Introduction To Health Care 5Th Edition Lee Haroun Full Chapter

Introduction to Health Care 5th Edition
Lee Haroun
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Contents
Preface xi
Dedication xviii
About the Authors xviii
Acknowledgments xviii
About this Book xix
Unit 1 | Health Care Today The Future of Health Care 48

Challenges in Health Care Today 48
CHAPTER 1
Providing Affordable Health Care 48
Your Career in Health Care 1
Providing Long-Term Care 49
Your Future in Health Care 2
Improving Social Conditions 49
Getting Off to a Good Start 3
Eliminating Racism in Health Care 50
Essential Core Qualities of Health
Maintaining the Quality of Care 50
Care Professionals 3
Treating Alzheimer’s and Other
Learning for Mastery 4
Forms of Dementia 51
Volunteering 5
Addressing Public Health Concerns 52
Professional Organizations 5
Encouraging Medication Adherence 52
Returning Adult Students 5
Managing the Opioid Crisis 52
Learning to Think Like a Health Care Professional 6
Preventing Antibiotic Resistance 52
Problem-Solving Process 6
Preventing Suicides 53
Making a Career Decision 9
Dealing with TV Prescription Drug Ads 53
Educational Requirements 9
Health Care Facilities and Services 53
Standards for Health Care Professionals 10
Hospitals 53
Occupational Profiles 11
Ambulatory Services 55
Therapeutic and Treatment Occupations 12
Long-Term Care Facilities 55
Diagnostic Occupations 24
Home Health Care Providers 56
Sources of Additional Information 32
Hospice 57
CHAPTER 2 Consolidation of Health Care Services 57
Health Care Yesterday, Today, and Tomorrow 36 New Types of Health Care Facilities 57
The History of Western Government Health Services 58
Health Care 37 State Health Departments 58
Trends and Issues in Health Local Health Departments 58
Care Today 42
CHAPTER 3
Specialization 42
Aging Population 43 Ethical and Legal Responsibilities 64
Cost of Health Care 43 The Purpose of Ethics 65
Variety of Approaches to Health Care 44 Ethics and the Law 65
Wellness 44 Ethics and Health Care 66
Holistic Medicine 44 Professional Codes of Ethics 68
Complementary, Alternative, and Personal Values 69

Integrative Medicine 45 Professional Values 69
iii
iv | Contents
Guiding Principles of Health Care Ethics 69 Ratios 112

Preserve Life 69 Converting Decimals, Fractions,
Do Good 73 Percentages, and Ratios 112
Respect Autonomy 73 Rounding Numbers 112
Uphold Justice 76 Solving Problems with Proportions 114
Be Honest 77 Estimating 116
Be Discreet 78 Statistics 116
Keep Promises 80 Military Time 116
Do No Harm 81 Roman Numerals 118
Patient Rights 82 Angles 118
Handling Ethical Dilemmas 84 Systems of Measurement 119
Who Decides? 84 Household System 119
Metric System 120
Unit 2 | The Language of Health Care Apothecary System 122
CHAPTER 4 Converting Systems of Measurement 122
Medical Terminology 89 Medication Safety 124
Importance of Medical Terminology 90 Temperature Conversion 124
The Building Blocks of Medical Language 90

Word Roots and Combining Forms 90
Unit 3 | The Human Body
Suffixes 93 CHAPTER 6
Prefixes 95 Organization of the Human Body 129
Deciphering Medical Terms 96 The Basis of Life 130
Example # 1 cardiology 96 Cells 130
Example # 2 polyarthritis 97 Tissues 133
Example # 3 echocardiogram 97 Describing the Body 133
Eponyms 97 Body Planes 134
Words with Special Meanings in Medicine 97 Directional Terms 134
Names of Drugs 97 The Body Cavities 134
Spelling and Pronunciation 97 Abdominal Descriptions 136
Medical Abbreviations
CHAPTER 7
and Symbols 99
Medical Dictionary 101
Structure and Function of the Human Body 140
The Importance of Anatomy and Physiology 141
Mastering Medical Terminology 101
Genetics 141
CHAPTER 5 The Systems of the Body 142
Medical Math 106 Systems for Movement and Protection 142
Importance of Math in Health Care 107 Skeletal 142
Math Anxiety 107 Muscular 150
Basic Calculations 107 Integumentary 152
Whole Numbers 109 Systems for Providing Energy and
Decimals 109 Removing Waste 154
Fractions 110 Circulatory 154
Percentages 111 Respiratory 161
Contents | v
Digestive 164
CHAPTER 10
Urinary 166
Infection Control 217
Systems for Sensing, Coordinating, and Controlling 168
Importance of Infection Control in Health Care 218
Eyes and Ears 168
Scope of the Problem 218
Nervous 172
Endocrine 177 Regulatory Agencies 219
Systems for Producing New Life 180 Microorganisms 219
Female Reproductive 180 Types of Microbes 220

Male Reproductive 182 Defense Mechanisms 224
How Infections Spread 224
CHAPTER 8
Preventing Infection 224
Growth and Development 187
Breaking the Chain of Infection 225
Knowing Your Patient 188
Handwashing 226
Life Stages 188
Personal Protective Equipment 229
Prenatal 189
Patient-Care Equipment 232
Infancy 191
Toddler 191 Antiseptics, Disinfectants, and Sterilization 232
Preschooler 192 Surgical Asepsis 236
School-Age Child 192 Standard Precautions 236

Adolescence 193 Environmental Control 239
Young Adulthood 193 Blood-Borne Pathogens 239
Middle Adulthood 194 Transmission Precautions 241
Later Adulthood 194 Disposal of Hazardous Waste 243
Care Considerations 196 Neutropenic Precautions 244
Other Developmental Theories 198 The Challenges 245
Jean Piaget 198 Influenza 245
Lawrence Kohlberg 198 Workplace Risks 245
Carol Gilligan 199 Other Infectious Diseases 251
Future Trends 199
Drug-Resistant Organisms 251
Death and Dying 200
Reporting Accidental Exposure 253
Unit 4 | Personal and Workplace Safety CHAPTER 11

CHAPTER 9 Environmental Safety 258
Body Mechanics 205 Importance of Environmental Safety in Health Care 259
The Importance of Prevention 206 General Safety Guidelines 259
Repetitive Motion Injuries 206 Moving Safely 259
Computer Use and Repetitive Motion Injuries 207 Dressing for Safety 259
Preventing Repetitive Motion Injuries 207 Working Safely with Patients 260
Visual Problems 208 Protecting Yourself and Others 261
Exertion Injuries 210 Reporting for Safety 262
Preventing Exertion Injuries 212 Workplace Violence 262
Treatment of Musculoskeletal and Nerve Injuries 213 Fire and Electrical Hazards 263
Back Belts 214 Chemical Hazards 268
vi | Contents
Radiation Hazards 268

CHAPTER 13
Infectious Waste 268
Professionalism 298
Oxygen Hazards 269
The Meaning of Professionalism 299
Bioterrorism 269
Professional Attitude 299
Emergency Code System 270 Professional Behaviors 300
Emergency Preparedness Plan 270 Technical Skills 301
Triage 271 Professional Appearance 301
Professional Distance 302
Unit 5 | Behaviors for Success Handling Difficult Situations Professionally 302
CHAPTER 12 Professional Acceptance of Criticism 303
Lifestyle Management 275 Professionalism Outside the Workplace 303
Importance of a Healthy Lifestyle 277 Professional Leadership 303
Habits and Health 277 CHAPTER 14

Diet and Nutrition 277 Professional Development and
Nutrients 277 Lifelong Learning 307
Calories 279 Professional Development 308
Carbohydrates 279 Professional Organizations 308
Sugars 279 Importance of Lifelong Learning 309
Fats 279 Keeping Up with Changes in Health Care 309
Salt (Sodium) 280 Continuing Education Units 310
Processed Foods 280 Ways to Earn CEUs 311
Organic Foods 280 Self-Directed Learning 312
Healthy Eating 281 Learn from Role Models and Mentors 313
Maintaining a Healthy Weight 282 Career Ladders 314
Body Mass Index 283

Unit 6 | Communication in the Health
Weight-Loss Diets 283 Care Setting
Vegetarian Diets 283
CHAPTER 15
Eating Disorders 284
The Patient as an Individual 317
Physical Activity 284
Patients as Individuals 318
Sleep 285
Philosophy of Individual Worth 319
Preventive Measures 285
Understanding Patients 319
Stress in Modern Life 286
The Meaning of Culture 320
External and Internal Stressors 286
Dominant Culture 321
Dealing with Stress 287
Individuals and Culture 321
Minimizing Health Risks 290 Cultural Differences 322
Smoking 290 Health Care Beliefs 324
Substance Abuse 291 Religious Beliefs and Health 324
Occupational Hazards 291 Harmony and Health 324
Safe Sex 292 Herbs and Plant Medicines 325
Burnout 292 Human Needs 327
Helping Patients Develop Healthy Lifestyles 293 Implications for Health Care Professionals 327
Contents | vii
Defense Mechanisms 330 Business Letters 367

Dealing with Loss 330 Using Form Letters 368
Treating Patients as Individuals 331 Writing Effective Letters 368
Business Letter Formats 368
CHAPTER 16
Preparing Letters for Mailing 372
The Communication Process 337 Memos 372
Importance of Communication in Health Care 338
Meeting Agendas 372
Communication with Patients 338
Minutes of Meetings 372
The Communication Process 340
Patient Education Materials 373
The Six Steps of the Communication Process 340
Confidentiality of Written Materials 374
Communication through the Life Span 347
Proofreading Written Work 374
Overcoming Communication Barriers 348
Patients Who Are Terminally Ill 348 CHAPTER 18
Patients Who Are in Pain, Medicated, Computers and Technology in Health Care 378
Confused, or Disoriented 349 Computers in Health Care 379
Patients with Dementia 349 Information Management 380
Patients Who Are Depressed 349 Creation of Documents 382
Patients Who Are Anxious 350 Spreadsheets 382
Patients Who Have Hearing Impairments 350 Diagnostics 384
Patients Who Have Visual Impairments 351 Medical Lab Testing 385
Patients Who Have Speech Impairments 351 Patient Monitoring 388
Patients Who Are Angry 352 Research 388
Patients Who Do Not Speak English 352 Education 389
Special Applications of Communication Skills 352 Communication 389
Telephone Communication 353 Virtual Communities 391
Patient Education 353 Telemedicine 391
Presentations to Groups 354 Using Computers Effectively 392
Gossip and Patient Privacy 354 Computer Security 393
Maintaining the Human Touch 394
CHAPTER 17
Learning More about Computers 394
Written Communication 359
Written Communication: A Vital Link in Health Care 360 CHAPTER 19
The Components of Good Writing 361 Documentation and Medical Records 398
Organizing Content 361 Medical Documentation and Recordkeeping 399
Preparing to Write 361 Purposes of Medical Documentation 399
Starting to Write 362 Characteristics of Good Medical
Spell Your Way to Success 362 Documentation 400
Spelling Tips 363 Making Corrections on Medical Documentation 401
Grammar at a Glance 363 Contents of the Medical Record 402
Capitalization Rules 363 Progress Notes 404
Punctuation Rules 364 Electronic Health Recordkeeping 405
Writing Numbers Correctly 367 Example of a Computerized System 406
Writing Titles Correctly 367 Advantages of Computerized Systems 407
viii | Contents
Challenges of Computerized Systems 407 Unit 8 | Business of Caring

Providers’ Concerns 408
CHAPTER 22
Personal Health Record 408
Paying for Health Care 481
Safeguarding Health Records 408
The Rising Costs of Health Care 482
HIPAA 409
Impact of Costs on Individuals 483
Cybersecurity 409
Health Care Institutions 483
Sending Protected Information 409
History of Health Care Reimbursement 484
Health Care Payment Methods 484
Unit 7 | Health Care Skills
Government Programs 484
CHAPTER 20 Veterans Health Care 485
Physical Assessment 413 Medicare and Medicaid Reimbursement 485
General Assessment 414 Managed Care 486
Noting Variances from Normal 415 Types of Managed Care Plans 486
General Survey 415 Prepaid Plans 486
Psychosocial Observations 416 Negotiated Fees 487
Physical Observations 416 Primary Care Providers 487
Pain Evaluation 419 Review of Services 487
ADL Evaluation 419 Providing Affordable
Vital Signs 419 Health Care 488
Temperature 420 Controlling Organizational Costs 489
Pulse 424 Health Care Professionals’
Respirations 428 Impact on Costs 490
Blood Pressure 429 Personal Efficiency 491
Height and Weight 433 Acting with Thought 492
CHAPTER 21 CHAPTER 23
Emergency Procedures 441 Quality Control and Customer Service 497
Emergency Situations 442 Quality of Care 498
When an Emergency Occurs 443 Approaches to Measuring Quality of Care 498
Cardiopulmonary Resuscitation (CPR) 444 Quality Improvement 499
First Aid Procedures 444 Centers for Medicare and Medicaid Services 499
Allergic Reactions 445 The Joint Commission 499
Bleeding and Wounds 447 Agency for Healthcare Research and Quality 500
Bone, Joint, and Muscle Injuries 447 American Hospital Association 500
Injuries to Facial Structures 452 Internal Monitoring 500
Burns 452 Reducing Medical Errors 501
Drug Abuse 461 Medication Errors 502
Poisoning 461 Customer Service 502
Temperature-Related Illness 462 Taking Responsibility for Quality 504
Other Conditions 466 Customer Satisfaction 505
Bandaging 466 Internal Customers 505
Contents | ix
Unit 9 | Securing and Maintaining Accepting the Job 540

Employment Declining the Job 542
Dealing with Rejection 542
CHAPTER 24
Filling out Applications 542
Job Leads and the Resume 512
Overview of the Job Search 513 CHAPTER 26
What Do You Have to Offer? 513
Successful Employment Strategies 549
What Are Your Expectations? 513
Getting Off to a Good Start 550
Organizing Your Time 514
Learning about the Job 550
Organizing Your Space and Supplies 514
Policies and Procedures 550
Projecting a Professional Image 514
Probationary Period 551
Finding Job Leads 515
Guidelines for Workplace Success 552
School Career Service 515
Act with Integrity 552
Community Career Centers 515
Demonstrate Loyalty 552
Networking 515
Follow the Chain of Command 552
Internet 516
Give a Full Day’s Work 553
Clinical Experience 518
Become Part of the Team 554
Cold Calls and Visits 518
Go Beyond the Minimum 554
Job Fairs 518
Employment Laws 555
The Resume 519
Grievances 555
Resume Contents 519
Sexual Harassment 557
Formatting the Resume 521
Tracking Your Progress 557
Important Resume Guidelines 524
Moving Up 558
Recent Resume Trends 524
Moving On 559
Cover Letters 524
If You Are Fired 561
Writing Good Cover Letters 528
CHAPTER 25 APPENDIX 1
Interview, Portfolio, and Application 531 Health Care Professional Organizations 565
The Job Interview 532 Therapeutic and Treating Occupations 565
The Importance of Proper Preparation 532 Dental Occupations 565
Learn About the Employer 532 Emergency Medical Occupations 565
Prepare to Demonstrate Your Qualifications 532 Home-Care and Long-Term Care
Prepare Your Questions 533 Occupations 565
Questions to Avoid 533 Massage Therapy Occupations 565
Anticipating an Employer’s Questions 533 Medical Office Occupations 565
Creating a Professional Appearance 535 Mental Health Occupations 566
Securing References 536 Nursing Occupations 566
Creating a Portfolio 537 Occupational Therapy Occupations 566
What to Take to an Interview 537 Pharmacy Occupations 566
Practice, Practice, Practice 538 Physical Therapy Occupations 566
Starting Off on the Right Foot 538 Respiratory Therapy Occupations 567
Recent Trends in Interviews 539 Surgical Occupations 567
After the Interview 539 Veterinary Occupations 567
Additional Requirements 540 Vision Care Occupations 567
x | Contents
Diagnostic Occupations 567 APPENDIX 2

