, and her job. In this context, high standards can best be described as a) she is messy. b) she doesn’t wash or clean very often, only once a month. c) her goals. 7) If you forget to change a patient’s dressing, does it affect your conscience? In this context, conscience can best be described as a) a moral sense of being right or wrong. b) make you think you are overworked. c) laziness. give opportunities to develop or enhance your critical thinking skills provide Pronunciation Hints with phonetic spellings based on Taber’s Cyclopedic Medical Dictionary, 20th Edition, F.A. Davis Company Example: BOX 1-4 PRONUNCIATION HINTS To understand the pronunciation guides for each of the following words, please refer to Taber’s Cyclopedic Medical Dictionary (F.A. Davis Company). domains – dō-măn’s unique – ū-nē-k leprosy – lĕp’rō-sē Alzheimer’s – ălts’hı̄ -mĕrz conscience – kon’shŭntz epilepsy - ĕp’ ı̆ -lĕp”sē Introduction xxiii 2165_FM_i-xxiv.qxd 12/2/09 10:52 AM Page xxiv encourage you to link to Medical English Clear and Simple on Davis Plus online for supple- mental language exercises assist you with pronunciation by linking you to Taber’s Cyclopedic Medical Dictionary’s audio features on the Davis Plus website. include a quick and easy Glossary of Terms on the Medical English Clear and Simple Davis Plus link. include an Answer Key that offers the rationale or reasoning for many of the questions and exercises to ensure your full understanding Example: Unit 8 Answer Key: Understanding Intramuscular Injections 1) at the dorsal gluteal site (also known as the gluteus medius or gluteus maximus). Note: This site is no longer a preferred site for an intramuscular injection. How- ever, many older patients and immigrants are familiar with it and will request that it be used. Clinical judgment by the health professional (usually the nurse in this situation) will determine if the patient can or cannot have the medication here and why. The patient’s choice must always be considered. INSTRUCTOR’S GUIDE Thank you for choosing Medical English Clear and Simple. You have found a wonderful resource for teaching! Readings, dialogues, and case studies predominate in the text, introducing the use of language to assess, confer, consult, interpret, interview, explore perception and perspective, and provide rationale. The focus is to teach communication in career-specific contexts. Exercises also include questioning, narratives, testimonies, and reflective discussions all within the bounds of health and health care. A complete list of these can be found in the Table of Contents. This book is best suited for co-occurring language and health studies courses. Its content closely reflects content in introductory and/or first-year nursing, medicine, and other health professions programs. As a companion to these, Medical English Clear and Simple can absolutely enhance student success. It is also well suited for any upgrading or refresher programs for inter- nationally educated nurses, as well as international medical graduates and so on who wish to either (1) immigrate or work in health in the USA or Canada, (2) participate in a clinical practicum here, or (c) speak to or correspond with American and Canadian health profession- als. Finally, you will also find this book helpful as an excellent resource for those health profes- sionals interested in learning English as a new language for personal and/or professional devel- opment purposes. Medical English Clear and Simple is designed in a cumulative, comprehensive fashion. Vocabu- lary and linguistic skills introduced in one unit are further developed in succeeding ones. With this in mind, the author recommends proceeding through the material in the order in which it has been designed. xxiv Introduction 2165_Ch01_001-052.qxd 12/1/09 2:55 PM Page 1 1 and Cultural Concepts of Health and Wellness Introduction to American and Canadian Health Care UNIT Welcome! Let’s begin our study of Medical English Clear and Simple. Unit 1 provides multiple opportunities for the reader to become acquainted with the American and Canadian approaches to health. It introduces language used in the context of health and health care, providing a foundation for use of the language in situations specific to health-care careers. It also aids in the development of an awareness of Western health care and the Western view of professionalism and professional expectations in health care. The use of appropriate terms and expressions in clinical situations is also included. While this context is reflected throughout this and subsequent units, Unit 1 provides the foundation. Unit 1’s focus and main subdivisions are Concepts of Health and Wellness, Professional Caring, The Drugstore, and Calling the Doctor’s Office. Subsequent chapters focus on specific body systems and the correct and appropriate use of language in caring for clients in specific situations. SECTION ONE Concepts of Health and Wellness This section introduces health and wellness through American and Canadian cultural perspec- tives. It includes two reading selections, each followed by reading exercises and by speaking, lis- tening, and writing exercises designed to improve your communication skills. Reading Selection 1-1 Read the following in its entirety. Many words may be new to you. The exercises that follow will help you learn