PAPER ENGLISH

NURSNG REPORT

BY :

Tu De Ngurah Papin Prasetiya

18.321.2864

BACHELOR OF NURSING

SEKOLAH TINGGI ILMU KESEHATAN

WIRA MEDIKA BALI

2019/2020
 A. NURSING REPORTS

Nursing Reports is an open access, peer-reviewed, online-only journal that

aims to influence the art and science of nursing by making rigorously conducted
research accessible and understood to the full spectrum of practicing nurses,
academics, educators and interested members of the public. The journal represents an
exhilarating opportunity to make a unique and significant contribution to nursing and
the wider community by addressing topics, theories and issues that concern the whole
field of Nursing Science, including research, practice, policy and education. The
primary intent of the journal is to present scientifically sound and influential
empirical and theoretical studies, critical reviews and open debates to the global
community of nurses. Short reports, opinions and insight into the plight of nurses the
world-over will provide a voice for those of all cultures, governments and
perspectives.The emphasis of Nursing Reports will be on ensuring that the highest
quality of evidence and contribution is made available to the greatest number of
nurses.Nursing Reports aims to make original, evidence-based, peer-reviewed
research available to the global community of nurses and to interested members of the
public. In addition, reviews of the literature, open debates on professional issues and
short reports from around the world are invited to contribute to our vibrant and
dynamic journal. All published work will adhere to the most stringent ethical
standards and journalistic principles of fairness, worth and credibility.

There are many different approaches to hand-off communication, including

shift report in a room, at the nurses' station, by phone, and at the bedside. Much of the
literature indicates a need for a standardized communication method such as the
Situation-Background-Assessment-Recommendation (SBAR) technique. This
technique provides a framework for effective communication among members of the
healthcare team and helps create an environment that allows individuals to speak up
and express their concerns. This, in turn, reduces the risk of adverse events and
ultimately fosters a culture of patient safety.

Improving the communication between caregivers can prevent negative

patient outcomes and strengthen a teamwork approach to care. The SBAR technique
provides common expectations such as what will be communicated, how it's
structured, and what are the required elements. It allows communication to be
focused on the problem and not the people. This is very important when staff
members are communicating hand-off information at the change of shifts.

The SBAR technique also provides a way to hand-off relevant information in

the presence of the patient, allowing active participation of the patient in his or her
care. The patient is central to all information surrounding care activities. Patients can
ask questions or add information to the discussion. Through this process, the patient
sees the staff working as a team and is assured that all involved know and agree on
the plan of care. Evidence suggests that better-informed patients are less anxious and
more likely to follow medical advice.

Now, let's take a look at how following the steps in the SBAR acronym leads
the speaker to convey information in a methodical and logical way so that the listener
can easily follow.

Following the steps

Situation. The "S" component should take about 8 to 12 seconds. The nurse
states what's happening now. If giving a shift report to the next caregiver, the nurse
states the patient's name, why the patient is on the unit, and introduces the nurse
coming on duty to the patient. For example: "Ms. J, this is Tina Jones, the registered
nurse who will be caring for you today. Tina, Ms. J is here to have rehab after her
right knee replacement." To be effective, you must be concise, clear, and to the point
when giving the report, leaving irrelevant information out of the conversation.

Background. During the "B" component, the nurse gives the next caregiver
brief background information specific to the patient's relevant history. This section
sets the context for what's being discussed, which may include the patient's diagnosis,
history of procedures done, and family situation. For example: "Ms. J had a right
knee replacement on June 3rd by Dr. Smith. She has a history of hypertension,
diabetes, and arthritis. She lives with her husband who's retired and able to care for
her at home when discharged."

Assessment. During the "A" component, the nurse reports the current
condition of the patient. For example: "Blood glucose levels have been stable, vital
signs within normal limits, and the incision line is clean and dry with no drainage
noted. The dressing was changed today. Ms. J is able to ambulate to the restroom
with a contact guard of one and the use of a walker. Her pain has been reported as a 7
on a 0-to-10 scale and she was given two hydrocodone pills at 9 a.m. The
hydrocodone appears to be helping her, especially when given before therapy."

