BAHASA INGGRIS

Materi III ini dirancang bagi mahasiswa program studi keperawatan yang
dalam modul 2020/2021
akan
berurusan dengan segala hal yang berkaitan dengan layanan medis, sehingga diharapkan
dapat memiliki kemampuan yang baik untuk berkomunikasi menggunakan Bahasa Inggris
dalam kalimat yang tepat.

MODULE

BAHASA INGGRIS III

ENGLISH FOR NURSING
(USED ONLY FOR INTERNAL CAMPUS)

Arrange by:
Nita Yuanita, S.Pd., M.Si.

Lectured by:
Lusiana Lestari, S.Si., M.M.
Nita Yuanita, S.Pd., M.Si.

YAYASAN DHARMA HUSADA INSANI GARUT

STIKes Karsa Husada Garut
Prodi S1 Kepewawatan
2021

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 BAHASA INGGRIS III 2020/2021
1ST MEETING
THE NURSING PROCESS

STEPS ON THE NURSING PROCESS

To achieve the goal of Nursing Care, a nurse has to follow a standardized Nursing Process that consists
of steps:
1. ASSESSING:
Assessing/ Assessment is the first step in the nursing process and involves
systematic and deliberate (disengaja) collection of information to determine
the person’s current and past functional and health status. In addition,
during the nursing assessment the nurse evaluates the person’s present and
past coping patterns. Information for the nursing assessment is obtained
through interview with the person or appropriate family or staff member;
physical examination (vital signs/ TPR-BP, high, weight, etc.); observation;
review of records; and collaboration with other health professionals.
2. DIAGNOSING:
Diagnosing/ Diagnostic reasoning is the second step in the nursing process and involves the analysis of
information obtained during the assessment step and the evaluation of the person's health status based
on that information. Formula to write Nursing Diagnosis: P (related to)+ E+S
P= Problem of Human responses (bio-psycho-socio-spiritual)
E= Etiology (P: Pathophysiology, S: Situation, M: Medication, M: Maturation)
S = Signs & Symptoms (Result of interview, Observation, Physical Examination and Diagnostic Test)

3. PLANNING:
Planning is the third step in the nursing process and involves setting priorities, developing desired
outcomes to problems/needs, and designing nursing interventions. Principles of Planning (NOC:
Nursing Outcomes Classification) should be SMART: Specific, Measurable, Achievable, Reasonable and
Time Type of Nursing Intervention (DET).
D= Diagnostic (observation) – observe, assess, explore, report, etc.
E= Education – educate, explain, tell, teach, assist, demonstrate, etc.
T= Treatment – Independent, Interdependent and Dependent- position, change, insert, administer,
irrigate, etc.

4. IMPLEMENTING:
Implementing/ Implementation is the fourth step in the nursing process and involves preparation,
intervention, and documentation. The client record contains daily documentation of the nursing
measures used to (1) assist the client to meet basic human needs, (2) resolve health problems, and (3)
implement select aspect of the medical plan of care. The plan of care is implemented: Competently,
Caringly (peduli), and Creatively.

5. EVALUATING:
Evaluating/ Evaluation is the fifth step in the nursing process. In this step the nurse determines the
person’s progress toward meeting health goals, the value of the nursing plan of care in achieving those
goals, and the overall quality of care received by the person. Ongoing evaluations of the client’s
responses to the plan of care are used to make decisions about terminating, continuing, or modifying
nursing care. The conclusions of evaluation are: 1. Goal met; 2. Goal not met; 3. Goal partially met; 4.
New problem. The commonest written in evaluation uses SOAP form (Subjective, Objective,
Assessment, Planning)

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SHARING OBSERVATION
Sharing observation, help patient identify and express their health problems. Communication
techniques on sharing observation could promote patients awareness of nonverbal behavior and
feelings, underlying their behavior and helping them to clarify the meaning of their behavior.

VOCABULARY
Pale : (adj..v.n) pucat
Tense : (adj..v.n) tegang
Painful : (adj.) menyakitkan
Sigh : (v.n) mendesah
Swollen: (adj.) bengkak
Tired : (adj.) lelah Bouncy: (adj.) bersemangat
Rigid : (adj.) kaku Daydream: (v.n) melamun
Stiff : (adj..v) kaku Afraid of : (adj.) ketakutan/ takut…
Bruise : (v.n) memar Confuse : (v) membingungkan
Tender : (adj..v.n) perih Papery : (adj.) kelihatan tipis dan
kering

Sallow: (adj..n) muka yang pucat kekuningan Suffocate: (v) nafas sesak seperti tercekik (suffocating)
Moan/ Groan : (v.n) mengerang, merintih Gasp : (v.n) terengah-engah terutama karena sakit

USEFUL EXPRESSIONS
 You look… when… (verb-ing)
 You seem … with your (part of the body)

 Your (part of the body) looks… + uncomfortable

 You seem to have + (a problem with + a part of the body)
+ ( a health problem: such as stomachache, headache, fever, a chest pain, etc)

Let’s Practice. Practice the substitution drills below!

1. You look… 3. You look uncomfortable with your…
tense leg
stiff position
happy stomach
Sad, etc chest,etc
2. Your……… looks … 4. You seem uncomfortable when …
skin sallow walking
eyes reddish moving your (hand)
nail yellowish, etc changing your clothes, etc
……..…… to have a problem with + (part of the body)

EXERCISE 1. Translate this sentences into communicative English!

1. Maaf pak, sepertinya perut anda sakit
2. Anda sepertinya kelelahan
3. Sepertinya bapak merasa tidak nyaman ketika berjalan
4. Maaf pak, kelihatannya bapak mengalami gangguan pada dada bapak
5. Jari tangan anda kelihatannya bengkak
6. Anda terlihat tidak nyaman ketika mengganti baju anda, bruise on your skin looks painful

EXERCISE 2. Arrange these jumbles words into a good sentence!

1. (look- scars- reddish- your)
2. (seem- respiration- to have- you- with- problem- your)
3. (your- look- uncomfortable- turning- head- when- you)
4. (skin- dry- your- looks)
5. (seem- with- uncomfortable- you- sling- that)

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2ND MEETING
PATIENTS ASSESSMENT

A nurse can understand the patient’s condition by doing the first step of the nursing process i.e.
assessment. Assessment consists of:
1. Assessing Nursing/ Illness History: Patient’s Identity; Chief Complaint; HPI (History of Present
Ilness); PNH (Past Nursing History); Family History.
2. Observation Vital Sign: T-P-R-BP (Temperature-Pulse-Respiration-Blood Pressure) and General
Appearance.
3. PE (Physical Examination through Approach of IPPA (Inspection; Palpation; Percussion;
Auscultation)
4. Result of Diagnostic Test: Blood; Urine; Stool; X-ray; CTSCAN; etc

During the assessment stage, it is enough for the nurse just to ask the patient: “How are you?” or “How
do you feel today?” The answer you get from the patient won’t always the answer the objective of the
assessment stage. In this stage, the nurse not just listens to the words the patient uses, but she should
observe the reactions and the body language which may tell you more than words. So, the nurse should
look for SIGN and SYMPTOMS of pain, discomfort, and illness.

 SIGN: are what the nurse can observe, what a nurse can see (of feel) for herself. The nurse can
observe: changes in recorded observation such as blood pressure, temperature, pulse and
respirations. In the assessment step are also known as findings. The nurse can see the sign such as:
 A bruise or bruising that I hematoma or not.
 A rash: an area of red lumps or pimples on the skin, which can be an erythema or urticarial
(allergy rash). Some rashes are very itchy so the patient wants to scratch it
 Sign of weight loss or weigh gain
 Changes in color of the skin as the symptoms of a certain disease
- White- pale: anemic- looking (tampak anemia)
- Blue- color : cyanosis
- Yellow color: jaundice (penyakit kuning)
- Inflammation: redness
 Swelling of puffiness (pembengkakan, bengkak): i.e. extra fluid in the tissues under the skin. (the
medical term for swelling is oedema that is spelt “edema” in American English
 Cuts, wound or lacerations (laserasi): breaks the skin (usually caused by an accident)

 SYMPTOMS are something that only the patient feels and knows about and tells the nurse about it.
Symptoms are known as complaints. In the assessment steps, symptoms are considered as a
subjective data.
The patient may say:
 I feel like vomiting or I feel sick in the stomach or I am nauseated (mual)
 I have pain in my chest
 I cannot sleep well or I suffer from insomnia
 I have diarrhea or I have frequent bowel actions (sering BAB)
 I feel dizzy or I have vertigo or I feel headache
 I am very thirsty or I am dehydrated
 I feel numbness (loss of sensation or changed sensation) or I have tingling (geli)

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EXERCISE 1. Now look at these common complaints: some are Signs and some are Symptoms. Make
two lists to differentiate “sign and symptom” based on the list below:
Irregular pulse; dull pain; stomachaches; dizziness; pale; diarrhea; jaundice; thirst; dyspnea
(sulit bernafas); constipation; headache; cyanosis; anorexia (kurang nafsu makan); laceration;
abrasion (luka lecet); weight gain; backache; inflammation (peradangan) ; shallow respiration
(shallow: dangkal)

SIGNS SYMPTOMS

1. … 1. …

2. … 2. …

etc. etc.