their meaning. PERSPECTIVES ON HEALTH CARE IN THE NEW MILLENNIUM In the United States of America and in Canada, perspectives on health care have changed over the last 30 years. Today, the public sees itself as a consumer of health- care services and products. This means that when individuals seek advice or treatment, they often come well-informed about their health issues and needs. Today’s patient ex- pects to be treated as an intelligent, competent person by the doctor, nurse, and other health-care professionals. No longer is the patient a passive receiver of health care. The new patient comes with information, education, and an inquiring mind. Professionally, today’s view of health care is concerned with health promotion and disease prevention. It is no longer disease-focused or cure-focused. Health care is concerned with quality of life. In this new perspective, it extends beyond health challenges and basic medical care to lifestyle adaptations to ensure optimal health. Healthy living programs in schools, businesses, and community agencies are an exam- ple of health promotion initiatives. Health-care professionals and governments at all 1 2165_Ch01_001-052.qxd 12/1/09 2:55 PM Page 2 levels collaborate with communities and patients/health-care consumers not only to promote health but also to provide the best health care possible. READING EXERCISES The following reading exercises challenge your ability to understand the general meaning of the se- lection, to learn new vocabulary and be able to expand on it, and to use new words in sentences. Understanding the General Meaning Read the text again. Think about it. Do you understand it? What is the general meaning of the text? What is its focus? Building Vocabulary Take a moment now to review what you have just read. Circle any words that are new to you. Write them down here. In a moment, you may see them again in exercises that will help you un- derstand their meaning. If not, at the end of this section, feel free to use your dictionary. Determining Meaning from Context. To build vocabulary, study the following words or terms taken from this text. Discover all you can about them by looking at them in con- text. Choose the correct meaning. Finally, take a look at how these words or terms expand in English. 1. Lifestyle (adjective; noun, singular) In context: a) He lives a busy lifestyle. He works long days and parties all night. b) A healthy lifestyle includes a balance between work, rest, play, and diet. c) Lifestyle adaptations are often necessary to ensure health and wellness. Meaning: Lifestyle can best be described as a) way of life b) good or bad c) alive or dead d) what style or fashion of food or clothes you like Word expansion: a) Nurse Wong’s lifestyle is very different from her colleagues. She likes to work nights and sleep all day. (noun) b) I would prefer a leisurely lifestyle; however, I have to work. (noun) c) I would prefer to style my life after Mother Teresa—work hard, be dedicated, and really, really help people. (conditional (would prefer) + verb, infinitive (style) + noun (life) combine as a verb phrase) d) The nurse suggested lifestyle adaptations to the client to help control his newly diagnosed diabetes. (adjective) 2 Introduction to American and Canadian Health Care and Cultural Concepts of Health and Wellness 2165_Ch01_001-052.qxd 12/1/09 2:55 PM Page 3 2. Consumer (noun) In context: a) She buys her food at the grocery store. She is a regular consumer there. b) Sometimes I think I am a consumer of information. I can’t get enough. Meaning: The term consumer can best be described as a) when your nose is plugged b) a customer, client, or patient c) a person who purchases, uses, or eats a product d) both (b) and (c) Word expansion: a) He was so hungry; he consumed all the food in the house. (verb, past tense) b) She cannot think. She is consumed by pain. (verb, present tense continuous) c) They have a consummate relationship. It’s perfect. (adjective) d) I am guilty of consuming too much junk food. (gerund, present participle used as a noun) e) He is a careful consumer, always checking the quality and prices of what he purchases. (noun) 3. Issue (noun, verb) In context: a) Today’s health issues include contraception and antibiotic-resistant organisms. b) Students love to debate political issues. Meaning: The word issues can best be described as meaning a) the main topics, results, or points of interest in a subject b) things you sneeze into c) giving d) none of the above Word expansion: a) I hope they will issue my working visa for Canada. (verb, future tense) b) The computer is issuing your results right now. Please wait. (verb, present tense continuous) c) They issued my driver’s license in 1992. (verb, past tense) d) Issuance of a passport requires your birth certificate and other identification. (noun, singular) e) The nurse had many issues she wanted to discuss with her supervisor. (noun, plural) 4. Needs (noun, verb) In context: a) A person’s primary needs include food, clothing, and shelter. b) What are your patient’s needs right now? Treatment or rest? c) He needs to find a way to pay off his debts. Meaning: Needs can best be described as meaning a) something you want b) something you require c) lack of food and water d) desire Word expansion a) Jack is emotionally needy. He follows his