Diagnostic Imaging Occupations 567
Useful Spanish Expressions for
Medical Laboratory Occupations 568
Health Care Professionals 569
Health Information Management
Occupations 568 Glossary 571
Environmental Occupations 568
Biomedical Engineering Occupations 568 References 583
Dietary Services Occupations 568
Index 589
Preface
Introduction to Health Care, time, today’s graduates face new challenges. Changes
Fifth Edition, is designed as an in health care are rapid and continuous. Professionals
introductory text for students at all levels are being given additional responsibilities.
who are entering college- Efficiency and flexibility, combined with competency,
level health care programs are vital to workplace success. To be competent and suc-
or for those who believe they cessful in this ever-changing environment, health care
may be interested in pursuing a career in health care. The professionals must be able to think for themselves and
fundamentals common to all health care professions are pre- learn and adapt as necessary to meet current employ-
sented in this full-color text to create a foundation on which ment demands.
students can build when they take their specific professional The authors recognize the need of health care educa-
courses. The topics included are appropriate for professions tors for materials that can assist them in preparing stu-
that involve direct patient care, such as nursing and dental dents to assess new situations, determine appropriate
assisting, as well as those that provide support services, such action, and apply on the job what they learned in the
as health information technology and pharmacy technician. classroom. This text is designed to help meet this need.
The goal of the text is to present a broad base of health care Students are introduced to the concept of thinking like
essentials. Therefore, skills and procedures that apply only to a health care professional (also called “critical thinking”)
specific professions are not included. in Chapter 1. The specific skills that make up applied
The text is written in easy-to-understand language. A thinking are explained in everyday language. A five-
variety of learning exercises are included in each chapter. step problem-solving model is clearly described to help
These exercises are designed to appeal to the different students systematically approach new situations. Every
ways that students comprehend and learn material. The chapter includes exercises called “Thinking It Through”
text can be used by students as a reference book after that require students to apply the concepts presented
completion of their introductory courses. in the text to typical on-the-job situations. Each chapter
then concludes with two application exercises and one
CONTENT FOR TODAY’S HEALTH CARE PROFESSIONAL problem-solving exercise that provide opportunities to
Introduction to Health Care, Fifth Edition, includes topics summarize and apply the chapter content. For a detailed
essential for today’s student and tomorrow’s health care review of the features in this book, see About This Book
professional. The basic concepts that create the foundation on page xix.
for health care education have been expanded beyond
those usually included in an introductory text. The follow- ORGANIZATION OF THE TEXT
ing topics have been included in response to the current
Introduction to Health Care, Fifth Edition, is divided into
needs of health care educators and employers:
nine units that contain between two and five chapters of
• Thinking skills related topics. The following overview highlights many of
• Study techniques the major concepts included in the text.
• Complementary and alternative medicine
Unit 1 | Health Care Today
• Prevention and wellness strategies
• Characteristics and trends of modern health care,
• Lifelong learning and continuing education
including changing patient demographics, chal-
• Documentation lenges in health care today, and complementary and
• Cost-control measures alternative medicine
• Performance improvement • Descriptions of many health occupations, organized
• Personal efficiency by type of work performed
• Customer service • Explanation of how to think like a health care
professional
EMPHASIS ON THINKING SKILLS • Personal characteristics required of health care
The dramatic growth of the health care industry promises professionals
to provide increasing numbers of employment opportu- • Legal and ethical responsibilities of health care
nities for graduates of health care programs. At the same professionals
xi
xii | Preface
Unit 2 | The Language of Health Care Unit 6 | Communication in the Health Care Setting
• Introduction to basic concepts of medical terminology • Patients as individuals
• Examples of common word elements • Basic human needs
• Suggested ways to approach the study of terminol- • Acknowledging diversity while avoiding cultural
ogy and to learn it systematically stereotypes
• Review of math skills necessary for health care • The six-step communication process
applications • Using questions and observations to assess specific
• Measurement systems and methods of converting patient needs
between systems • Basic oral and written communication techniques
• Calculating drug dosages • Overview of computer applications in health care
• Tips for dealing with math anxiety • Basics of health care documentation and medical
records
Unit 3 | The Human Body
• Brief overview of the basic organization, structure,
Unit 7 | Health Care Skills
and functions of the body systems, intended as an • Basic assessment skills
introduction rather than a complete anatomy and • Hands-on skills, such as taking vital signs and mea-
physiology course suring height and weight
• Examples of diseases and conditions related to each • Normal ranges and significant changes
body system
• Step-by-step instructions for performing basic emer-
• Preventive measures for each system, including life- gency procedures (Cardiopulmonary resuscitation is
style management tips not included because certification is often required
• Physical and mental milestones of growth and devel- of health care students and the course is taught by
opment over the life span and the implications when certified instructors who use annually updated, writ-
providing health care ten materials instead of a textbook.)
Unit 4 | Personal and Workplace Safety Unit 8 | Business of Caring

• Basic skills and habits needed to protect both health • Health care as a business
care professionals and patients • Improving care while controlling costs
• Explanations of body mechanics and infection • Working efficiently
control • Customer service
• Hands-on skills, such as using a fire extinguisher
Unit 9 | Securing and Maintaining Employment
Unit 5 | Behaviors for Success • Application of job search skills to health care
• Self-care practices important for health care profes- employment
sionals, including dealing with stress • Tips for remaining successfully employed
• Characteristics of professionalism essential for career • Behaviors for job success, including teamwork and
success leadership skills
• Lifelong learning and continuing education strategies • Employment legalities
Preface | xiii
MAJOR CHANGES TO THE FIFTH EDITION

Book Chapter Description of Changes
Chapter 1 • Reordered material in chapter to be more logical: beginning chapter with “Getting Off to a Good Start”
and ending with career profiles
• Added more specific study tips and resources
• Deleted references to learning styles, now considered inaccurate
• Added information and suggestions about volunteering and joining a professional organization in
preparation for a career in health care
• Updated career information and added Occupational Outlook Handbook web addresses for each
within the text
• Added information about the levels of education needed for various health care careers
Chapter 2 • Reorganized chapter content for more logical presentation
• Updated health care industry statistics
• Expanded list of advancements in medicine and health care
• Added section on future of health care, including discussion of precision/personalized
medicine
• Added topics: health disparities, racism in health care, managing the opioid crisis and increase in
suicides, and concerns about TV drug ads
• Added definition of western medicine
• Deleted some events in table on history of health care to make more manageable for
students
Chapter 3 • Added sections on professional values, patient rights, and legalization of medical marijuana
• Updated information on physician-assisted suicide
• Expanded information on the Patient Care Partnership
Chapter 4 • Added root words for colors, how drugs are named, eponyms, and acronyms
Chapter 5 • Revised section on solving problems with proportions to make more clear
• Added the basic formula method for calculating medication dosages
• Added section on statistics in health care
Chapter 7 • Added a few diseases and conditions related to the various body systems
Chapter 8 • Revised Erikson’s stages of psychosocial development
Chapter 9 • Major reorganization of content for more logical flow
• Added section specific to exertion injuries
• Revised discussion about back belts, including opinions that they should not be used routinely.
Replaced all figures showing health care professionals wearing back belts
• Included ways to help prevent back injuries
Chapter 10 • Reorganized chapter content for better flow
• Updated current disease threats
• Added information about influenza
Chapter 11 • Added sample contents of an incident report
• Updated safety data sheets, previously called material safety data sheets
• Added information about violence in the health care workplace
(continued)
xiv | Preface

Chapter 12 • Reorganized section on nutrition for better flow
• Updated information on effects of cholesterol in foods
• Revised definitions of carbohydrates and fiber
• Distinguished between different types of fats
• Added information about sodium and its effects
• Added discussion about sugar
• Expanded section on causes of overweight and obesity
• Updated statistics for:
°° Leading causes of death in the United States
°° Prevalence of overweight and obesity
°° Deaths due to smoking and secondhand smoke
°° Incidence and deaths from substance abuse
°° Cases of HIV
Chapter 13 • Added discussion about empathy
• Updated information about tattoos and piercings in the workplace
• Added professionalism outside the workplace, including on social media
Chapter 14 Added new sections on professional development, learning from role models and mentors,
and career ladders
Chapter 15 • Deleted table listing characteristics of various cultural and ethnic groups
• Expanded information on bias, including strategies for recognizing bias
Added explanation of implicit bias
• Expanded view of culture to include factors such as socioeconomic status (poverty)
• Revision of section on Abraham Maslow, including deletion of his hierarchy
Chapter 16 • Added discussion of health literacy
• Explained “teach back” as a communication-check technique
• Added discussion of communication through the life span
• Expanded section on communicating with people who have dementia
• Revised and updated the patient education section
Chapter 17 • Added material on writing emails and email etiquette
Chapter 18 • Added guidelines for writing and sending professional emails
• Added section on computerized testing in medical labs
• Moved information on electronic medical records to Chapter 19
Chapter 19 • Reorganized content for more logical flow
• Added information on purposes of medical documentation
• Added negative consequences of poor records
• Moved electronic records to this chapter from Chapter 18 and expanded to include advantages,
sample situation with a patient, challenges
• Added section on cybersecurity
• Expanded section on HIPAA, including sending protected information
Chapter 21 • Added RICE mnemonic for treating bone, joint, and muscle injuries and SAMPLE for getting
information about an illness or injury
• Updated information on properly removing ticks from the skin
Chapter 22 • Expanded information on Medicaid
• Added section on Veterans’ Health Administration
• Added section on impact of health costs on individuals
(continued)
Preface | xv

Chapter 23 • Added information about the following:
°° Partnership for Patients
°° The Joint Commission
°° Agency for Healthcare Quality and Research
°° American Hospital Association: Patient Care Partnership
• Added sections on reducing medical errors, including medication errors
Chapter 24 • Updated job-search websites, deleting those no longer available
• Added discussion about avoiding job-search scams on the Internet
• Expanded information about using the Internet in the job search
Chapter 26 • Added section on advancing in one’s career (“Moving Up”)
STUDENT RESOURCES Chapter Animation Topic
Online Resources 7 Digestion
Online resources are available to enhance the learning 7 Urine Formation

experience. Additional resources include:
7 Vision
• PowerPoint® presentations
7 Hearing
• Anatomy and pathophysiology videos
• Health care–related videos 7 Endocrine System
• Mathematics tutorials 7 Female Reproductive System
Redeeming an Access Code: 7 Male Reproductive System
1. Go to: http://www.cengage.com
7 Types of Muscle Tissue
2. Register as a new user or log in as an existing user if
you already have an account with Cengage Learning 7 Anatomy of the Heart
or cengage.com 7 Firing of Neurotransmitters
3. Select Go to My Account
4. Open the product from the My Account page
Animations and Videos Included on the Online Resources Chapter Video Topic
Chapter Animation Topic 9 Body Mechanics
4 Word Parts Work Together 10 Infection Control
4 Combining Word Roots 10 Controlling Disease
4 Dangerous Abbreviations 10 Sterile Gloves and the Sterile Field
6 Anatomy of a Typical Cell 10 The Chain of Infection
6 Body Planes 10 Transmission-Based Precautions
7 Shoulder Injuries 10 Proper Handwashing
7 Skin 10 Removing Contaminated Gloves
7 The Heart (Conduction System) 10 Sterilizing Instruments in Autoclave
7 The Blood 11 Fire Safety
7 Types of Fractures 11 Using a Fire Extinguisher
7 Respiration 17 Business Correspondence

(continued) (continued)
xvi | Preface
Chapter Video Topic ° Procedure check-off forms for evaluating skills

20 Thermometers (Chemical-dot) ° Suggestions for class activities
° Teaching thinking skills

20 Digital/Electronic Thermometers
° Answers to review questions found at the end of
20 Measuring a Tympanic Temperature each chapter in the text
20 Measuring a Temporal Artery ° Websites and corresponding activities to support
Temperature and expand on the information presented in the
text and provide enrichment assignments for
20 Measuring Apical and Radial Pulse students.
20 Counting Respirations
20 Measuring Height and Weight
MINDTAP: EMPOWER YOUR STUDENTS
MindTap is a platform that propels students from memo-
20 Measuring Blood Pressure rization to mastery. It gives you complete control of your
21 Allergic Reaction Management course, so you can provide engaging content, challenge
every learner, and build student confidence. Customize
21 Burns interactive syllabi to emphasize priority topics, then add
21 Obstructed Airway your own material or notes to the eBook as desired. This
outcomes-driven application gives you the tools needed
to empower students and boost both understanding and
Math Tutorials for Chapter 5 performance.
Convert between Celsius and Fahrenheit Temperatures Access Everything You Need in One Place
Weight and Volume Equivalents Cut down on prep with the preloaded and organized
MindTap course materials. Teach more efficiently with
The Metric System
interactive multimedia, assignments, quizzes, and more.
The Apothecary System Give your students the power to read, listen, and study on
their phones, so they can learn on their terms.
An Introduction to Decimals
Empower Students to Reach their Potential
Adding and Subtracting Fractions
Twelve distinct metrics give you actionable insights
Fractions, Decimals, Ratios, and Percent into student engagement. Identify topics troubling
Dividing Fractions your entire class and instantly communicate with those
struggling. Students can track their scores to stay
Fractions and Decimals motivated towards their goals. Together, you can be
unstoppable.
INSTRUCTOR RESOURCES Control Your Course –and Your Content

Resources for instructors include: Get the flexibility to reorder textbook chapters, add
your own notes, and embed a variety of content includ-
• Cognero® Testbank makes generating tests and quiz-
ing Open Educational Resources (OER). Personalize course
zes a snap. You can create customized assessments
content to your students’ needs. They can even read your
for your students with the click of a button. Add your
notes, add their own, and highlight key text to aid their
own unique questions and print tests for easy class
learning.
preparation.
• Customizable instructor slide presentations created in Get a Dedicated Team, Whenever You Need Them
PowerPoint® focus on key concepts from each chapter. MindTap isn’t just a tool, it’s backed by a personal-
• Electronic Instructor’s Manual includes the following ized team eager to support you. We can help set up your
course and tailor it to your specific objectives, so you’ll
items to help instructors most effectively use the text be ready to make an impact from day one. Know we’ll be
in planning and teaching an introductory course: standing by to help you and your students until the final
° Suggested answers to “Thinking It Through” and day of the term.
“Application Exercises” found in the text To learn more, visit www.cengage.com/mindtap
Preface | xvii
INFECTION CONTROL AT A GLANCE

Topic Content Summary Page Number(s)
Infection Control Scope of the problem, regulatory agencies 218–219
Microorganisms Types of microorganisms 219–224
How Infections Spread and Preventing Breaking the chain of infection by using various methods, 224–245
Infection including standard and transmission precautions and asepsis
Procedures
10–1 Handwashing These procedures show step-by-step directions and 227–228
10–2 Nonsterile Gloves rationales with accompanying figures to illustrate the steps. 230–231
10–3 Applying and Removing PPE 232–235
10–4 Sterile Gloves 237–239
The Challenges The most common contagions that health care professionals 245–253
may encounter, including drug resistant organisms
Reporting Accidental Exposure OSHA regulations that apply to all health care facilities 253
LIST OF VITAL SIGNS PROCEDURES

Procedure Number Procedure Purpose Page Number(s)
20–1 Temperature Measures how much heat is in the body. An elevation may 421–423
indicate that an infection or other disease process is present
20–2 Radial Pulse Measures how fast the heart is beating when felt at the wrist 424–425
20–3 Apical Pulse Measures how fast the heart is beating by listening over the 426–427
heart with a stethoscope
20–4 Respirations Measures how fast the patient is breathing 428
20–5 Blood Pressure Indicates how hard the heart is working to distribute blood 431–432
to all parts of the body
LIST OF FIRST AID PROCEDURES

Procedure Number First Aid Procedure Page Number(s)
21–1 Allergic Reactions 445–447
21–2 Bleeding and Wounds 448–452
21–3 Bone, Joint, and Muscle Injuries 453–455
21–4 Facial Injuries 456–457
21–5 Burns 459–461
21–6 Drug-Related Problems 462
21–7 Poisonings 463
21–8 Temperature-Related Illnesses 464–465
21–9 Other Common Conditions 466–473
21–10 Applying a Triangular Sling 474–475
21–11 Applying a Spiral Wrap 475–476
21–12 Applying a Figure-Eight Wrap 476–477
21–13 Applying a Bandage to a Finger 478
Dedication
In memory of David, who continues to inspire.
—Lee Haroun
To the future health care professionals who will dedicate their time and energy to taking care
of those in need of their services. May your career be as rewarding to you as mine is to me.
—Dakota Mitchell
About the Authors