PHYSICAL EXAMINATION SKILLS

Inspection, Palpation, Percussion and Auscultation are examination techniques that enable the nurse to
collect a broad range of physical data about patients.
1. Inspection : The process of observation, a visual examination of the patient’s body parts to
detect normal characteristic or significant physical signs.
2. Palpation : Involves the use of the sense of touch. Giving gentle pressure or deep pressure
using your hand is the main activity of palpation.
3. Percussion : Involves tapping the body with the fingertips to evaluate the size, borders and
consistency of body organs and discover fluids in the body cavities.
4. Auscultation : Listening the sounds produced by the body.

EXERCISE 2. Mention what examination techniques based on each activity listed below!
1. Examining patient’s respiratory
2. Inspecting the mouth and throat
3. Asking the patient to stand up to find whether there is scoliosis or not
4. Pressing her middle finger of non-dominant hand firmly against the patient’s back with palm and
finger remaining of the skin, the tip of the middle finger of the dominant hand strikes the other,
using quick, sharp stroke
5. Observing the color of the eyes
6. Observing the movement of the air through the lungs
7. Testing deep tendon reflexes using hammer
8. Checking the tender area with her hand
9. Pressing abdomen deeply to check the condition of underlying organ
10. Preparing a good lighting, then he observe the body part.

EXERCISE 3. What kind of examination techniques shows in each picture?

1. ………………… 2. ………………… 3. ………………… 4. ………………… 5. ………………

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6. …………… 7.……………… 8. ……………… 9. ……………… 10. ………………

3RD MEETING
ASKING THE DIMENSIONS OF SYMPTOM

Communication techniques on asking dimension of symptom: Nurses have to be able to explore the
patient’s complaints by asking a certain question about dimension of symptoms. The patient’s
responses are reported in nursing documentation and then it is reported to the physician on duty.

Possible questions about asking the dimension of symptom: Possible Patient’s responses:
 LOCATION  LOCATION
 Show me where the pain is? It is in + (a part of the body)
 Where do you feel it? The pain is around my + (part of
 Could you point at the pain you feel? the body)
 Does it move around?
 FREQUENCY/ TIMING
 FREQUENCY/ TIMING
 When did you first notice it?
It started… 3(days, hours) ago
 How long does it last?
It last in about 5 minutes
 How often does it happen?
It is recurrent (very often, in two
 Is it occasional, frequent or constant? hours)
 QUALITY/ CHARACTER
 What is it like?
 Is it sharp, dull, stabbing, aching?  QUALITY? CHARACTER
 Do you feel… (sharp/dull/ stabbing/ aching)? It is…(sharp pain)
 AGGRAVATING or ALLEVIATING FACTORS I feel…
 What makes it better/ worst?
 When does it change?  AGGRAVATING or
 Have you noticed other changes associated with this? ALLEVIATING FACTORS
 SETTING/ CAUSE OF PAIN If I lie down on bed, I feel better
 Does this interfere with your usual activities? It becomes more painful when
In what ways? walking/ standing
 Does it occur in a particular place or under certain
circumstances?  SETTING/ CAUSE OF PAIN
 Do you know the cause of your pain? It occurs in cold weather
 SEVERITY/ INTENSITY OF PAIN It occurs if I eat fat
 On a scale 0 to10, with ten the worst, how would you rate
your pain/how would you rate what you feel right now?
 SEVERITY/ INTENSITY OF PAIN
 What is the worst it has been
I think it… (the scale is 6)/ It is…
The worst/ It has been 8

VOCABULARY:
Dull: (adj.) rasa tidak begitu sakit tapi berlangsung terus
Stabbing: (n.adj.) sakit yang berdenyut, seperti pukulan
Sharp: (n.adv) rasa sakit yang menusuk- nusuk
Aching: (n.adj.) sakit yang berlangsung terus menerus

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Aggravating factors: (n) factor yang memperburuk
Alleviating factors: (n) factor yang meringankan
Trobbing: (adj.) sakit seperti pukulan berulang- ulang
Hot, Burning: (adv.adj.) sakit seperti terkena api
Squeezing: (adj.) rasa sakit yag menekan
Numb: (v.adj.) mati rasa

CONVERSATION PRACTICE
Patient : Nurse, I feel pain around my navel Nurse : What is the worst it has been?
Nurse : Would point at where exactly you feel the pain? Patient : It’s 8
Patient : It’s in here (pointing at the lower right abdomen) Nurse : What makes it worse?
Nurse : Is it in here (pressing the area of lower right Patient : It becomes more painful if I do
abdomen) the squatting bowel motion
Patient : Ouch. Don’t touch my stomach, it increases pain Nurse : Do you feel other health
Nurse : OK. Now, what is it like? Is it sharp, dull, stabbing, problem?
aching? Patient : Yes, I vomit frequently after
Patient : I feel sharp pain meals. I also feel feverish
Nurse : On a scale 0 to 10, with ten the worst, how would Nurse : So, let me check your
you rate what you feel right now? temperature
Patient : I think it is 7 Patient : Sure

EXERCISE 1. Translate these sentences into communicative English!

1. Dimana anda merasakan sakitnya?
2. Apakah anda pernah memperhatikan ada
perubahan lain sehubungan dengan rasa
sakit ini?
3. Apa yang bisa mengurangi rasa sakit itu?
4. Kapan rasa sakit itu berubah?
5. Berapa lama sakit itu berlangsung?
6. Bagaimana rasa sakit itu mempengaruhi
kegiatan anda sehari-hari?
7. Apakah sakitnya menyebar?
8. Berapa sering itu (rasa sakitnya) terjadi?
9. Tolong tunjukan dimana sakitnya?
10. Kapan pertama kali anda merasakan sakitnya?
11. Sakinya seperti apa? Terasa menusuk? Agak sakit
tapi terus berlanjut?terasa sakit tiba-tba dating
dan hilang lalu dating lagi?
12. Apa yang menjadikan rasa sakit itu makin buruk?
13. Berapa skala terburuk yang pernah anda
rasakan?
14. Dalam skala 1 sampai 10 dengan 10 yang
terburuk. Bagaimana tingkat rasa sakit anda
sekarang?

EXERCISE 2. Arrange jumbled words into a sentence!

1. ( vomiting – have – I – been)
2. (short – lost – have – a lot of – I – weigh – in – time)
3. ( 3 days – more – pain – My – than – persist)
4. (pain – mainly – back – lower – is – part – The – my – of)
5. (pain - The - back - leg - shoots – the – my – down - of)

EXERCISE 3. Complete the conversation with the appropriate question about Dimension of Symptom!
Patient : Nurse, I have pain in my chest
Nurse : (1)…………………………..?
Patient : it started a week ago, after exercising.
Nurse : (2)…………………………..?
Patient : Yes, sometimes I feel it in my throat and upper jaw
Nurse : (3)…………………………? Sharp, dull, stabbing, aching?
Patient : I feel dull pain

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Nurse : On a scale 0 to 10, with ten as the worst, how (4)………………? And what is the worst it has been?
Patient : I think it’s about 6 and the worst is about an 8
Nurse : Does it occur in a particular place or under certain circumstances?
Patient : Yes, it occurs in a cold weather or after heavy meals
Nurse : (5)………………………..…?
Patient : When I exercise heavily. What is it, nurse?
Nurse : Your doctor will explain it to you, but don’t worry
4TH MEETING
CHECKING VITAL SIGN

It is now common practice for nurses to communicate with patients as much as possible when they are
doing routine nursing task. If nurses talk, the patients become involved in their treatment. As a nurse
take the patient’s vital signs, it will be better a nurse says what she/ he is going to do, explains why she/
he is doing it and give the patient feedback.

USEFUL EXPRESSION
1. Explaining the procedures
It’s time for me to…
I just want to…
I would like to…
I am going to…
measure your blood pressure
count your pulse
check your respiration
measure your temperature
put this cuff (around your upper arm)
insert this (thermometer) into your armpit

2. Instruction and expression during the implementation

Would you… lie down on the couch
Would you mind…(verb –ing) lie flat on the bed
Please,… roll your sleeve up
Now, I want you to… give me your right/ left hand
slip off your top things (buka baju)
unbutton your shirt (buka kancing baju)
roll yourself into side lying position
take a deep breath
breathe in… breathe out…
to put this (thermometer) into our mouth

3. Nurse Response 4. Patient’s Response

 OK, Fine. That’s it  Yes, please
 Fine/ good  Okay nurse
 All is done/ Finished  No problem

VOCABULARY
Pulse rate
Tension or compressibility
Beats per minute
Expiration-breathing out
Inspiration-breathing in
: jumlah denyutan Patient’ chart : lembar (penilaian) pasien
: ketegangan Normal pulse rhythm : irama denyutan normal
: denyutan per menit Rhythm or regularity : irama denyutan/ cepat-
: hembuskan nafas lambat
: tarik nafas

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EXERCISE 1. Translate into communicative English!