girlfriend around like a puppy dog. (adjective) b) I need a vacation. No, not really. I just want one. (verb, present tense) c) Do you donate money to the needy? (noun) d) There are many needy people in the world. (adjective) Introduction to American and Canadian Health Care and Cultural Concepts of Health and Wellness 3 2165_Ch01_001-052.qxd 12/1/09 2:55 PM Page 4 5. Passive receiver (noun, verb) In context: a) Why doesn’t she complain about her treatment instead of just passively receiving it? b) She is so compliant. She accepts everything. She really is a passive receiver of her life. Meaning: The term passive receiver can best be described as a) outspoken b) submissive and acted upon c) disinterested and apathetic d) unconscious Word expansion: a) In some countries, nurses are the passive receivers of physicians’ orders. In the United States and in Canada, nurses have a responsibility to question orders if they think they are wrong. (noun) b) How can you sit there and passively receive the insults of that person? (adverb [passively] + verb present tense [receive]) c) Passive reception requires the ability to be submissive and just allow things to happen to you. (term, adjective + noun, combined) 6. Health promotion (noun [identifying a concept]; adjective) In context: a) Nurses are always involved in health promotion in the community. b) The government sponsors health promotion by advertising healthy lifestyle choices on TV. Meaning: The term/concept health promotion can best be understood as meaning a) an activity that only doctors do b) teaching and providing information about healthy living c) a TV advertisement campaign d) when you are healthy Word expansion: a) I am promoting health each time I teach a patient about healthy eating. (verb, present tense, continuous + object of verb) b) How do you promote health with your patients? (verb, present tense + noun ) c) The community has begun to sponsor many health promotion meetings and activities. (adjective + noun form term) d) Community officials and health-care professionals joined in planning activities for health promotion. (noun) 7. Prevention (noun, adjective) In context: a) Prevention of starvation is a priority for the World Health Organization. b) Disaster prevention is the concern of environmentalists and politicians. Meaning: Prevention can best be described as a) gathering knowledge about a subject b) inoculation c) taking positive action to avoid a terrible illness or situation from occurring d) taking political action by blockading or marching Word expansion: a) The city of Vancouver, British Columbia, hopes to prevent a bridge disaster if an earth- quake should occur. They have ordered structural repairs to all bridges. (verb, infinitive) b) Can measles be prevented? (verb, past tense) c) Preventing the spread of HIV/AIDS is a global issue. (gerund, present participle used as a noun) 4 Introduction to American and Canadian Health Care and Cultural Concepts of Health and Wellness 2165_Ch01_001-052.qxd 12/1/09 2:55 PM Page 5 8. Disease (noun) In context: a) The disease of polio has been eradicated in North America. b) Do you suffer from a disease? Meaning: The word disease can best be described as a) pathological change in organs or tissues revealed by particular signs and symptoms b) an illness that last only 3 days c) something only children and old people get d) a condition that is always curable Word expansion: a) We wanted to save the ovaries, but they were too diseased. We removed them. (adjective) b) Some diseases are infectious; others are not. (noun, plural) 9. Cure (noun) In context: a) Canadians Drs. Banting and Best didn’t find the cure for diabetes; they found a treat- ment that saved many people’s lives. b) There is no cure for the common cold. Meaning: The noun cure can best be described as a) treating the symptoms of a disease b) a particular method of treatment designed to restore health c) remission d) none of the above Word expansion: a) If a doctor could restore health to 100%, she could say she cured the patient. (verb, past tense) b) Bob had prostate cancer but says he is now cured. (adjective) c) Scientists are interested in curing AIDS as well as preventing it. (gerund, present partici- ple used as noun) d) Some herbs have curative factors. (adjective) e) Some diseases, such as Huntington’s disease, are incurable. (adjective) 10. Collaborate (verb) In context: a) It is important for the nurse and doctor to collaborate on a plan of care for the patient. b) If we collaborate, we can get this job done quickly. Meaning: The word collaborate can best be described as a) being efficient b) being responsible c) taking turns d) working together and planning together Word expansion: a) The multidisciplinary health-care team worked in collaboration to help the patient through rehabilitation. (noun, object of preposition “in”) b) The hospital is collaborating with Social Services to ensure the rights of the child are protected. (verb, present tense, continuous) c) Luckily, the insurance company collaborated with us and paid the medical bills for Joe. (verb, past tense) d) The health-care team used a collaborative approach to the patient’s care and he improved quickly. (adjective) Introduction to American and Canadian Health Care and Cultural Concepts of Health and Wellness 5 2165_Ch01_001-052.qxd 12/1/09 2:55 PM Page 6 Using New Words in Sentences. Use a key word from the previous exercise to create a new sentence. 