Lee Haroun has a Master’s of Art in Education from Portland State University (Oregon), a Master’s in Business Administration
from National University in San Diego, and a Doctorate of Education from the University of San Diego.
She has more than 35 years’ experience in teaching and educational administration and has developed curricula for a
variety of postsecondary programs, including occupational therapy assistant, health information professional, insurance
coder, and patient care technician.
Lee is the author of Career Development for Health Professionals (Elsevier Science); co-author of Teaching Ideas and
Classroom Activities for Health Care with Susan Royce (Cengage Learning); co-author of Occupational Therapy Fieldwork
Survival Guide with Bonnie Napier-Tibere (F. A. Davis; out of print); and technical writer for Essentials of Health and Wellness
by James Robinson and Deborah McCormick (Cengage Learning).
Dakota Mitchell has a Master’s of Science degree in Nursing from the University of California, San Francisco, and a
Master’s in Business Administration degree from the University of Santa Clara. The combination of these two degrees pro-
vides a framework for understanding and functioning within the current and rapidly evolving world of health care today.
Dakota has 30-plus years of experience in health care, including education, management, and curriculum consultation.
Besides many years in classroom and clinical teaching, she has developed and implemented unique and innovative health
care programs at both the vocational and associate’s degree levels.
Acknowledgments
The authors wish to acknowledge the help, support, Mischelle Monagle, MSN, MBA, RN
and continual good humor of Laura Stewart, Managing Dean of College of Nursing & Health Professions
Editor, Deb Myette-Flis, Senior Product Manager, and Carl Sandburg College Galesburg, Illinois
Ken McGrath, Senior Content Manager, at Cengage Shirley J. Cherry, Ed.D., R.T. (R)
Learning who patiently shepherded us through the Associate Professor and Program Director
process of producing a fifth edition. A special thank Radiologic Science East Tennessee State University
you to all the reviewers who offered many wonderful Johnson City, TN
suggestions.
S. Summers
Dr. Susan Grant Adjunct Professor
Assistant Professor Johnson County Community College Overland Park,
Harper College- Health Science Palatine, IL Kansas
xviii
About This Book
Objectives: Overview of chapter con-
Unit
tent and goals for learning. Review 1 Health Care Today
these before beginning to read the CHAPTER 1
chapter and use the objectives to Your Career in Health Care
check your progress after completing KEY TERMS
assessment
OBJECTIVES
Studying and applying the material in this chapter will help you to:
the chapter.
biases
1. Describe the current economic status of the health care industry.
career ladders
2. Describe the general employment projections for the health care industry.
certification
3. List the ten health care jobs expected to have the largest percentage
diagnostic
increases between 2016 and 2026, according to the U.S. Department of
integrity Labor Statistics.
licensure 4. List the six health care jobs expected to have the highest numbers of
manual dexterity openings between 2016 and 2026, according to the U.S. Department
objective data of Labor Statistics.
Key Terms: List of important vocabulary and key concepts. opinions

problem-solving process
registration
5. Explain why work in health care can be both satisfying and demanding.
6. Describe the essential core qualities demonstrated by effective health
care professionals.
Understanding vocabulary is critical to understanding the concepts

reliable 7. Give examples of how students can apply the essential core qualities
scope of practice while they are in school.
signs 8. Explain the meaning of “learning for mastery.”
subjective data 9. Explain how students can use questions to master new subjects.
presented in the chapter. Key terms are bolded and defined the first symptoms
therapeutic
10. Give examples of suggestions to improve your note-taking, reading,
writing, and test-taking skills.
11. Describe the advantages and challenges that may be experienced by
adult students who are returning to school.
time they appear in the chapter. There is also a comprehensive glos- 12. List the five techniques that adult students can use to develop their
personal organization and time management skills.
13. Explain the meaning of “thinking like a health care professional.”
sary in the back of the book.

14. Describe the five-step problem-solving process.
15. List the personal factors that should be considered when choosing a
The Case of the Confused Student health care career.
Kevin Yang is a recent high 16. List the five levels of education typical for health care career fields.
school graduate who hopes to 17. Explain the purpose of standards for health care professionals.
pursue a career in health care. 18. Give the meaning of the following terms as they pertain to health care
He has enrolled to start classes in professional standards: certification, registration, and licensure.
September at a local community
college that offers many health 19. Explain the meaning of school accreditation and name the two major
care programs. Last spring Kevin accreditation organizations for health care programs.
attended two career fairs at local 20. List the four requirements students typically must meet before taking
hospitals and learned about a professional exams.
variety of careers. He knows that 21. Describe the four classifications of health care careers and give three
he wants to combine his mechani- examples of careers for each classification.
The Case of . . . : These health care scenarios introduce chapter con-

cal aptitude with his desire to
22. State the educational and certification requirements, major duties, and
work with people, but he feels
attributes necessary for success in occupations in which you are interested.
(continues) 23. List the eight resources recommended for students to learn more about
specific health care careers.
tent and show why the material in the chapter is important for the
competent health care professional. An application exercise at the
end of the chapter refers back to the case.
Fascinating Facts
In 2016, there were 46 million persons aged 65 and over,
representing 15% of the total population. By 2060, this
number is projected to be 98 million persons, who will
make up 24% of the population. This increase will have
Fascinating Facts: Interesting information related to the chapter major implications for the health care industry, driving
the need for more professionals.
topics.
Source: https://www.prb.org/aging-unitedstates-fact-sheet/
Table 1–3 Dental Occupations

Career Education Testing and Approval
Dentist (DDS or DMD) 2–4 years college preprofessional Licensed by states:
education 1. Graduate from accredited dental school
4 years dental school 2. Pass written and practical exams
2–4 years additional education if
seeking specialty
Dental Hygienist (RDH) Associate’s or bachelor’s degree Licensed by states:
2–4 years depending on 1. Graduate from accredited dental hygiene school
program requirements 2. Pass national board exams administered by the
Tables: These provide summaries of related facts. Use them as study

American Dental Association Joint Commission on
National Dental Examinations
3. Pass state and/or locally administered clinical
aids and for quick reference.

exams
4. Pass state exam covering dental hygiene law
Dental Assistant (CDA or RDA) 1–2 year educational program Requirements vary by state; voluntary certifications
(recommended) or on-the-job available through Dental Assisting National Board
training
Dental Laboratory Technician On-the-job training or 2-year Voluntary certification available from National
associate’s degree program Association of Dental Laboratories and/or National
Board for Certification in Dental Laboratory
Technology
Box 1–1
Boxes: These include special features and additional information that Examples of Health Care Occupations
expand on and support the material presented in the chapter. Art Therapist
Athletic Trainer
Audiologist
Health Educator
Medical Illustrator
Medical Librarian
Medical Photographer
Medical Writer
Music Therapist
Speech and Language Pathologist
Colored photos and illustrations: These reinforce important

concepts and topics. Use them to increase your understanding of
the material.
© Tyler Olson/Shutterstock.com.
FIGURE 1–5 As older nurses retire, there will be a great need

for newly trained registered nurses.
xix
xx | About This Book
Thinking It Through: Located throughout the chapter,

these exercises are a very important part of this text. The
Thinking It Through health care scenarios require you to think about the con-
Craig Oakley is a physical therapy assistant who does
home visits for a rehabilitation service. One of his
cepts presented in the chapter and use them to resolve
patients, Mr. Singh, suffers from rheumatoid arthritis and typical problems encountered by health care profession-
has asked Craig’s opinion about taking Chinese herbal
remedies that he has read help restore joint health. als. Use the exercises to develop the thinking skills neces-
1. How should Craig respond? sary to be a successful health care professional.
2. What are some of the resources he can consult
in order to find out more about the treatment?
3. What precautions should Craig follow when
speaking with Mr. Singh about complementary
and alternative therapies? Procedures: A step-by-step format that helps you master
basic hands-on skills. Pay special attention to the ratio-
nales that explain the reasons for the actions.
PROCEDURE 10–1
HANDWASHING
Procedure Rationale
1. Turn faucet on using a clean, dry paper towel. (See Figure 10–5a.) Faucets are always considered contaminated.
2. Run warm water over hands and wrists. Warm water helps remove superficial dirt and
microorganisms.
3. Do not lean against the sink, and avoid splashing clothing The sink is always considered contaminated; water
with water. splashed from the sink is contaminated, and wet
material easily conducts microorganisms.
Suggested Learning Activities: Try these interesting

SUGGESTED LEARNING ACTIVITIES
1. Create a personal plan for developing the core qualities demonstrated by health care professionals.
projects that include doing research on the Internet,
2. Determine if there are study skills you need to improve and create a plan to improve them. reporting on observations from daily life, and visiting
3. Choose a problem in your life that you would like to work on and apply the five steps of the problem-solving process. Report
on the results. health care facilities.
4. Seek opportunities to observe health care professionals at work. Report on the qualities they demonstrate that you believe
make them effective.
5. Research an occupational area or specific career that interests you: interview a working professional, send for information
or visit the Internet site of the appropriate professional organization (see Appendix 1), request a job description from a local
facility, and/or read the job descriptions in the Occupational Outlook Handbook.
Web Activities: Use these guided assignments to increase

WEB ACTIVITIES
your research skills and learn more about the chapter
WikiHow
https://www.wikihow.com/Improve-Your-Study-Skills content. The activities refer you to specific websites.
How to Improve Your Study Skills
1. Read this illustrated guide.
2. Are there any suggestions you think might help you?
3. If so, try them for a couple of weeks and report on how they work for you.
Review Questions: The questions are keyed to the chap-

REVIEW QUESTIONS
ter objectives to ensure your mastery of the chapter con-
1. What are the ten significant events that changed the way health care was delivered?
2. What are the definitions of the following terms: gene therapy and targeted drug therapy? tent. Use them to check your learning and identify areas
that need more study.
3. What is today’s leading prevention and treatment option?
4. Explain the meaning of specialization and its impact on health care.
5. What are the effects of the aging population on health care?
6. What has happened with health care costs over the past few decades?
Problem-Solving Practice: Practice your skills with these

PROBLEM-SOLVING PRACTICE
A growing number of children in Trueville, USA, are becoming overweight and obese. A group of concerned citizens has organized
typical, real-world problems encountered by students
a committee to find ways to help children in the community attain normal weights and raise their levels of fitness. How might the
committee use the five-step problem-solving process?
and health care professionals.
APPLICATION EXERCISES Application Exercises: Opportunities to apply the chap-

1. Refer back to The Case of the Confused Student at the beginning of the chapter. Using the information in this chapter, list ter’s major concepts to typical health care situations. Use
these exercises to practice using your knowledge in ways
your recommendations for occupations that Kevin should investigate.
2. Juan has always been interested in helping people. He also likes science and has maintained good grades throughout high
similar to those you may encounter on the job.

school in chemistry, biology, and physics. He has enrolled in the local community college and is taking “Introduction to
Health Care.” Juan thinks that a career in health care might be for him, but he doesn’t feel that he knows enough to make a
career decision at this time. He’s not sure what’s out there or what jobs would be appropriate for him.
a. What does Juan need to know in order to conduct an effective career search?
b. Describe how he can use the problem-solving process to help him make a tentative career decision.
c. Explain methods that Juan can use to research and learn more about different career options.
Unit
1 Health Care Today

CHAPTER 1
Your Career in Health Care
KEY TERMS OBJECTIVES
assessment Studying and applying the material in this chapter will help you to:
biases
1. Describe the current economic status of the health care industry.
career ladders
2. Describe the general employment projections for the health care industry.
certification
3. List the ten health care jobs expected to have the largest percentage
diagnostic
increases between 2016 and 2026, according to the U.S. Department of
integrity Labor Statistics.
licensure 4. List the six health care jobs expected to have the highest numbers of
manual dexterity openings between 2016 and 2026, according to the U.S. Department
objective data of Labor Statistics.
opinions 5. Explain why work in health care can be both satisfying and demanding.
problem-solving process 6. Describe the essential core qualities demonstrated by effective health
registration care professionals.
reliable 7. Give examples of how students can apply the essential core qualities
scope of practice while they are in school.
signs 8. Explain the meaning of “learning for mastery.”
subjective data 9. Explain how students can use questions to master new subjects.
symptoms 10. Give examples of suggestions to improve your note-taking, reading,
therapeutic writing, and test-taking skills.
11. Describe the advantages and challenges that may be experienced by
adult students who are returning to school.
12. List the five techniques that adult students can use to develop their
personal organization and time management skills.
13. Explain the meaning of “thinking like a health care professional.”
14. Describe the five-step problem-solving process.
15. List the personal factors that should be considered when choosing a
The Case of the Confused Student health care career.
Kevin Yang is a recent high 16. List the five levels of education typical for health care career fields.
school graduate who hopes to 17. Explain the purpose of standards for health care professionals.
pursue a career in health care. 18. Give the meaning of the following terms as they pertain to health care
He has enrolled to start classes in professional standards: certification, registration, and licensure.
September at a local community
college that offers many health 19. Explain the meaning of school accreditation and name the two major
care programs. Last spring Kevin accreditation organizations for health care programs.
attended two career fairs at local 20. List the four requirements students typically must meet before taking
hospitals and learned about a professional exams.
variety of careers. He knows that 21. Describe the four classifications of health care careers and give three
he wants to combine his mechani- examples of careers for each classification.
cal aptitude with his desire to
22. State the educational and certification requirements, major duties, and
work with people, but he feels
attributes necessary for success in occupations in which you are interested.
(continues) 23. List the eight resources recommended for students to learn more about
specific health care careers.
1
2 | Chapter 1
overwhelmed by the number of choices in the health care field. He is not sure how to learn more about the requirements
and rewards of various occupations, what the daily duties would be, and how much education is necessary to enter
them. He is also unsure how to best go about making a decision that will significantly affect his life. This chapter includes
basic information about a variety of health care career areas and occupations, a problem-solving process that can be
used to make effective personal and professional decisions, and tips on succeeding in a health care career program.
YOUR FUTURE IN HEALTH CARE Table 1–1 Examples of Growing Health Care Jobs
Projected
Health care is an exciting and growing field. The purpose Percentage Increase
of this text is to help you make an informed career choice in Employment,
and acquire the basic knowledge to continue the studies Job 2016–2026
necessary for your chosen field. Home Health Aide 47%
The health care industry is the largest service employer
Personal Care Aide 39%
in the United States, providing more than 18 million jobs
and the need for health care professionals continues to Physician Assistant 37%
grow (https://www.cdc.gov/niosh/topics/healthcare/default
Nurse Practitioner 36%
.html). According to the United States Bureau of Labor
Statistics, the health care industry will increase by 18% and Physical Therapist Assistant 31%
add 2.4 million new jobs between 2016 and 2020 (https:// Physical Therapist Aide 29%
www.bls.gov/ooh/healthcare/home.htm). This is faster than
the average growth of all other occupations. Federal econo- Medical Assistant 29%
mists report that, in 2017, the amount spent on health care Occupational Therapy Assistant 29%
was $3.5 trillion. Further, it is projected that the cost of health
Physical Therapist 28%
care will continue to grow at least 4% annually.
Many health care occupations are projected to have Massage Therapist 26%
employment increases of more than 25%. (See Table 1–1.) Source: Bureau of Labor Statistics. Occupational Outlook Handbook. Fastest Growing
Ten of the 20 fastest-growing jobs in all industries are health Occupations. https://www.bls.gov/ooh/fastest-growing.htm
care–related. At the same time, 6 of the 20 occupations
with the largest numerical increases are in health care. Table 1–2 Occupations with the Largest Numerical Increases
(See Table 1–2.) It should be noted that various sources
Numerical Increase in
give different occupations as having the fastest growth Job Positions, 2016–2026
and highest numbers of new hires; however, health care is
Personal Care Aides 777,600
included in all lists. The information provided here is from
the U.S. Bureau of Labor Statistics. Registered Nurses 438,100
Careers in health care can be sources of great satisfac- Home Health Aides 431,200
tion. Health care professionals perform valuable services
that make a significant contribution to the community. Medical Assistants 183,900
Each day their work makes a difference in the quality of life Nursing Assistants 173,400
of those they serve. Whether you choose to work directly
Medical Secretaries 129,000
with patients or provide support services, be assured that
what you do is important and of benefit to others. Source: https://www.bls.gov/ooh/most-new-jobs.htm/
As well as providing satisfaction, health care work
makes many demands on those who pursue it. The work be noted and addressed before they become critical. The
must be taken seriously because it affects the well-being consequences of mistakes can be devastating if, for exam-
of others. All tasks must be performed thoughtfully and ple, a prescription for medication is incorrect or the wrong
conscientiously. Nothing can be taken for granted or done procedure is performed. The work can also be stressful.
automatically, not even routine assignments. Health care Depending on the chosen occupation, it can involve long
professionals must be willing to devote their full attention hours, dealing with the death of patients, and working
to everything they say and do. Potential problems must quickly under pressure. (See Figure 1–1.)
Your Career in Health Care | 3
well-being of others. When necessary, be willing to