Recommendation. During the "R" component, the nurse states what he or she
thinks would be the desired response to the patient's care of the day. She may suggest
that discharge planning be initiated by discussing needs with the patient, contacting
the physician with discharge plans, and conveying to the rest of the care team what
needs to be done before discharge. You don't need to read the entire patient profile or
orders. For example: "Ms. J is scheduled for discharge this Friday and will need to
speak to the discharge planner today."

Remember, not everything about the patient needs to be conveyed, just what's
pertinent to the situation at that time. Also remember that effective communication
takes two: Ask if there are any questions and remind team members and the patient
that you'll be available should further clarification be needed.

Communication concerns

Although nurses communicate all the time with their patients, it's sometimes
difficult for them to conduct a report that includes the patient. One reason for this
uneasiness has been identified as a fear of having to interrupt the patient if he or she
monopolized the report episode. Staff nurses who feel comfortable communicating in
the presence of and with patients can share their techniques to demonstrate best
practices to the nurses who are unsure of the process.

Informing the patient of his or her role in the bedside report process is also
important. To guide patient participation and minimize the disclosure of irrelevant
information, remind your patient of the upcoming bedside report toward the end of
the shift. To minimize interruptions by the patient during the report, use this time to
address the patient's needs for pain relief, toileting, and other requests.

You should also discuss the bedside report process with the patient upon
admission to the unit. The patient can choose whether the family or significant other
can be present during the bedside report, and those wishes must be passed from nurse
to nurse. One hospital made signs for each patient room that reminded the patients, as
well as the nurses, about the reporting process. Preparing patients proved to be a vital
part of this hospital's implementation process and successful bedside report.

A. NURSING PROCESS

The nursing process is a scientific method used by nurses to ensure the quality of
patient care.This approach can be broken down into five separate steps.

Assessment Phase

The first step of the nursing process is assessment. During this phase, the nurse
gathers information about a patient's psychological, physiological, sociological, and
spiritual status. This data can be collected in a variety of ways. Generally, nurses will
conduct a patient interview. Physical examinations, referencing a patient's health
history, obtaining a patient's family history, and general observation can also be used
to gather assessment data. Patient interaction is generally the heaviest during this
evaluative phase.
Diagnosing Phase

The diagnosing phase involves a nurse making an educated judgment about a

potential or actual health problem with a patient. Multiple diagnoses are sometimes
made for a single patient. These assessments not only include an actual description of
the problem (e.g. sleep deprivation) but also whether or not a patient is at risk of
developing further problems. These diagnoses are also used to determine a patient's
readiness for health improvement and whether or not they may have developed a
syndrome. The diagnoses phase is a critical step as it is used to determine the course
of treatment.

Planning Phase

Once a patient and nurse agree on the diagnoses, a plan of action can be
developed. If multiple diagnoses need to be addressed, the head nurse will prioritize
each assessment and devote attention to severe symptoms and high risk factors. Each
problem is assigned a clear, measurable goal for the expected beneficial outcome. For
this phase, nurses generally refer to the evidence-based Nursing Outcome
Classification, which is a set of standardized terms and measurements for tracking
patient wellness. The Nursing Interventions Classification may also be used as a
resource for planning.

Implementing Phase

The implementing phase is where the nurse follows through on the decided plan of
action. This plan is specific to each patient and focuses on achievable outcomes.
Actions involved in a nursing care plan include monitoring the patient for signs of
change or improvement, directly caring for the patient or performing necessary
medical tasks, educating and instructing the patient about further health management,
and referring or contacting the patient for follow-up. Implementation can take place
over the course of hours, days, weeks, or even months.

Evaluation Phase

Once all nursing intervention actions have taken place, the nurse completes an
evaluation to determine of the goals for patient wellness have been met. The possible
patient outcomes are generally described under three terms: patient's condition
improved, patient's condition stabilized, and patient's condition deteriorated, died, or
discharged. In the event the condition of the patient has shown no improvement, or if
the wellness goals were not met, the nursing process begins again from the first step.
1. USEFUL EXPRESION
Useful Expressions To Express Your Opinion

In my opinion, ... In my eyes, ...