1) (Bob, addictive) 2) (nurses, not) 3) (promotion) 4) (overweight, excessive) 5) (unhealthy, youth) 6) (political, health care) SPEAKING EXERCISE Read the following completed sentences aloud. Ask a peer or teacher to help you with pronun- ciation. Proceed to the Pronunciation Hint section following. This will also help. Bob says he is not unhealthy, but he is most certainly very overweight. He is obese. Members of multidisciplinary research teams are trying to collaborate and find a cure for addiction and obesity. PRONUNCIATION HINTS To understand the pronunciation guides for each of the following words, please refer to Taber’s Cyclopedic Medical Dictionary (F. A. Davis Company). unhealthy – ŭn-hĕlth-ē overweight – ō-vur-wăt’ addiction – ă-dı̆k’shŭn multidisciplinary – mŭl’’tı̄ -dı̆s’ı̆ -plı̆ -năr-ē obese – ō-bēs’ LISTENING EXERCISE If you would like to hear more native English speakers from Canada and the United States, search the Internet for radio stations located there. Many radio stations have programs dedicated to the subject of health and wellness. Try to find one. Listen carefully by Internet or radio to hear many of the words you have just learned. WRITING EXERCISE Use your new vocabulary. Write a sentence or two by combining these words and names in a meaningful way. Dr. Banting collaborated disease Dr. Best cure famous treatment 6 Introduction to American and Canadian Health Care and Cultural Concepts of Health and Wellness 2165_Ch01_001-052.qxd 12/1/09 2:55 PM Page 7 Reading Selection 1-2 Read the following aloud or silently to yourself. HEALTH IS A STATE OF OPTIMAL WELL-BEING It is a “... a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.... to reach a level of optimal physical, mental and social well-being, an individual or group is able to realize aspirations, to satisfy needs, and to change or cope with the environment. Health, therefore, is seen as a resource for living, a positive concept emphasizing social and personal resources, as well as physical capacities.” —World Health Organization1 READING EXERCISES This time you are asked questions to test your general understanding of the reading selection, asked about the meaning of specific words, and provided with an opportunity to practice answer- ing multiple-choice questions—the type of question most frequently used on nursing exams—as a way of building vocabulary. Understanding the General Meaning In your own words, answer the following questions based on your reading. 1) What is the gist of this reading? The main point? 2) Is this academic language easy or difficult for you to read? Please explain. Building Vocabulary Take a moment now to review what you have just read. Consider the vocabulary list below. Do you understand these words? Think about them. In a moment, you will see them again in exer- cises that will help you understand their meaning. If need be, at the end of this section feel free to use your dictionary for clarification. optimal state infirmity needs realize capacities A variety of exercises—mix and match, explaining the meaning of words, and multiple choice—can be used to expand your vocabulary Mix and Match. Consider what you have just read. Complete the exercise in Box 1-1 by matching a term or phrase from the text to the English language explanation. To do this, you must consider the meaning of words in the context of Western health care. You might be interested to know that not only are these terms and phrases very commonly used by health professionals, but they also appear on national licensing exams. 1 Definition available at the World Health Organization website, http://www.who.int/aboutwho/en/definition.html Introduction to American and Canadian Health Care and Cultural Concepts of Health and Wellness 7 2165_Ch01_001-052.qxd 12/1/09 2:55 PM Page 8 BOX 1-1 Mix and Match Draw a line from the term or phrase in the left column to the explanation in the right column. TERM OR PHRASE EXPLANATION optimal well-being dreams and goals physical well-being the ability to feel comfortable among other people; social ease and skills mental well-being physical fitness; a healthy, active body social resources emotional stability; free from mental or emotional disturbance to satisfy needs physical/emotional surroundings aspirations the ability to accomplish what must be done to survive and grow environment personal sense of wellness Sentence Completion. Complete the following sentences using your own words. 1) Frederica has very poor vision, yet she says her health is very good. That is her subjective opinion. Subjective means 2) The test results for Mrs. Ortega have arrived from the laboratory. When you read them you discover she does not have diabetes and she is in optimal health in general. In this case, opti- mal health is defined objectively. Objectively means 3) The medical concept of physical fitness means Exam Writing in North America Cultural Context Students planning to write a licensing exam such as the Nursing Certification Licensing Examination (NCLEX) in the United States or the Canadian Registered Nurse Exam (CRNE)/Canadian Nursing Examination (CNE) in Canada will enjoy the opportunity to practice multiple-choice questions. These national exams include 75% to 100% multiple-choice questions. Multiple Choice. Complete the following multiple-choice questions that deal with the sub- ject of health. This mock test provides an opportunity to see a variety of usages for the new vocabulary. Choose the best answer. 