put the needs of patients ahead of your own. Have
respect for all people and help them regardless of
their race, nationality, economic status, religion, age,
or lifestyle preferences. (See Figure 1–2.)
°°Start now: Show respect and consideration for
© kurhan/Shutterstock.com.
instructors and classmates. Be kind to everyone,
regardless of his or her background. Refrain from
talking during lectures. Prepare for classes so the
instructor does not need to take time to answer
questions about material covered in the reading or
study assignments. Practice courtesy in the class-
FIGURE 1–1 Successful health care professionals work hard. At room and throughout the school. Volunteer to help
the same time, they enjoy the satisfaction of helping others. others, as needed or as possible.
• Have integrity: Be honest at all times. Respect the
GETTING OFF TO A GOOD START privacy of others. Be loyal to the employer. Accept
responsibility for your actions.
Health care educational programs are designed to prepare
students to succeed in the workplace. Instructors dedicate °°Start now: Do your own work. Never copy the
themselves to helping students who put forth the neces- homework assignments of others or cheat on
sary effort to graduate and become employed. Take advan- exams. Always tell the truth. Never share anything
tage of the learning opportunities available in your school told to you in confidence.
and commit yourself to doing your best toward becoming • Be dependable: Be at work on time and as scheduled.
a competent, qualified health care professional. Follow through and finish all assigned tasks. Perform
work accurately and completely. Work without con-
Essential Core Qualities of Health stant supervision and reminders.
Care Professionals °°Start now: Be at school on time and attend all
As a student, you have many opportunities in school to classes. Complete assignments on time. Strive for
begin to practice good workplace habits. Work hard now to accuracy in all written and practical assignments.
develop the skills that will make you a valuable employee. Follow through on all obligations and anything you
At the same time, you can be acquiring habits that also have volunteered to do.
contribute to academic success. The qualities essential for • Work well with others: Strive to understand the feel-
health care professionals to be effective and successful can ings and needs of others. Be courteous and consider-
be applied in the classroom, in the lab, and at the clinical ate. Practice good communication skills. Be a good
(externship/internship/fieldwork) site. Start now while you team member by cooperating and contributing to
are in school to develop and apply them. the achievement of group goals. Take directions
• Care about others: Have compassion. Apply knowl- willingly from the supervisor.
edge and skills to decrease suffering and increase the
© Alexander Raths/Shutterstock.com.
Fascinating Facts
In 2016, there were 46 million persons aged 65 and over,
representing 15% of the total population. By 2060, this
number is projected to be 98 million persons, who will
make up 24% of the population. This increase will have
major implications for the health care industry, driving
the need for more professionals.
Source: https://www.prb.org/aging-unitedstates-fact-sheet/ FIGURE 1–2 One of the most important qualities of the health
care professional is compassion.
4 | Chapter 1
°°Start now: Be understanding of the needs of • When working with patients, ask what might work
instructors and classmates. Participate in class. Do best for them and when it should be done.
your share when working on group assignments. • When sharing important information with a class-
• Be flexible: Be willing to adapt to changing condi- mate or coworker, ask yourself what you know about
tions and emergencies. Do what is needed to carry this person that will help you communicate most
out tasks. Acquire knowledge and skills necessary to effectively.
keep up with advances in technology and changes in • When working in a health care facility, consider how
the way health care is delivered. your work habits might be changed to improve over-
°°Start now: Accept instructional differences, all efficiency.
changes in class schedules, and other unexpected Some students believe that the role of their instructors
occurrences. Be willing to cooperate as needed. is to tell them rather than ask them. In reality, instructors
• Be willing to learn: Keep skills up to date. Ask ques- who continually ask questions that require students to
tions, attend workshops, read professional publica- explain their answers and actions are encouraging them
tions, use the Internet, and continue to acquire new to learn and to think like health care professionals. Some
skills. instructors even respond to a student’s question with
another question. Their intention is to teach students to
°°Start now: Be willing to learn: Take your studies begin to think for themselves and trust that they are capa-
seriously. Make school a high priority. Dedicate
ble of finding the answer. Instructors also use questioning
sufficient time to studying throughout the length
to guide students in pulling known facts together, mak-
of each course to ensure maximum learning.
ing connections, and applying what they know to new
situations. For example, suppose that a respiratory therapy
Learning for Mastery student is working with a hospitalized patient. He has stud-
Health care professionals must know what they are doing. ied the illness presented by the patient and knows how
Mistakes on the job can result in serious consequences. to perform the prescribed breathing treatments. Through
Therefore, it is essential that students commit to learning questioning, the instructor guides this student to explain
the material presented in their courses. Learning means why these particular treatments have been prescribed.
more than just memorizing facts. It means striving to The student is encouraged to consider the nature of the
understand and remember information so that it can be illness and the properties of the treatments and medica-
applied to new situations. This understanding provides a tions, and draw conclusions about the relationships among
basis for thinking like a health care professional, which is these factors.
discussed later in this chapter.
Students who do only the minimum necessary to pass Getting the Most from Your Studies
tests may think they are learning, but in reality, they are not If necessary, spend some time now working to improve
likely to have acquired the long-term knowledge neces- your study skills: taking notes, reading, writing, and prepar-
sary to perform on the job. Students who study to under- ing for tests. Something to keep in mind is that these skills
stand and always search out the why of the subject increase can also help you to get a job and succeed. For example,
their chances of becoming highly competent health care taking a patient history requires good note-taking skills;
professionals who can think on their feet and meet new understanding the instructions for a piece of equipment
challenges as they arise. requires the ability to read and understand technical mate-
One effective way for students to master subjects is to rial; preparing a letter asking about job openings requires
ask themselves questions about what they are learning or good writing skills; and if you think about it, everything you
doing. Questions serve to gather information, expand your do when working with a patient is a test, something you
view of a subject, and stimulate the mind. They help ensure must do correctly “to pass.”
that actions are not based on false assumptions or insuf- The following suggestions may help you to:
ficient information. • Take good notes: Concentrate on writing down the
Questions can be asked mentally (to oneself) or of important points, rather than everything the instruc-
others. Think of the five Ws plus the one H: What, When, tor says. Listen for clues from instructors about what
Where, Why, Who, and How. The following examples show is important. Write in outline form to keep notes
how questions can be used to promote learning: organized. Set up pages using the Cornell System
• When learning new information, ask why it is impor- format to leave space for adding notes and ques-
tant and to whom? How does it relate to what is tions after class when you review your notes. (See
already known? Figure 1–3.) For more detailed information about the
many subjects, and https://www.tests.com and http://

Name Date
Subject Page #
www.testprepreview.com that contains free practice tests
for a number of health care subjects and occupations.
Volunteering
If you have the time, volunteering is an excellent way to
jump-start your career. Not only do you learn skills, such as
study notes column working with others, you learn more about the health care
notes field and acquire information that can help you choose a
and career that is right for you. Although work in a health care
questions environment is optimal, volunteering for non profits, such
to quiz as Habitat for Humanity, also provide good experience.
self Some educational programs have an admission
requirement that you have some experience in the field
you are entering. For example, university veterinary medi-
cine programs require applicants to have a minimum num-
summary ber of hours of experience. And when looking for a job, you
can list on your résumé the skills you learned and applied
through volunteering. This also shows potential employers
that you have initiative and a sincere interest in helping
others.
FIGURE 1–3 Page set-up for the Cornell note-taking
system.
Professional Organizations
Cornell system, see http://lsc.cornell.edu/notes.html Joining a professional organization while you are a student
and http://www.openculture.com/2018/10/the-cornell- gives you networking opportunities, a chance to learn how
note-taking-system.html. to be successful in your chosen field, and access to work-
• Read for comprehension and learning: When shops and other learning activities. And, as with volunteer-
reading textbooks or information on websites, ing, putting a professional membership on your résumé
start by skimming through the chapter or section. demonstrates your interest and initiative. See Chapter 14
Then focus your attention by creating questions and Appendix 1 for more information about professional
and reading for the answers. Create questions from organizations.
articles or section titles and from the material itself.
After reading a section of material, ask yourself the Returning Adult Students
questions and try to answer without looking at the
Many students who enroll in health care programs are
text. This has been shown to be one of the most
adults returning to school after working in other fields,
effective ways to learn. For more reading strategies,
raising families, and/or handling other adult responsibili-
see https://www.educationcorner.com/textbook-
ties. Some adults find the experience of attending classes
strategies.html and https://learningcenter.unc.edu
stressful and wonder if they have what it takes to study and
/tips-and-tools/reading-textbooks-effectively/.
learn new information and skills.
• Write: See Chapter 17 of this text. Also, Purdue These fears are natural, but the fact is that most adults
University’s online writing lab has information on have acquired life experiences and skills they can apply
dozens of topics related to writing: https://owl.purdue to their learning which, in many cases, will help them
.edu/owl/purdue_owl.html. become excellent students. For example, holding down
• Prepare for tests: Plan to study every day, even a job contributes to the ability to set priorities, communi-
for a short time. Reviewing material over time is cate, demonstrate dependability, and apply practical skills
much more effective than cramming at the last such as math. The self-confidence developed as a result of
minute. Use the questions you create for read- handling adult responsibilities can be applied to reviewing
ing and note-taking to practice. For more infor- one’s study skills, including those that may not have been
mation, see https://www.educationcorner.com/ used for many years.
test-taking-strategies.html. Quizlet at https://quizlet The most pressing problem for many adult students is
.com/ that contains learning tools and flashcards on finding the time to fulfill all their responsibilities: attending
6 | Chapter 1
classes, studying, caring for the family, and perhaps hold- • Practicing good communication skills when gather-
ing down a full- or part-time job. Practicing good time ing and distributing information (see Chapters 16
management and personal organization skills, such as the and 17)
following, can be helpful in handling the additional work • Understanding exactly what one is legally allowed to
of attending school: do in one’s profession, known as scope of practice
• Start each day with a list of what needs to be accom- One of the major goals of this text is to provide stu-
plished, ranked from most to least important. dents with opportunities to practice thinking like a health
• Advise others of your study schedule. Plan care or care professional. This discussion on thinking is being pre-
activities for your children to allow you the time sented at the beginning of the text so that students will
needed. have maximum time to apply and practice thinking skills.
• Schedule time, even if for short periods, with fam- The “Thinking It Through,” “Application Exercises,” and
ily members. Some children enjoy doing homework “Problem-Solving Practice” features, which appear in every
with mom or dad. chapter, encourage students to apply thinking skills to the
topics presented.
• Create personal organization techniques, such as
Thinking proficiently can be applied to the personal, as
clustering errands, keeping things in repair, and plan-
well as professional, areas of your life. For example, buying
ning backups to prevent wasting time and energy.
a certain puppy simply because it is cute and seems the
• Ask for help when you need it. Delegate tasks at friendliest is an emotional decision. An informed, thinking
home. Let another family member fix dinner once or decision involves learning about available breeds, physical
twice a week. and personality characteristics, common health problems,
• See the Time Management section in Chapter 12 for and methods of training. Knowing these facts will help
more suggestions. ensure that the puppy selected best fits the new owner’s
lifestyle and will be a suitable companion.
Thinking like a health care professional can be
LEARNING TO THINK LIKE A HEALTH described as an “examined process.” This means not sim-
ply accepting situations without observing and consider-
CARE PROFESSIONAL ing the meaning of what is observed. Effective thinkers are
A common problem in health care today is that some grad- aware of their thoughts and of why and how they are act-
uates spend months, or even years, accumulating informa- ing or making decisions.
tion, but are unable to apply it when they need it on the As stated earlier, nothing in health care work can be
job. The lack of effective thinking skills is a primary reason done routinely and without thinking. Mindless actions
for this unfortunate situation. Regardless of the health care occur as the result of not paying attention or basing deci-
area or occupational level chosen by students, it is essential sions on ideas that have been accepted “just because.”
that they learn to think like health care professionals. This These ideas may come from family members, friends,
type of thinking actually involves many skills and, in this personal experiences, television, movies, and magazines.
text, has the following meanings: Health care professionals must learn to think for them-
• Learning for understanding, not simply to memorize selves, gather facts, and use their own observations for
facts making decisions.
• Applying learned material to new situations
• Having an organized approach to problem-solving Problem-Solving Process
• Basing decisions on facts, rather than on emo- Important applications of thinking skills are problem-
tional reactions or biases (certain beliefs and feel- solving and decision-making, two very important compe-
ings, usually negative, about a person because he tencies for health care professionals. There are a variety of
or she belongs to a specific group or has certain problem-solving and decision-making models. This book
characteristics) presents a five-step problem-solving process to help stu-
• Drawing on many facts and creating relationships dents and health care professionals approach problem-
among them solving in an organized manner:
• Locating reliable sources of information with which 1. Identify the problem
to make decisions 2. Gather information
• Basing decisions on ethical principles (see Chapter 3) 3. Create alternatives
5 2
Identify the
problem
The problem-solving
Evaluate and revise Gather
as needed
loop information
4 3
Choose an alternative Create