To my mind, ... As far as I am concerned, .. Speaking personally, ...

From my point of view, ... As for me / As to me, ...

My view / opinion / belief / impression / conviction is that ...

I hold the view that ...

I would say that ... It seems to me that ...

I am of the opinion that ...

My impression is that ... I am under the impression that ...

It is my impression that ...

I have the feeling that ... My own feeling on the subject is that ...

I have no doubt that ... I am sure / I am certain that ...

I think / consider / find / feel / believe / suppose / presume / assume that ...
I hold the opinion that ... (I form / adopt an opinion.)

I dare say that ...

I guess that ... I bet that ....

I gather that ...

It goes without saying that ...

Useful Words To Express Your Agreement

I agree with you / him ... I share your view.

I think so.

I really think so.

(The author / the narrator / the protagonist / etc.) is right
He is quite right / absolutely right He may be right.
I have no objection. I approve of it.

I have come to the same conclusion I hold the same opinion. We

are of one mind / of the same mind on that question.
I am at one with him on that point. It is true. That is
right.

That's just it ! Fair enough ! Quite so !

Just so ! Yes of course !

Useful Words To Express Your Disagreement

I don't agree. I disagree. I don't
think so.
You are / he is wrong. I think otherwise.

I don't think that's quite right.

I don't agree with you/him. I don't agree with what you say.

I am afraid that is not quite true.

I take a different view. I don't share his/her/your view.

This argument does not hold water.
Not at all ! Nonsense ! Rubbish !

He's off his head !

2. VOCABULARY

A vocabulary is a set of familiar words within a person's language. A vocabulary,

usually developed with age, serves as a useful and fundamental tool for
communication and acquiring knowledge. Acquiring an extensive vocabulary is one
of the largest challenges in learning a second language.

Definition and usage

Vocabulary is commonly defined as "all the words known and used by a

particular person".Knowing a word, however, is not as simple as merely being able to
recognize or use it. There are several aspects of word knowledge that are used to
measure word knowledge.

Productive and receptive knowledge

The first major distinction that must be made when evaluating word
knowledge is whether the knowledge is productive (also called achieve) or receptive
(also called receive); even within those opposing categories, there is often no clear
distinction. Words that are generally understood when heard or read or seen constitute
a person's receptive vocabulary. These words may range from well-known to barely
known (see degree of knowledge below). A person's receptive vocabulary is the
larger of the two. For example, although a young child may not yet be able to speak,
write, or sign, he or she may be able to follow simple commands and appear to
understand a good portion of the language to which they are exposed. In this case, the
child's receptive vocabulary is likely tens, if not hundreds of words, but his or her
active vocabulary is zero. When that child learns to speak or sign, however, the
child's active vocabulary begins to increase. It is also possible for the productive
vocabulary to be larger than the receptive vocabulary, for example in a second-
language learner who has learned words through study rather than exposure, and can
produce them, but has difficulty recognizing them in conversation.

Productive vocabulary, therefore, generally refers to words that can be

produced within an appropriate context and match the intended meaning of the
speaker or signer. As with receptive vocabulary, however, there are many degrees at
which a particular word may be considered part of an active vocabulary. Knowing
how to pronounce, sign, or write a word does not necessarily mean that the word that
has been used correctly or accurately reflects the intended message; but it does reflect
a minimal amount of productive knowledge.

Degree of knowledge

Within the receptive–productive distinction lies a range of abilities that are often
referred to as degree of knowledge. This simply indicates that a word gradually enters
a person's vocabulary over a period of time as more aspects of word knowledge are
learnt. Roughly, these stages could be described as:

1. Never encountered the word.

2. Heard the word, but cannot define it.
3. Recognize the word due to context or tone of voice.
4. Able to use the word and understand the general and/or intended meaning, but
cannot clearly explain it.
5. Fluent with the word – its use and definition.