1. Pak, sekarang saya mau mengukur tekanan darah anda.
2. Silahkan berbaring di tempat tidur itu.
3. Sekarang saya mau masukkan thermometer ini ke ketiak ibu, tolong angkat tangan ibu.
4. Silahkan buka bajunya, saya ingin mengecek pernafasan anda..tarik nafas dalam-dalam, lepaskan
nafas…tarik nafas…lepaskan…
5. Tolong ulurkan lengan kiri Anda, saya akan menghitung denyut nadi.
CONVERSATION PRACTICE
Situation: A nurse comes to Mr. Jack’s room to take his vital signs
Nurse : Good morning Mr. Jack After the nurse pump the bulb to inflate the
Mr. J : Good morning too, nurse cuff then she puts stethoscope over brachialis
Nurse : How are you doing now, Sir? artery and listens the sound of artery from
Mr. J : I am feeling terrible beginning to ending, after she gets the result of
Nurse : Terrible! What’s going on with you? B/P, she release the cuff then puts it back onto
Mr. J : I have pain on my head trolley
Nurse : I see, do you have any else complaint, Sir? Nurse: Well Mr. Jack, I am going to check your
Mr. J : And a little stiff on my leg temperature now?
Nurse : Okay Mr. Jack, let me check your blood Mr. J : Okay
pressure and your temperature first? Nurse: Could you raise your arm because I’ll put
Mr. J : Yes, please this thermometer on your armpit?
Nurse : Would you mind lying down on the bed Mr. J : Like this nurse?
please? Nurse: Yes, thanks (then the nurse puts it at his
Mr. J : No problem armpit) and now place your left hand on
Nurse : Can I have your arm, Mr. Jack? your shoulder for a moment?
Mr. J : Here it is. Mr. J : With my pleasure.
Nurse : Good… will you roll your sleeve up, please? Nurse: Very good
Mr. J : Yes After 5 minutes, she takes thermometer back
Nurse : Good, now, I want to put this cuff around from Mr. Jack’s armpit.
your upper arm then I’ll search your pulse Nurse: Well Mr. Jack, your blood pressure is high
on your inner of lower arm enough; it’s about 160/90 mmHg and
Mr. J : Okay temperature 37.5 0C, pulse 88 bpm, Rr:
Nurse : Now, I am going to pump this bulb to 20x/m, I will report to Dr. Frank about
inflate the cuff, maybe you will have your complaints. I’ll be back in a few
tingling on your finger for a while but it’s minute.
okay. Mr. J : Thank you very much nurse
Mr. J : I see Nurse: You’re welcome

Now Read This:

The normal temperature of a healthy adult ranges from 37 0C to 37,20C
A temperature of 360C is below normal
A temperature of 380C is above normal
The normal pulse rate of an adult at rest ranges from 72 to 80 beats per minute
72 beats per minute is the maximum normal pulse rate
80 beats per minute is the maximum normal pulse rate

EXERCISE 2. Now complete these sentences:

a) the most suitable temperature for a patient’s room … 200C to 23,30C

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b) A … of 370C is normal
c) A pulse rate of 100 beats per minute for an adult at rest is …
d) … blood pressure in a young adult is about 120/80 mm/Hg
e) A pulse rate of 65 beats per minute is …

5TH MEETING
ASKING & TELLING ABOUT MEASUREMENT

USEFUL EXPRESSION
Starting an intervention Telling a measurement
I need to take your temperature * It’s 370 C (thirty seven degree centigrade/ Celsius)
I am going to measure your height * You are running a temperature
I would like to count your pulse * You have a temperature (mean the temperature is
I just want to weight you higher than normal because of an illness)
Please weigh yourself on that scale * You weigh 67 kilo.
Asking a measurement * You are 170 cm tall
What is my temperature? * It is …… over…… (telling blood pressure)
blood pressure? * It is within normal limit
pulse?
height?
How much do I weigh?
Is it normal

MEASUREMENT
Some countries they use Fahrenheit in measuring temperature but others centigrade or Celsius. In
Indonesia people are more familiar with Celsius thermometer than Fahrenheit. It is necessary for the
nurse to be familiar with both the centigrade and the Fahrenheit scale.

THE FORMULA TO CONVERT Fahrenheit and Centigrade (Celsius)

Fahrenheit to Centigrade temperature thermometers look a like
(Fahrenheit - 32) x 5/9 = Centigrade/ Celsius  Both are made of same-sized tube
containing mercury
(0F- 32) x 5/9 = 0C
 The column of mercury in each
Example: Change 2120F to 0C thermometer rises to the same height
2120 - 32 = 180 when placed in a beaker of freezing
180 x 5/9 = 900/9 = 1000 C water and to the same height in
Centigrade to Fahrenheit temperature boiling water
(Centigrade x 9/5 )+32 = Fahrenheit  The centigrade and Fahrenheit
(0C x 9/5)+32 = 0F thermometer differ from each other
in the way they are graduated
Example: Change 1000C to 0F (graduated scale: pembagian skala)
1000 x 9/5 = 900/5 = 180
180 + 32 = 2120 F

VOCABULARY Types of Thermometers

Celsius : Ukuran Suhu tubuh 370 (00-1000)

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Fahrenheit : Ukuran Suhu tubuh 98.60 (320-2120)
Formula : Rumus
Scale : Skala, Timbangan
Convert : merubah
Equivalent : setara
Freezing point : titik beku
Boiling point : titik didih

EXERCISE 1
Match the Fahrenheit and equivalent with Celsius temperatures!
A: What is … degree Fahrenheit?
B: It’s … degree Celsius
a. Ninety __ Nineteen
b. One hundred and four __ Twenty two
c. Seventy two __ Ten
d. Three __ Thirty
e. Fifty __ Thirty two
f. Eighty six __ Forty
g. Sixty six __ Sixteen below zero

EXERCISE 2
Convert the following temperature and report the result!
Example:
2120F = 1000C
“two hundreds and twelve degree Fahrenheit equals a hundred degree Celsius (or centigrade)
1. 98.60 F = …… 0C
2. 102.40 F = …… 0C
3. 95.20 F = …… 0C
4. 370 C = …… 0F
5. 350 C = …… 0F
0
6. 41 C = …… 0F

EXERCISE 3
Discuss the following conversation then complete the blank with suitable expression you have learned!
At Dr. Frank’s Clinic
Patient : Good afternoon
Nurse : Good afternoon. Have a seat please
Patient : Thank you
Nurse : So, how can I help you?
Patient : Yes, I need to visit Dr. Frank. Is he available now?
Nurse : Sure, he I available now. (asking personal data, complete name, address, etc.). So, what’s your
problem?
Patient : I feel hot
Nurse : Have you taken your temperature with a thermometer?
Patient : Not yet.
Nurse : OK. Now (1) …………………just put in this (thermometer) into your right armpit.
It just takes 5 to 10 minutes
Patient : (2) …………………?

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Nurse : (3) …………………. OK. (4) …………………? (doing the instruction) Keep steady, don’t move. Fine.
(looking at the scale) OK, fine. You weigh 65 kilos. Now I need to check your blood pressure
(checking blood pressure)
Patient : (5) …………………?
Nurse : It’s 130 over 100

(after doing an initial examination, Dr. Frank calls her to come into the examination room)

6TH MEETING
GIVING INJECTION (PART 1)

The World Health Organization (WHO) defines a safe injection to be one that does not harm the
recipient, does not harm the health care worker and does not harm the community. Needles, syringes
and other skin-piercing medical devices can harm:
 The patient, when unsterile devices are reused and transmit disease
 The health care worker, when they suffer needle-sticks can cause disease
 The community, when the public can pick up and reuse syringes or when unsafe burning causes
harmful emissions

Syringe is a medical instrument that used to give an injection. There are 3 parts to a syringe: the
needle, the barrel, and the plunger. The needle goes into your skin. The barrel holds the medicine and
has markings on it like a ruler. The markings are for milliliters (mL). The plunger is used to get
medicine into and out of the syringe.

TRANSLATE THE FOLLOWING DESCRIPTIONS ABOUT INJECTION TECHNIQUES!

1. Intramuscular Injection (IM)

An intramuscular (IM) injection is a shot of medicine given into a muscle. Medicines that must be given
into a muscle include medicines that need to take effect quickly and medicines that cannot be taken in
other ways, such as swallowed by mouth, injected into a blood vessel, or absorbed through the skin.
There are 4 main sites that can be used for IM injections: Thigh (vastus lateralis muscle), Top of upper
arm (deltoid muscle), Hip (ventrogluteal or gluteus medius muscle), Buttocks (dorsogluteal muscle). If
many injections need to be given, injections should be given in different sites (rotated) each time. An
injection should be separated from the previous site by 1 inch (2.5 cm). The ideal site depends on your
age, size, and amount of medicine in the injection.