and take action alternatives
FIGURE 1–4 Steps in the problem-solving process.
4. Choose an alternative and take action Jamie’s first reaction is, “I can’t help it. My car is old and
5. Evaluate and revise as needed breaks down a lot.” When her car won’t start, she must rely
on family and friends to drop her off at work. Their sched-
(See Figure 1–4.)
ules are not the same as Jamie’s, so she often arrives late.
Taking the time to think about what she has said
Step One—Identify the Problem (“I can’t help it”), Jamie realizes that being at work on time
Identifying problems is not always as simple as it sounds. is her responsibility. She is now able to identify the real
Factors that are described as the problem are often only problem: lack of reliable transportation. This enables her to
symptoms of the problem. For example, Jamie, a radiologic start seeking effective solutions. Accepting responsibility
technologist, does not receive the high scores she had for a problem makes it possible to start doing something
hoped for on her performance review at work. When she about it.
receives the rating “poor” in the dependability category,
she feels upset and believes that her problem is “receiving Step Two—Gather Information
a poor evaluation because her supervisor dislikes her.”
Good problem-solving is based on having accurate and
Identifying the real nature of problems requires a will-
reliable information. Acting on assumptions (untested
ingness to observe, pay attention, and confront difficult
ideas), opinions (beliefs not based on facts or knowledge),
issues. Problem-solvers must look beyond what seems
and emotions can result in poor decisions. In health care,
obvious and use questions effectively to identify the real
gathering information is also known as assessment. There
situation. Denying or ignoring problems does not make
are many methods for gathering information:
them go away. Problems that are not addressed tend to get
worse, because no action is being taken to resolve them. • Review what is already known: What knowledge do
In Jamie’s case, she must be willing to speak frankly with I have about the problem or situation? About the
her supervisor about her low rating. It turns out that the causes? About possible solutions?
real problem is actually what caused the poor evaluation, • Collect objective data: What can be observed?
not the evaluation itself. In Jamie’s case, it is her frequent Measured? Tested? What are the facts? When work-
tardiness. ing with patients, objective data are called signs.
8 | Chapter 1
• Collect subjective data: How do I feel about a situ- one and consider the likely consequences, both positive
ation? What do I want? What do others want? When and negative.
working with patients, subjective data refer to what Based on her research, Jamie creates the following list:
is reported by the patient, such as pain and feeling 1. Take the bus to work. When the weather is nice, walk-
nauseated. Also known as symptoms, they cannot ing to the bus stop will be a good form of exercise. In
be directly observed or measured by the health care rainy weather, common about five months of the year
professional, but nevertheless must be taken into where she lives, getting to the bus stop without get-
account. ting soaked is not likely. Also, the bus ride takes about
• Conduct research: What are the facts? Are they from 30 minutes longer, each way, than driving to work.
a reliable (trustworthy) source? How do I know? Are
they scientifically based? (Can they be tested?)
• Ask for help: Who has useful knowledge? Are there
experts available who can give me reliable informa-
tion and help me find a solution? Thinking It Through
When she starts out, Jamie finds the idea of solving her Linda Stevens, LPN, works on a medical floor at the local
transportation problem overwhelming. The only solution hospital. One of the patients she has been assigned to
that makes sense to her is buying a new car, but she knows take care of is Frank Gibbons, a 72-year-old newly diag-
that most likely she cannot afford one at this time. When nosed with diabetes (a condition in which the body
she puts her fear aside and commits herself to gathering does not produce enough insulin to control blood
information, she discovers the following: sugar levels). Part of Linda’s process of preparing to
• Carpools have been organized at the facility where care for her patients is to review the patients’ charts for
she works. any new physician orders. She notes that Dr. Romero
• The most economical new car for sale in her area was in the previous evening and ordered the patient’s
costs $14,795. blood sugar to be checked at 8 a.m. According to the
results, insulin is to be given. (The higher the level of
• There are many articles on the Internet about how
blood sugar, the greater the amount of insulin that is
to buy a car.
given, based on a formula defined by the physician.)
• Consumer Reports magazine has a recent article Linda is a “thinking nurse” and starts to question if this
about purchasing used cars and publishes annual is an appropriate order. She realizes that breakfast trays
reports on the performance of most auto models arrive at 7:30 a.m. on her floor and that Mr. Gibbons will
manufactured over the past 10 years. already have eaten when she checks his insulin level
• Her credit union sponsors car sales to help buyers at 8 a.m. She knows that after eating, a person’s blood
who have limited funds to spend. They also offer low- sugar normally increases for a few hours. This is why
interest loans to buyers who qualify. blood sugar tests are usually ordered when the patient
• A cousin has an older car that he wants to sell. has not eaten for a number of hours. Linda reasons that
if she calculates the amount of insulin based on the
• There is a bus route within half a mile of her
temporarily elevated blood sugar levels, Mr. Gibbons
apartment.
will receive too much insulin and may have a nega-
• A local college offers a workshop that teaches people tive reaction. Linda calls Dr. Romero to clarify the order.
how to buy a car. Dr. Romero states that he believed the breakfast trays
• The local high school has an auto-mechanic training did not arrive until 8:30 a.m. He thanks Linda for catch-
program. For a small fee, students will check over ing the error and changes the order.
used cars before they are purchased. • What might have happened if Linda had simply
performed the blood sugar test exactly as ordered?
Step Three—Create Alternatives • Do you think Linda should have been considered
The third step in problem-solving is to create a list of responsible for the error if she had followed the
alternatives. Ideas for solutions and actions are gener- orders exactly?
ated based on the information collected. All possibilities • Review the five Ws and How questions in relation to
should be considered before one is selected. Some alter- this situation. Give examples of questions that Linda
natives may prove, on further investigation, to be imprac- may have asked herself.
tical or unworkable. It is essential to think through each
2. Take the workshop on how to buy a car, then purchase

a used one through the credit union. The monthly car
MAKING A CAREER DECISION
payments and higher insurance rates will mean hav- There are hundreds of job titles in health care and the
ing to budget carefully to meet all expenses. Chances number continues to grow. They require a wide range of
of buying a “lemon” can be reduced by using the skills and abilities. Students who are considering a career
service offered at the high school. in health care should learn as much as possible about the
requirements, responsibilities, and conditions of their areas
3. Continue to rely on others for rides to work.
of interest. This knowledge will help them to make good
(Nonaction is also an alternative.)
career choices that match their preferences and abilities.
4. Ask her father for a loan to buy a new car. While Jamie For example, some individuals interested in health care
would like to have a shiny new car, she has been would find the emergency medical technician’s (EMT)
financially independent for several years and prefers job to be interesting and exciting. EMTs have opportuni-
to remain that way. ties to apply their skills to help others in significant ways,
Some potential alternatives do not appear on the previ- sometimes even saving lives. At the same time, the work
ous list because of information acquired during step two: is physically and emotionally demanding. It is often per-
1. Carpool participants must have a reliable vehicle of formed under difficult circumstances. Emergencies do not
their own. This might be an alternative later, if she happen at convenient times and places. The schedules for
purchases a dependable car. EMTs include nights, weekends, and holidays, and they are
called out to work in all types of weather conditions. All
2. Her cousin’s car has more than 175,000 miles and is
aspects of an occupation must be considered to increase
not one of the more reliable models, according to the
the chances of choosing a career that will provide long-
reports she studied.
term satisfaction.
When choosing an occupation, students should care-
Step Four—Choose an Alternative and fully consider the following factors about themselves:
Take Action
• Educational background
Step four is critical. A common difficulty in problem-solving
• The amount of additional time they are willing to
and decision-making is failure to act. Opportunities are
dedicate to their education
missed and accomplishments not realized when there is
no follow-through. • Natural abilities
Jamie decides to combine two alternatives. There are • Personality traits
five months of dry weather ahead, so she decides to take • The type of activities they most enjoy
the bus to work. She will use the extra riding time to read
• Preferences for workplace environment and
and keep up with advances in radiology. In October, she
conditions
plans to buy a used car. In the meantime, she will create a
personal budget to control expenses and save money, and
will learn more about how to buy a car and which model is
Educational Requirements
likely to give her the best value. Each occupational area, such as radiology and physical
therapy, has positions that require different amounts
of education and training and involve varying amounts
Step Five—Evaluate and Revise as
of responsibility. Collectively, these levels are known as
Needed
career ladders. The following levels are typical for health
Evaluation means reviewing the results of the actions care:
taken. Even well-thought-out plans can prove to be inef-
• Professional: requires 4 or more years of college.
fective or have unexpected, negative consequences. And
Many require advanced training and degrees, such
circumstances can change. It is sometimes necessary to
as a doctorate. Examples of occupations: dentist,
make adjustments or choose another alternative. It may
physical therapist
even require going back to step two to gather additional
information and go through the process again. • Technologist or Therapist: 3–4 years of college. Many
When applying the process to health care work, it is require graduate degrees and advanced training.
important to remember that the needs of patients and Examples of occupations: speech therapist, occupa-
facilities may change and/or additional information may tional therapist
become available. This can affect the process and force • Technician: associate’s degree, vocational training,
revisions to be made before the entire process has been on-the-job training. Examples of occupations: phar-
completed. Problem-solving is a continual process. macy technician, veterinary technician
10 | Chapter 1
• Assistant: associate’s degree, vocational training, or Professionals who use this term in their title include regis-
on-the-job training. Example of occupations: physi- tered nurse, registered respiratory therapist, and registered
cal therapist assistant medical assistant. (A profession may require registration,
• Aide: vocational training, on-the-job-training. but not include that term in the title.)
Examples of occupations: home health aide, psychi- Licensure is a designation that means the person has
atric aide. been granted permission to legally perform certain acts.
Licenses are granted by government agencies, often the
It is important to note that in spite of these general cat-
state. The specific occupations that require licensure
egories, the occupational title does not necessarily indicate
vary from state to state. Some occupations are licensed
the level of education required. For example, most states
in most, but not all, states. The word licensed does not
require a physical therapist assistant to have a 2-year asso-
usually appear with the title of licensed professions. For
ciate’s degree. However, becoming a veterinary assistant
example, in the following list of licensed professions, only
does not require a degree. For this reason, it is necessary to
one includes the term: dentist, dental hygienist, physician,
investigate the educational and certification requirements
registered nurse, and licensed practical/vocational nurse.
for any job in which you are interested.
The various types of approvals can be confusing.
A current trend is that on-the-job training, in which individ-
Certification and registration are often, but not always,
uals learn necessary job skills after being employed, is being
required to work legally. Even when not required by law,
replaced in many occupations by formal training. For example,
they provide credibility and are preferred by many employ-
aide-level positions are being assigned more responsibilities,
ers when hiring. Medical assisting is an example of an
and classroom training is becoming necessary. Today’s health
occupation in which voluntary certification or registration
care facilities need individuals who have current skills, are able
enhances the graduate’s chances of being hired. Licensure,
to think for themselves, and can start immediately as contrib-
if required for a profession, is never voluntary.
uting members of the health care team.
Some professions have more than one form of approval.
Medical assistants, for example, can be either certified or
Standards for Health Care Professionals registered. Both approvals require meeting specific edu-
Standards for health care professionals have been estab- cational requirements and passing a national exam. The
lished to protect the public from potential harm caused American Association of Medical Assistants grants the title
by incompetence. Testing, along with various approval and “certified.” The American Medical Technologists grants the
monitoring mechanisms, have been developed to deter- title “registered.”
mine whether professionals have met specific standards. Certification and licensing exams vary by occupation.
The purpose of standards is to ensure that professionals Some consist of multiple-choice questions that are pre-
master at least the minimum knowledge and skills neces- sented in a computerized format. Others contain case studies
sary to safely and competently practice their professions. and ask questions to test the candidates’ knowledge about
Students should be aware that in addition to knowledge handling situations that may be encountered on the job. Still
and skill standards, some occupations require background others have a practical component that requires c andidates
checks and drug testing. Individuals who have been con- to demonstrate their ability to perform certain tasks. In addi-
victed of certain crimes are prohibited from taking certifi- tion to occupational questions, some states test the knowl-
cation exams or practicing certain occupations. edge of the laws that apply to health care occupations.
Standards may be set by state boards or national pro- Another point that can be confusing is that some pro-
fessional organizations. There are several terms that desig- fessions are licensed but use the title “registered.” Nurses
nate various types of approvals. Certification is a general take a national exam that, when passed, entitles them to
term that means a person has met predetermined stan- apply for a license in the state where they want to work.
dards. The process of becoming certified usually involves They can become licensed in any state as long as they fol-
completing certain educational requirements and passing low the proper application process. In addition, they are
a professional examination. Most individuals who work in listed in a registry. Although “registered nurse” is the title
health care go through a certification process, although for the occupation, it is also a licensed profession.
their title might not include the term certified. Examples Study the contents of Tables 1–8 and 1–9. Note the vari-
of occupations that do include this term in their title are ety of titles and educational levels within the nursing and
certified occupational therapy assistant, certified medical occupational therapy careers. As you can see, professional
assistant, and certified nursing assistant. titles and the types of approval granted do not necessar-
Some occupations require registration, which means ily indicate the level of education achieved. For example,
being placed on an official list (registry) after meeting the the educational requirements for a certified nursing assis-
educational and testing requirements for the profession. tant can be less than 200 hours of instruction; a certified
occupational therapy assistant, however, must earn an 3. Health Information Management

associate’s degree. The titles given refer to the specific 4. Environmental
methods chosen by various organizations to ensure that
Note that there is overlap among the categories. For
their standards are met, rather than to the educational
example, although listed in the therapeutic and treatment
requirements. Furthermore, some titles may be acquired
section, a major responsibility of dentists and physicians
with varying amounts of education. Using the example
is to diagnose their patients’ conditions. And although
of the registered nurse once again, we see that qualifying
dietetics is listed in the environmental category, nutrition
education can be either an associate’s or bachelor’s degree.
experts prescribe diets as part of the treatment of health
It is essential that students understand what is neces-
conditions such as diabetes and heart disease.
sary for them to work in their chosen occupation. Most
Occupational titles are further divided into specific
examining and licensing boards require attending an
career areas, such as dental and mental health. The edu-
accredited school and/or program. The two common accre
cational and certification, registration, and/or licensing
diting agencies for health care programs are as follows:
requirements for various occupational levels are presented
1. Commission on Accreditation of Allied Health in Tables 1–3 through 1–20. (Note that the abbreviations
Education Programs (CAAHEP). Find more informa- given in the tables for job titles assume that the individual
tion at www.caahep.org has achieved the required approval, such as certification.
2. Accrediting Bureau of Health Education Schools For example, RN stands for registered nurse.) Along with
(ABHES). Find more information at www.abhes.org each table, occupations that generally require associate’s
Being accredited means that the school and/or pro- degrees or vocational training are described in more detail.
gram meets the standards set by a specific professional It is important for students to keep in mind that the
organization. To become accredited, a school or program information in this chapter consists of brief overviews
must formally apply for approval. Once the application and contains only some of the hundreds of health care
is accepted, a team from the organization visits the cam- jobs available today. (See Box 1–1 for examples of addi-
pus to ensure that all standards are being met. For some tional occupations.) It is also important to note that there
careers, such as paramedics, educational programs must are more rungs on each career ladder than appear in the
be approved by the state. Others, such as occupational tables. For example, there are many nurse specialties, such
therapy assistant, require that programs be approved by as nurse anesthetist, clinical nurse specialist, and nurse
the career’s professional organization. practitioner, as well as doctoral degrees in nursing. Many
In addition to attending an accredited program, stu- health care providers earn advanced degrees beyond the
dents must meet the following requirements before most basic requirements for their professions.
professional exams can be taken: Job growth projections were taken from the Bureau
of Labor Statistics for the period 2016 to 2026. Salaries,
• High school diploma or the equivalent
however, have not been included for the various occupa-
• Completion of specific courses tions because it is difficult to provide accurate, up-to-date
• Successful completion of the clinical portion of the
training
• Not having been convicted of certain crimes
Box 1–1
After being obtained, most certifications require spe- Examples of Health Care Occupations
cific amounts of continuing education. This is discussed
further in Chapter 14. Individuals who fail to maintain the Art Therapist
competency and conduct standards for their profession Athletic Trainer
can lose their certification or license. The purpose of health
Audiologist
care regulation is not to provide one-time approval. It is an
ongoing effort to ensure that only qualified professionals Health Educator
are serving the public. Medical Illustrator
Medical Librarian
OCCUPATIONAL PROFILES Medical Photographer
The occupations described in this section are organized Medical Writer
into four categories: Music Therapist
1. Therapeutic and Treatment Speech and Language Pathologist
2. Diagnostic
12 | Chapter 1
information that applies to all geographic areas, individual Dental Occupations

facilities, and current economic conditions. Students are
Dental professionals treat diseases and conditions of the
encouraged to check the latest statistics provided by the
teeth and soft tissues of the mouth. They perform preven-
Bureau of Labor to see current median salaries for occu-
tive measures, restore missing and defective teeth, diag-
pations of interest. The median salary for a dentist means
nose and treat diseases of the gums, perform cosmetic
that half of all dentists earn less than that amount and half
dentistry, and provide patient education. (See Table 1–3.)
earn more. Students can also find sources on the Internet
to learn about typical salaries in their states. For example, Dental Hygienist
many professional organizations collect and report salary The primary responsibility of a dental hygienist is to pro-
information. vide preventive dental care. This is accomplished by clean-
It is also important to note that the education and certi- ing the teeth with special instruments and equipment,
fication requirements given in tables are subject to change. examining the mouth and taking X-rays, and providing
Students should check with professional organizations patient education about dental care. Although hygien-
and their state’s licensing board for the most up-to-date ists perform their work independently, they are under the
information. supervision of a dentist. Work schedules are often flexible,
and many hygienists work part-time and/or for more than
Therapeutic and Treatment Occupations one dentist. The work involves prolonged patient contact,
Therapeutic and treatment occupations provide services standing and reaching, and requires the ability to get along
that assist patients to regain or attain maximum wellness. well with others. Good manual dexterity (skill working
They may involve direct patient care, such as nursing, or with the hands) and hand–eye coordination are essential.
provide services that contribute to the patient’s recovery, Jobs in dental hygiene are projected to grow by 20% from
such as the pharmacy professions. The majority of health 2016, much faster than average among all occupations. See
care occupations fall into this category. https://www.bls.gov/ooh/healthcare/dental-hygienists.htm.
Table 1–3 Dental Occupations