1) Health can best be described as a) physical well-being. b) spiritual well-being. c) not being disabled or ill. d) a positive state of mind and body. e) all of the above 8 Introduction to American and Canadian Health Care and Cultural Concepts of Health and Wellness 2165_Ch01_001-052.qxd 12/1/09 2:55 PM Page 9 2) The patient with diabetes says he is in good health. This means a) he feels well and his diabetes is under control. b) he is foolish. c) he is disabled and doesn’t know it. d) he needs to get a doctor’s opinion. 3) The elderly patient is very, very thin. She has not eaten a proper meal in 1 week. She is in poor health. Poor health is best described as a) too lazy to buy groceries. b) improper nutrition and health care. c) being in the hospital. d) she’s okay. It is alright to be very thin. 4) Mrs. Anderson is in failing health. She is 94, has cancer, and now has pneumonia. Failing health can best be described as a) no family visits her. b) lack of nutrition and exercise. c) in deteriorating condition and may die. d) needs to see a doctor. 5) My mom is in relatively good health. She has arthritis and eczema, but otherwise she is well. Relatively good health means a) able to function and have a quality of life that suits her. b) deteriorating condition and may die. c) she is my relative and is in good health. d) none of the above 6) I am a nurse. It is important for me to give good health care to my patients. Giving good health care can be described as a) providing the best professional treatment, skills, compassion, and caring activities possible. b) providing basic physical care only. c) following doctors orders only. d) none of the above SPEAKING EXERCISE Return to the reading that defines health. Read it aloud now, even if you are reading alone. If you are able to record your voice, please do so. Then listen back. Check your pronunciation with the box below or ask a native English speaker to help you. PRONUNCIATION HINTS To understand the pronunciation guides for each of the following words, please refer to Taber’s Cyclopedic Medical Dictionary (F. A. Davis Company). health – hĕlth ŏ optimal – ŏp’tı̆m-ăl aspirations – ăs-pı̆ -rā’shŭnz Introduction to American and Canadian Health Care and Cultural Concepts of Health and Wellness 9 2165_Ch01_001-052.qxd 12/1/09 2:55 PM Page 10 LISTENING EXERCISE At this point in Medical English Clear and Simple, you have some homework. You are encouraged to speak to a native English-speaking health professional if you know one or to watch an English lan- guage television show or film set in an American health-care setting. Listen. The purpose of this exercise is simply to begin to familiarize yourself with how English is spoken in the context of health care. WRITING EXERCISE—A REFLECTIVE QUESTION As you can see from the reading selections and exercises, health is considered holistically from a Western perspective. Biological, psychological, sociological, environmental, and spiritual factors are all considered in its definition. How is health defined in your country of origin? Write a short paragraph here. SECTION T WO Professional Caring Now that we have taken a look at culturally bound concepts of health and wellness in Canada and the United States, this section introduces the concepts of professional caring and the roles of professional caregivers. The meaning of holism and holistic care are explored. Exercises provide opportunities to compare and contrast how the Western model of health-care delivery applies to that of other countries. Please remember that although some of the readings that follow are based in nursing, they are relevant to all health-care professionals. Reading Selection 1-3 Read the following. If an opportunity arises, discuss it with friends. Offer your own thoughts and opinions. Make comparisons with your own country or others to enrich the discussion. PROFESSIONAL CARING Professional caring is based on a foundation of providing support for people in need as well as promoting their personal growth and development. This can mean progressing from a position of physical and/or emotional health challenges to a position of wellness. Earlier in this chapter, we reviewed the definition of health and discovered that it includes the biological, psychological, sociological, and spiritual aspects of a person’s lived experience. Health also includes the element of environment: factors that can help or hinder an individual’s ability to meet everyday challenges and enjoy quality of life. According to the International Council of Nurses (ICN), nurses have four responsibilities: preventing illness, restoring health, alleviating suffering, and promoting health (ICN 1975). These are the domains of professional caring, and they apply to all health professions. In the United States and Canada, we often refer to Jean Watson’s theory of Transpersonal Caring.1 She, like others, sees that nursing and medicine have moved from the medical model of care to a model that includes valuing the transpersonal relationship between the caregiver and care-receiver—that professional caring is a standard of practice. It includes compassion, competence, confidence, conscience, and commitment. 