2. Subcutaneous Injection (SC)

“Subcutaneous” means under the skin. A subcutaneous injection (SC) is a shot given into
the fat layer between the skin and muscle. Some medications cannot be given by mouth
because acid and enzymes in the stomach would destroy them. For small amounts and
certain kinds of medicine, subcutaneous injection can be a useful, safe and convenient

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method of getting a medication into your body. The sites where you can give a subcutaneous injection
are abdomen, thigh, lower back and upper Arm

3. Intradermal Injection (ID)

An intradermal (ID) injection is the injection of a small amount of fluid into the dermal
layer of the skin. This layer, underneath the epidermis (the upper skin layer and only a
few mm thick), is highly vascularized and contains a large amount of immune cells,
mainly dermal dendritic cells. 
Intradermal injections are used for vaccination or skin testing and to administer local
anesthetics to test for drug sensitivity before administering larger amounts by other
methods. Appropriate sites are the inner forearm and the upper back. For skin testing,
examine the site to ensure that it is free of lesions and hair, as these might interfere with
accuracy when reading the results.

4. Intravenous Injection (IV)

Intravenous is a term that means “into the vein”. Intravenous medication
administration occurs when a needle is inserted into a vein. There are two kinds of
intravenous (IV) medication administration; an IV “push”, a one-time rapid injection
of medication into the bloodstream and IV infusion, a slow “drip” of medication into
the vein over a set period of time, to deliver a constant amount of therapy.

An injection can involve one or more single doses of a substance administered through a needle. The
needle is usually placed in a vein near the elbow, the wrist, or on the back of the hand. Different sites
can be used if necessary. Sometimes, an IV medication is given as a push or bolus dose (large quantity of
a particular medication increases the concentration of a drug in the blood stream so the drug can start
working quickly) More often, an IV “line” or peripheral venous catheter (PVC)/ IV catheter is inserted
for quick and safe access over time

Before any IV medications are administered, a health care professional must follow the six “rights” of
medication administration, even now there are claimed that more than six right medication
administration:
1. the right patient; 6. the right preparation & documentation.
2. with the right medication; 7. right education and information
3. at the right dose; 8. right to refuse
4. by the right route; 9. right history & assessment
5. at the right time & 10. right drug interaction and evaluation

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7TH MEETING
GIVING INJECTION (PART 2)

USEFUL EXPRESSION
 Explaining the Procedures
 It’s time for me to…
 I just want to… into your buttock
 I am going to… give an injection into your (upper)
 I would… arm
 I need to… into your vein

 Giving Instruction and Expression during the Implementation

 Would you …, please? give me your right/ left hand
 Would you mind…V-ing, please? lie face down
 Now, I want you to… roll up your sleeve
 Please… lower your pants down

 Cautionary Expression
 This will give a little pain
 You may feel a (little) bit uncomfortable
 You will feel a jab

 Don’t worry. It just gives a little pain

 Don’t move while I am doing the injection
 Don’t be stiff. Flex your buttock please

CONVERSATION PRACTICE
Instrument for Intramuscular Injection
∞ Syringe ∞ Alcohol swab ∞ Disposable gloves
∞ Pain killer injection ∞ Kidney dish ∞ Medication administration record

Situation: Nurse Rosalyn comes to Mr. Black room. She wants to give pain killer injection to him
Nurse Rosalyn: Good evening Mr. Black, how are you feeling now?
Mr. Black : I am feeling bad nurse. I still have pain on my leg. I can’t stand it anymore
Nurse Rosalyn : Yes, I understand it, I come here to give you pain killer injection
Mr. Black : Really! Oh… you’re very good nurse
Nurse Rosalyn : Okay, I am going to prepare the instruments and wash my hands first
Mr. Black : Please

Then she withdraws 2 ml of Pethidine into syringe and come back to Mr. Black room
Nurse Rosalyn : Now, would you lie onto your tummy, please?

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Mr. Black : No problem
Nurse Rosalyn : Very good, and now would you mind lowering your pant down, please?
Mr. Black : No, I don’t mind
Nurse Rosalyn : Thanks, now I am going to put on this glove
Mr. Black : Good
Nurse Rosalyn : Firstly, I will clean the site of injection using this alcohol swab (on dorsogluteal muscle),
please don’t move while I am injecting this medicine okay, Sir!
Mr. Black : Yes
Nurse Rosalyn : And now I inject this needle quickly and firmly with 900 angles and then pull back on
plunger to aspirate medication, if no blood in syringe, I will inject medication slowly.
After that withdraw it then applying alcohol gently over site and massage site slightly.
Mr. Black : Is it finish nurse?
Nurse Rosalyn : Yes, Sir.
Mr. Black : Thanks a lot
Nurse Rosalyn : You’re welcome

EXERCISE 1
Arrange these jumbled words into a good sentence
1. (injection- nurse- This- scares- me!)
2. (arm- have- I- injection- my- got- never- in- before)
3. (to- allergic- I’m- nurse- penicillin)
4. (feel- getting- in- sore- injection- my- I buttock- after)
5. (won’t- be- painful- injection- This)

EXERCISE 2.
Translate these sentences into communicative English!
1. Pak, sekarang saya mau menyuntik bapak
2. Telungkup di tempat tidur itu
3. Buka sedikit celananya
4. Sedikit sakit ya pak
5. Bagus, sudah selesai

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8TH MEETING
TAKING BLOOD SAMPLE

VOCABULARY
Blood sample : Contoh darah Blood group : Golongan darah
Blood chemist : Kimia darah Puncture site : tempat tusukan
CT : Waktu pembekuan A letter of referral : Surat rujukan
CBC : Darah lengkap Within normal limit : dalam batas normal
BSR : Laju Endap Darah Below normal : di bawah normal
BT : Waktu perdarahan Abnormally high/ above normal : tidak normal (tinggi)

MEDICAL INSTRUMENTS USED FOR TAKING BLOOD SAMPLE ARE:

 Syringe 2,5 ml/ 5 ml  Vacutainer with EDTA Sterile glove
 Tourniquet  Tape
 Kidney dish Tray/ Trolley  Swab alcohol/ Cotton alcohol
 Rubber sheet

USEFUL EXPRESSION
1. Explaining the procedures
 I just want …
 I would like …
 I am going to …
to take your blood sample
to roll this tourniquet round your upper arm
to apply this tourniquet round your upper arm

2. Giving instruction during implementation

 Would you …, please? roll your sleeve up
 Would you mind …(v-ing)? open your fist
 Please,… hold on
 Now I want to… fold your arm
o Can I have your…, please?
o Give me your…, please?
Right/ left hand

3. Cautionary expression
 This will give… a little bit uncomfortable
 You may feel/ You’ll feel … a pain/ a jab

4. Reassurance ( if patient looks afraid of the injection)

 Don’t worry. It’s OK
 It won’t take long

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 Everything will be OK
 I’ll do this as quickly as I can
 It shouldn’t be painful

CONVERSATION PRACTICE
Situation: A nurse wants to take Mr. Jack’s Blood Samples in Emergency Room
Nurse : Good evening Mr. Jack?
Mr. J : Good evening too, Nurse.
Nurse : Well Mr. Jack, I just got a phone call
from Dr. Andrew, he said that I have to Mr. J : No problem.
take some blood sample from you.
Mr. J : What’s that for?
Nurse : We want to know about your blood
group, CBC, ESR, BT, CT, etc.
Mr. J : I see, you can take it now
Nurse : Good, thanks. Now would you like to lie
down on your bed, please?
Mr. J : Okay.
Nurse : Thanks and now will you raise your
arm, please? Cause I want to put this
rubber sheet under your arm.
Mr. J : No Problem.
Nurse : Can I have your arm, Sir?
Mr. J : Which one, left or right?
Nurse : The right one, Sir.
Mr. J : Here they are.
Nurse : Thanks, and now could you roll your
sleeve up, Sir?
Mr. J : Okay, Nurse.
Nurse : Good, and now will you fist your hand and I
want to apply tourniquet above your
elbow?
Nurse : And now I am going to clean your skin by
this alcohol.
Mr. J : That’s good, Nurse.
Nurse : Please don’t move when this needle is
inserted into your vein, maybe you will feel
a little bit pain but it’s okay
Mr. J : Be careful, Nurse. I am afraid of needle.
Nurse : Don’t worry.
Then the nurse inserts the needle into vein, when
the blood appears in the barrel, the nurse pulls
back the plunger slowly until the blood in the
barrel is full of blood. Then she withdraws the
needle gently the puts new alcohol swab over the
puncture site and fixed it by tape.
Nurse : I have your blood now.
Mr. J : That’s relieve
Nurse : Good, can you fold your arm, now!
Mr. J : No problem.
Nurse : Thanks a lot.
Mr. J : It’s okay.