Career Education Testing and Approval
Dentist (DDS or DMD) 2–4 years college preprofessional Licensed by states:
education 1. Graduate from accredited dental school
4 years dental school 2. Pass written and practical exams
2–4 years additional education if
seeking specialty
Dental Hygienist (RDH) Associate’s or bachelor’s degree Licensed by states:
2–4 years depending on 1. Graduate from accredited dental hygiene school
program requirements 2. Pass national board exams administered by the
American Dental Association Joint Commission on
National Dental Examinations
3. Pass state and/or locally administered clinical
exams
4. Pass state exam covering dental hygiene law
Dental Assistant (CDA or RDA) 1–2 year educational program Requirements vary by state; voluntary certifications
(recommended) or on-the-job available through Dental Assisting National Board
training
Dental Laboratory Technician On-the-job training or 2-year Voluntary certification available from National
associate’s degree program Association of Dental Laboratories and/or National
Board for Certification in Dental Laboratory
Technology
Dental Assistant squads, police departments, and fire departments, and

Dental assistants are trained to perform a variety of duties employment is expected to grow 15% from 2016. (See
in the dental office. They may work closely with the dentist Table 1–4.) See https://www.bls.gov/ooh/healthcare/emts-
by preparing patients for treatment, passing instruments, and-paramedics.htm.
and suctioning the mouth during procedures performed
by the dentist. Laboratory duties may include sterilizing Massage Therapy Occupations
and preparing instruments, creating casts of the teeth, Massage therapists use different types of massage, such
and making temporary crowns. Administrative dental assis- as Swedish, deep tissue, and reflexology, to treat ailments
tants greet patients, schedule appointments, keep patient and injuries; decompress tired muscles; reduce stress; and
records, send bills, and perform other clerical duties as promote wellness. There are dozens of specialties, or types
needed. Dental assistants must have good manual dex- of massage, each designed to achieve specific results.
terity, the ability and willingness to follow directions, and A large percentage of massage therapists are self-
good interpersonal skills. This occupation is experienc- employed, with the remainder working in settings ranging
ing a 19% job growth, much faster than the average for from physician and chiropractors’ offices to fitness centers
all occupations. See https://www.bls.gov/ooh/healthcare to spas. Massage therapy is physically demanding, as it
/dental-assistants.htm. requires standing and repetitive movements. Working with
clients requires good communication, empathy, and the
Dental Laboratory Technician
ability to make clients feel comfortable with the personal
Dental laboratory technicians make the items used by den- nature of massage treatment. Job growth rate is excellent,
tists to replace and restore teeth, such as crowns, bridges, projected to be 26%. (See Table 1–5.) See https://www.bls
and dentures. These are fabricated using models of the .gov/ooh/healthcare/massage-therapists.htm.
patient’s mouth and involve working with plaster, wax,
metal, and porcelain. Small handheld tools, grinding and Medical Office Occupations
polishing equipment, and heat sources for melting and
Medical office personnel treat patients who are seeking
baking are used. The work is precise and very delicate.
to maintain or improve their health or who need treat-
Successful technicians are patient and steady-handed and
ment for illnesses and injuries. Medical offices are staffed
have good vision, especially the ability to discriminate
by a physician who may be either a medical doctor (MD)
colors, needed for matching replacements to remaining
or a doctor of osteopathic medicine (DO). MDs and DOs
teeth. Growth in the number of jobs is expected to be 13%,
receive similar training and perform similar functions.
higher than average for all occupations. See https://www
The major difference is that osteopathic physicians place
.bls.gov/ooh/production/dental-and-ophthalmic-laboratory-
more emphasis on the musculoskeletal system. Doctors of
technicians-and-medical-appliance-technicians.htm.
osteopathy also tend to approach medicine more holisti-
cally, meaning that they consider mental and emotional
Emergency Medical Occupations
as well as physical health. Physicians may provide general
Emergency medical technicians provide quick response care or they may specialize in what and who they treat. (For
service to victims of medical emergencies. All EMTs are a list of medical specialties see Box 1–2.)
qualified to give life support and immediate care such as In addition to the physician, medical offices need sup-
restoring breathing, controlling bleeding, administering port staff to assist with patient care and to perform clini-
oxygen, bandaging wounds, and treating a person for cal, laboratory, and administrative duties. (See Table 1–6.)
shock. EMTs transport victims to health care facilities and (Note: Physicians and occupations designated as “medical
provide necessary care en route. Intermediate EMTs have office support staff” also work in other settings, such as
additional skills that include administering fluids intrave- large clinics, hospitals, rehabilitation centers, etc.)
nously and using a defibrillator to administer an electrical
shock to a person whose heart has stopped. Paramedics, Medical Assistant
the highest level EMTs, are qualified to administer drugs, Medical assistants must be prepared to carry out a wide vari-
interpret electrocardiograms (measurements of the heart’s ety of duties. They may work closely with the physician and/
electrical activity), and perform various invasive proce- or perform clinical tasks. Clinical, or “back office assistants’,”
dures (involving puncture or insertion of an instrument or duties include preparing patients, taking vital signs, help-
material into the body). EMTs must be emotionally stable, ing the physician with exams and procedures, and perform-
able to deal calmly with stressful situations, physically ing a variety of tests and procedures on patients. Medical
coordinated, able to move quickly and easily, and able to assistants may also choose to concentrate on administra-
lift and carry heavy loads. EMTs are employed by rescue tive or “front office tasks,” which include receiving patients,
14 | Chapter 1
Table 1–4 Emergency Medical Occupations

Career Education Testing and Certification
Paramedic Typically 1–2 years; may result Licensed by states:
in a certificate or associate’s Most states require certification from the National
degree Registry of Emergency Medical Technicians, which
includes the following:
1. Complete a state-approved paramedic course
that meets or exceeds the U.S. Department of
Transportation National Standard Curriculum
2. Pass written and practical exams
3. Pass a state-approved psychomotor exam
EMT-Intermediate/99 Training requirements vary by Licensed by states:
EMT-Intermediate/85 state Most states require certification from the National
Note: Some states have Typically consist of 30–350 Registry of Emergency Medical Technicians, which
only one level referred hours of training, depending on includes the following:
to as Advanced EMT the scope of practice 1. Complete a state-approved EMT-Intermediate/99
or EMT-Intermediate/85 course that meets or
exceeds the U.S. Department of Transportation
National Standard Curriculum
EMT-Basic Training requirements vary by Licensed by states:
state, typically at least 120 hours Most states require certification from the National
over 6 to 15 weeks of training Registry of Emergency Medical Technicians, which
1. Complete a state-approved EMT-Basic course
First Responder/Emergency Training requirements vary by Licensed by states:
Medical Responder state Most states require certification from the National
Registry of Emergency Medical Technicians, which
1. Complete a state-approved first-responder course
Note: Some states have their own certification programs and different names and titles for emergency service personnel.
Table 1–5 Massage Therapy Occupations

Massage Therapist Requirements vary by state and Most states regulate and require formal education and
locality; ranges from 3 to 24 months national or state licensure or certification. In addition, some
cities, towns, and counties have their own regulations and
licensing requirements. Certification required for licensure in
many states is offered by the National Certification Board for
Therapeutic Massage and Bodywork (NCBTMB). Some states
also require practical exams.
Box 1–2
Medical Specialists
Physicians who specialize in treating specific parts of the body:
Cardiologist Heart and blood vessels

Dermatologist Skin
Endocrinologist Endocrine system (glands)
Gastroenterologist Stomach and intestines
Gynecologist Female reproductive organs
Internist Internal organs, including the lungs, heart, glands, intestines, and kidneys
Nephrologist Kidneys
Neurologist Brain and nervous system
Ophthalmologist Eyes
Orthopedist Muscles and bones
Otolaryngologist or Otorhinolaryngologist Ear, nose, and throat
Proctologist Lower part of the large intestine
Psychiatrist Mind
Urologist Kidneys, bladder, and urinary system
Physicians who perform specific kinds of work:
Anesthesiologist Administers medication to cause loss of sensation or feeling during

surgery
Emergency Physician Treats acute illnesses and injuries
Oncologist Diagnoses and treats tumors (cancer)
Pathologist Diagnoses disease by studying changes in organs, tissues, and cells
Physiatrist Treats conditions associated with physical medicine and patients in
need of rehabilitation
Plastic Surgeon Performs corrective surgery to repair injured or malformed body parts
Radiologist Uses X-rays and radiation to diagnose and treat diseases
Sports Medicine Physician Prevents and treats injuries sustained in athletic events and
physical activities
Surgeon Performs surgery to correct deformities and treat injuries and diseases
Thoracic Surgeon Performs surgery on the lungs, heart, and chest cavity
(continues)
16 | Chapter 1
Box 1–2
Physicians who work with specific populations:
Family Practice Physician Promotes wellness and treats individuals in all age groups
Gerontologist Promotes wellness and treats older persons
Obstetrician Assists women with pregnancy and childbirth
Pediatrician Promotes wellness and treats children
Table 1–6 Medical Office Occupations

Physician (MD, DO) 4 years college preprofessional education Licensed by states:
4 years medical school 1. Graduate from accredited medical school
MD: 3–8 years of graduate medical education 2. Complete graduate medical education
(internship and residency) 3. Pass written examination
DO: 1-year internship and a 2- to 6-year
residency
Physician’s Assistant (PA) Varies. 2–4 years college 1 24-month Requirements vary by state; most require
(minimum) PA program passing the exam administered by National
Commission on Certification of Physician’s
Assistants
Medical Assistant Certificate program or associate’s degree Specific tasks, such as giving injections,
Administrative and/or regulated by some states. Optional
Clinical (MA, CMA, RMA) certification through exam administered
Certified Medical by the American Association of Medical
Assistant (CMA) Assistants. Optional registration through
exam administered by the American Medical
Registered Medical
Technologists
Assistant (RMA)
answering the telephone, maintaining patient records, and treating substance abuse problems, group homes, and
handling insurance and billing duties. In small offices, the prisons. Diagnoses encountered range from mild anxiety
medical assistant may have both front and back office assign- disorders, in which patients experience temporary feelings
ments. Medical assistants must be able to follow directions, of distress, to serious conditions, such as schizophrenia,
work accurately, get along well with others, and have good that result in behaviors that are unsafe for both the patient
manual dexterity. The occupation is expected to grow much and the public. (See Table 1–7.)
faster than average for all occupations at 29%. See https://
www.bls.gov/ooh/healthcare/medical-assistants.htm. Psychiatric/Mental Health Technician
Mental health technicians work with patients under the
Mental Health Occupations direction of a psychiatrist, a psychologist, or a registered
Mental health professionals provide care, treatment, coun- nurse. They carry out care plans, assist with group activities,
seling, and activities for patients with mental, emotional, listen to patients and provide encouragement, and note
and/or psychosocial (combination of mental and social) behavior. The work requires a strong desire to help others,
problems. These services are provided for patients in a patience, understanding, excellent oral communication skills,
wide variety of settings, including medical offices dedi- and emotional stability. Employment growth is expected to
cated to the practice of psychiatry, psychiatric hospitals, be 6%, about average for all occupations. See https://www.bls
halfway houses, general hospitals, clinics dedicated to .gov/ooh/healthcare/psychiatric-technicians-and-aides.htm.
Table 1–7 Mental Health Occupations

Psychiatrist (MD) 4 years college preprofessional education Licensed by states:
4 years medical school 1. Graduate from accredited medical
4–7 years of medical graduate education school
(internship and residency) 2. Complete specialized studies, internship,
and residency
3. Pass written exam
Clinical Psychologist 4 years college Licensed by states:
(PhD, PsyD) 2–3 years graduate school Pass written exam
(master’s degree)
Additional 31 years (doctorate)
Clinical Social Worker 4 years college Licensed by states:
2–3 years graduate school, including Pass written exam
supervised experience (master’s degree)
Psychiatric Clinical Nurse Licensure as RN Licensed by states:
Specialist 2–31 years graduate school 1. Requirements vary by state but include
(master’s or doctoral degree) passing a written exam
Mental Health Technician Certificate or associate’s degree in human Licensed by some states
services or mental health preferred
Psychiatric Aide Some states require formal training Varies by state
program
Psychiatric Aide Registered Nurse

Psychiatric aides assist other health care professionals and Registered nurses provide a wide variety of patient care
provide help with the physical needs of patients, such as services. They give direct patient care or supervise other
hygiene and feeding. They provide companionship for personnel who do so, serve as patient advocates (sup-
patients and may help escort patients within or outside port the interests of patients), and provide patient educa-
the care facility. Aides must be patient, caring, and respon- tion. They are often the professionals who coordinate the
sible. (Note: Psychiatric aides generally have less formal overall care of patients by interacting with all other health
education than mental health technicians. In some states, care professionals involved. Registered nurses can achieve
however, the two job titles refer to the same level of educa- many educational levels and pursue a great number of
tion and work duties.) Job growth is about the same as for specialties. Opportunities range from direct patient care
mental health technicians at 6%. See https://www.bls.gov to management of a hospital department. Specific day-to-
/ooh/healthcare/psychiatric-technicians-and-aides.htm. day activities are determined by the work setting, which
may be a hospital, clinic, long-term care facility, school,
prison, or patients’ homes. Registered nurses must be car-
Nursing Occupations ing and responsible, have excellent assessment and com-
Nurses promote health and provide care and treatment for munication skills, and be emotionally stable and able to
patients with all types of health problems. Nursing care is both follow orders and supervise others. Registered nurs-
carried out through the application of a structured process ing is one of the most versatile careers in any field. It is one
to determine each patient’s needs, develop individual care of the occupations projected to have the largest number
plans, implement the plans, and then evaluate their effec- of job openings during the period 2016 to 2026. In fact,
tiveness. An important responsibility of the nurse is to some areas of the United States are reporting shortages
provide education to patients and their families regarding of qualified registered nurses. See https://www.bls.gov/ooh
self-care and health maintenance. (See Table 1–8.) /healthcare/registered-nurses.htm. (See Figure 1–5.)
18 | Chapter 1
Table 1–8 Nursing Occupations