Depth of knowledge

The differing degrees of word knowledge imply a greater depth of knowledge, but
the process is more complex than that. There are many facets to knowing a word,
some of which are not hierarchical so their acquisition does not necessarily follow a
linear progression suggested by degree of knowledge. Several frameworks of word
knowledge have been proposed to better operationalise this concept. One such
framework includes nine facets:

1. orthography – written form

2. phonology – spoken form
3. reference – meaning
4. semantics – concept and reference
5. register – appropriacy of use or cash register
 6. collocation – lexical neighbours
7. word associations
8. syntax – grammatical function
9. morphology – word parts

Definition of word

Words can be defined in various ways, and estimates of vocabulary size differ
depending on the definition used. The most common definition is that of a lemma
(the uninflected or dictionary form; this includes walk, but not walks, walked or
walking). Most of the time lemmas do not include proper nouns (names of people,
places, companies, etc). Another definition often used in research of vocabulary size
is that of word family. These are all the words that can be derived from a ground
word (e.g., the words effortless, effortlessly, effortful, effortfully are all part of the
word family effort). Estimates of vocabulary size range from as high as 200 thousand
to as low as 10 thousand, depending on the definition used.

Types of vocabulary

Listed in order of most ample to most limited:

Reading vocabulary

A literate person's vocabulary is all the words they can recognize when
reading. This is generally the largest type of vocabulary simply because a reader
tends to be exposed to more words by reading than by listening.

Listening vocabulary

A person's listening vocabulary is all the words they can recognize when
listening to speech. People may still understand words they were not exposed to
before using cues such as tone, gestures, the topic of discussion and the social context
of the conversation.

Speaking vocabulary

A person's speaking vocabulary is all the words they use in speech. It is likely
to be a subset of the listening vocabulary. Due to the spontaneous nature of speech,
words are often misused. This misuse, though slight and unintentional, may be
compensated by facial expressions and tone of voice.
Writing vocabulary

Words are used in various forms of writing from formal essays to social
media feeds. Many written words do not commonly appear in speech. Writers
generally use a limited set of words when communicating.For example, if there are a
number of synonyms, a writer may have a preference as to which of them to use, and
they are unlikely to use technical vocabulary relating to a subject in which they have
no knowledge or interest.

Focal vocabulary

Focal vocabulary is a specialized set of terms and distinctions that is

particularly important to a certain group: those with a particular focus of experience
or activity. A lexicon, or vocabulary, is a language's dictionary: its set of names for
things, events, and ideas. Some linguists believe that lexicon influences people's
perception of things, the Sapir–Whorf hypothesis. For example, the Nuer of Sudan
have an elaborate vocabulary to describe cattle. The Nuer have dozens of names for
cattle because of the cattle's particular histories, economies, and environments This
kind of comparison has elicited some linguistic controversy, as with the number of
"Eskimo words for snow". English speakers with relevant specialised knowledge can
also display elaborate and precise vocabularies for snow and cattle when the need
arises.

Vocabulary growth

Main article: Vocabulary development

During its infancy, a child instinctively builds a vocabulary. Infants imitate
words that they hear and then associate those words with objects and actions. This is
the listening vocabulary. The speaking vocabulary follows, as a child's thoughts
become more reliant on his/her ability to self-express without relying on gestures or
babbling. Once the reading and writing vocabularies start to develop, through
questions and education, the child starts to discover the anomalies and irregularities
of language.

In first grade, a child who can read learns about twice as many words as one
who cannot. Generally, this gap does not narrow later. This results in a wide range of
vocabulary by age five or six, when an English-speaking child will have learned
about 1500 words.

Vocabulary grows throughout our entire life. Between the ages of 20 and 60,
people learn some 6,000 more lemmas, or one every other day.An average 20-year-
old knows 42,000 words coming from 11,100 word families; an average 60-year-old
knows 48,200 lemmas coming from 13,400 word families.People expand their
vocabularies by e.g. reading, playing word games, and participating in vocabulary-
related programs. Exposure to traditional print media teaches correct spelling and
vocabulary, while exposure to text messaging leads to more relaxed word
acceptability constraints

Importance

 An extensive vocabulary aids expression and communication.

 Vocabulary size has been directly linked to reading comprehension.
 Linguistic vocabulary is synonymous with thinking vocabulary.
 A person may be judged by others based on his or her vocabulary.
 Wilkins (1972) once said, "Without grammar, very little can be conveyed,
without vocabulary, nothing can be conveyed."