From the conversation above, we can conclude “the steps for taking blood sample”, as follow:
o First, ask the patient to lying down on the couch
o Put the rubber sheet under his/ her arm.
o Then, take the right or left arm of the patient, and ask her/ him to roll the sleeve up.
o Next, ask the patient to fist his/ her hand and apply the tourniquet above the patient’s elbow.
o Clean the patient’s skin before inserted needle into his/ her vein.
o Then insert the needle into vein.
o When the blood appears in the barrel, pulls back the plunger slowly until the blood in the barrel is
full of blood.
o Then withdraws the needle gently.
o Puts new alcohol swab over the puncture site and fixed it by tape.
o Now you have the blood sample of the patient.

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EXERCISE
Practice the conversation above then explain “the steps for taking blood sample” in your own words!

9TH MEETING
EXPLAINING MEDICATION

o Medicine: A substance which can cure or prevent a disease, replace vital substance that the body
lacks or relieve symptoms. It is especially in the form of liquid that you drink to cure an illness.
o Drug: A substance used for minor complaints which generally have obvious benefits and negligible
risk; otherwise, most of us would prefer to put up with the complaint. For more serious diseases,
more powerful drugs are required and the risk of adverse reaction is usually higher.
TO CONCLUDE = > ALL MEDICINES ARE DRUGS, WHEREAS NOT ALL DRUGS ARE MEDICINE

There are different ways of giving medication to the patients

1. Medication by inhalation
2. Medication by inunctions (by rubbing of ointment or oil into the skin)
3. Rectal medication ( a tablet or capsule)
4. Medication by dropper
5. Medication by injection (IV: Intravenous Injection, IM: Intramuscular Injection, Subcutaneous or
hypodermic Injection/ medication, Intra-cutaneous or intradermal injection/ medication)
6. Sublingual medication (a tablet is placed under a patient’s tongue until it dissolves)
7. Oral medication (by placing a tablet or capsule on patient’s tongue, then patient swallows the
medicine following a drink of water)

Where do you find medicine?

Pharmacy : 1. a shop/ store that sells medicines and drugs
2. a place in a hospital where medicines are prepared
Drugstore : a shop/ store that sells medicines and also other types of goods, for example: cosmetics/
toiletries
Dispensary: a place in a hospital, shop/ store, etc. where medicine are prepared for patients

The following abbreviations are commonly used by doctors when they prescribe drugs:
b.i.d : twice a day 1/5 : one fifth/ one over five
t.i.d : three times a day 7/12 : seven twelfth/ seven over twelve
q.i.d : four times a day 0.60 : zero point sixty
p.r.n : when necessary tab : tablets
2 hrly : once every two hours caps : capsules
4 hrly : once every four hours + : add/ plus/ and
a.c : before meals/ on an empty stomach - : minus/ subtract
p.c : after meals/ after food X : times/ multiply
p.o : orally (through the mouth) : : divided

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3x1 : three times a day = : equal/ same with
3 x 250 mg : three two hundred and fifty milligrams BP : Blood Pressure
120/60 : one hundred and twenty over sixty TPR : Temperature/ Pulse/ Respiration
20x/m : twenty times per minutes (respiration rate) MAR : Medication Administration Record

EXERCISE 1. Answer the questions based on the INSTRUCTION LABEL “EYEDROPS”

instruction label! For soothing and cleansing eyes.
1. What is the purpose of the medicine? Squeeze 2 or more drops into each eye as
2. How to use the medicine? needed.
Replace cap.
3. Is there any caution on the label? If there’s any,
Do not touch dropper tip to any surface
mention it!

VOCABULARY
 Prescription : resep dokter  Capsule : a small container which has a
 Receipt : tanda terima measured amount of medicine
 to relieve : untuk meredakan (sakit) inside and which dissolves when
 to shake : kocok (mengocok) you swallow it.
 one spoonful : satu sendok makan/ takar  Pill : a small flat round piece of medicine
 indigestion : salah cerna/ ketidaksanggupan (syn. tablet) that you swallow
mencerna without chewing it.
 adverse reaction : kontra indikasi/ reaksi  Ampoule : a small container usually made of
penolakan (tubuh) glass containing a drug that will be
terhadap suatu obat used for an injection.

USEFUL EXPRESSION
Patient expression related to medication Giving caution
 How should I take this…  Just tell me if there’s something you don’t
 What is the use of this… (tablet, medicine, capsule)? understand and I’ll go over it all
(menanyakan kegunaan obat)  You must call the nurse if there is an
 How to use these…(tablets)? (menanyakan dosis) adverse reaction
Oral medication  Don’t take this more than… (three times/ 8
 Please take this… (one tablet per day/ one tablet tablets in 24hours)
every 8 hours)  Don’t use it if it makes…(a skin rash)
syrup one spoonful… (three times a day)  Don’t continue if an adverse reaction
to reduce…(your temperature) occurs
to relieve…+ your (physical problem. e.g. pain,  Take these antibiotics all up
running nose, cold, etc )  In case (the tablets) give you
 Here are some tablets/ pills (which) you are to take indigestion /make you suffer from
…(one) of every…(eight) hours indigestion, please…, please…(take them
 Have you taken the medicine? during/ after meals)

Now Read This:

When you give a dose in tablet form, you must make up the weight on the prescription from the
smallest number of tablets possible. Example: You must give 1 gram of Sulfasuxidine. The tablets are
labeled 250mg. How many tablets you must give? The answer is 4 tablets.

EXERCISE 2.

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a) You must give 0,5 gram of aspirin. You have 2x250mg tablets and 10x50mg tablets. Which do you
give?
b) You must order medicine for the prescription Penicillin 20ml b.d. x 3 days. How many ml of penicillin
will you need for the three days?
c) You must give 5mg of a drug for every 1kg of a patient’s body weight. He weight 65kg. How many mg
do you give?
d) A capsule contains 200mg of a drug. How many gram the drug are there in 10 capsule?
e) You must give one tablet q.ds. How many do you give in three days?

10TH MEETING
REINFORCING DIETARY PROGRAM

Dietician is the right consultant to decide what kind of diet a patient should go with. A nurse in charge
has to confirm that the diet program is applied to the patient as scheduled. The nurse has to
communicate the diet program to the patient regularly. The aim of the communication is to reinforce
the program, so that the patient can cope with the program.

Notes on different hospital diets

1. A full diet: (or normal diet) where the patient can choose his food for each meal from the menu
2. A light diet: (or soft diet) contain very little fiber and food which is easily digested. i.e. foods made
from refined flour and not including whole grains or seeds
3. A free liquid diet: (or fluid only diet) includes all liquid foods such as soup (strained, creamed or
pureed), drink and cooked refined cereals such as ‘porridge/ gruel’, plain ice-cream, sorbet and
semi-liquid dessert made with milk or gelatin.
4. A clear liquid diet: includes only water, flavored or plain water ice, strained fruit juices, vegetable
water, clear soup and different varieties of tea or coffee without milk
(Taken from English for Nursing and Healthcare, by Robin A. Bradley, page 168)
e.g. - a patient on a liquid diet is not allowed to eat solid food
- a diabetic isn’t allowed to have sugar in his tea or coffee
- personal allergies must be written on the patient’s case notes and the dietician must be
notified

USEFUL EXPRESSION
 Offering food
- What would you like to have for your … breakfast
- What do you like for your … lunch
- What (do/ will) you have for … dinner
- Do you like (certain food) … for your … supper

 Assessment
Are you allergic to … (a certain kind of food)?

 Explaining a Dietary Program

- Now, I want to … explain the dietary food that is good for your health

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- I am going to …
recommend a dietary program

 Recommending a Diet
OK you have to go on …
a dietary program
the recommended dietary program
…………………is/ are good for your health
Fruit
Consuming vegetables
Drinking a lot of water
You’d better/You may consume…
more calories/ fruit/ carbohydrate/ green leafy vegetables
a little bit
 Prohibition
You are prohibited to drink/ to eat… (a certain kind of food or drink)
You have to/ should avoid …
to restrict yourself to drink/ to eat

 Telling Doctor’s Diagnosis

Well according to (doctor’s report/ your physician/ doctor’s note) you have a problem with your …
(stomach/ digestion/ cholesterol/ liver/ blood sugar, etc.)

 Rationale (if patient asks)

It … contains too much (fat, carbohydrate, etc.)
Consuming excessive + … (certain kind of food: sweet, rice, etc.) will worsen your condition
aggravate your … (health problem)
increase the cholesterol/ blood sugar, etc.