Certified Registered Nurse Be a registered nurse Licensed by states:
Anesthetist (CRNA) Complete specialized education leading Pass a national certification exam
to a master’s degree
Nurse Practitioner (CRNP) Be a registered nurse Licensed by states:
Complete additional educational and Pass a national certification exam
clinical practice requirements (most are
master’s or doctoral degree programs)
Registered Nurse (RN) 4-year (bachelor’s) college degree Licensed by states:
(preferred by most and required by many 1. Graduate from approved program
hospitals) or 2-year (associate’s) degree
2. Pass the National Council Licensing
Examination for Nurses (N-CLEX)
Licensed Practical/Licensed 1- or 2-year state-approved associate’s Licensed by states:
Vocational Nurse (LPN/LVN) degree or diploma program 1. Graduate from approved program
2. Pass national licensing exam
Certified Nursing Assistant (CNA) States have various training requirements All states require certification for work in
for classroom and clinical experience long-term care facilities
Programs must meet specific federal Requirements guided by federal
minimum standards regulations established by the Omnibus
Typical program is at least 8 weeks Budget Reconciliation Act of 1987 (OBRA)
Certification requirements vary for other
work environments
Patient Care Technician/Patient Vocational training program Certification required if nursing
Care Assistant assistant duties are included. Voluntary
certifications available:
1. National Health Association
2. National Center for Competency
Testing
Home Health Aide States have various training requirements Approval requirements vary by state
for classroom and clinical experience. under guidance of OBRA
Some types of employers require formal Voluntary certification available from the
training. National Association for Home Care and
Hospice
Licensed Practical/Vocational Nurse vary by region. Most new jobs are in residential care facili-
Licensed practical nurses (known as licensed vocational ties and home health environments. Employment growth
nurses in California and Texas) provide basic patient care is expected to be faster than average for all occupations
under the direction of physicians and registered nurses. at 12%. See https://www.bls.gov/ooh/healthcare/licensed-
Most practical nurses carry out bedside tasks that include practical-and-licensed-vocational-nurses.htm.
taking vital signs, administering medications, applying
dressings and hot and cold packs, treating bedsores, and Certified Nursing Assistant
giving various comfort measures. They are also responsible Nursing assistants work under the supervision of nursing
for recording patient information. Practical nurses must be staff to help care for patients’ basic needs. They may take
caring, responsible, emotionally stable, and able to follow vital signs, assist patients with hygiene and feeding, give
directions and work under supervision. Job opportunities comfort measures, change bedding, and help transport
© Rob Marmium/Shutterstock.com.
© Tyler Olson/Shutterstock.com.
FIGURE 1–5 As older nurses retire, there will be a great need
FIGURE 1–6 Home health aide is a fast-growing occupation.
for newly trained registered nurses.
Aides must be compassionate, patient, and interested in
helping older adults and people with disabilities.
patients. The variety and level of duties depend on state medications. Because of the aging population, this is one
laws, the amount of training, and the needs of the facility. of the fastest growing of all occupations, projected to be
Assistants must be patient, caring, dependable, and able to 39%. See https://www.bls.gov/ooh/healthcare/home-health-
follow directions. This is a fast-growing occupation, with an aides-and-personal-care-aides.htm.
expected increase of 18%. This is especially true for individu-
als who are also qualified to work as home health aides. See Occupational Therapy Occupations
https://www.bls.gov/ooh/healthcare/nursing-assistants.htm.
The purpose of occupational therapy is to help individuals
Patient Care Technician attain the highest level of function and self-sufficiency pos-
The work of patient care technicians is similar to that of sible. Difficulties in performing the activities of daily living
nursing assistants. They work under the supervision of phy- can be the result of physical, mental, or emotional problems
sicians or nurses, taking vital signs, collecting specimens, caused by disease, injury, or congenital (present at birth)
and assisting patients with eating, hygiene, and grooming. conditions. Occupational therapists evaluate patients, set
Patient care technicians work in hospitals, clinics, and reha- goals to increase their function and lessen their limitations,
bilitation facilities. See https://www.bls.gov/ooh/healthcare and create treatment plans to achieve these goals. Treatment
/nursing-assistants.htm. may involve individual or group activities, exercise, provid-
ing adaptive equipment such as splints and special tools,
Home Health Aide and teaching patients new ways to perform daily tasks. Job
Home health aides help people with disabilities, older adults, growth rate for occupational therapists is projected at 24%,
and the chronically ill. Their work is similar to that of certi- much faster than other occupations. (See Table 1–9.)
fied nursing assistants. In fact, many home health aides have
Occupational Therapy Assistant
nursing assistant certification. They may work in patients’
homes or in a care facility, assisting with moving patients, Occupational therapy assistants work under the supervi-
providing personal care, and dressing. In the client’s home, sion of occupational therapists. They carry out rehabilita-
duties may include preparing meals, providing companion- tive activities and exercises prescribed in treatment plans
ship, doing light housekeeping, and providing transporta- prepared by occupational therapists. Other important
tion. In some states, with the proper training and under the duties include patient education, monitoring patient prog-
supervision of a nurse, they are allowed to give medications ress, and preparing reports for the therapist. Typical tasks
to clients, take vital signs, and assist patients with prescribed include teaching a patient to use special devices that enable
exercises. This is one of the fastest growing of all occupa- the performance of everyday tasks, such as reaching, dress-
tions, at 47%. (See Figure 1–6.) See https://www.bls.gov/ooh ing, and cooking; assisting with a stretching exercise; and
/healthcare/home-health-aides-and-personal-care-aides.htm. making a hand splint. Occupational therapy assistants must
have good communication skills, be patient and caring, and
Personal Care Aide be sensitive to the needs of people who suffer from a vari-
Personal care aides help residents and patients with daily ety of disabilities. The number of new positions is expected
tasks such as bathing, grooming, dressing, and eating. They to grow rapidly at 29%. See https://www.bls.gov/ooh
cannot perform medically related tasks, such as giving /healthcare/occupational-therapy-assistants-and-aides.htm.
20 | Chapter 1
Table 1–9 Occupational Therapy Occupations

Career Education Testing and Licensure
Occupational Therapist (OTR) Master’s degree (minimum) or Licensed in all states
doctorate National registration:
1. Graduate from program accredited by the American
Occupational Therapy Association (AOTA)
2. Pass national exam administered by National Board
for Certification in Occupational Therapy (NBCOT)
Occupational Therapy 2-year (associate’s) college Licensure or certification required in most states
Assistant (COTA) degree National certification:
1. Graduate from program accredited by AOTA
2. Pass national exam administered by NBCOT
Occupational Therapy Aide Certificate program or None
on-the-job training
Occupational Therapy Aide faster than average for all occupations, at 12% especially for
Aides help therapists and assistants by performing sup- technicians who are certified. See https://www.bls.gov/ooh
portive duties such as preparing supplies for activities, /healthcare/pharmacy-technicians.htm.
assisting with patient transfers, helping with patient treat-
ments and activities, and cleaning activity areas. Some Physical Therapy Occupations
aides are cross-trained to assist other rehabilitation profes- The purpose of physical therapy is to help patients improve
sionals such as physical therapists. Rehabilitation skills may their physical functions by increasing muscle strength,
be combined with nursing assistance training and certifica- range of motion, movement, and by decreasing pain. This
tion. Aides must be responsible and able to follow direc- is accomplished through assessment and the creation and
tions. For aides who are also certified nursing assistants, implementation of treatment programs that may include
the number of positions is expected to grow rapidly. See exercise, massage, and the use of modalities such as heat,
https://www.bls.gov/ooh/healthcare/occupational-therapy- cold, and electrical stimulation. Physical therapists teach
assistants-and-aides.htm. patients to perform exercises and use equipment, such as
canes and crutches. (See Table 1–11 and Figure 1–7.)
Pharmacy Occupations
Pharmacy professionals prepare and dispense medications Physical Therapist Assistant
to promote patient wellness and recovery, as well as phar- Assistants work with patients under the supervision of
maceutical products used to diagnose health conditions. a physical therapist to carry out treatment plans. They
Important duties also include educating patients about the teach and supervise exercises, apply modalities, perform
proper use of medications and ensuring that patients are massages, assist patients with ambulatory devices such
not given drugs that will cause harm because of allergic as walkers and canes, and document progress. Physical
reactions or negative interactions with other drugs. (See therapist assistants must be patient and encouraging
Table 1–10.) and have the physical strength to assist patients with
e xercises. This occupation is projected to be among
Pharmacy Technician the fastest growing in the next several years at 29%.
Pharmacy technicians work under the supervision of a See https://www.bls.gov/ooh/healthcare/physical-therapist-
licensed pharmacist. They fill orders for drugs, stock medi- assistants-and-aides.htm.
cation carts, record and store incoming drug supplies, and
reorder inventory as needed. They also assist in maintain- Physical Therapist Aide
ing paperwork and records required for controlled drugs Aides support the work of therapists and assistants by pre-
(drugs that have potential for abuse). Pharmacy technicians paring and cleaning equipment and therapy areas, assist-
must be responsible, detail oriented, and able to follow ing with treatments, transporting patients, and ordering
directions exactly. Job opportunities are expected to grow and maintaining supplies. Aides must be responsible and
Table 1–10 Pharmacy Occupations

Pharmacist (PharmD) 2–3 years college Licensed by states:
3–4 years pharmacy school 1. Graduate from college of pharmacy accredited
(doctoral degree) by the American Council on Pharmaceutical
Education
2. Pass the North American Pharmacist Licensure
Exam (NAPLEX)
3. Most states also require passing the Multistate
Pharmacy Jurisprudence Exam (MPJE)
(Pharmacy law)
Pharmacy Technician Up to 1 year on-the-job-training A few states require licensure, certification, or
or 1- or 2-year college certificate registration
program or associate’s degree Voluntary national certification available
through examination administered by Pharmacy
Technician Certification Board and the Institute for
Certification of Pharmacy Technicians
Pharmacy Aide/Helper/Clerk High school diploma and None
on-the-job-training or vocational
training program
Table 1–11 Physical Therapy Occupations

Physical Therapist (PT) 3–4 four years college Licensed by states:
(bachelor’s degree) 1. Graduate from program accredited by the
31 years graduate studies Commission on Accreditation in Physical
(doctorate) Therapy Education (CAPTE)
2. Pass exam administered by the Federation of
State Boards of Physical Therapy
Physical Therapist Assistant (PTA) 2-year (associate’s) college All states require licensure, certification, and/or
degree registration:
1. Graduate from program accredited by CAPTE
2. Pass exam administered by the Federation of
State Boards of Physical Therapy
Physical Therapist Aide On-the-job-training or None
vocational training program
able to follow directions. Job growth is expected to be heart disease, acute diseases (lasting a short time but are
much faster than average. See https://www.bls.gov/ooh relatively severe) such as pneumonia, or chronic diseases
/healthcare/physical-therapist-assistants-and-aides.htm. (lasting a long time) such as emphysema. (See Table 1–12
and Figure 1–8.)
Respiratory Therapy Occupations
Respiratory therapy involves evaluating, treating, and Respiratory Therapist
caring for patients with breathing disorders. Respiratory Respiratory therapists perform a variety of tasks to assist
therapists assist patients who have difficulty breathing or patients with breathing. These include using special
cannot breathe on their own because of conditions such as instruments to measure lung capacity and drawing blood
22 | Chapter 1
FIGURE 1–8 Respiratory therapists administer medications and

treatments to patients who have lung and heart disorders.
Many people are alive today as a result of modern sur-

gery. Surgical occupations involve the care of the patient
FIGURE 1–7 Physical therapist assistants help patients improve before, during, and after surgery. (See Table 1–13 and
their physical function after accidents, surgery, and illness. Figure 1–9.)
Surgical Technologist/Surgical Technician/

samples to test for levels of oxygen and other compo- Operating Room Technician
nents. Therapists provide patients with oxygen and con- The health care professionals who are trained to perform
nect those who cannot breathe on their own to ventilators. important functions in the operating room may work
The monitoring and maintenance of equipment are critical under a variety of job titles. Duties include sterilizing and
to a patient’s well-being. Therapists also administer aero- setting up instruments, preparing equipment and linens
sol medications and perform chest physiotherapy, which in the operating room, and preparing patients for surgery
involves thumping and vibrating the patient’s chest cavity to and transporting them to the operating room. During
remove mucus from the lungs. Respiratory therapists must surgery, technicians may perform a variety of tasks: pass
have good technical aptitude and be attentive to detail and instruments to the surgeon, hold retractors (instruments
able to work under stress. Jobs are expected to grow much that open or draw back tissue, bone, etc.), cut sutures, oper-
faster than average for all occupations at 23%. See https:// ate lights and equipment, and assist with the preparation
www.bls.gov/ooh/healthcare/respiratory-therapists.htm. of specimens. Work in surgery requires excellent manual
dexterity, attention to detail, the stamina to stand for long
Surgical Occupations hours, and the ability to respond quickly. Employment is
Surgical procedures vary from minor to extremely com- expected to grow faster than average for all occupations
plex and from emergency to elective. The types of surgery at 12%. See https://www.bls.gov/ooh/healthcare/surgical-
available and their complexity are growing at a fast rate. technologists.htm.
Table 1–12 Respiratory Therapy Occupations

Respiratory Therapist (RRT, CRT) Associate’s or bachelor’s degree Licensed in all states except Alaska:
1. Graduate an accredited program (accepted
approval agencies vary by state)
2. Pass exam administered by the National Board for
Respiratory Care
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It is delightful to witness the care which the swallow manifests
towards her brood. When able to leave the nest, she leads them to
the ridge of the barn, where, settled in a row, and as yet unable to fly,
she feeds them with great assiduity. In a day or two they become
capable of flight, and then they follow their parents in all their
evolutions, and are fed by them while on the wing. In a short time
they commence an independent career, and set up for themselves.
The notes of the swallow, though hurried and twittering, are very
pleasing; and the more so as they are associated in our minds with
ideas of spring, and calm serenity, and rural pleasures. The time in
which the bird pours forth its melody is chiefly at sunrise, when, in
“token of a goodly day,” his rays are bright and warm.
“The breezy call of incense-breathing morn,
The swallow, twittering from the straw-built shed,”
unite alike to call man from his couch of rest, and to praise “the God
of seasons as they roll.”
After the work of rearing the young, ere autumn sears the leaf, the
swallow prepares to depart. Multitudes, from various quarters, now
congregate together, and perch at night in clusters on barns or the
branches of trees, but especially among the reeds of marshes and
fens, round which they may be observed wheeling and sinking and
rising again, all the time twittering vociferously, before they finally
settle. It was from this circumstance that some of the older
naturalists supposed the swallow to become torpid and remain
submerged beneath the water during winter, and to issue forth from
its liquid tenement on the return of spring; a theory utterly
incompatible with reason and facts, and now universally discarded.
The great body of these birds depart about the end of September.
The Holy Scriptures make frequent allusions to this interesting
bird. Jeremiah, reproaching the Jews for their turning away from
God, alludes to the swallow as obeying His laws, while they who
have seen his glory rebelled: “Yea, the stork in the heaven knoweth
her appointed times; and the turtle and the crane and the swallow
observe the time of their coming; but my people know not the
judgment of the Lord.” viii. 7.
The Psalmist notices the partiality of this bird for the temple of
worship, the sanctuary of God: “Yea, the sparrow hath found an
house, and the swallow a nest for herself, where she may lay her
young, even thine altars, O Lord of hosts, my King and my God.”
Psalm lxxxiv. 3. Hezekiah, king of Judah, wrote of himself, “Like a
crane or a swallow, so did I chatter.” Is. xxxviii. 14. In these casual
notices we at least trace out that the habits, migration, and song of
the swallow, were known to the inspired writers; a circumstance of
no little value, since a false assertion that the facts of natural history
are not correctly stated in the Bible, has long been among the weak
engines used by the infidel against the validity of that book, “which
maketh wise unto salvation.”
The Sand Martin, or Bank Swallow, is a most curious bird of this
family. It is the least of the tribe, and the first to arrive, appearing a
week or two before the swallow, and often while the weather is
severe. Its flight is vacillating, but it is equally fond of skimming over
the surface of the water. This bird, unlike its race, mines deep holes
in sand or chalk cliffs, to the depth of two feet, or even more, at the
extremity of which it constructs a loose nest of fine grass and
feathers, artificially put together, in which it rears its brood.
The sand martin is of a social disposition; hence flocks of them
unite to colonize a favorite locality, such as a precipitous bank or
rock, which they crowd with their burrows. Professor Pallas says,
that on the high banks of the Irtish, their nests are in some places so
numerous, that, when disturbed, the inmates come out in vast flocks
and fill the air like flies; and, according to Wilson, they swarm in
immense multitudes along the banks of the Ohio and Kentucky.
What, it may be asked, are the instruments by which this little
creature is able to bore into the solid rock, and excavate such a
chamber? Its beak is its only instrument. This is a sharp little awl,
peculiarly hard, and tapering suddenly to a point from a broad base;
with this tool the bird proceeds to work, picking away from the centre
to the circumference of the aperture, which is nearly circular; thus it
works round and round as it proceeds, the gallery being more or less
curved in its course, and having a narrow funnel-shaped termination.
The author of “The Architecture of Birds” informs us that he has
watched one of these swallows “cling with its sharp claws to the face
of a sandbank, and peg in its bill, as a miner would do his pickaxe, till
it had loosened a considerable portion of the sand, and then tumbled
it down amongst the rubbish below.”
The Human Frame likened to a House.
Man’s body’s like a house: his greater bones
Are the main timbers; and the lesser ones
Are smaller joists; his limbs are laths daubed o’er,
Plastered with flesh and blood; his mouth’s the door;
His throat’s the narrow entry; and his heart
Is the great chamber, full of curious art.
His stomach is the kitchen, where the meat
Is often put, half sod, for want of heat.
His spleen’s a vessel nature does allot
To take the scum that rises from the pot;
His lungs are like the bellows, that respire
In every office, quickening every fire;
His nose the chimney is, whereby are vented
Such fumes as with the bellows are augmented;
His eyes are crystal windows, clear and bright,
Let in the object, and let out the sight;
And as the timber is, or great or small,
Or strong or weak, ’tis apt to stand or fall.
Chinese Spectacles.
Mr. Davis, in his account of China, tells us that the people there
do not make glass that is fine enough for spectacles, and therefore
they use pieces of rock crystal for the purpose. The rims of the
spectacles are of immense size and width, and give a very wise
appearance to the wearer. The spectacles are attached to the head
by silken strings slung over the ears, as represented in the picture.
View of the Bastile.
Story of Philip Brusque;
s h o w i n g t h e n at u r e a n d n e c e s s i t y o f
government and laws.
CHAPTER I.
Early Life of Philip Brusque.—He engages in the French Revolution.
—Is at length suspected by Robespierre, and obliged to fly.—
Enters on board a Ship, and is cast away upon an uninhabited
Island in the Indian Ocean.—Description of the place.—Philip
fancies that he is now happy, having found perfect Liberty.
Philip Brusque was a young Frenchman, who engaged very