1 University of Colorado School of Nursing, Transpersonal Caring and the Caring Moment Defined, http://www2.uchsc.edu/son/caring/content/transpersonal.asp 10 Introduction to American and Canadian Health Care and Cultural Concepts of Health and Wellness 2165_Ch01_001-052.qxd 12/1/09 2:55 PM Page 11 Additionally, a number of theories of health-care practices support multicultural care. Evident in our health-care philosophy, this is the belief that health professionals require a level of cultural competency to provide the best care: a solid understand- ing of sociocultural practices from around the world. This knowledge helps them provide an additional level of empathy and promotes trust, respect, and optimal health outcomes. READING EXERCISES The following reading exercises challenge your ability to understand the meaning of the selection and to learn and use new vocabulary. Understanding the General Meaning 1) Read the text again. Think about it. Do you understand it? What is the general meaning of the text? What is its focus? 2) Although the reading talks about nursing, it claims to be applicable to other health professions. For example, the four responsibilities of nurses are described. Are these the same professional characteristics of other health professions? If so, name those professions. Building Vocabulary Take a moment now to review what you have just read. Circle any words that are new to you. Write them down here. In a moment, you may see them again in exercises that will help you un- derstand their meaning. If not, at the end of this section, feel free to use your dictionary. Multiple Choice. Here are some words to review. Do you understand them? Try to dis- cover their meaning from their context-based use in the reading selection and in the stem of the question. Again, these are multiple-choice questions, the most common type of question you’ll find on nursing exams. 1) I am a competent nurse. In this context, competent can best be described as a) learning about a subject. b) skilled, knowledgeable, and capable. c) unsure of how to treat new problems. 2) Canada is a multicultural mosaic while the United States is more of a melting pot. In this context, melting pot can best be described as a) each culture being valued as separate to mainstream culture. b) an expectation that all new immigrants assimilate into mainstream culture. c) only Caucasians are valued. Introduction to American and Canadian Health Care and Cultural Concepts of Health and Wellness 11 2165_Ch01_001-052.qxd 12/1/09 2:55 PM Page 12 3) My father faces the health challenge of diabetes. In this context, health challenge can best be described as a) He is sick and should be in the hospital. b) He is afraid of this illness and cannot cope. He needs a full-time nurse. c) He has a chronic illness that he must treat and be aware of as he goes about his life. 4) My father’s lived experience of diabetes has been positive. He is quite comfortable with it. In this context, lived experience can best be described as a) His unique, personal experience with this health challenge. It has been one of accep- tance and adaptability. b) He hates his diabetes. c) His personal experience of living with diabetes has been bad and he considers himself a sick person. 5) Professional caring means having high standards of care, knowledge, and skills to help people meet their health-care needs. In this context, professional caring can best be described as a) requiring advanced education, training, and preparation. b) a function that can be done by anyone with compassion and a will to help. c) simply a synonym for caring. 6) Veronica has high standards of cleanliness for herself, her home, and her job. In this context, high standards can best be described as a) she is messy. b) she doesn’t wash or clean very often, only once a month. c) cleanliness is an important goal for her. 7) If you forget to change a patient’s dressing, does it affect your conscience? In this context, conscience can best be described as a) a moral sense of being right or wrong. b) making you think you are overworked. c) laziness. Using New Words in Sentences. Use the following words or phrases in complete sentences. 1) demonstrate a high level of competency 2) challenge, epilepsy 3) standards, care, professional SPEAKING EXERCISE Read the following sentences aloud. Ask a peer or teacher to help you with pronunciation. Proceed to the Pronunciation Hints section following. This will also help. These are the domains of professional caring and apply to all health professions. Ravinder has a unique, personal experience with this health challenge of leprosy. It has been one of acceptance and adaptability. Mr. Heinrich has severe Alzheimer’s disease. He is not competent to manage his own finances. 12 Introduction to American and Canadian Health Care and Cultural Concepts of Health and Wellness 2165_Ch01_001-052.qxd 12/1/09 2:55 PM Page 13 PRONUNCIATION HINTS To understand the pronunciation guides for each of the following words, please refer to Taber’s Cyclopedic Medical Dictionary (F. A. Davis Company). domains – dō-măn’s unique – ū-nē-k leprosy – lĕp’rō-sē Alzheimer’s – ălts’hı̄ -mĕrz conscience – kon’shŭntz epilepsy – ĕp’i-lĕp’’sē LISTENING EXERCISE