Vocabulary size

Native-language vocabulary

Estimating average vocabulary size poses various difficulties and limitations

due to the different definitions and methods employed such as what is the word, what
is to know a word, what sample dictionaries were used, how tests were conducted,
and so on. Native speakers' vocabularies also vary widely within a language, and are
dependent on the level of the speaker's education.

As a result estimates vary from as little as 10,000 to as many as over 50,000

for young adult native speakers of English.

One most recent 2016 study shows that 20-year-old English native speakers
recognize on average 42,000 lemmas, ranging from 27,100 for the lowest 5% of the
population to 51,700 lemmas for the highest 5%. These lemmas come from 6,100
word families in the lowest 5% of the population and 14,900 word families in the
highest 5%. 60-year-olds know on average 6,000 lemmas more. [8]

According to another, earlier 1995 study junior-high students would be able to

recognize the meanings of about 10,000–12,000 words, whereas for college students
this number grows up to about 12,000–17,000 and for elderly adults up to about
17,000 or more.

For native speakers of German average absolute vocabulary sizes range from
5,900 lemmas in first grade to 73,000 for adults

Foreign-language vocabulary
The effects of vocabulary size on language comprehension

The knowledge of the 3000 most frequent English word families or the 5000
most frequent words provides 95% vocabulary coverage of spoken discourse For
minimal reading comprehension a threshold of 3,000 word families (5,000 lexical
items) was suggestedand for reading for pleasure 5,000 word families (8,000 lexical
items) are required. An "optimal" threshold of 8,000 word families yields the
coverage of 98% (including proper nouns).

Second language vocabulary acquisition

Learning vocabulary is one of the first steps in learning a second language,

but a learner never finishes vocabulary acquisition. Whether in one's native language
or a second language, the acquisition of new vocabulary is an ongoing process. There
are many techniques that help one acquire new vocabulary.

Memorization

Although memorization can be seen as tedious or boring, associating one

word in the native language with the corresponding word in the second language until
memorized is considered one of the best methods of vocabulary acquisition. By the
time students reach adulthood, they generally have gathered a number of personalized
memorization methods. Although many argue that memorization does not typically
require the complex cognitive processing that increases retention (Sagarra and Alba,
2006) it does typically require a large amount of repetition, and spaced repetition with
flashcards is an established method for memorization, particularly used for
vocabulary acquisition in computer-assisted language learning. Other methods
typically require more time and longer to recall.

Some words cannot be easily linked through association or other methods.

When a word in the second language is phonologically or visually similar to a word
in the native language, one often assumes they also share similar meanings. Though
this is frequently the case, it is not always true. When faced with a false friend,
memorization and repetition are the keys to mastery. If a second language learner
relies solely on word associations to learn new vocabulary, that person will have a
very difficult time mastering false friends. When large amounts of vocabulary must
be acquired in a limited amount of time, when the learner needs to recall information
quickly, when words represent abstract concepts or are difficult to picture in a mental
image, or when discriminating between false friends, rote memorization is the method
to use. A neural network model of novel word learning across orthographies,
accounting for L1-specific memorization abilities of L2-learners has recently been
introduced (Hadzibeganovic and Cannas, 2009).
The Keyword Method

One useful method of building vocabulary in a second language is the

keyword method. If time is available or one wants to emphasize a few key words, one
can create mnemonic devices or word associations. Although these strategies tend to
take longer to implement and may take longer in recollection, they create new or
unusual connections that can increase retention. The keyword method requires deeper
cognitive processing, thus increasing the likelihood of retention (Sagarra and Alba,
2006).This method uses fits within Paivio's (1986) dual coding theory because it uses
both verbal and image memory systems. However, this method is best for words that
represent concrete and imageable things. Abstract concepts or words that do not bring
a distinct image to mind are difficult to associate. In addition, studies have shown that
associative vocabulary learning is more successful with younger students (Sagarra
and Alba, 2006).Older students tend to rely less on creating word associations to
remember vocabulary.