 Patient Expression
Can I…/ May I…
consume + (a certain kind of food or drink)
order another menu?
borrow … (the dishes)?
have …
a … juice?/ menu list?/ more rice?/ more hot water?, etc.
Nurse Response: Sure/ Certainly (more formal)

 Other Expression
- Did you enjoy your meal?
- Why don’t you eat your food?
- Can I take the dishes now?
- Have a nice meal/ Enjoy your meal When can I start … (drinking/ having a meal)?
- Do you have any problem with your meal?
- Is he portion (we provide) enough for you?
- Don’t take anything to eat before the anesthetic wears off
- You have to wait until the anesthetic has worn off (hilang pengaruhnya) before you eat anything

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EXERCISE 1. Translate these sentences into communicative English
1. Pak, anda mengalami masalah lambung (gastric problem), anda diminta menghindari makanan
yang asam
2. Saya akan menjelaskan program diet yang sesuai dengan kebutuhan anda
3. Apakah porsi makanannya cukup untuk ibu?
4. Apakah bapak mengalami masalah makan?
5. Apakah anda alergi terhadap makanan laut?
6. Ini daftar pilihan menu, silahkan pilih untuk sarapan anda besok
7. Dokter mendiagnosis anda mengalami diabetes elitus, saya menyarankan bapak banyak
mengkonsumsi sayuran hijau
8. Anda harus membatasi diri dalam mengkonsumsi minuman berkarbonasi
9. Maaf, makanan itu mengandung terlalu banyak lemak, anda harus menghindari memakannya.
10. Anda belum boleh mengkonsumsi apapun. Tunggu dulu sampai pengaruh obat iusnya hilang.

11TH MEETING
PROMOTING HYGIENE

COMMUNICATION TIPS WHEN DOING COMPLETE BATHING

 Use an organized approach and reassuring tone of voice so the patient feel safe and comfortable
during bathing
 Encourage the patient to report any concern or discomfort during the bath
 Encourage as much independence in the patient’s self-care skills as appropriate. Provide positive
feedback

BENEFITS OF BATHING
 Cleansing the skin: removal of perspiration, some bacteria, sebum and dead skin cells. Minimizes
skin irritation and reduce the chance of infection
 Stimulating circulation: muscle activity, warm water and stroking extremities enhance circulation
 Promoting Range of Motion (ROM): movement of extremities maintains joint function
 Reducing body odors: secretion and excretion from axilla a perineal area result body odors that are
eliminated by bathing
 Improve self-image: promotes relaxation and feeling clean and comfortable. Care of hair and teeth
enhance s appearance and sense of well-being

VOCABULARY
Extremities : (n) kaki dan tangan Maintain : (v) menjaga, memelihara, mempertahankan
Thorough : (adj) seksama, teliti Enhance : (v) menambah, meninggikan, meningkatkan
Secretion : (n) pengeluaran, keluarnya Excretion : (n) pengeluaran kotoran badan (sweat)
Moisture : (n) embun(an), uap lembab Sebum : (n) zat berminyak yang diproduksi secara
Perspiration : (n) keringat
alami oleh tubuh
Odor : (n) bau (badan)
Chill : (v.n.adj) rasa dingin, menggigil, kedinginan
Axilla : (n) daerah lipatan tubuh
Perineal : (n) perineum, daerah antara Stroke : (n.v) memberikan tekanan permukaan kulit
kedua belah paha Emollient cream : (n) krim untuk melembutkan kulit

CONVERSATION
Nurse : Good morning Mr. John?
Mr. J : Good morning
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Nurse : How are you today?
Mr. J : Not very well, I’m afraid
Nurse : Don’t worry Sir, it will be OK. Now it’s time to take a bath.
I will help you unless you would prefer family member to help you
Mr. J : Yes, my sister, but she is out this morning
Nurse : No problem let me help you. Are you having pain this morning?
Mr. J : No, I don’t think so
Nurse : Do you have any problem with your skin?
Mr. J : Not really
Nurse : Is this (water) warm enough for you?
Mr. J : Yes Nurse, it’s warm enough
Nurse : Where can I find your toiletries?
Mr. J : In that drawer
Nurse : OK, let’s get started. It’s time to get undressed

COMPLETE BATHING
Equipment needed
Washcloth : (n) lap (pencuci) badan
Hospital gown : (n) pakaian rumah sakit yang dipakai pasien
Bath blanket : (n) alas untuk mandi
Laundry bag : (n) tempat pakaian kotor
Soap & Soap dish : (n) sabun dan tempat sabun
Disposable gloves : (n) sarung tangan sekali pakai
Toiletry item : (n) perlengkapan rias (deodorant, powder, lotion)

USEFUL EXPRESSION
 ASSESMENT
Question to ask
 Do you have …(any problem related to condition of the skin)?
skin rashes
itchy skin
a painful part of our body when you touch it?
any problem with your skin?
skin allergic to cosmetic product?
your own soap?
 Do you… usually use lotion after bath?
need my assistance for bathing
 Is there any of your family or next of kin who wants to help you take a bath?
 Is it warm enough/ too hot for your body?

 STARTING AN INTERVENTION
State what you are going to do immediately
 I just want to… put this towel under your head
 I would like to… clean your (part of the body)
 I am going to… lift your (part of the body)
 I need to… wash your upper/ lower body
 Let me… help you take off your gown
help you lift up your head

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 IMPLEMENTATION
Instruction
 Will you… lie on your side/ sideways
 Would you… close your eyes
 Please… lie flat on your back
 Now, I want you to…

After bath expression

 Do you usually use any deodorant or powder on your underarm?
 Do you use any lotion?
 What kind deodorant do you use?
 Where do you put/ keep your (deodorant/ soap, etc)?
 Can you reach the call button?

EXERCISE 1. Refers to the useful expression listed above

Give appropriate comments, expressions, and questions according to nursing procedures listed below!
1. Assess degree of assistance needed for bathing.
Possible expression: ………………………………………………
2. Identify any problem related to the condition of the skin.
Possible expression: ………………………………………………
3. Protect the patient from injury by controlling water temperature.
Possible expression: ………………………………………………
4. Remove patient’s gown or pajamas.
Possible expression: ………………………………………………
5. Apply body lotion to skin as needed.
Possible expression: ………………………………………………

EXERCISE 2. Translate these sentences into communicative English

1. Maaf Pak, sekarang sudah waktunya mandi.
2. Apakah ada bagian tubuh anda yang sakit apabila disentuh?
3. Biasanya pakai sabun apa?
4. Boleh saya bantu membuka baju?
5. Saya mau meletakkan handuk ini di bawah lengan anda.

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12TH MEETING
DISCHARGE INSTRUCTION
(POST HOSPITAL CARE INSTRUCTION)

Personal care after discharge from the hospital is vital to reduce readmissions and
complications.
 Discharge instructions from your
physician will include:  improve the comprehension of post hospital care
 Your admission reason and
discharge diagnosis
 Pending tests, results of tests and
surgeries or procedures
 Tests or blood work that needs done
 Special instructions
 Referrals to other agencies or
services
 List of medications (the dosage,
times, and frequency)
 Prescription for any newly
prescribed medications
 Pain medications as ordered
 Follow-up appointments with your
physician/s
 Activity restrictions if any
 Diet
 Fluid requirements if necessary
 Wound care and signs of infection
 When to call your physician or
return to the hospital
 Here are the seven steps you need to follow to
instruction.
1. Let’s patients know why you’re calling ASAP
2. Reassure your patient that their recovery is a top
priority.
3. Confirm they received their discharge instructions
4. Review and Clarify any misunderstanding
 Address the specific instructions provided to
each patients
 Create a meaningful connection with the patient
over the telephone
5. Facilitate all outstanding follow up care activities
 Helping them find appropriate PCPs (Personal
Care Physician)/ Physician Specialist
 Scheduling follow up appointments with
relevant health care practitioners
 Coordinating patient transportation services as
needed
 Arranging any additional follow up services
(telephonic, in-home nurse visit, medication,
etc)
6. Find the causes of non-compliance/ poor literacy
7. Notify relevant departments and/ or employees

VOCABULARY
Avoid : (v) menghindari, mengurangi

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Indicated : (v) dianjurkan
Suggest : (v) menyarankan
Contraindicated : (v) dilarang
Pus : (n) nanah
Splint : (n) penyangga pada luka patah tulang
Paralysis : (n) kelumpuhan
Swollen : (adj) bengkak
Foul : (adj.v.n) sangat bau
Rash : (n.adj) kulit yang memerah (ruam,jw.biduren)
Rub : (v.n) mengucek
Patch : (n.v) menutup dengan perban
Convulsion : (n) gerakan tubuh yang tidak terkontrol (jw.kekedutan)
Therapeutic : (adj) yang mengandung unsur atau nilai pengobatan

USEFUL EXPRESSION
Pattern 1: Recommendation. Saran/ Anjuran
Pattern Meaning Example

Have to harus dilakukan - You should take the complete (entire)

Should dose prescribed.
Must - These tablets contain antibiotic. It is
Be + required required you to take the complete dose
essential prescribed
important
indicate

Had better + bare infinitive sangat - You’d better take your medicine
Advice dianjurkan regularly
Suggest menyarankan - I advise you to see a doctor soon
- I suggest you drink a lot of water

Pattern 2: Prohibition. Larangan

Pattern Meaning Example

Should not Dilarang - You should not drink this antibiotic

Must not tidak boleh with milk.
May not + …

Should + avoid +ing sangat - You should avoid drinking alcohol

Have to + avoid + ing dianjurkan
Had better not + bare infinitive menyarankan

EXERCISE 1. Translate these expressions into communicative English!