heartily in the revolution that began to agitate France about the year
1789. He was young, ardent and discontented. Though he had little
education, he had still read many of the papers and pamphlets of the
day. These had filled his mind with a horror of kings, and the most
intoxicating dreams of liberty. Knowing little of political government,
except that of France, and which he saw to be corrupt and despotic,
he adopted the idea that all government was bad, and to this he
attributed nearly all the evils of society. With the ardor of a young but
heated fancy, he looked forward to the destruction of the monarchy
as certain to bring a political millennium, when every man should
walk forth in freedom and happiness, restrained by no law except the
moral sense of man, and the innate perception and love of human
rights.
With these views, which were then common among the French
people, and which artful disorganizers had disseminated, in order
thereby to acquire power, Philip arrived at Paris. He was soon
engaged in several of the debating clubs of that great metropolis,
and being possessed of natural eloquence, he speedily became a
leader. He was present at the destruction of the Bastile, and his own
vigorous hand battered down more than one of the iron doors of that
horrid prison. Looking upon these gloomy walls, with their dark
chambers, and the chains and instruments of torture which were
found there, as at once emblems and instruments of that tyranny
which had cursed his country for ages, Philip felt a high inspiration in
witnessing its demolition. As one portion after another of the massy
wall was hurled to the earth, he seemed to fancy that a whole nation
must breathe more freely; and in seeing the pallid wretches delivered
from the dungeon, where some of them had been imprisoned for
years, he seemed to think that he saw the spirit of his country set at
liberty.
The Bastile was soon but a heap of ruins. The whole fabric of the
French monarchy, which had existed for twelve centuries, in a few
brief years had shared the same fate. Louis XVI. had been
beheaded, and his beautiful queen had been brought to the block. In
all these scenes Brusque had taken a part. He was present at the
execution of Marie Antoinette. He had no respect for majesty, but he
was not yet lost to a sense of decency in respect to woman. The
shocking and brutal insults offered to the queen, worse than anything
ever witnessed among savages, disgusted Philip. He was indeed
sick of blood, and he ventured to speak his sentiments aloud. His
words were repeated to Robespierre and the rest of the bloody men
who then held the sway. Philip became suspected, and he was
obliged to fly to save his life. He reached the coast of France with
difficulty, and entering on board a merchant ship as a sailor, set out
upon a voyage to China.
Nothing remarkable happened for some time; but when the ship
had doubled the Cape of Good Hope, and entered the Indian Ocean,
a violent storm arose. The vessel contended bravely with the waves
for a time, but at length her masts were swept away, the helm was
broken, and the hull of the ship rolled like a log amidst the tumbling
waters. She then drifted for a time at the mercy of the winds, and at
length came near a small island. She then struck on a rock, and
went to pieces. All the crew were drowned except the hero of our
story, who seized upon a plank, and, after two days of toil and
suffering, reached the shore of the island.
He landed upon a pebbly beach, but he was so exhausted as only
to be able to draw himself up from the waves. There he lay for a long
time, almost unconscious of existence. At length, his strength
returned, and he began to think over what had happened. When his
reason was, at last, fully returned, he fell upon his knees, and
thanked Heaven for his preservation. It was the first prayer he had
uttered for years, for Philip Brusque had been told by the French
revolutionists that there was no God, and that prayer was a mere
mockery. But now he prayed, and felt in his heart that there was
indeed a God, that claimed gratitude and thanksgiving from the lips
of one who had been saved from death, while his companions had
all been drowned.
Philip was soon able to look about the island and make
observations. It was a lovely spot, about four miles in circuit, and
pleasantly varied with hills and valleys. It was almost covered with
beautiful trees, on some of which there were delicious fruits. Birds of
bright feathers and joyous notes glanced through the forests, and
sweet perfumes were wafted on the warm, soft breezes. Philip
walked about the island, his delight and wonder increasing at every
step. And what seemed to please him most of all was, that the island
was without a single human inhabitant except himself.
“Now,” said Philip, in the fulness of his heart, “I shall be happy.
Here I can enjoy perfect liberty. Here is no prison like the Bastile;
here is no king to make slaves of his fellow-men; here is no
Robespierre to plot the murder of his fellow-citizens. Oh liberty! how
have I worshipped thee, and here, in this lone island, I have now
found thee. Here, I can labor or rest, eat or drink, wake or sleep, as I
please. Here is no one to control my actions or my thoughts. In my
native country, all the land belongs to a few persons, but here I can
take as much land as I please. I can freely pick the fruit from the
trees according to my choice or my wants. How different is my
situation from what it was in France! There, everything belonged to
somebody, and I was restrained from taking anything, unless I paid
for it. Here, all is free; all is mine. Here I can enjoy perfect liberty. In
France, I was under the check and control of a thousand laws; here,
there is no law but my own will. Here, I have indeed found perfect
liberty.”
(To be continued.)
The Sailor’s Family.
There once lived in Ireland a sailor, who had a wife and one
child. He was poor, but still he provided a small house for his family,
had it decently furnished, and, as he always brought them money
when he came home from his voyages, they were quite comfortable.
He was very fond of his little boy, and he, too, was very fond of his
father. The sailor used to go in a ship to the West Indies, and, when
he returned, he always brought back some nice oranges and other
good things for his little son.
Well, the Irishman, whose name was Kelly, had once been gone
on a voyage to the West Indies for several months, and his family
were expecting every day that he would return. Whenever the door
was opened, the boy looked up to see if it was not his father who
had come.
Four months passed away, and no news came. And now Mrs.
Kelly had become very much afraid that something had happened to
her husband. She feared that the vessel had been cast away upon
some rocky shore, or that it had sunk in the deep sea, or that some
other misfortune had occurred, by which her husband had perished.
The boy, too, became very uneasy, and was every day expressing
his wonder that his father did not come back. At length, a man, who
lived near by, came into the house, and told Mrs. Kelly that he had
brought sad news. He then went on to tell her that the vessel in
which her husband sailed, had been driven ashore in a gale of wind,
and dashed to pieces upon a rocky island, and it was supposed that
all on board had perished.
Some persons from another vessel had landed upon the island,
and found papers and pieces of the wreck upon the shore, by which
they knew it was the vessel in which Kelly had sailed. The island was
small, and there was no person upon it.
This was sad intelligence to the poor sailor’s wife, and it was long
before she could find it in her heart to break the news to her child.
When he heard it, he shed many tears, and peace returned no more
to the sailor’s home.
Being deprived of the assistance of her husband, Mrs. Kelly was
obliged to make great exertions to support herself and child with
comfort. She was, however, very industrious, and, for a time, she got
along pretty well.
At length she was taken sick, and a little girl was added to her
family. When she was partially recovered, she found herself poor,
and a good deal in debt to her landlord. He was a cruel man; he took
away her furniture for what she owed him, and then turned the
widow and her family into the street.
The poor woman was still unwell; and it was with great difficulty
that she walked about a mile to the house of a farmer, whom she
knew, hoping that he would render her assistance. But he would give
her nothing.
She was now in great distress, and did not know where to find
even shelter. Sad, sick, and almost broken-hearted, she crept toward
a stable, and sat down upon some straw. Here she remained for
some time, with her infant in her arms, and her boy’s head resting on
her lap.
Where could she now look for aid? She had no friends, from
whom she could expect assistance. At length her thoughts turned to
that good Being, who is ever the friend of the poor and the
distressed. To him she prayed fervently, and so deeply was her mind
absorbed in this act of devotion, that she did not notice a man who at
the moment was passing by, on the public road.
He was on foot, and seeing the woman and her children, stepped
toward them, to observe them more carefully. When Mrs. Kelly had
finished her petition and opened her eyes, the man was standing
before her.
She instantly perceived that he was a sailor, and that his
countenance bespoke amazement; and then it struck her that he
seemed to bear a wonderful likeness to her lost husband. At length
he spoke her name, and the poor woman, betwixt fear and joy, would
have fallen through faintness to the ground. Kelly supported her, for
it was he!
When she recovered, mutual explanations took place. She told
her story, and he related his, which was this. The ship in which he
sailed was wrecked upon the island, and all perished save himself
and two others. These were taken off the island, by a vessel going to
the East Indies. As soon as he could, he left this ship, and got into a
vessel that was going to England; and thus, after an absence of
eight months, returned to his country. I need not attempt to describe
the happiness that now filled again the hearts of the sailor’s family.
The Groom and the Horse;
a fa b l e , t o s h o w t h e d i s a d va n ta g e s o f
deception.
A groom, whose business it was to take care of a certain horse,
let the animal go loose into the field. After a while, he wanted to
catch him, but the brute chose to run about at liberty, rather than be
shut up in the stable; so he pranced round the field and kept out of
the groom’s way. The groom now went to the granary, and got the
measure with which he was wont to bring the horse his oats. When
the horse saw the measure, he thought to be sure that the groom
had some oats for him; and so he went up to him, and was instantly
caught and taken to the stable.
Another day, the horse was in the field, and refused to be caught.
So the groom again got the measure, and held it out, inviting the
horse, as before, to come up to him. But the animal shook his head,
saying, “Nay, master groom; you told me a lie the other day, and I am
not so silly as to be cheated a second time by you.”
“But,” said the groom, “I did not tell you a lie; I only held out the
measure, and you fancied that it was full of oats. I did not tell you
there were oats in it.”
“Your excuse is worse than the cheat itself,” said the horse. “You
held out the measure, and thereby did as much as to say, ‘I have got
some oats for you.’”
Actions speak as well as words. Every deceiver, whether by
words or deeds, is a liar; and nobody, that has been once deceived
by him, will fail to shun and despise him ever after.
The Druids.
The Druids were a remarkable race of priests, who first came

into Europe with the Celts, the first settlers of that quarter of the
globe, and who seem to have exercised almost unlimited sway in
civil and religious matters. Of their origin and history very little is
known; but the early writers have given such accounts of them as to
make it evident that their influence among the Gauls and Britons was
very great. At the time they flourished, Christianity had not
penetrated into those countries, and the religion of the Druids was
exercised there without check or control. The best account of them is
given by Julius Cæsar, who conquered Gaul and a part of Britain
about fifty years before Christ; but these countries were so wild and
uncultivated, and the manners of the people so barbarous, that all
the intelligence he could collect respecting this singular race of men,
is far from satisfying our curiosity.
The Druids appear to have exercised the office of civil
magistrates, as well as that of ministers of religion. Neither their laws
nor precepts of religion were committed to writing, but were
preserved in poems, which were learned by heart, and recited on
special occasions. They had the power of life and death over the
multitude; and such was the superstitious terror with which they
inspired the people, that their orders were always implicitly obeyed.
The most characteristic part of their religious worship was their
veneration for the oak tree, and the mistletoe, which is a plant that
grows on the trunks of the oak. No ceremony was performed by the
Druids without some part of this tree being used to consecrate it.
They wore garlands of oak leaves upon their heads, for they
believed that everything which grew upon this tree came from
heaven.
The ceremony of gathering the mistletoe was always performed
with much solemnity, and in such a manner as to strike the multitude
with awe. This plant is very rare, and when any of it was discovered,
the Druids set out with great pomp to procure it. This was always
done on the sixth day of the moon, a day which they deemed of
particular sanctity. When they arrived at the oak on which the
mistletoe grew, a great banquet and sacrifice was prepared under
the tree. Two white bulls were tied by the horns to the trunk of the
tree. One of the priests, clad in a white garment, then mounted the
tree, and with a golden knife cut off the mistletoe, which was
received by another priest in a white cloak. They then offered up
their prayers and sacrifices. The mistletoe, besides being an object
of religious veneration, was considered an antidote to poison, and to
possess many other virtues.
The Druids performed their worship in the deepest recesses of
the woods, far from human dwellings; a circumstance which added
to the superstitious awe with which the common people regarded
them. One of these spots is described by the poet Lucan. This wood,
according to his account, had never been touched by the axe since
the creation. The trees of it grew so thick and were so interwoven,
that the rays of the sun could not penetrate through the branches,
and a damp and chilling darkness reigned throughout. Nothing was
to be seen in the neighborhood except a multitude of altars, on which
human victims had been sacrificed, and the blood of which had
stained the trees of a horrid crimson. Ancient traditions affirmed that
no bird ever perched upon their branches, no beast ever walked
under them, no wind ever blew through them, and no lightning ever
struck them.
The idols which these gloomy recesses contained, were a species
of rude and shapeless trunks, having some resemblance to the
human figure, and covered with a tawny yellow moss. If the
superstitious belief of the multitude might be credited, these mystic
groves were frequently shaken by some unearthly movement, and
dreadful sounds issued from the caverns and hollows which
abounded in them. Sometimes, we are told, the woods would be
wrapt in a flame of fire without being consumed; and sometimes the
oaks would be twined round with monstrous dragons. At the hours of
noon and midnight the priests entered these gloomy abodes, to

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Unit 1 | Health Care Today The Future of Health Care 48

Variety of Approaches to Health Care 44 Ethics and the Law 65

Wellness 44 Ethics and Health Care 66

Holistic Medicine 44 Professional Codes of Ethics 68

Complementary, Alternative, and Personal Values 69

Guiding Principles of Health Care Ethics 69 Ratios 112

Medical Terminology 89 Medication Safety 124

Importance of Medical Terminology 90 Temperature Conversion 124

The Building Blocks of Medical Language 90

Systems for Producing New Life 180 Microorganisms 219

Female Reproductive 180 Types of Microbes 220

Preschooler 192 Surgical Asepsis 236

School-Age Child 192 Standard Precautions 236

Unit 4 | Personal and Workplace Safety CHAPTER 11

Radiation Hazards 268

Habits and Health 277 CHAPTER 14

Maintaining a Healthy Weight 282 Career Ladders 314

Body Mass Index 283

Defense Mechanisms 330 Business Letters 367

Challenges of Computerized Systems 407 Unit 8 | Business of Caring

Unit 9 | Securing and Maintaining Accepting the Job 540

Diagnostic Occupations 567 APPENDIX 2

Unit 4 | Personal and Workplace Safety Unit 8 | Business of Caring

MAJOR CHANGES TO THE FIFTH EDITION

Book Chapter Description of Changes

Book Chapter Description of Changes

STUDENT RESOURCES Chapter Animation Topic

Online Resources 7 Digestion

Online resources are available to enhance the learning 7 Urine Formation

Chapter Animation Topic 9 Body Mechanics

4 Word Parts Work Together 10 Infection Control

4 Combining Word Roots 10 Controlling Disease

4 Dangerous Abbreviations 10 Sterile Gloves and the Sterile Field

6 Anatomy of a Typical Cell 10 The Chain of Infection

6 Body Planes 10 Transmission-Based Precautions

7 Shoulder Injuries 10 Proper Handwashing

7 Skin 10 Removing Contaminated Gloves

7 The Heart (Conduction System) 10 Sterilizing Instruments in Autoclave

7 The Blood 11 Fire Safety

7 Types of Fractures 11 Using a Fire Extinguisher

7 Respiration 17 Business Correspondence

Chapter Video Topic ° Procedure check-off forms for evaluating skills

° Teaching thinking skills

INSTRUCTOR RESOURCES Control Your Course –and Your Content

INFECTION CONTROL AT A GLANCE

LIST OF VITAL SIGNS PROCEDURES

LIST OF FIRST AID PROCEDURES