Word lists

Several word lists have been developed to provide people with a limited
vocabulary either for the purpose of rapid language proficiency or for effective
communication. These include Basic English (850 words), Special English (1,500
words), General Service List (2,000 words), and Academic Word List. Some learner's
dictionaries have developed defining vocabularies which contain only most common
and basic words. As a result word definitions in such dictionaries can be understood
even by learners with a limited vocabulary.

3. CASE STUDY
What is it?
Case study is a research methodology, typically seen in
social and life sciences. There is no one definition of case
study research.
1. However, very simply... ‘a case study can be defined as an intensive study about a
person, a group of people or a unit, which is aimed to generalize over several
units’. A case study has also been described as an inten- sive, systematic
investigation of a single individual, group,community or some other unit in which
the researcher examines in-depth data relating to several variables.
2. Researchers describe how case studies examine complex phenomena in the
natural setting to increase understanding of them.
3. Indeed
4. Sandelowski
5. Suggests using case studies in research means that the holisticnature of nursing
care can be addressed. Furthermore, when describing the steps undertaken while
using a case study approach, this method of research allows the researcher to take
a complex and broad topic, or phenom- enon, and narrow it down into a
 manageable research question(s). By collecting qualitative or quantitative data-
sets about the phenomenon, the researcher gains a more in-depth insight into the
phenomenon than would be obtained using only one type of data. This is
illustrated in the examples provided at the end of this paper. Often there are
several similar cases to consider such as educational or social service programmes
that are delivered from a number of locations. Although similar, they are complex
and have unique features. In these circumstances, the evaluation of several,
similar cases will provide a better answer to a research ques- tion than if only one
case is examined, hence the multi- ple-case study. Stake asserts that the cases are
grouped and viewed as one entity, called the quintain.
6. ‘We study what is similar and different about the cases to under-
stand the quintain better’. Method The steps when using case study methodology are
the same as for other types of research.The first step is defining the single case or
identifying a group of similar cases that can then be incorporated into a multiple-
casestudy. A search to determine what is known about the case(s) is typically
conducted. This may include a review of the literature, grey literature, media, reports
and more, which serves to establish a basic understanding of the cases and informs
the development of research ques- tions. Data in case studies are often, but not
exclusively, qualitative in nature. In multiple-case studies, analysis within cases and
across cases is conducted. Themes arise from the analyses and assertions about the
cases as a whole, or the quintain, emerge.
Benefits and limitations of case studies If a researcher wants to study a
specific phenomenon arising from a particular entity, then a single-case study is
warranted and will allow for a in-depth understanding of the single phenomenon and,
as discussed above, would involve collecting several different types of data. This is
illustrated in example 1 below. Using a multiple-case research study allows for a
more in-depth understanding of the cases as a unit, through comparison of similarities
and differences of the individual cases embedded within the quintain. Evidence
arising from multiple-case studies is often stronger and more reliable than from
single-case research. Multi-ple-case studies allow for more comprehensive explo-
ration of research questions and theory development.Despite the advantages of case
studies, there are limitations. The sheer volume of data is difficult to orga- nise and
data analysis and integration strategies need to be carefully thought through. There is
also sometimesa temptation to veer away from the research focus.Reporting of
findings from multiple-case research studies is also challenging at times,
1. particularly in rela-tion to the word limits for some journal papers. Examples of
case studies
Example 1: nurses’ paediatric pain management practices One of the authors of this
paper (AT) has used a case study approach to explore nurses’ paediatric pain
management practices. This involved collecting several datasets:
1. Observational data to gain a picture about actual pain management practices.
2. Questionnaire data about nurses’ knowledge about paediatric pain management
practices and how well they felt they managed pain in children.
3. Questionnaire data about how critical nurses perceived pain management tasks to
be.
These datasets were analysed separately and then compared 7–9 and demonstrated
that nurses’ level of theoretical did not impact on the quality of their pain
management practices. 7 Nor did individual nurse’s percep- tions of how critical a
task was effect the likelihood of them carrying out this task in practice. 8 There was
also a difference in self-reported and observed practices 9; actual (observed) practices
did not confirm to best practice guide- lines, whereas self-reported practices tended
to. Example 2: quality of care for complex patients at Nurse Practitioner-Led Clinics
(NPLCs) The other author of this paper (RH) has conducted a multiple-case study to
determine the quality of care for patients with complex clinical presentations in
NPLCs in Ontario, Canada. 10 Five NPLCs served as individual cases that, together,
represented the quatrain. Three types of data were collected including:
1. Review of documentation related to the NPLC model (media, annual reports,
research articles, grey literature and regulatory legislation).
2. Interviews with nurse practitioners (NPs) practicing at the five NPLCs to
determine their perceptions of the impact of the NPLC model on the quality of
care provided to patients with multimorbidity.
3. Chart audits conducted at the five NPLCs to determine the extent to which
evidence-based guidelines were followed for patients with diabetes and at least
one other chronic condition. The three sources of data collected from the five
NPLCs were analysed and themes arose related to the quality of care for complex
patients at NPLCs. The multiple-case study confirmed that nurse practitioners are
the primary care providers at the NPLCs, and this positively impacts the quality
of care for patients with multimorbidity. Healthcare policy, such as lack of an
increase in salary for NPs for 10 years, has resulted in issues in recruitment and
retention of NPs at NPLCs. This, along with insuf- ficient resources in the
communities where NPLCs are located and high patient vulnerability at NPLCs,
have a negative impact on the quality of care. 10 Conclusion.
These examples illustrate how collecting data about a single case or multiple cases
helps us to better under- stand the phenomenon in question. Case study meth-
odology serves to provide a framework for evaluation and analysis of complex issues.
It shines a light on the holistic nature of nursing practice and offers a perspec- tive
that informs improved patient care. Competing interests
None declared. Provenance and peer review Commissioned; internally peer
reviewed.