1. Lukanya harus dijaga supaya tetap kering dan bersih
You should keep the injury dry and clean
2. Anda harus minum banyak air
3. Anda jangan makan apapun 2 jam setelah muntah
4. Kalau anak anda panasnya tinggi, anda harus segera menelpon UGD

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5. Anda sebaiknya meninggikan posisi kaki yang terluka selama satu atau dua hari sampai
bengkaknya mengempis
6. Anda harus mengindari gerakan-gerakan yang menimbulkan rasa sakit
7. Anda tidak boleh mengucek mata anda
8. Anda perlu menghindari kontak langsung dengan sinar yang terang atau sinar matahari
9. Kalau anda merasa semakin sakit atau muntah, anda harus segera kembali ke UGD
10. Selama hidung anda masih berdarah, anda tidak boleh minum air panas.

EXERCISE 2. Study the discharge instruction below and answer the question!
Case: A child with an injury receives a treatment in the ER
“OK Mrs. Brown, now I’ll give you suggestion what to do at home for your son’s injury care. You should
keep the injury clean and dry. You have to cover the injury with clean dressing and change daily. It’s
important to rest the injury and elevate it for 12 hours. Contact your doctor if you find redness or
increased soreness. Comeback here in two days to check your sutures”
1. Who is the patient? Mrs. Brown or her son?
2. What is the patient’s problem?
3. What does the nurse suggest?

13TH MEETING
LET’S MAKE NURSING REPORT
(NURSING DOCUMENTATION)

TIPS ON WRITING NURSING REPORT/ NURSING DOCUMENTATION:

 Ensure the statements are factual and recorded in consecutive order, as they happen. Only record
what you, as the nurse, see, hear, or do.
 Do not use jargon, meaningless phrases, or personal opinions (e.g., “the patient's vision appears
blurred” or “the patient's vision appears to be improving”). If you want to make a comment about
changes in the patient's vision, check the visual acuity and record it.
 Do not use an abbreviation unless you are sure that it is commonly understood and in general use.
For example, BP and VA are in general use and would be safe to use on records when commenting
on blood pressure and visual acuity, respectively.
 Do not speculate, make offensive statements, or use humor about the patient. Patients have the
right to see their records!
 If you make an error, cross it out with one clear line through it, and sign. Do not use sticky labels or
correction fluid.
 Write legibly and in clear, short sentences.
 Remember, some information you have been given by the patient may be confidential. Think
carefully and decide whether it is necessary to record it in writing where anyone may be able to
read it; all members of the eye care team, and also the patient and relatives, have a right to access
nursing records.
Now, translate the writing tips above!

READING COMPREHENSION
Soon after Jack had returned to the ward, he began to regain consciousness. The nurse who was
looking after him removed the airway from his mouth and gave him a pillow for his head. For next few
hours he slept soundly. From time to time the toes of his injured leg were examined to see if they were
warm and pink, and his pulse and blood pressure were taken half hourly.

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At six p.m. Jack woke up and complained of severe pain in his leg. The surgeon who had
performed the operation had prescribed Pethidine if Jack complained of pain. And he was given an
intramuscular injection of 50 mgs of Pethidine at 6.10 p.m. As his blood pressure was now within
normal limits, the bed blocks were taken away and a bed cradle was put in his head to take the weight
of the bed clothes of his legs. A nurse offered him a bottle but he said he could not manage pass water.
A house man visited Jack during the evening to check that he was alright and he would be able to
sleep. He prescribed a second injection of pethidine, which was to be given at midnight if Jack
complained further pain. Two nurses came and help Jack to wash his hands and face and to change from
the white theater gown into his pajama jacket. Jack who had been allowed frequent sips of water
because he had not complained nausea, was given a cup of tea and told the nurses that he was
beginning to feel fine.

Answer the following questions based on the reading text!

1. What happened soon after Jack returned to the 6. Why was a bed cradle put in Jack’s bed?
ward? 7. Why did a house man visit Jack during
2. What did the nurse was looking after him do? the evening?
3. What did Jack do when he woke up at 6 p.m.? 8. What did two nurses help Jack to do?
4. What was Jack given at 6.10 p.m.? 9. Had Jack complained of feeling sick?
5. Who had prescribed the pethidine? 10. What did he tell the nurse?
SAMPLE OF NURSING DOCUMENTATION
Mornin Afternon
g Nursing Note &
Read morning report.
Routine Evening
7.00 a.m. Take over from night shift to morning shift Routine
nurses and do patient’s round 4.00 p.m. Evening complete bed bath
7.30 a.m. Prepare patient for breakfast Dressing renewed. Wound is still wet.
8.00 a.m. Collect used dishes and return to ward kitchen Patient still has pain on the leg
for washing Bed making and make patient comfortable
9.15 a.m. Toilet round position.
9.30 a.m. Take vital sign 4.15 p.m. Patient tea and extra Ponstan 500 mgs given
BP.120/90;P.88bpm;Rr.20x/m;T.37.80C 4.30 p.m. Patient try to ambulate
10.00 Dr Frank does round with nurse in charge 5.15 p.m. Apply urine catheter, urine (+), blood (-)
a.m. Order> Change dressing twice a day Pain lower abdomen (-)
> Give high calorie & high protein diet 6.30 p.m Patient’s family visit the patient.
> Collect urine for 24 hours 7.00 p.m. Prepare patient for dinner. Patients eats a lot.
> Amoxicillin 3 x 500 mg 7.15 p.m. Collect plate and cup and return to ward
> Ponstan 4 x 500 mg kitchen for washing
> Bring the patient to X-rays Dept. 8.00 p.m. Treatment to be given as prescribed
10.30 Bring him to X-rays room 8.15 p.m. Control all condition of the patients
8.30 p.m. Complete intake and output charts
a.m.
8.45 p.m. Patients settled for night
11.00 Patient returned from X-rays Dept, X-rays film
9.00 p.m. Make afternoon report. Take over the ward
a.m. (+)
from afternoon to night nurses and does
Milk drinks and meals given to the patient
patient’s round
11.15 Collect plate and cup and return to ward kitchen
a.m. for washing
11.30 Change dressing. The wound looks wet, bad Night
Read afternoon report
a.m. odor. Routine
It’s covered by sterile and clean gauze. 9.00 p.m. Take over from afternoon shift nurses to night
11.45 Mr. Jack complains pain on the leg and lower shift nurses and does patient’s round. General
a.m. abdomen. condition of patient is stable, patient s wathing
Doing examination on her abdomen, distended TV with family.
on lower abdomen and no void for 2 days. 9.30 p.m. Serve drinks
12.00 Report to DR. Frank about Ms. Jane complained 10.00 p.m. Light out
a.m. Order> Giving extra Pethidine 50 mgs 10.30 p.m. Prepare all medications for morning therapy
> Applying urine catheter Prepare for early morning routine
11.00 p.m. All bedpans and urinals are washed and boiled
> Observation for blood in urine
12.00 m.n. Control all condition of patients. Patient are
> call him back within 30 minutes

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 BAHASA INGGRIS III 2020/2021
12.15 Inject Pethidine 50 mgs sleeping well.
a.m. 1.00 a.m. Mr. Jack complains pain in her leg.
1.00 p.m. Prepare patients for lunch. Patient eats little, no Extra Ponstan 500 mgs is given
appetite. 2.00 a.m. Control condition of Mr. Jack. He is sleeping
2.00 p.m. Treatment given as order/ as prescribed. well.
2.30 p.m. Make patient comfortable for afternoon rest. 4.30 a.m. Light on
Make afternoon duty. Take over of ward from 5.30 a.m. Partial morning bed bath
morning shift to afternoon shift nurses and does Change dressing. Wound looks dry.
ward round. Bed making and make comfortable position
6.30 a.m. Patient try to ambulate
7.00 a.m. Prepare patient for breakfast. Patients eats a
Afternon
lot.
&
Read morning report. 7.15 a.m. Collect plate and cup and return to ward
Evening
kitchen for washing
Routine
7.30 a.m. Treatment to be given as prescribed
2.00 p.m. Take over of ward from morning shift to
7.45 a.m. Complete intake and output charts
afternoon shift nurses and does ward round. 8.00 a.m. Make night report. Take over the ward from
General condition of patient is stable, patient is night to morning shift nurses and do patient’s
sleeping soundly. round
3.00 p.m. Take vital sign BP.120/80;P.88
bpm;Rr.24x/m;T.37.50C

EXERCISE: Answer the questions based on ‘Nursing Daily Report” to check your comprehension!

NURSING DAILY PROGRESS REPORT

DATE REPORT INCLUDING TREATMENT SIGN 1. Who is the complete name of the patient?
Sept 7 2. What happen to the patient when she is
2 p.m. Admitted at 2 p.m. Suspected fracture Carol
admitted to hospital?
leg in a road traffic accident at 9 a.m.
3. What’s nurse do at 4.00 p.m. and why
today, lacerations of face and hands
also present. Fully conciousness she’s doing it?
2.30 Clean the wound with H2 O2 and 4. What is Dr. Frank’s order to nurse the
covered by sterile gauze. nurse?
3.00 I.V.I. Lactate Ringer in progress 5. At what time should the patient’s parent
3.30 Given A.T.S. & Pethidine 50 mgs I.M.I. send donors to theater?
4.00 Checked vital sign. T. 38.50C;P.100 Mary
bpm;Rr.20x/m; BP.120/90.
4.30 Patient pale and feel sweaty.
Frightened, reassurance given.
5.00 Took to X-rays for left leg, film(+) Shanty
fracture at tibia and fibula
5.30 Called Dr. Frank. Order: Prepare for
operation, take blood sample, sign fo a
consent form.
6.00 Took blood sample for X-match & Roza
blood group, CBC, BSR. Please ask the
parent to send donors to theater at 9
a.m.
8.00 Ms. Jane parents visited and ask a sign
consent form (+). They will send
donors to theater. Last vital sign
T.36.50C;P.80 bpm;Rr 16x/m;BP
120/70

Family Name First Name Ward Bed

Johnson Jane Jasmine 2

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14TH MEETING
BECOMING A GOOD NURSE

Read the article below!

HOW TO BE A GOOD NURSE

Being a nurse is more than just getting your degree. Being a nurse requires you to have very specific
skills in order to provide the best possible care to your patients, including the core attributes of genuine
caring, nurturing, ability to teach, being health conscious and a good communicator. Being a good nurse
means you excel at these skills and consider them essential to the work you do every day. These skills
can be developed in advance of a career in nursing, but you may not know your success performing
some of these skills until you’re on the job.
(Medically reviewed by Luba Lee, FNP-BC, MS )

PREPARING YOURSELF TO BE A GOOD NURSE

Step 1. Think critically
Critical thinking is a process by which you review the situation, analyze what’s going on, and
question what you don’t know. It is complex and you have to think several moves ahead. You need to be
able to assess a patient critically to determine his medical needs, while taking multiple factors and
potential outcomes into account.

Step 2. Communicate effectively.

Communicating effectively means you can listen well when someone else is speaking to you, and
that you can speak clearly and concisely to someone else (e.g. patient, doctor, other nurses, family
members, etc.). As a nurse you’re also likely to make a lot of notes whether in a physical chart or on the
computer, therefore you must also be able to communicate effectively in writing as you may not be
there in person to explain what you meant. As a good nurse you need to be able to listen to a doctor’s
instructions and carry out those instructions quickly without needing to clarify every detail. At the same
time, don't hesitate to ask questions to clarify what is needed. An exceptional nurse not only listens and
carries out instruction, they advocate for their patients. As their nurse, you may need to do the speaking

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up for your patients. Encourage your patient to write down questions that they want answered and that
you know them as well to help facilitate questions.

Step 3. Be detail-oriented.
Being detail-oriented means you pay attention to both the big stuff and the small stuff. When
dealing with a patient, even the smallest anomaly or symptom can be a big deal, so you need to always
be paying attention. Being detail-oriented means you ensure all your patients get the exact treatment
they need, when they need it

Step 4. Organize efficiently.

Nurses, especially those working in a hospital, need to deal with multiple patients at the same time.
Each patient has their own personal requirements that are critical to their well-being. As a nurse you
need to be able to organize yourself to keep track of who each of your patients are, what their
treatments are, when they need their treatments, and the small details about the patient that will help
them feel better (both physically and emotionally). Being able to organize yourself efficiently means
being able to do the following things when needed: Learning to say no; Finding balance in your life;
Asking for help; Prioritizing; Spending your time wisely.

Step 5. Maintain physical stamina.

Physical stamina isn’t just about being able to do physical activities; it is about being able to do
them over a long period of time, over and over again. Most nurses will be on their feet for their entire
shift, which can last 12 hours or more. Nurses may also need to restrain patients, help patients walk
from one place to another, hold patients up, move patients to and from a bed or gurney, and other
physically demanding tasks. If you aren’t up to the physical requirements of the job, you will likely be in
a lot of pain at the end of a shift

Step 6. React and think quickly.

Being able to think and react quickly comes with experience and confidence. Reacting quickly
doesn’t mean forgoing critical thinking; it means going through the critical thinking process quickly and
carrying out your decision immediately. Thinking and reacting quickly can also include knowing when
it’s time to get help from someone else ASAP. Don’t worry if you may be overreacting or if someone will
have a bad opinion of you because you bothered them, those things aren’t important. Keep in mind that
your patient’s well-being is always the most important thing and react quickly when that well-being is
in jeopardy (bahaya).

Step 7. Understand and have the ability to be compassionate.

One of a nurse's main jobs is to take direct care of patients. You’ll likely see these people at their
worst. Nurses need to understand that their patients are human beings that are probably stressed,
scared, depressed, upset, in pain, and confused. This understanding requires the ability to be
compassionate and empathetic. Being able to put yourself in your patient’s shoes will help you
understand what she's going through, and what she needs from you.

Step 8. Have emotional stability.

As a nurse you need to be able to control your emotions while you’re on the job, and not allow
those emotions to cloud your judgement or slow your reaction time. Being emotionally stable doesn’t
mean keeping all your emotions bottled-up forever. It means knowing when the time is right for letting
those emotions out and allowing you that emotional release on a regular basis. Try exercise, time with
friends, yoga, reading, and developing hobbies.

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Step 9. Take responsibility.

Being a responsible nurse means not cutting any corners. Not allowing yourself to make an error,
but if you do, making sure the proper people know about the error you made and making sure it’s
corrected as soon as possible. Being responsible also means using your best judgement when evaluating
a patient' needs and making good decisions that are in the best interests of your patients.

Step 10. Respect everyone.

In addition being compassionate, empathetic, and sympathetic to your patients and their needs,
you also need to be respectful and not treating patients differently because of their backgrounds,
ethnicity or personality. Being respectful of your patients also means being truthful with them. When
communicating news — good or bad — you need to understand that the patient has the right to
honesty. Be straight-forward with your patients, but do it respectfully and with compassion.

Step 11. Keep calm under pressure and during a crisis.

Keeping calm means maintaining your level-headedness. It means having confidence in what you’re
doing and the decisions you’re making. Your confidence will grow not only throughout your education,
but the longer you’re on the job. As a nurse, you can’t panic when something unexpected happens, and
you can’t freeze up because you aren’t sure what to do.
Step 12. Adapt to new and constantly changing situations.
As a nurse no two days will ever be the same. While you may have some routine, it is likely that the
routine will also change every now and again. No two patients are going to behave the same, even when
they’re getting the exact same treatment. Nurses need to be adaptable and flexible. Nurses need to
understand that their work environment and job requirements will change on a daily basis. Being
flexible and adaptable, and just going with the flow, will not only help your day go smoother, it will help
reduce the amount of stress you feel.

Step 13. Improve your knowledge constantly.

Nurses, just like many professions, are constantly learning. Whether they learn through a formal
classroom environment, or simply by observing, doesn’t matter. What matters is that you are constantly
improving your knowledge and skills, and recognizing specific areas where you might need
improvement. It also means receiving feedback from your peers and supervisors critically, and working
with your supervisor and others to correct any deficiencies you have with your skills.

There is not a single skill you learn as a nurse that can’t be used effectively somewhere else. If you
ever decide to move away from nursing, don’t consider you time as a nurse to be a waste. It’s actually
quite the opposite. Use the skills you learned as a nurse and apply them to any other job you decide to
take on.

(taken from source: https://www.wikihow.com/Be-a-Good-Nurse)

Now, watch the video on YouTube about Good Nurse vs. Bad Nurse
Then find some other good qualities that make good nurses! Discuss it with your friends
Here’s the link:
https://www.youtube.com/watch?v=j2J7KW80G3Q

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COURSE REFERENCE:

 Ardiansyah. (2004). Let’s Speak English, Nurse!. Jakarta: EGC

 Djauhari, Imam D. (…). Mastery on English Grammar. Jakarta: -
 Grice, Tony. (2009). Everyday English for Nursing, 1st & 2nd ed.. Jakarta: EGC
 Murphy, Raymond. (1987). English Grammar In Use: A self study reference and practice book for
intermediate students. Cambridge: Cambridge University Press
 Nursalam. (2010). English in Nursing-Midwifery Science And Technology. Jakarta: Salemba Medika
 Philips, Deborah. (2001). Longman Complete Course for the Toefl Test. NY: Longman
 Pramudya, Leo A. (2011). English for the Professional Nurses, Course Book 1 & 2. Jakarta: EPN
Consultant
 Richards, Jack C. (1984). Person to Person. England: Oxford University Press
 Rizka, Haira, dkk. (…). English for Nursing: Practical English Conversation for Professional
Nurses. Yogyakarta: Pustaka Baru Press

And other various sources that can support the learning activity

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