Useful expressions :
You are fantastic.
You're terrific.
You look great!
You look nice.
You are looking good.
May I say how elegant you look.
I f I may so, you are quite charming.
My compliments on your beautiful.
I really must express my admiration for your party.
What a charming dress!
That's a very nice coat!
I like your hair style!
What a nice dress!
What a charming dress!
That's a very nice coat!
You're looking glamorous.
Dialogue
N hospital A, there s a patent after appendix surgery. Doctor A come to see
paten P to see the patent condition. Doctor A first met Nurse B first.

Nurse B : good morning doc

Doctor A : good morning too. How s the condition of the Patent P?
Nurse B : the patent condition improves. Last night there was a slight bleeding
from the surgery, doc.
Doctor A : has t been handled?
Nurse B : already. Let’s look at the patent condition
Doctor A : okay

The nurse also delvers Doctor A to see the patent’s condition.

Doctor A : morning sr. how s the situation. Are you okay?

Px P : morning doc. My scar s a bit painful.
( while showing the former operation )
Doctor A : yes sr.
Hey nurse, help the patent to change poston to be comfortable
Nurse B : Okay, doc.

5 minute while

Nurse B : okay sir, stay a while. Will be there n 15 minute to give pan
medicine
Px P : Okay nurse, thank you.

After giving he patent comfortable poston and time contract, the doctor and
nurse leave the patent room.

Nurse B : doctor, how to prevent this problem?

Doctor A : give her an analgesic to relive her pan. Then provde relaxation
technique.
Nurse B : okay, doc. Can you write the receipt medicine?
Doctor A : okay wat.
This s a receipt
Nurse B : Thank you doc.
Doctor A : okay, nurse. Tomorrow wll come here to see the patent condition.
Nurse B : okay, doc. Thank you
Doctor A : your welcome
 DAFTAR PUSTAKA
https://www.pagepressjournals.org/index.php/nursing/
https://journals.lww.com/nursingmadeincrediblyeasy/Fulltext/2011/09000/Looking_t
o_improve_your_bedside_report__Try_SBAR.14
http://www.cmft.nhs.uk/directorates/mentor/documents/Assessingplanningimplement
ingandevaluatingcare_001.pdf
http://s1-keperawatan.umm.ac.id/files/file/EPN%20Book%202.pdf
http://matt.might.net/articles/grammars-bnf-ebnf/